[2018-2019] Emergency Medicine Rank Order List Thread

[TrashPanda13]

Applicant Summary
Board scores: 240s/260s
EM rotation grades: High Pass/Honors/Honors
AOA: No
Medical school region: Midwest

Main considerations in creating this ROL: 3 years. Location. Family. COL. Fellowship opps. Residents and faculty. Work life balance. Patient diversity. Spanish population. International opportunities. And honestly mostly just gut feeling.

1) CA -- University of California Davis
Pros: 3 years. Gosh I love the fit here. Loved the PD and faculty I met. Great training sight diversity. County/academic. Enough patient diversity and Spanish speaking population. Residents seemed cool. Work Life balance seemed reasonable. Tracks and electives felt flexible. Told I would have opportunities to work sports medicine if desired. Family lives in the area. Sacramento isn’t for everyone, but I like it (lots of great things within an hour or so). Had a great gut feeling coming out of the interview day.

Cons: Residents seemed quite cool, but I'm worried they aren't that close knit or do things together often.

2) TX -- UT Southwestern Medical Center - Dallas
Pros: Very close to being number one. 3 years. Fun residents with good comradery. Great international opps. Enjoyed interaction with faculty. I liked Dallas a great deal, good COL. Spanish population. Decent work life balance. Felt comfortable during the interviews. Big name for fellowship opportunities down the line.

Cons: Wish the interview with the program director was 1 v 1 and not just what questions do you have. Consult heavy and strong other programs makes me a touch nervous.

3) NM -- University of New Mexico
Pros: 3 years. Loved my time here. Residents seemed very down to earth. Flexible elective opportunities with many international opportunities/large network. Good work life balance. Flexible vacation schedule. Great crit care. residents felt strong. Sick population. Lots of Spanish patients. Great outdoors activities in the area. COL.

Cons: The area seems a bit crime ridden to own a home, and I do not have family or friends in the area. Didn't hear much about their peds exposure. Unsure how I feel about their second required project.

4) CA -- Loma Linda University School of Medicine
Pros: Another program close to being at the top. 3 years. Spanish speaking population. Fun residents. International opportunities and lots of elective time. Residents felt strong. Peds experiences sounded the best on my trail. Inland empire is within an hour of many great things in LA and outdoor activities without having to be in Los Angeles.

Cons: Seems like a high work/hour load.

5) DE -- Christiana Care Health Services
Pros: Got along well with the PD. The residents at the dinner were all fun with a decent turnout. Crème of the crop community program. Dominate program at the hospital. Lots of exposure. Pay to cost of living I hate to admit is quite good. Not too far from Philly without having to be in Philly. Would love to be here.

Cons: Interview day was a bit short (never thought I’d say that), and I wasn’t sure I got to know the place well enough to rank it higher. Lacking in the Spanish speaking population. The area is a touch sleepy, but I don’t mind too much. I think I could find enough fun things to keep entertained with an occasional Philly trip.

6) NJ -- Cooper Hospital
Pros: Chair of the department in inspirational! EM is very strong in this hospital, strongest of their programs I’d wager. Sick population. Underserved for certain. Nice schedule. Like the faculty. PD and APD seem delightful. Philly has lots to do. The residents and staff seemed very fun.

Cons: Lots of shifts due to 8 hour shifts. Camden is a bit scary even for my taste. Philly can be a bit too urban for my taste. Trauma breakdown seemed weird, and I still don’t quite understand it.

7) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: Inspiring. Lets start with the obvious. Big name. Residents seemed cool, with decent but not huge turnout to dinner. Chicago has lots of fun things to do. Enjoy the diversity in patient population. This one came down to a good deal of great gut feeling from the dinner to the interview day. Felt like a great fit.

Cons: 4 years and it didn’t seem well used. Not a ton of elective time. 2 months IM really is a bit of a much. Bit cold for my taste. COL will hurt a bit. Graduated responsibilities didn’t seem like my favorite thing. Far from family, friends, and significant other.

8) LA -- Louisiana State University - New Orleans
Pros: Amazing relationship with trauma and amazing trauma immersion. Passionate faculty. Extremely cool group of residents. New Orleans is a fun city. COL. Good work life balance.

Cons: 4 years. Residents didn’t seem thrilled by the 4th year either. No mountains or skiing. Touch hot. One of the few locations I don’t see myself living long term.

9) TX -- CHRISTUS Health / Texas A&M
Pros: Procedures. Procedures. Procedures. Procedures. Cool group of residents. Faculty seemed cool. Great outdoor activities. COL. New ED soonish?

Cons: Small faculty group. Corpus Christi airport isn’t great, and the town is a bit small and isolated. Would be extremely happy here.

10) CA -- Riverside Community Hospital / University of California Riverside
Pros: Wellness. Resources. Spanish population. Area is new things to do without being in LA.

Cons: No international opportunity allowed. HCA. I didn’t click well with the residents. Program is still having growing pain. 3 year old program. No alumni network. I’d still be very happy at this point in my list, but the fit is getting worse.

11) CA -- Kaweah Delta Health Care District
Pros: I’m pretty sure I ranked this far too low. Really fun happy group of residents. COL. Schedule is great. Plenty of procedures. Great interactions with the faculty.

Cons: A bit newer, but I think it is past the growing pains. Small alumni. Kind of out in the valley, but there are things to drive to if I have time. Fellowship probably wouldn’t be a problem, but it isn’t a place that is well known yet. I really liked this place a great deal and already regret putting it this low. I’d be very happy to be at this program.

12) LA -- Louisiana State University - Baton Rouge
Pros: 3 years. Cost of living. Faculty seemed nice.

Cons: I didn’t get to know the residents well enough to gage (to my own fault thanks to travel plans). Not sure about Baton Rouge. Not a great airport. No friends of family nearby. Honestly mostly came down to location that I hadn’t thought through.

13) CA -- Desert Regional Medical Center
Pros: 3 years. Not far from LA. Residents seem very nice, mellow. Good schedule, I think.

Cons: Didn’t click with the PD or their sales pitch. Newer program. Small network of alumni. Unsure of job prospects.

14) NV -- UNLV
Pros: You’ll come out strong clinically I suspect. Vegas is easy enough to travel from.

Cons: This is probably the only school I’ll be unhappy to see come match day. 12 hours shifts all 3 years. Interns seemed burnt out. Multiple residents spent the dinner insulting other programs instead of talking about their own. The APD didn’t bother to read my app and couldn’t be bothered to portray any semblance of interest. PD seemed fine to me. The suburbs of Vegas really didn’t feel like my cup of tea. Couldn’t help but be excited to leave. At the end of the day, I still think this is a strong program that I could thrive in even if I was less happy. Still an EM physician.

15) TX -- TX A&M Scott & White Memorial Hospital
Pros: Loved the interview day. PD seemed very passionate. Faculty were fun and interesting. Cost of living is cheap cheap. I liked the hospital.

Cons: So why so low? The dinner. Residents immediately told me if I like going out to restaurants or bars or anything to not come here. I don’t like to go out often, but it was very off putting. I asked what they enjoy doing together after work and was told we are all tired and just want to see our family and don’t hang out. Interns looked miserable—by far the most tired looking on the trail. 1st years go through hell so they can go easy 2nd and third year. 12s first year. I honestly think this is a good program with good training but was unfortunately a poor fit to what I was looking for.

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[gamerEMdoc]

Dr. Galuska was great too each time I worked with him, although only a couple shifts as he does nights. Had the interview with him early in the season (and it was actually fun) and he set my expectations high for interview season, which most programs ruined with lame questions.

 

[theEMdude]

DO Applicant:
230s/240s; 700s/750s; PE: pass
76 apps, 28 interviews; went on 11. HP/HP/H/H. All audition were from heavy hitter ACGME programs. Was told during an interview all four SLOE's were extremely strong. Probably what boosted me up.
Main Consideration: level of training and feeling. I want to be a doc that actually enjoys residency vs the ones that just tell stories of how miserable it is.

1) Baystate: crazy solid training. Never seen more confident/comfortable residents. Very sick population. Inner city trauma + rural folk. 130K+ volume. Highest acuity of any ER residency in the country 3 yrs in a row. Crazy procedure numbers; even the rare stuff (crics/thoras). Odd/even trauma. If it's ER's day; any procedure that needs to be done including thoracotomy is ER residents. Fun group of residents that seem to hang out a lot. Really nice, new 98 bed ER with locked psych and attached peds EM. Attendings very laid back and really into teaching. Hands down best PD in the country. Really progressive ultrasound (TEE during codes). Come out ultrasound certified. Residents seemed really happy and raved about the program. Residents get first pick at fellowship options. 20/19/18 9+1. 4wks vacation + 5days Christmas/new years. High pay. Good outdoor access. Killington 2hr drive. Really believe if this program was somewhere sexy (Ca, Chicago, Boston....) it would be considered top 5 in the country.
2) Rochester: Super solid training on all fronts. 115 bed ER. 7 bed critical care ER unit. Badass. Residents seemed happy. 4wks vacation. Good pay. More academic vibe. Residents definitely seemed well prepared for any job. Good alumni network. Good ultrasound training.
3) Albany: Again good program. Busiest level 1 in NY. New peds er. 7mon ER PGY1. 4wks vacation. Location is great. Adirondacks. Epic outdoor access. Main drawback is super old ER EMR and inpatient is all handwritten notes and orders. Also got a burnt out vibe during social. None of residents were really bragging about program, rather talking about how hard/long hrs residency is. Just different vibe from other programs.
4) Nebraska: 60K volume. 600 traumas. Am worried about trauma training here. Creighton ER recently closed so maybe numbers will bump. 31ish bed ER. Crazy sim center. Program is definitely dripping in money. Solid, just couldn't get myself stoked on it.
5) UC Davis: County/academic vibe. High volume. Training is solid for sure. Great didactics. Residents seemed confident. Good alumni network. Didn't like how traumas are run here. Unless on trauma month; trauma is ran by surgery and EM gets airway. Seemed to be some Ortho encroachment. Heard a resident joking about forgetting how to reduce fxrs. Sac is ehh. Crazy hot summers.
6) Kalamazoo: long interview day. Older program. 16 resident class. 2 hospitals. Combined volume of 160K. Really didn't feel like it though. Couple residents said trauma was lacking. Heavy EMS. Drive around a response vehicle with everything from chest tubes to a freaking Geiger counter haha. pretty crazy. Didn't vibe with the PD.
7) UIC Peoria: good volume. Really nice ED. heavy flight. Moonlighting opportunities second year. Free food. Low COL. Only 3 residents at the dinner and they all didn't really seem like they wanted to be there. Kinda like pulling teeth from them to get info about the program. A resident mentioned that you have to watch you mouth around some of the attendings which I thought was weird given were ER. Couldn't get over the heavy religious vibe. Have to get approval from nuns for ectopics, BC... Actually saw the nuns walking around the hospital which was a trip. Overall solid program just don't think I would get along well here...
8) CMU Saginaw: Super solid program. Definitely a hidden gem. Really good training with heavy trauma. PD seemed great and super passionate. Resident class was definitely older. Level 2. Saginaw is great from an outdoor standpoint but very isolating. Just couldn't get over location/level 2 status. Want to train at a Level 1 and see the weird ****.
9) Buffalo: Great program with great training. Work the Bills games. Response vehicle. Good EMS training. ER at the downtown hospital was possibly the nicest ER ive ever seen. PD seemed really cool. Just couldn't get over the 12hr shifts all 3 yrs. And 6 different hospitals. Residents also seemed kinda burnt out. Program would be much higher if it wasn't 12hr shifts.
10) Syracuse: Good on all front just couldn't find anything epic about it. PD was great and hilarious. Didn't vibe with the residents. More of an introverted group from what I saw. Great outdoor access except skiing/MTB. ER was kinda small and felt really cramped/outdated.
11) MSU Lansing: Training seemed solid. Good numbers. Nice ED. Just didn't vibe with any of the faculty except for the PD. Lansing is alright. A PGY1 at the dinner completely embarrassed himself with this cringing tangent. Kind wrote off the program from that point forward just cuz I knew I could never work with that person.

 

[DwightKShruteATTRM]

DO Applicant:
230s/240s; 700s/750s; PE: pass
76 apps, 28 interviews; went on 11. HP/HP/H/H. All audition were from heavy hitter ACGME programs. Was told during an interview all four SLOE's were extremely strong. Probably what boosted me up.
Main Consideration: level of training and feeling. I want to be a doc that actually enjoys residency vs the ones that just tell stories of how miserable it is.

1) Baystate: crazy solid training. Never seen more confident/comfortable residents. Very sick population. Inner city trauma + rural folk. 130K+ volume. Highest acuity of any ER residency in the country 3 yrs in a row. Crazy procedure numbers; even the rare stuff (crics/thoras). Odd/even trauma. If it's ER's day; any procedure that needs to be done including thoracotomy is ER residents. Fun group of residents that seem to hang out a lot. Really nice, new 98 bed ER with locked psych and attached peds EM. Attendings very laid back and really into teaching. Hands down best PD in the country. Really progressive ultrasound (TEE during codes). Come out ultrasound certified. Residents seemed really happy and raved about the program. Residents get first pick at fellowship options. 20/19/18 9+1. 4wks vacation + 5days Christmas/new years. High pay. Good outdoor access. Killington 2hr drive. Really believe if this program was somewhere sexy (Ca, Chicago, Boston....) it would be considered top 5 in the country.

Hope to see you at Baystate! It is also my number 1!

 

[TrashPanda13]

Applicant Summary
Board scores: 250s/260s
EM rotation grades: Honors/Honors/Pass (P/F only)
AOA: No
Medical school region: Midwest
Anything that made you more competitive: told all good SLOEs but never saw them, national leadership, few pubs FIT,

Main considerations in creating this ROL: Preferenced county training - big county guy, similarity/connection with PD and residents, large class size, large alumni size/job placement, EM respect within the hospital , reputation, unquestionable great training

DO Applicant so did consider whether or not program had DOs in past

1) CA -- Los Angeles County/University of Southern California Medical Center
Pros: Crazy large, high volume county institution. Great history in EM - job placement anywhere. EM powerhouse of hospital; carry code bag. Rotated here and loved it; kept coming back to it throughout the interview process. Probably my favorite PD of the trail; solid dude with serious commitment to wellness. Residents were awesome to hang out with and total badasses. Great opportunities in MedEd. Jail ED unique opportunity. Can't say enough good things about this place. LA is cool, but also a negative.

Cons: Spanish - mi espanol es muy mal. No EPIC. 12s - they are brutal; no way around it. Have less of them in more senior years; will see how this changes with 20 residents. LA location - positive and negative for me. LA traffic sucks and it's expensive, but not as bad as some.

2) CA -- Los Angeles County - Harbor-UCLA Medical Center
Pros: County training. Great rep in EM. Long history. Big name faculty. EM powerhouse of hospital. Like the teaching rounds idea a lot as MedEd is my interest. Patient population more diverse than USC supposedly so a bit less spanish. Live by the beach. Seem to be very wellness focused. All of my interviews were very genuine; great people.

Cons: Didn't hit it off quite as well with all residents as some places. Didn't get to interview with PD which unfortunately played into decision a little. Like idea of living by the beach, but didn't feel quite as in the city living as I wanted. Spanish. A lot of construction about to happen.

3) CO -- Denver Health
Comments: still really loved this place and it was almost my #1. Would be stoked to end up here. Just having not rotated here I couldn't ignore some of my worries.

Pro: Loved my interview here. Interviewed at University site. Really enjoyed sit down with leadership team before interview day. New PD is awesome. New APD Sungar was awesome and a DO so I connected with that. Program trains badasses. Like the dual site experience. Denver probably the city I'd like to live in the most; have a ton of friends there. EPIC. 8s which I love. Felt like these residents were really similar to me as well.

Cons: One thing I felt when shadowing part of a shift at DH compared to other places was that zones are more residents on own islands as opposed to team based. Gets you ton of autonomy but seemed as though shift is more just like head down, treading water as opposed to like like churning through patients but also listening to music and chatting with co-residents. No shift reduction over 4 years. Conference felt less collegial when we observed and a bit more serious than some places.

4) OH -- University of Cincinnati College of Medicine
Pros: Great history in EM. Love the way they do their model of graduated responsibility. Probably the best I've seen. Will get job anywhere. Academic support but with county patient population. All of the elective months. Super supportive of leadership opportunities. Liked the chair when he talked to us; knew things about our app. EPIC. Great respect in the hospital.

Cons: Never had a DO and definitely got a few comments to that end when interviewing. Felt a bit more academic than I think I was looking for. Lived in Ohio my whole life - on one hand Cincinnati the city didn't scare me but I also am looking for a new experience in residency.

5) GA -- Emory University School of Medicine
Pros: Love Grady hospital. Super county vibe which I love but with academic support and Emory name. PD is amazing. Faculty I interviewed with were great. Super supportive of leadership. Residents were so cool. Large class size. Atlanta was awesome when I interviewed. EPIC. Would be super happy here.

Cons: 3 year - kind of wanted a 4 to have more elective time and just open all possible doors for fellowship or job placement post residency. Plus I just want that extra time to be a little crispy as opposed to medium rare. Otherwise don't have many cons.

6) IL -- John H. Stroger, Jr. Hospital of Cook County
Pros: Classic, gritty county training. Great national name in EM. Could get great job placement. Loved the residents. Love Chicago. Interim PDs were baller. Tarlan is a badass. Think program is definitely on the upswing. 8s.

Cons: Definitely the most resource limited of the county places I went to. Less academic ties. Trauma in separate zone. Lots of competition in Chicago.

7) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
Pros: Loved the leadership team here, especially the chair who had us over to his house. Great history in EM with tons of famous grads. Super supportive of leadership. Tons of funding and opportunities for elective. West LA is my favorite area of LA.

Cons: More academic of a feel than I wanted. Like the OV county exposure but the drive sucks and not as much trauma. AV seems to be where you get all your procedures but again very far. Didn't hit it off quite as well with residents. Would still love this place.

8) CA -- Alameda Health System - Highland Hospital
Pros: Gritty, county vibe. EM runs hospital. Bay area access to tons of activities. Residents were super cool. Seem to have good balance of work with wellness here. US here is next level if that is your jam.

Cons: Tons of construction. Bay area is EXPENSIVE. Smaller class size. Faculty size felt way too small. Had a couple interviews that just didn't flow as smooth as some. Not much of a name outside EM in case I parlay into management or something.

9) IL -- University of Chicago Medicine
Pros: Babcock is amazing. One of my favorite PDs. Schedule here is baller. Resident seemed genuinely happy and had a fun social. Chicago is awesome. Cool flight opportunities. New ED is beautiful. South side chicago county patient population which I connect with well coming from midwest.

Cons: Too academic for me. Still going through some growing pains likely with trauma set up. 3 years.

10) IN -- Indiana University School of Medicine
Pros: Great rep in EM. Super solid training with multiple practice settings. Loved Eskenazi the county site. ICU set up here unlike any other with the one resident - one attending team so all procedures yours. Large class size. Good funding.

Cons: 3 year. Location - Indy still super cool and affordable but am looking for a bigger city. Definitely more family friendly here than single. Not many cons. Would be stoked to end up here.

11) OH -- Case Western Reserve University/Metro Health Medical Center
Pros: LOVE this program. Great county training. Residents and attendings are awesome. CCF exposure too gets you unique dual setting. Case Western support. Cleveland is an awesome city. These residents come out well trained.

Cons: 3 years. Smaller class size than some. Love this place a ton would love to be here, but need a change from Ohio for a little.

12) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
Pros: Tons of funding. Great opportunities in Education. Name outside EM carries weight.

Cons: Almost no time at county hospital. At main hospital, other specialties have more clout. Connected with some residents, not others. Palo Alto expensive and more suburban of a feel. Just not for me.

13) AZ -- Maricopa Medical Center
Pros: County training. 1 elective month each of the 3 years. In general, liked PD's mindset of supporting residents carving out own path to leadership, but didn't hit it off with him as well.

Cons: Limited resources. ED not as big as I thought it would be. Going through some changes that will probably be for the better but didn't want to be in the middle of that ie shipping out to all these other sites. More of a family feel to residents. Just not for me.

Anything else to add? Honestly would be happy anywhere on list. Long time observer of the spreadsheet and decided to share list as I often looked to this/old sheets just to see what others were thinking as it helped me process my own thoughts. Especially as a DO applicant. Hope you find this helpful.

Applied to: 44 programs
Declined: probably like 10-15
Interviewed: ranked all interviews
Rejected: another like 10-15; mostly academic places and east coast as I did both aways on the west coast.

 

[TrashPanda13]

Applicant summary
Board scores: 240s/240s
EM rotation grades: Honors/Honors/Honors
AOA: No
Medical school region: Southeast

Main considerations in creating this ROL: fit, training, location, proximity to family/friends

1) CA -- Los Angeles County/University of Southern California Medical Center
+: amazing training, organized learning structure, got along with people
-: so many 12s, 2nd/3rd years definitely seemed burned out, COL

2)CA -- Alameda Health System - Highland Hospital
+: people seemed amazing, month off between 1st/2nd year, great alumni network, huge social EM mission
-: weird EMR, maybe a little too close to home

3) CA -- Los Angeles County - Harbor-UCLA Medical Center
+: culture of teaching, schedule, training, close to the beach
-: seemed a bit unorganized at times, didn't get along super well with some people

4)CA -- University of California Davis
+: 3 year program though I'm not against doing a 4 year program, different sites/practice settings, COL
-: not the most "happening" city, not a ton of diversity amongst the residents

5) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
+: multiple training sites, got along with the PD and a couple faculty really well, tons of opportunity for travel abroad, SCRIBES as a 2nd year!!
-: maybe too bougie for me, the commute would be absolutely terrible (I'm from CA)

6) CA -- University of California San Francisco/ Fresno
+: training, you run that hospital, tons of autonomy
-: Fresno dating scene is probably not the best, almost everyone is married/in serious relationships

7) IL -- University of Illinois Hospital - Chicago
+: schedule, people are cool, got a good vibe from people, multiple practice settings, social EM mission/programs
-: far from home, winter is rough, too far from family

8) LA -- Louisiana State University - New Orleans
+: autonomy, New Orleans is such a cool city
-: teaching isn't the best, hospital isn't the most functional

9) IL -- Advocate Christ Medical Center
+: awesome training, schedule
-: not much else to offer except amazing training

10) AZ -- Maricopa Medical Center
+: Phoenix is cool
-: felt underwhelmed, they don't seem to have a strong presence in the hospital

11) WA -- University of Washington Emergency Medicine Residency Program
+: Seattle
-: no diversity amongst residents, PD was eh, city was cool but I didn't like it as much as I wanted to

12) CA -- Riverside Community Hospital / University of California Riverside
+: concierge service for residents, COL, tons of autonomy
-: very small class, Riverside is pretty isolated

13) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
+: TONS of opportunity for global health/rotations abroad
-: training seems eh

Applied to: Highland, Maricopa, Hennepin, Kaiser San Diego, Loma Linda, UCLA-Harbor, LSU New Orleans, Oregon Health & Science University, UC Riverside, Stanford, UCLA-Reagan, University of Arizona, University of Arizona South, UC Irvine, UC San Diego, UCSF Fresno, UC Davis, University of Chicago, University of Illinois Chicago, University of Maryland, University of Nevada Las Vegas, University of Pennsylvania, University of Southern California LAC, UT Austin, Utah, University of Washington, University of Pittsburgh, Advocate Christ, Indiana, Medical College of Wisconsin, UCSF SF General, Henry Ford, MGH/BW, Baylor, Boston University Medical Center, Cook County, UT Southwestern
Declined: UT Southwestern, UC Irvine, Kaiser SD, UC San Diego, Loma Linda
Attended: Highland, Maricopa, UCLA Harbor, LSU New Orleans, UC Riverside, Stanford, UCLA Reagan, UCSF Fresno, UC Davis, University of Illinois Chicago, University of Southern California, University of Washington, Advocate Christ
Rejected: Hennepin, Oregon Health & Science University, Rush, University of Chicago, University of Maryland, University of Pennsylvania, University of Pittsburgh

 

[TrashPanda13]

Applicant summary
Board scores: 240s/250s
EM rotation grades: Honors/Pass (P/F only)
AOA: Yes
Medical school region: Midwest
Anything else that made you more competitive: GHHS Officer

Main considerations in creating this ROL: Fit with the people in the program, geography

1) MI -- William Beaumont Hospital
Strong ICU experience, massive volume, great faculty and residents. Rotations at Troy add variety and exposure. Very good academics/didactics. Strong balance of academic and community institution. Simply had the intangible feel of being right. Ortho experience is lacking but being improved. Lots of consultants/specialties means that it's easy to just consult.

2) MI -- St John Hospital & Medical Center
Awesome balance of patients (inner city + suburbs). Super welcoming staff/residents. Very kind PD who seems to really care about her residents. No ortho residency. Longitudinal peds. Tons of procedures. Tactical EMS + ability to be deputized and work with Detroit SWAT. Full month of peds floors. Lots of off-service intern year (only 2.5 months of adult ED).

3) MI -- Henry Ford Hospital
Strong ICU experience with many EM CC faculty. Close/friendly residents. Lots of acuity. 3 full elective months. Graduated responsibility in the ER. Invested in teaching. Produces incredibly kind, competent faculty who love to teach. Very busy. Crowded ER with curtains and hall beds. Tons of off service in first year..

4) MI -- Sinai-Grace Hospital
Probably one of the best PDs I interviewed with, who is incredibly invested in residents. Feels like the Wild West and procedure heavy. Full responsibility from Day 1. Tons of ICU experience with ED CC as PGY3. ED runs all trauma. Level 2 but sees more Level 1s than anywhere else in Wayne County. Currently undergoing nursing staffing change and question of what will happen to DMC docs with buyout (though EC itself is safe due to staffing group). Poor environment for patients.

5) MI -- Spectrum Health Grand Rapids/Michigan State University
Level I Adult + Level 1 Peds; Very happy residents; Good relationship w/ other departments; Responsive to resident feedback; Huge volume. Slightly dated department; Fewer ICU rotations (2 SICU, PICU, MICU).

8) MI -- Michigan State University/Sparrow Hospital - Lansing
Good blend with Sparrow and McLaren experiences. Decent amount of ICU experience. Very responsive faculty. Lots of program history. Great new facility. Program with "warning" due to past board pass rates. Multiple floor months intern year.

9) OH -- Mercy St. Vincent Medical Center
Flight program sounds great. Surprising amount of CC time. Run (almost) all traumas and all codes in the hospital. Very happy residents overall. Strong program leadership. Inner city population but well funded. New ED is gorgeous. Comparatively slow department. Relatively inbred leadership. Not sure if it's good or bad but shift time is based on the month you're in (avoids flipping schedules too much and leads to more time off that isn't sleep, but isn't real world.

10) MI -- Western Michigan University Homer Stryker MD School of Medicine
Tons of ICU time. Super strong EMS program: 1 24h shift/month and equipped with vehicle. 8 hour shifts. Peds floor time. 1.5 months of OB. No patient handoff.

11) MN -- Mayo Clinic School of Graduate Medical Education
See zebras and can be prepared to see anything. Virtually unlimited resources. Flight medicine opportunities, all run directly by Mayo. Surprising amount of elective time. Longitudinal community shifts. Ability to rotate at Mayo AZ and FL for different experiences. Super swanky gym for cheap. Consult heavy ED. Rochester is a smaller town/less to do. Lower volumes. Can be overburdened by the “Mayo seekers.”

12) OH -- Case Western Reserve University/Metro Health Medical Center
Full month of flight med. Shifts split between Cleveland Clinic and Metro. Integrated peds. Tons of trauma. PGY2 runs all 2+3 traumas. New hospital being built. Get some community shifts/month. ICU split between CC and MH. Have to pay to park (though not much). Don’t have dictation in EC. Residents constantly talking about “working hard.”

13) OH -- University of Toledo Medical Center
Robust program at ProMedica. Huge opportunities in Global Health, Disaster Medicine, Flight. Really great Sim Center. Very happy residents. UT is starting to die given the new affiliation with ProMedica. UT EMR sucks but TTH uses Epic.

14) MI -- Genesys Regional Medical Center
Very happy residents. Low cost of living area. Mix of Flint and “nicer” Grand Blanc population. Very nice PD and APD. Beautiful hospital overall. 4 year program. Lots of time spent off-service. Full month of medicine floors and full month of general surgery.

15) MI -- Henry Ford Wyandotte Hospital
Good community program requiring residents to take responsibility of patients. Relatively unopposed in the ED. SICU+MICU at HF Main. Shock Trauma rotation. Most traumas get diverted downtown to Main. Little specialist coverage means more falls on residents.

16) MI -- Lakeland Health Emergency Medicine Residency Program
Awesome faculty, but PD can get a bit intense. Cheap area to live w/ lakeshore, breweries, dunes nearby. Residents all seem very happy and incredibly competent. Completely unopposed in the ED. Experience varies due to sites. Moonlighting opportunities abound in the area. 4 year program. Benton Harbor is close and not great. Not a ton of knowledge of the program from areas not in the area decreases future job prospects.

17) MI -- Beaumont Farmington Hills/Botsford Good outrotations (Beau RO, Shock, Tox at DMC). Lots of volume per resident. Location allows for city and suburban population. Truly resident-run ED with lots of procedures. 4 years. Lots of floor months. Bizarre interview day and dinner. Shifts are assigned per PGY (1s work AMs, 2s later AM, 3s only overnights, 4s only afternoons). Tons of patients per resident without much time for learning ("we don't sit to talk about patients, we just do things").

18) MI -- McLaren Macomb
Great retention rate; close relationships; strong support of other residency programs; largest facility in Macomb County. Small program/volume overall; dated facilities; incredibly ****ty EMR (can't type and requires phone in dictation). No patient handoff.


Applied: Advocate Health Care, Ascension Macomb/Oakland, Ascension St. John Main, Beaumont Farmington Hills/Botsford, Beaumont Royal Oak, Case Western (MetroHealth), Case Western/University Hospitals Cleveland, Central Michigan University, Cook County, Denver Health, Detroit Receiving/DMC, Genesys, Health Partners/Regions, Hennepin County, Henry Ford Allegiance Health, Henry Ford Macomb, Henry Ford Main, Henry Ford Wyandotte, Indiana University, Lakeland Health, Mayo Clinic, McLaren Macomb, McLaren Oakland, Medical College of Wisconsin, Mercy Health Muskegon, Mercy St. Vincent, Metro Health Grand Rapids, Ohio State University, ProMedica Monroe, Rush University, Sinai Grace/DMC, Sparrow, Spectrum, St. Mary Mercy, Temple University, University of Chicago, University of Illinois, University of Maryland (Baltimore Shock), University of Michigan, University of Tennessee Nashville, University of Toledo, University of Wisconsin, Vanderbilt University, Western Michigan/Stryker, Wright State
Declined: Ascension Macomb/Oakland, Case Western/University Hospitals Cleveland, Central Michigan University, Denver Health, Denver Health, Health Partners/Regions, Henry Ford Allegiance, Henry Ford Macomb, Indiana University, Mercy Health Muskegon, Ohio State University, ProMedica Monroe, Rush University, St. Mary Mercy, Temple University, University of Maryland (Baltimore Shock), University of Tennessee Nashville, University of Wisconsin
Attended: Beaumont Royal Oak, Ascension St. John Main, Henry Ford Main, Sinai Grace/DMC, Spectrum, Sparrow, Mercy St. Vincent, Western Michigan University/Stryker, Mayo Clinic, Case Western (MetroHealth), University of Toledo, Genesys, Henry Ford Wyandotte, Lakeland Health, Beaumont Farmington Hills/Botsford, McLaren Macomb
Rejected: Hennepin County, McLaren Oakland, University of Chicago, University of Illinois, Vanderbilt University

 

[AlgernonMed]

16) MI -- Lakeland Health Emergency Medicine Residency Program
Awesome faculty, but PD can get a bit intense. Cheap area to live w/ lakeshore, breweries, dunes nearby. Residents all seem very happy and incredibly competent. Completely unopposed in the ED. Experience varies due to sites. Moonlighting opportunities abound in the area. 4 year program. Benton Harbor is close and not great. Not a ton of knowledge of the program from areas not in the area decreases future job prospects.

I completely agree that the PD here can get pretty intense, but I saw very few directors or faculty who would stand up for their residents as much as he does. He expects a high standard of care and their residents are great examples of providing this.

 

[doggydog]

This thread is kind of a dud this year.

 

[enalli]

I saw very few directors or faculty who would stand up for their residents as much as he does.

What exactly is this opinion based on? Standing up for the residents is kind of the baseline expectation for PDs. I'm sure a lot of people here could vouch for their own PDs having their back (myself included).

I know nothing about the PD you're mentioning and am sure they're amazing, but I'm interested in hearing what makes them so special.

 

[Rekt]

What exactly is this opinion based on? Standing up for the residents is kind of the baseline expectation for PDs. I'm sure a lot of people here could vouch for their own PDs having their back (myself included).

I know nothing about the PD you're mentioning and am sure they're amazing, but I'm interested in hearing what makes them so special.

I thought he was very cocky/arrogant for a small community program that's in the middle of nowhere.

 

[SamtheWise]

This thread is kind of a dud this year.

We need some controversial rank lists to liven things up, I wanna see someone rank Cinci first, or say something negative about Hennepin, or an all 3 year rank list ("I just feel like the 4th year is a scam"). Really stir it up.

Honestly ever since the doximity rankings came out I feel like for all the talk of 'finding the best fit' now everyone just ranks LA-county, Harbor, Denver, Cinci in that order.

 

[gamerEMdoc]

What exactly is this opinion based on? Standing up for the residents is kind of the baseline expectation for PDs. I'm sure a lot of people here could vouch for their own PDs having their back (myself included).

I know nothing about the PD you're mentioning and am sure they're amazing, but I'm interested in hearing what makes them so special.

Agreed. I’d say having your residents best interests at heart is kind of the main job of the PD.

 

[Zebra Hunter]

Want some controversy on this thread? Here's a small bit.

3) UT Southwestern/Parkland – Dallas, TX
Big sexy name. Big sexy hospital. Big sexy numbers. As a DO, it was really difficult to not rank this #1 as it would be nice for the pseudoprestige(even though the name is for IM and surgery). BY FAR the funnest pre-interview dinner. Friggin’ margarita machine at a resident’s house. All around residents were awesome and really fun and I wanted to stay all night. But this was all negated by having to be at the hospital at 7am sharp (seriously why??). The IV day definitely had the most residents in and out talking to us and hanging out. IV was a mix of standardized and normal questions. PD interview left a lot to be desired. All other interviews were 20 mins. Hers was about 8 minutes and was just told to ask questions, but it seemed like she was in a hurry for us to go away. Pretty off putting. This hospital is NOT county. This is mostly academic regardless of what faculty tells you. Everything is (still) consulted out. Nothing in place to improve it. Residents were not shy about trauma being malignant. They all said you’re literally a scribe for a month. Only place to admit you don’t get your procedure numbers until your trauma month in Fort Worth at a L2. Otherwise does have a well-known, expenses paid 2month New Zealand rotation which sounds amazing. Pay is really high at 59k, but negated by really expensive insurance (600$) and Dallas is inflated more than FW. A PGY-2.5 told me she only headed one code, which I thought was pretty ridiculous. Parkland is a stupidly nice hospital. The ED is really nice but is built like an internal med floor. Literally couldn’t tell if they had a single patient in the entire ED (honestly didn’t seem like it). Any female complaint goes to an ob/gyn pod and EM only does 2(?) weeks here (Big con for me, not sure why this isn’t a bigger negative for people). But I’m sure you come out competent enough and would be able to get any job you want. Overall, a little too academic, too consult heavy, and clinical training fell a little short to be #1 for me despite the name.

Why the hell is this applicant ranking this program #3 (but considered it #1) when their review reads as pretty scathing? So you hate the PD, are told by multiple residents that trauma is malignant, are told you act as a scribe for your trauma month at parkland, have an upper level resident admit that they are significantly inexperienced for their level of training, state that they are consulting out everything and that there is "nothing in place to improve it", residents admitting they have low procedure numbers, terrible OB/Gyn experience, too academic. This is how you should not rank programs. Don't rank someone high just because of name recognition. Do so because you would actually like training there.

Now to be forthcoming, I did one of my rotations here 4th year of medical school and almost all of this was accurate at that time to an extent. I also know a few individuals that trained there. One didn't like it primarily because of the low procedure numbers. The others appeared to enjoy it. Can't speak to any of their competency, however. From what I can recall, it wasn't until 2014 that their ER was "allowed" by anesthesia to use ketamine or propofol for procedural sedation. They were very quick to consult ortho for reductions. I saw a hip dislocation that they didn't even attempt, they just called ortho to deal with it. Trauma attendings would literally just berate the EM residents during bad trauma cases. The EM residents on their trauma months literally just sat in the corner of the trauma bay and scribed (lol), which is why it appears that they added on a trauma month at a community hospital (which also means you have one less month in the ED as you have to do two months on trauma). I'm sure you get decent training, but it has much of the same issues that many big academic EM programs have, and that is largely being seen as the red headed stepchild of the hospital and being consult happy.

 

[Spagett!]

We need some controversial rank lists to liven things up, I wanna see someone rank Cinci first, or say something negative about Hennepin, or an all 3 year rank list ("I just feel like the 4th year is a scam"). Really stir it up.

Honestly ever since the doximity rankings came out I feel like for all the talk of 'finding the best fit' now everyone just ranks LA-county, Harbor, Denver, Cinci in that order.

It may seem like that due to a number of ROL that do in fact have the order very similar to doximity, and I also thought before that it was mostly a doximity bate session, but just from a quick glance I see some interesting #1's like: Stanford, UCSF, BMC, Cook, Carolinas, Vanderbilt...just picking from the lists where they also ranked LAC/harbor/denver.

 

[Rekt]

We need some controversial rank lists to liven things up, I wanna see someone rank Cinci first, or say something negative about Hennepin, or an all 3 year rank list ("I just feel like the 4th year is a scam"). Really stir it up.

Honestly ever since the doximity rankings came out I feel like for all the talk of 'finding the best fit' now everyone just ranks LA-county, Harbor, Denver, Cinci in that order.

4 year EM programs ARE a scam. Enjoy your medicine months and one less year of attending salary for slave labor.
Lol @ not being allowed to do ED intubations until third year at Hennepin. Top tier right there.

 

[Zebra Hunter]

4 year EM programs ARE a scam. Enjoy your medicine months and one less year of attending salary for slave labor.
Lol @ not being allowed to do ED intubations until third year at Hennepin. Top tier right there.

I thought it was second year? It is still a ridiculous policy either way, but if it is actually third year it goes from ridiculous to idiotic.

 

[jw3600]

We need some controversial rank lists to liven things up, I wanna see someone rank Cinci first, or say something negative about Hennepin, or an all 3 year rank list ("I just feel like the 4th year is a scam"). Really stir it up.

Honestly ever since the doximity rankings came out I feel like for all the talk of 'finding the best fit' now everyone just ranks LA-county, Harbor, Denver, Cinci in that order.

4th year isn't a scam (at most places). It's just the price you pay for either a dope city or a big name. If you don't have either of those 2 then it's 100% a scam.

 

[enalli]

4th year isn't a scam (at most places). It's just the price you pay for either a dope city or a big name. If you don't have either of those 2 then it's 100% a scam.

That's a non-sequitur; there's nothing about big names or dope cities that necessitates an extra year of training.

 

[tatum]

That's a non-sequitur; there's nothing about big names or dope cities that necessitates an extra year of training.

If anything, having an extra year of training just because you can 2/2 your name/location makes it even more of a scam?

 

[TheComebacKid]

They were very quick to consult ortho for reductions. I saw a hip dislocation that they didn't even attempt, they just called ortho to deal with it.

If you ask me, orthopedic training at the vast majority of programs is lacking. I rotated at 2 separate county programs that were heavily reliant on ortho and called them down for reductions without attempting them. I'm sure there are some ortho training experiences that are better than others, but ortho is one of those things that within academic hospitals is often punted to orthopedic services. At my residency, they are very protective of any orthopedic procedures and want to be consulted on everything, but we are fortunate in that typically we get a crack at the reduction as well. That being said, ortho training at my program for EM residents is still far from perfect, as it is at many other places.

 

[enalli]

If you ask me, orthopedic training at the vast majority of programs is lacking. I rotated at 2 separate county programs that were heavily reliant on ortho and called them down for reductions without attempting them. I'm sure there are some ortho training experiences that are better than others, but ortho is one of those things that within academic hospitals is often punted to orthopedic services. At my residency, they are very protective of any orthopedic procedures and want to be consulted on everything, but we are fortunate in that typically we get a crack at the reduction as well. That being said, ortho training at my program for EM residents is still far from perfect, as it is at many other places.

Agree 100%. This is certainly part of the problem at certain institutions. At other places, even if ortho isn't overly protective of their procedures, the pressure of dispositioning patients can make residents call consults just to move things along. If you have 30 people in the waiting room, is it more efficient to spend 10-20 minutes doing a procedure, or have someone else do it while you get two other patients started?

 

[Ruby109]

We need some controversial rank lists to liven things up, I wanna see someone rank Cinci first, or say something negative about Hennepin, or an all 3 year rank list ("I just feel like the 4th year is a scam"). Really stir it up.

Honestly ever since the doximity rankings came out I feel like for all the talk of 'finding the best fit' now everyone just ranks LA-county, Harbor, Denver, Cinci in that order.

There are like 7 people on the spreadsheet, at least, who've ranked Cinci first, myself included! They are wonderful and I love them and I'm going to be an emotional wreck when I (hopefully) match there in 2 weeks!

 

[enalli]

4 year EM programs ARE a scam. Enjoy your medicine months and one less year of attending salary for slave labor.

I don't want to give them any ideas, but I wonder why all the new HCA residencies aren't 4 years. Wouldn't that maximize their free/cheap labor?

 

[enalli]

We need some controversial rank lists to liven things up, I wanna see someone rank Cinci first, or say something negative about Hennepin, or an all 3 year rank list ("I just feel like the 4th year is a scam"). Really stir it up.

Honestly ever since the doximity rankings came out I feel like for all the talk of 'finding the best fit' now everyone just ranks LA-county, Harbor, Denver, Cinci in that order.

These rankings weren't a thing when I was in residency--do people actually take them seriously? I can understand ranking specialties where patients choose the "best" doctors thus creating a cycle of more interesting patients leading to better clinicians and so on. But the nature of EM makes it relatively immune to that effect. No one plans to go near a prestigious hospital to have their heart attack.

 

[tatum]

These rankings weren't a thing when I was in residency--do people actually take them seriously? I can understand ranking specialties where patients choose the "best" doctors thus creating a cycle of more interesting patients leading to better clinicians and so on. But the nature of EM makes it relatively immune to that effect. No one plans to go near a prestigious hospital to have their heart attack.

As a current student, I can say that many of us don't care about them much at all. But, as someone who has spent time on the spreadsheet this is how it goes: People argue the rankings must have "correlation with strength of training" because the top 10 are in line with the general opinion of experienced EM docs they talk with and that this supports their validity (maybe? but what about everything outside the top 10?). They then move on to discuss job prospects arguing that the programs higher on the list lead to better academic placement and have the best alumni bases (this seems tough to support/deny given all of our lack of experience in that process). Ultimately, it's 100% an ego thing IMO. If a ranking system exists then neurotic, over-achieving medical students will strive for the top of the rankings - it wouldn't even matter if doximity came out and said it was just like 5 random em docs making the list I don't think. People DO take them seriously tho.. way way too seriously.

 

[Brigade4Radiant]

For EM big names don’t matter much. If you want academics do a fellowship they are not competitive also you get paid more as a fellow.

In a lot of the academic places it’s not like EM is the most respected department you still fight with medicine no matter how prestigious the EM program is.

 

[Rekt]

These rankings weren't a thing when I was in residency--do people actually take them seriously? I can understand ranking specialties where patients choose the "best" doctors thus creating a cycle of more interesting patients leading to better clinicians and so on. But the nature of EM makes it relatively immune to that effect. No one plans to go near a prestigious hospital to have their heart attack.

Well that's why the "big names" in EM aren't the same as any other specialty. People don't think big name when they hear Cincinnati or Denver, but they're big in the EM world. Places like HAEMR/Hopkins have a huge name, but are probably average at best clinical training and some are even downright pathetic like Dartmouth. Most people going EM realize that, but plenty still pick HAEMR or like the previous person eluded to about UTSW, for silly names.

 

[LaceyMD]

These rankings weren't a thing when I was in residency--do people actually take them seriously? I can understand ranking specialties where patients choose the "best" doctors thus creating a cycle of more interesting patients leading to better clinicians and so on. But the nature of EM makes it relatively immune to that effect. No one plans to go near a prestigious hospital to have their heart attack.

I don't think anyone except a small subset of med students cares about the rankings. They're the students who haven't broken the "I have to go to a #1 ranked college or my life is over" mindset. Personally, I never bothered to look at them and couldn't tell you where any of the programs on my own rank list fall on the doximity ranking.

 

[jw3600]

That's a non-sequitur; there's nothing about big names or dope cities that necessitates an extra year of training.

Fair. In my opinion if you like LA and really want to live there the 4th year isn’t a bad price to pay.

 

[TheComebacKid]

Well that's why the "big names" in EM aren't the same as any other specialty. People don't think big name when they hear Cincinnati or Denver, but they're big in the EM world. Places like HAEMR/Hopkins have a huge name, but are probably average at best clinical training and some are even downright pathetic like Dartmouth. Most people going EM realize that, but plenty still pick HAEMR or like the previous person eluded to about UTSW, for silly names.

I would be careful calling out programs like that and making these kind of generalized assumptions.

HAEMR, Hopkins etc are phenomenal programs on many aspects. It's all about fit and what your career interests are. Denver/LAC may not deliver in certain regards.

My program provides excellent training when it comes to managing traumas, crashing/critically ill patients. However, our acuity is so high that overall our pph numbers are lower than other programs, and some of our graduates take time to get adjusted once they are in the community. For all I know, the Dartmouth residents are better than my program when it comes to reducing fractures, complex lac repairs etc which is highly sought after once you go into practice. Programs are different and have different strengths and weaknesses.

I think the biggest myth that is propagated is that somehow if you train at HAEMR vs Denver, the Denver grad will be better clinically. It's just not true, and not what I have seen in real life. Medical students watch the Code Black documentary get extremely enamored and think that all the LAC+USC grads are total badasses, when in reality the people training at UCLA/Olive View across town are getting awesome clinical education and performing exceptionally well in practice.

The SDN circle jerk for LAC/Denver/Cincy/Harbor/Hennepin/Carolinas/Slovis is really unique to SDN, and in clinical practice makes virtually zero difference. In fact at my program we have an attending who trained at Denver and another one who trained at HAEMR and both of them are equally phenomenal clinically.

Choose a program where you will be happy, where your significant other will be happy, and that meshes somewhat with your career interests i.e. EMS, CCM, community practice etc. I tell pretty much all the med students to stay off this thread (and doximity for that matter) given how stupid it is.

 

[TrashPanda13]

Applicant summary
Board scores: 220s/240s
EM rotation grades: High Pass/Honors/Honors
AOA: No
Medical school region: East coast
Less competitive: DO student, ****ty DO school. Low Step 1.
More competitive: EMS experience, ED scribe, officer of EM interest-group, was told all of my SLOEs were very good. During an interview I could see one was top 10%, another was top 1/3.

Main considerations in creating this ROL
1. Location. Wife and I wanted to stay in the SE so I only applied to programs in the SE.
2. Work/life balance. After doing my AIs, I realized how important this was to me and it ended up being a huge factor when making my ROL. I have a family so shift length (8/9s > 12s), resident wellness, time off, moonlighting opportunities, health coverage, and COL all played a big part in my decisions.
3. Perceived fit aka "gut-feeling". This is basically 2b. I want to go somewhere where I get along very well with not only the residents but the faculty. I like to have a good time while on shift and want to be able to cut up. Looked for programs/people that were down-to-earth and didn't take themselves too seriously.
4. Quality of residents & reputation of the program/hospital.

1) NC -- Wake Forest University
Rotated here. Had an incredible month, vibed with the residents, received great feedback about fit and felt the same. Got to do lots of procedures and given lots of autonomy.

Pros: Legitimately happy residents. Got along very well with all of them. Seemed like they were truly interested in learning about me as a person. None complained or seemed overworked. They felt supported. Obviously the training is great. Attendings were all present but gave plenty of autonomy. Got along with attendings very well. EM has great reputation at hospital. Well-respected among other services. Great relationship with trauma. Great PEM experience. Big focus on "you learn EM by spending time in the ED" so lots of EM months. Nurses/ancillary staff had lots of respect for residents. Wake Forest has a great reputation, especially in the SE, so I have no doubt finding a great job after will be no problem. The location is a Pro for me since I have a family. Seems like a great place for young families, not so much for singles. Incredibly low COL with great neighborhoods nearby. Traffic is almost non-existent. Near mountains(outdoor activities). EPIC EHR.

Cons: Large academic hospital, all specialties represented. Lots of the trauma patients are transfers from other hospitals. Not much penetrating trauma. Old, outdated ED with very few private rooms, only curtains (however, the important equipment is top notch ie US machines, glide scopes, etc). PD(Lefevbre) is a little off-putting but after talking with the residents, I felt comfortable that it was just his personality and they all loved/appreciated him. Not a population epicenter, closest airport is 30+ mins away. Overall, I was worried about the acuity compared to some of the other programs below.

2) SC -- Palmetto Health Richland
Rotated here. Even before rotating here, this place was my #1 and the rotation only confirmed that. WF would just be a better fit for me personally.

Pros: Extremely busy ED with the sickest patient population I experienced throughout all rotations. Very high volume. Residents see so much acuity and are very strong clinically. All private rooms but the volume is so high there were always hall beds (even commonly inside the nursing station where you're working). Near home. Familiar with Columbia. EMS opportunities(offer "tracks" starting PGY2 if you have an interest. Event medicine opportunities(residents work the USC football games). Global medicine opportunities. Hour-log system seems like a cool way to get time off for what you want to do outside of work. Residents were all cool, got along very well. Didn't have as much interaction with the attendings here but they all seemed cool. I can see why people call it a "boys club"; most were male and grew up in the SE but that is true for myself so I got along well with everyone. Lots of trauma, both blunt and penetrating. Big focus on US, residents all very comfortable with it. Large SIM center that is run by EM folks. Really cool moonlighting setup with a place for you to stay and expenses paid for. I have no doubt whatsoever that after training here, I would be comfortable working any volume/acuity after graduating.


Cons: 12hr shifts. Depending on the shift, some residents have up to 2 hours of charting to finish after. The residents were content but they definitely work a lot more and had higher patients/hour than other programs. Again, I have no doubt they will be well-equipped to work anywhere out of residency but Almost all attendings seemed to have trained there(could be considered a soft red flag). So I was worried that I would learn the "Palmetto" way of EM and wanted a little more diversity in my training. Depending on the attending, residents probably had the least oversight vs. other programs. This can be good and bad. I don't want to be somewhere with a short leash, but I also want attendings to be present and seeking teaching opportunities, especially in the first 1-2 years. Cerner EHR. Columbia doesn't seem like the best city to live in. Traffic is terrible.

3) SC -- Greenville Health

Pros: Very busy ED with high acuity. Super nice hospital and the ED is large/updated. PD(Pfennig) is incredible and I would love to work for her. She is bringing in attendings from Cinci, Vandy, Carolinas, Harvard that all bring a different "spice" to the program and are all very passionate about teaching. This is going to be a really great program soon. Best pay/benefits on the interview trail. Get like $300/month for food which can be used at Starbucks, Chik-Fil-A, Subway, etc. Give you iPhone. The cafeteria food seemed good too. Huge, beautiful SIM center at the medical school on campus. Greenville, SC would be a really cool city to live in. It's growing and has lots of young professionals. The downtown area is incredible and it seems like there is at least one or two festivals each month. EPIC EHR. Mostly 9 hour shifts. Good shift overlap.

Cons: New program. Still working out relationship with trauma (currently rotating airways days). No true EMS exposure or advanced opportunities. Not always enough computers for residents (said they were planning to make more space). Some of the ED docs that were working there prior to the program starting are still not on board with having residents. One of them even told me he doesn't like working with residents because it "slows him down." He seemed like an dingus though. Also had a bad interaction with one of the PGY2s. I asked a question about autonomy and she really blew me off and made me feel stupid for even asking such a question. Questionable off-serve rotations. Definitely NOT a resident-run ED yet, unless they increase class size, it will be some time before this is the case. Lots of attendings will go see patients on their own, even when working with a resident.

4) GA -- Medical College of Georgia
Rotated here. Thought I was going to love it, but not so much.

Pros: Didactics seemed fun and the APD(graduated from MCG a few years back) seemed like a cool, young guy that was very smart and cared about the residents. Good PED training. Opportunities for wilderness medicine, EMS and tactical medicine. Close to home. Good reputation. Get to work Masters golf tournament. 8hr shifts but they aren't always the same as attending shifts.

Cons: Army affiliation. I thought this would be a Pro but not for me personally. Did not get along with some the residents. Attendings would stay on their phone or disappear for hours and residents wouldn't know where they were when needed. I witnessed an attending chew out a PGY2 for missing a central line and basically threw him out of the way to do it himself. Poor moonlighting opportunities. Takes a really long time to get labs/radio studies back. Didn't like the location. Augusta is a really odd place. North Augusta(SC) seemed nice though.

5) AR -- University of Arkansas
This was one of the big interview trail surprises. Usually when the pre-interview dinner is at a residents house I roll my eyes and think of how awkward it's going to be but it was actually super chill and we all had a great time. The resident hosting was very open and honest.

Pros: The faculty and residents all seem very close and spend time together outside of work. Location is cool. Lots of outdoor activities nearby. PD was funny, sarcastic and I appreciated his honesty too. I don't remember a lot from this interview but I just remember I got great vibes from everyone i interviewed with and felt very comfortable there.

Cons: Farther away from "home" for me.

6) GA -- Wellstar Kennestone

Pros: Large, high-volume ED. Residents are very involved with making changes. Building a new, even larger ED that will be completed this year. Not many other competing programs at the hospital. PD came from Emory. Has big ideas and plans for the program. Interviews were all super chill with the exception of the PD who just asked some very specific questions and didn't respond to answers (not conversational at all).

Cons: New program. Residents were not exactly my type but seemed to really be enjoying their time so far. Location. Atlanta sucks. I hate traffic. Unless you live near the hospital, commute could be up to 1.5 hours back and forth even if you live <10-15 miles away.

7) SC -- Grand Strand Medical Center

Pros: Live at the beach. Busy trauma center. All of the residents were super, super cool and easy to get along with. Amazing facilities and best-of-the-best equipment. Residents get to do everything and they all talk about how high the acuity is. PD is very odd but has big ideas for the program. Interviewed with 2 students who rotated there and they had nothing but great things to say about the experience. Low COL.

Cons: Residents complained of being overworked. 12hr shifts and a lot of them/month. HCA program. No moonlighting opportunities and not sure if it's supported. Small SIM lab. Interviewers were all odd and asked weird questions. bad vibes from them. Seem like they are having problems with didactics and will be changing to something else soon. Currently do Foundations. Some crappy EHR i've never even heard of. Residents all say it's terrible.

8) LA -- Louisiana State University - Baton Rouge
Pros: EM is one of the few (if only?) programs at the hospital, so largely unopposed which is nice. Really liked the PD(Caffery). BR seems like a chill city. Residents were all awesome and super easy to get along with. They all loved the program and seemed to hang out outside of work. Hospital was very nice. EPIC EHR.

Cons: Location. Not sure if I want to live in LA. Plenty of outdoor activities but you have to get out of the city. Have to go to different site for OBGYN. Terrible traffic.

9) VA -- Eastern Virginia Medical School
Pros: Close to the beach. Plenty of outdoor activities. Norfolk seems like a watered down, smaller version of Greenville, SC. Low COL. Mostly 9hr shifts. Really nice ED with large fish bowl with wall between patient rooms. They send you to a lot of different hospitals to push community EM. I think it would be a great experience. Great EMS opportunities during training, would be able to get involved early. Strong EMS fellowship. Nice SIM lab. Big focus on US (get SonoSIM as intern).

Cons: Didn't get along with the residents as well as other places. Terrible moonlighting opportunities.

10) TX -- CHRISTUS Health / Texas A&M
Pros: Unopposed program. Live near the beach. Apparently have high acuity and large volume. Talked to student who rotated here and said it was very busy and the residents were all very capable.

Cons: Far from home. Pre-interview dinner was awkward cause all the residents sat together at one end of the table. Just talked to other students entire time. CC doesn't seem like a place that has a lot going on. Not sure if it's just a vacation town or what but it was so dead. The PD was super weird, imho. Didn't vibe super well with other interviewers either.

11) NC -- East Carolina University/Vidant Medical Center
Considered not ranking. Did not get along with the residents at all. The pre-interview dinner was awkward. Residents had trouble finding good thing to say about program. Had nothing good to say about area. Warned us about the PD in advance. My interview with him was fine but he is an odd duck. Other interviews were fine but no good vibes.

12) LA -- Louisiana State University - Shreveport
Considered not ranking. Shreveport is not a place to raise a family. The PD is off-putting. Residents didn't have many great things to say about activities outside of the hospital. Hospital is very old and run down but the new ED is dope. Really cool design. I have no doubt they get amazing training but this would not be a great fit for me.

Anything else to add?
Your SLOEs are everything. Give 110% on your AIs. Study and make sure you're improving every day. I had a low Step 1 but made up for it with a higher CK score which was mentioned at several interviews. If you are a DO, take the USMLE exams!

I had no idea how competitive I would be going into ERAS so I over-applied which included many "back-up" programs that are less competitive like former DO programs or new programs.

Applied to: University of Alabama, University of Arkansas, Unity Health, Florida Atlantic University, Jackson Memorial, Kendall Regional, Aventura, Mount Sinai Miami, University of Central Florida HCA, Palm Beach HCA, Florida State University, West Florida HCA, Oak Hill HCA, University of South Florida, University of Florida Jacksonville, Florida Hospital Orlando, Orlando Health, University of Florida Gainsville, University of South Florida, WellStar Kennestone, Emory, Medical College of Georgia, University of Louisville, University of Kentucky, LSU-Baton Rouge, LSU-Shreveport, University of Missouri, St. Louis University, University of Mississippi, East Carolina University, Carolinas, Wake Forest, Duke, University of North Carolina, Greenville Health System, Palmetto Health, Medical University of South Carolina, UT-Memphis, UT-Nashville, UT-Chatt, Vanderbilt, CHRISTUS Health, University of Texas-Houston, Baylor, Eastern Virginia Medical School, Carlion Clinic, University of Virginia, Virginia Commonwealth, West Virginia University

Declined: Mount Sinai Miami, FSU, University of Mississippi, St. Louis University, West Virginia University, Florida Atlantic University, Unity Health, Kendall Regional, Oak Hill HCA, all Florida HCAs actually,
Interviewed: All that are ranked.
Withdrew prior to hearing back from: None
Rejected:University of Alabama, Jackson Memorial, University of South Florida, Emory, Carolinas, University of North Carolina, Medical University of South Carolina, UT-Nashville, UT-Chatt. Carlion Clinic.

 

[TheComebacKid]

As a current student, I can say that many of us don't care about them much at all. But, as someone who has spent time on the spreadsheet this is how it goes: People argue the rankings must have "correlation with strength of training" because the top 10 are in line with the general opinion of experienced EM docs they talk with and that this supports their validity (maybe? but what about everything outside the top 10?). They then move on to discuss job prospects arguing that the programs higher on the list lead to better academic placement and have the best alumni bases (this seems tough to support/deny given all of our lack of experience in that process). Ultimately, it's 100% an ego thing IMO. If a ranking system exists then neurotic, over-achieving medical students will strive for the top of the rankings - it wouldn't even matter if doximity came out and said it was just like 5 random em docs making the list I don't think. People DO take them seriously tho.. way way too seriously.

And this shows how dumb med students are.

Doximity is not an authenticated/vetted process for ranking programs. It's a social media website for physicians. Programs that have more graduates (i.e. are older) are at the top of the list and programs that are newer are usually at the bottom because they don't have enough reviews. Nothing in doximity takes into account strength of clinical training, acuity, resident happiness etc.

Just FYI, because of how stupid the ranking system is, my program (with a handful of other programs that are represented at CORD) made an agreement not to partake in doximity i.e. not encourage our graduates/current residents to fill out the reviews. Some of my colleagues at other programs are specifically getting solicited emails from their admin to actually fill out reviews to push up their rankings. The whole process is *****ic and for people who have any understanding of how it works, it should be glaringly obvious the process is extremely flawed. How many BAD reviews have you seen on doximity? I've seen almost none. Most of them are just super positive.

Maybe my approach was different because I was just so elated that any medical school would even want to take me that I cared zero about any US News rankings. Same went for residency training.

 

[TrashPanda13]

Applicant summary
Board scores: Left blank
EM rotation grades: Honors/Honors/Honors
Anything that made you more competitive: EM research.

Main considerations in creating this ROL: Couples matching.

1) CA -- Los Angeles County - Harbor-UCLA Medical Center
2) CA -- Los Angeles County/University of Southern California Medical Center
3) CA -- Ronald Reagan UCLA Medical Center / Olive View UCLA Medical Center
4) CA -- Alameda Health System - Highland Hospital
5) CA -- University of California San Francisco - San Francisco General Hospital
6) CA -- University of California San Diego
7) WA -- University of Washington Emergency Medicine Residency Program
8) IL -- University of Chicago Medicine
9) MN -- Hennepin County Medical Center
10) MO -- Washington University St. Louis/Barnes-Jewish Hospital
11) PA -- Temple University School of Medicine
12) NY -- Mount Sinai School of Medicine - New York
13) PA -- Hospital of University of Pennsylvania
14) NC -- Duke University Medical Center
15) CA -- Stanford University Medical Center/Kaiser Permanente Medical Center
16) IL -- McGaw Medical Center of Northwestern University
17) NY -- Jacobi/Montefiore - Albert Einstein College of Medicine
18) NY -- Mount Sinai St. Luke's Roosevelt Hospital Center
19) MN -- Mayo Clinic School of Graduate Medical Education
20) NC -- University of North Carolina

 

[TrashPanda13]

Applicant summary
Board scores: 240s/240s
EM rotation grades: Honors/High Pass/Honors
AOA: No

Main considerations in creating this ROL: Decent weather and outdoors access, major airport (considering only programs near SO was too restrictive but want easy logistical access), mission, unopposed/county>specialist-heavy, some degree of elective time or academic resources, 3 year program or a 4-year with space to pursue academic interests, decent fellowship placement

1) AZ -- Maricopa Medical Center
Just great feels from the residents here. Most respected residency in the hospital, everyone seems both extremely confident and happy. I like the DIY academic opportunities offered by the 1 month per year of elective. Southwest gets interesting pathology, and concern about trauma experience seems unfounded given that Copa residents also staff the other trauma centers in Phoenix. Patients way more diverse than expected (seemed like a third Spanish speaking, third English, third other). Single crazy docbox seems like a more fun way to get through a shift collaboratively than split into a number of pods. Creighton merger seems like it won't affect anything negatively. Prefer hot to cold and tons of adventure opportunities in the desert, and Phoenix itself has more than enough restaurants and music for me. Very humane schedule, including nights in one month. I think I'd be happiest here without sacrificing anything, and they place well for fellowship with grads practicing everywhere

Cons: academic opportunities take a bit more work to pursue in certain fields (but they support you hugely in finding those opportunities), interview day could better logistically

2) GA -- Emory University School of Medicine
Really tough decision between this for #1. Atlanta is way cooler than I expected. Emory is flush with money and academic opportunities including the CDC next door. Grady is legendary. Did a shadow shift and it was really exciting, the 3rd years are super confident and the place gets intense. Had a great time at the pre-interview social and really clicked with residents, they don't seem overworked and unhappy as some old SDN reviews made me expect; their schedule actually seems super reasonable although they work hard on shifts. Diverse group of residents and patients

Cons: medicine month is kinda lame, otherwise not much to complain about

3) PA -- Temple University School of Medicine
These guys work to fill an important role for a community hurt by drug use and violence, and I loved their mission. Really got along both with residents and faculty (especially Dr. Garg) I met. Feel like you get an amazing crazy clinical experience here. Couple different sites for diversity in patients and experience. Philly is my favorite city in the northeast and not far from friends and family.

Cons: the circadian shifts seem like they would grind me down, but apparently residents wanted this and some people love it. Northeast would bum me out for half the year. 2 weeks of elective, twice, makes it hard to dig into anything during residency. Other than schedule-related stuff, I loved everything about the residency/residents

4) CA -- Alameda Health System - Highland Hospital
The no-suit interview days really lines up with my distaste for the annoyingly overly formal interview season; just generally felt like these folks are on the same page with me on a lot of things. Had a blast during interview day, loved my interviewers and co-interviewees. Opportunity to be great at more than "just" being a doctor; truly inspiring people (EM leaders, public health folk, researchers, activists) have come from here and remain here. Awesome social mission. Seems like they have time years 2-4 to get involved in other things, and the area seems fun with great cultural and outdoors access

Cons: yeah, I have a trouble getting over the 4-year thing, but would still be stoked here. Would hemorrhage money living in the bay area but its better than SF proper

5) CA -- University of California Irvine Medical Center
Wish I had time to make the resident social here. Love the area, near the ocean and trails and LA cultural offerings. Enjoyed most of my faculty interviews, seems like an innovative program with their 1-on-1 shift supervision, in-house medical journals, ultrasound innovation. People don't mention it in the same breath as the big LA programs, but UCI seems to have great patient numbers and pathology, and the folks I met seem really happy to be there

Cons: social EM not as strong as those above, small class seems like it may be tougher to find people to hang with, Long Beach would be sweet to live in but pricy and a bit of a drive (and Irvine itself isn't really exciting)

6) NC -- University of North Carolina
Other than maybe Maricopa probably my favorite residents of the trail. Loved the interviewers too, and the public health opportunities through the UNC ties. Wake seems like a great compliment to the academic UNC experience. Area is affordable and livable.

Cons: commute between UNC and Wake, I know "trauma is overrated" but I want an experience that is probably rowdier than UNC/Wake has, the Triangle isn't the most fascinating part of the country either urban or outdoor activity-wise

7) CA -- Loma Linda University School of Medicine
Really tough, this could have been at the top of my list. Sweet combo of the healthiest population and oldest people in the country (the Blue Zone at LL) and the bankrupt nightmare of San Bernardino, with massive catchment zone and flight opportunities. Great global health opportunities and strong mission. The whole concern about the Adventist-affiliation seems utterly unfounded, my atheist-self felt quite welcomed here, and I'm not too worried about a meatless/caffeineless cafeteria so long as I can brew my own coffee in the ED. Loved the residents and faculty I met with, everyone seems really nice and happy. I dig the weather here, the proximity to the beach and desert and mountains (an hour or so to all of those is acceptable to me)

Cons: just really tough to make this logistically work out with the SO; nearest direct flights would be to LAX and that's not close. Not as much fun urban stuff in the immediate vicinity

8) PA -- Thomas Jefferson University
Great social mission and service that they were totally low-key about. Would have a great lifestyle and be happy here. Cool innovation stuff going on here with great resources for projects you dream up. Liked the residents. Philly is cool.

Cons: didn't really click with any faculty, concerns about acuity (seems overshadowed by Temple trauma-wise, and lots of the other stuff seems referred in, and they just lost Cooper as the trauma rotation), not as excited about living in the northeast

9) TX -- UT Southwestern Medical Center - Dallas
Such a fun social with the residents and they felt like they could totally become my friends. I just didn't feel like they were as driven by the things I am clinically (notably the social EM). Huge catchment zone and lots of pathology but it sounds like EM's role is secondary to strong surgery and IM departments. The huge facility seems eerily quiet for an ED, which is probably better for patient privacy and experience but I kinda like the things-happening-in-your-face ED feel

10) UT -- University of Utah Hospital & Clinics
Loved SLC and its outdoor opportunities. Beautiful facility. Residents seemed cool, but at multiple times more got the feeling they were there for SLC than the residency. Went to M&M and saw a weird tension interaction between two attendings that lingered with me. Interviews felt very stiff with lots of behavioral questions. Never felt like I got a clear answer about EM's scope of practice relative to the consulting services (similar concern as UTSW above).

11) CA -- University of California Davis
Central valley pathology is crazy, Sacramento seems cool, and its close to great outdoors things. Big turnoff here was the resident social, I felt the whole time like they only wanted to hang with each other, and didn't really feel welcomed. One of my interviewers seemed to think maybe I shouldn't be doing a residency

12) CO -- Denver Health
I loved the people, place, mission. So much. The malignant thing seems unfounded, but what doesn't is how hard they work. I would be happy to do a 4-year if it made time for me to hone in on my academic interests too, or would be happy to work a crazy intense clinical schedule for 3 years if I could then have an extra year back in my life to do a fellowship, and this places works you really hard for all four years and on that crazy circadian schedule. Probably come out a stronger doctor than almost anywhere on this list... but I also want to be other things too, you know? Its hard and I wish they weren't so awesome, I do think this would be an awesome fit for certain people.

13) NY -- New York-Presbyterian - Queens
3 year program, super diverse patients, friendly residents. They just didn't seem exactly like my people and I'm not super stoked to live in NYC.

14) NY -- New York Presbyterian Hospital
Awesome academic ties and opportunities, but seems they work you pretty hard for a four year residency. Commute between two campuses is tough. Don't want to live in NYC.

15) PA -- Albert Einstein Medical Center
Love the patient population they serve, seems to be the best pathology in Philly other than Temple. But 4-year program with really tough schedule throughout. Residents seem exhausted. Bizarre, poorly proofread follow-up email makes me worry about attention to detail.

16) CA -- University of California San Francisco/ Fresno
Incredible pathology, EM runs the hospital, up there with Denver as the best clinical training on the list. Just seems like a really tough schedule over four years with limited time to explore other things, and in an area that would make my relationship really tough similarly to Loma Linda above.

17) PA -- Crozer Chester Medical Center
New program, I think its promising, young faculty seem pretty excited about the direction its heading. Just worried that it hasn't graduated a class yet, and the class size is currently tiny so I'm not sure how much I'd see my co-residents. Also, would be an annoying commute every day from Philly (definitely the best place to live for residents here)

 

[gamerEMdoc]

Just to piggy back on the doximitry thing, I think its really foolish to base your rank list based on something like this, unless that's whats important to you. Its not going to mean you get trained better, its not going to mean you'll have better job prospects, but if prestige is important to you, then by all means use it. Listen, everyone values different things. Some people care about geography, some don't. Some people care about research, some don't. Some people care about the people and the vibe at a given program, some don't. I think one of the thing I have stressed for years now here is that your decisions to rank programs should be based on what you value, and this is going to be different for every single person. Base your rank list on your values and your opinions of places, not what others value. No matter where you train, it will be more than adequate to prepare you for when you graduate. So don't worry about the tiny details if they don't matter to you. Will some programs probably train you better than others? Sure, but I assure you, an online list isn't going to accurately tell you which ones will or wont.

Personally, I think autonomy is probably one of the more important issues, but this is my opinion. I enjoy working in places where people aren't stealing procedures from me or my residents. TO ME that was important when choosing a residency back when I was applying, and is important to me now in terms of training residents. But I also realize that every student has different things they are looking for in their life and their training that they value. So I think from an advising standpoint, its important for students to realize that you need to ask yourself what are the most important factors TO YOU (not anyone else) in deciding where to train, and then figure out where to apply from there. If it's geography and you only want to match in Florida no matter what, you may be perfectly ok doing an HCA residency in Florida, because the #1 thing that mattered to you was living there. Or maybe its research that is your thing. Maybe like me you like procedures, pulling on bones, shoving tubes into places, etc. Regardless, find what you value and stop relying on what others think to make your decisions for you.

 

[EMDOc19]

Applicant summary:
Board scores: 230s/240s
COMLEX: 560's/520's/Pass PE first try
EM rotation grades: High pass/Honors
AOA: No
Med school region: Midwest
Anything that made you more competitive: No not really


Main considerations in making this ROL: Location/being close to family is the most important thing to me. Prefer a county feel vs an academic feel.


1) OH – Case Western/MetroHealth
Pros: Good location since most of my family is from the Cleveland area. Excellent trauma exposure, longitudinal peds, good ultrasound training, tons of flight medicine opportunities, high acuity, no floor months, residents were super chill and fun to hang out with. Cleveland is a relatively cheap place to live and has a decent night life. I get the feeling you would come out of this place extremely well trained


Cons: Residents seemed tired and burnt out. They also seemed unsure about if they like the shifts they have to do at the Cleveland Clinic. Minimal food allowance.



2) OH – Akron General
Pros: Close to Cleveland. Residents were all extremely close and very friendly. Program director was very laid back and funny. Loved the atmosphere here- all residents and attendings are on first name basis. Residents seemed very happy overall

Cons: Have to drive to Metro for trauma month (might be changing in the future). Would not want to live in Akron. Residents spend a lot of time doing US guided PIV’s when nurses can’t get access- good skill to have but would get annoying after a while.

3) OH – St. Vincent Mercy Toledo
Pros: Established program. EM residents really run the show here and are highly respected in the hospital. Dr. King seems like a wonderful PD and has tons of connections everywhere. Good flight medicine if you’re into that.
Cons: Living in Toledo… Ultrasound training was mediocre in the past, but they are working to change that and have hired excellent US faculty.

4) OH -- Doctors
Pros: Love Columbus- great city with tons of bars and restaurants, and good night life/music scenes as well (definitely a great city to be 23-30 in- tons of young professional and recent college grads). The residents were some of the sharpest I've encountered (not just saying that because I'm a DO). Great faculty that were willing to teach (lots of OSU grads). Family in the Columbus area.
Cons: Too community for me. Also, a very small hospital with almost every residency you can imagine- felt very congested. For the life of me I can’t figure out why the residency isn’t based out of Grant which is Ohio Health’s level one trauma center. Doctors does not have a trauma designation. Small residency class and didn’t mesh well with some of the residents. Hospital is located on the west side of Columbus and attracts an “interesting” patient population.

5) TX -- JPS
Pros: Solid county program. Not a lot of competing residences so you really get to do a lot- one resident said he did a lateral canthotomy during one of his first shifts as an intern. Good ultrasound with training in regional nerve blocks. Liked the residents and PD.
Cons: Have to travel to Dallas for peds. Far from my family in Ohio. Fort Worth seemed like a really cool city, but not as cool as Dallas.


6) TX – UT Health San Antonio
Pros: Liked this program more than I thought I would. Interview dinner was probably the most fun one I had. Program director was very laid back and seemed like a great guy. San Antonio is cheap and doesn't have terrible traffic.


Cons: No longitudinal peds. Seemed like they were very into global health- this is not really something I care for... Feel like I would have to learn Spanish if I matched here. San Antonio just doesn't do it for me for some reason. Don't like Mexican food.... Far from home

7) GA -- WellStar
Pros: High volume ED with not a lot of other competing residencies. Building a massive new ED across the street. Great program director- former APD at Emory. Tons of money for meals.
Cons: New program. Atlanta traffic is awful. Residents were slightly quirky. Lots of floor months. They have had some issues scheduling rotations such as OB.

8) NC – ECU/Vidant
Pros: Huge catchment area- you will see a ton here. High volume. Seemed like they get good training
Cons: By far my least favorite PD on the trail- all the other applicants that day felt the same way. The residents were very quirky and socially awkward and admitted this was not on the top of their lists. Greenville was downright depressing- need a bigger city. Considered not ranking, but didn't want to risk it.


Anything to add: As a DO I would encourage other DO’s to take both USMLE’s and to apply broadly.
Applied to: MetroHealth, Akron General, University Hospital/Case Western, St. Vincent Mercy, Doctors Hospital, University of Kentucky, University of Louisville, Detroit Medical Center/Wayne State, Detroit Medical Center/Cedars Sinai, William Beaumont, Spectrum Health, Presence Resurrection, Advocate Christ, University of Illinois, Rush University, Medical College of Wisconsin, Drexel University, Greenville Health, Palmetto Health, Wellstar Kennestone, University of South Florida, University of Florida Gainesville, University of Florida Jacksonville, McGovern, John Peter Smith, University of Texas Southwestern, University of Arkansas, Maricopa Medical Center, University of Nevada Las Vegas, Virginia Commonwealth University, SUNY Buffalo, Kansas City Truman Medical Center, Ohio State University, Cook County Medical Center, University of Michigan, Medical University of South Carolina, Indiana University School of Medicine, Jackson Memorial Hospital, Louisiana State University, University of Alabama, Orlando Regional Medical Center, Carolinas Medical Center, Allegheny, University of Maryland, UT Chattanooga, Emory, Boston University, University of Texas Austin, Baylor, Henry Ford Hospital, University of Tennessee- Murfreesboro, East Carolina School of Medicine, Carillion Clinic/Virginia Tech, Wake Forest University, University of Iowa, St. John Medical Center, Eastern Virginia Medical School, Grand Strand, Kendall Regional Medical Center, Atlantic Health

Applied to these in mid-October: Wright State, UT San Antonio, Florida Atlantic, Albert Einstein, Loyola, Brandon Regional/HCA, St. Elizabeth Boardman, University of Central Florida Ocala,

Declined interview invite: None
Attended interview at: All
Withdrew prior to hearing back from: None
True Rejections: Allegheny, Virginia Tech Carilion, Maryland, Boston University, Carolinas, UT Murfreesboro, UT Chattanooga, Emory, UT Austin, Henry Ford, University of Alabama, University of Cincinnati, UNLV, University of Arkansas, University of Michigan, University of Indiana, University of Wisconsin.

Ghosted or sent a “thanks for applying, we have concluded our interview season” by the rest.

 

[alpinism]

Want some controversy on this thread? Here's a small bit.



Why the hell is this applicant ranking this program #3 (but considered it #1) when their review reads as pretty scathing? So you hate the PD, are told by multiple residents that trauma is malignant, are told you act as a scribe for your trauma month at parkland, have an upper level resident admit that they are significantly inexperienced for their level of training, state that they are consulting out everything and that there is "nothing in place to improve it", residents admitting they have low procedure numbers, terrible OB/Gyn experience, too academic. This is how you should not rank programs. Don't rank someone high just because of name recognition. Do so because you would actually like training there.

Now to be forthcoming, I did one of my rotations here 4th year of medical school and almost all of this was accurate at that time to an extent. I also know a few individuals that trained there. One didn't like it primarily because of the low procedure numbers. The others appeared to enjoy it. Can't speak to any of their competency, however. From what I can recall, it wasn't until 2014 that their ER was "allowed" by anesthesia to use ketamine or propofol for procedural sedation. They were very quick to consult ortho for reductions. I saw a hip dislocation that they didn't even attempt, they just called ortho to deal with it. Trauma attendings would literally just berate the EM residents during bad trauma cases. The EM residents on their trauma months literally just sat in the corner of the trauma bay and scribed (lol), which is why it appears that they added on a trauma month at a community hospital (which also means you have one less month in the ED as you have to do two months on trauma). I'm sure you get decent training, but it has much of the same issues that many big academic EM programs have, and that is largely being seen as the red headed stepchild of the hospital and being consult happy.

As much as they hate to admit it many people going into EM still obsess over prestige even if it means getting subpar training at the expense of name recognition.

Stanford is another example. Horrible training at the primary site with tons of consulting. Secondary site is kaiser which is basically a glorified urgent care clinic. Yeah they have the valley but its only 10% of your time. Add on to that the fact that its 4 years in literally the most expensive city with the worst traffic imaginable. But people will justify it because you get the Stanford name and opportunities in research/teaching/global health that most residents will never use even if they go into academics.

 

[alpinism]

The GW review was pretty damming.

PGY-3 resident who only tubed 2 patients in the department?

There are family medicine residences out there with better airway training.

 

[Spagett!]

As much as they hate to admit it many people going into EM still obsess over prestige even if it means getting subpar training at the expense of name recognition.

Stanford is another example. Horrible training at the primary site with tons of consulting. Secondary site is kaiser which is basically a glorified urgent care clinic. Yeah they have the valley but its only 10% of your time. Add on to that the fact that its 4 years in literally the most expensive city with the worst traffic imaginable. But people will justify it because you get the Stanford name and opportunities in research/teaching/global health that most residents will never use even if they go into academics.

After having interviewed at multiple big name academic programs, the reality is that this isn't always true though (not saying you said that but just clarifying.) HAEMR, Northwestern, UCSF come to mind as huge names that also provide great training. As with all things, I think it's just case dependent.

 

[TheComebacKid]

Stanford is another example. Horrible training at the primary site with tons of consulting. Secondary site is kaiser which is basically a glorified urgent care clinic. Yeah they have the valley but its only 10% of your time. Add on to that the fact that its 4 years in literally the most expensive city with the worst traffic imaginable. But people will justify it because you get the Stanford name and opportunities in research/teaching/global health that most residents will never use even if they go into academics.

I highly doubt that you if evaluated two EM residency trained grads that you would be able to tell the difference between who trained at Stanford and who trained at Denver/Cincy/LAC/Harbor/Hennepin/SDN circle jerk programs.

The program bashing that occurs on here is pretty unwarranted. While some programs may be subjectively better than others, residency training is largely standardized and most centers (even in the community) get enough pathology to make you a competent EM physician to practice independently.

I believe the vast majority of applicants don't go to Stanford because of the prowess of it's undergrad campus, or because they want a name that will impress their grandmother. They go there because they value unique aspects of the clinical training, the location, the culture of the program, etc.

 

[gamerEMdoc]

As long as there is enough patients to see in the ED for the given number of residents they have, then its fine. As long as you are pushed to see patients, you are going to see what you need to see, and do what you need to do, to be able to competently practice EM when you get out.

 

[deleted547339]

As long as there is enough patients to see in the ED for the given number of residents they have, then its fine. As long as you are pushed to see patients, you are going to see what you need to see, and do what you need to do, to be able to competently practice EM when you get out.

Eh. I’m not so sure. The minimum requirements for some things are super low (e.g. intubation). I know the general consensus here is that any program is fine, but I’m not convinced - I’ve seen some very questionable EPs. If you only do 15 tubes in the ER and another 15 in the OR, I wouldn’t consider you competent, but ABEM would. Only having a dozen ED patients that you have to intubate, manage hemodynamics, sedation, evaluate post-tube CXR, etc isn’t enough. I knew residents as a “good” program that had only done about 10 lines and tubes by midway through third year. I had well over 100 part way into my residency - I am sure I got better training than many of those at other programs.

 

[Rekt]

I highly doubt that you if evaluated two EM residency trained grads that you would be able to tell the difference between who trained at Stanford and who trained at Denver/Cincy/LAC/Harbor/Hennepin/SDN circle jerk programs.

The program bashing that occurs on here is pretty unwarranted. While some programs may be subjectively better than others, residency training is largely standardized and most centers (even in the community) get enough pathology to make you a competent EM physician to practice independently.

I believe the vast majority of applicants don't go to Stanford because of the prowess of it's undergrad campus, or because they want a name that will impress their grandmother. They go there because they value unique aspects of the clinical training, the location, the culture of the program, etc.

Your EM experience must be very homogeneous if you cannot tell the difference between practicing EPs. There's clearly a difference in comfort level with procedures and acuity. And I'll stop you right there, people are picking Stanford for the name. @TimesNewRoman is correct. Just because you meet ACGME standards to become a board certified EP, doesn't mean you're going to be a great one. It really comes down to high volume of high-acuity patients and procedures. You can circlejerk a bunch of bedside teaching and reading about your tube q3months at privileged academic center, but the guy that does one every other shift is just going to be better than you. There's very clear stark differences between clinical training at a variety of programs.

 

[namethatsmell]

I'd argue your practice environment as an attending will determine how "good" you're perceived to be. The reality is that every ER program, just like the individual ER doc, will have strengths and weaknesses that will be amplified or minimized significantly depending on your practice environment. After some years in practice, probably everything settles out depending on where you work.

The worst ER doc I've ever seen came from a big name program that shows up on all these lists. He excelled brilliantly in a few areas of EM but there were SO many gaping holes in his knowledge/performance. It was strange.

The ER doc with the most bouncebacks I've seen came from a program that is in the top five of many of these lists.

The two best ER docs I've ever worked with came from a no-name community program and the other from a no-name DO program.

You do need a certain amount of tubes/lines (which is more importantly a surrogate to resuscitation experience) to be competent and 15 or whatever is nowhere near enough. But EM is so much more than tubes/lines. I'd rather work with a new grad from a place I've never heard of who did 100 tubes/lines and also has good peds knowledge and can reduce a shoulder than a new grad who did 300 tubes/lines and can pontificate about the pros and cons of LR vs plasmalyte they learned about in their fancy CC ED unit but doesn't feel comfortable attempting a PTA.

Probably 75% of EM programs have the components needed to make you a great EM doc if you put in the work. The quality of the new CMG programs will be much more...variable.

 

[gamerEMdoc]

Eh. I’m not so sure. The minimum requirements for some things are super low (e.g. intubation). I know the general consensus here is that any program is fine, but I’m not convinced - I’ve seen some very questionable EPs. If you only do 15 tubes in the ER and another 15 in the OR, I wouldn’t consider you competent, but ABEM would. Only having a dozen ED patients that you have to intubate, manage hemodynamics, sedation, evaluate post-tube CXR, etc isn’t enough. I knew residents as a “good” program that had only done about 10 lines and tubes by midway through third year. I had well over 100 part way into my residency - I am sure I got better training than many of those at other programs.

I don't know how that could possibly happen if the ED volume to resident ratio isn't completely out of whack. (Too many residents/too little volume). Residencies aren't at urgent cares. Who are intubating the patients that come in if residents are getting the bare minimum? Either the place has anesthesia coming down to the ED to intubate (if so that's unbelievably bad), they have too many EM residents for their volume, or its an anomaly with one resident who is shying away and hiding from procedures and the residency isn't calling them out.

 

[gamerEMdoc]

Agreed. Great docs can come from places you never heard of. Terrible docs can come from name places. Back in the day when we used locums from time to time (thankfully that has been over for several years) we had a new grad from Umass who saw less than 1 pt/hr as a locums, and called our cath lab for RBBBs. We also had a guy who would tell EVERYONE how he trained at Yale and who never saw anything close to 1.0/hr. Had a new Pitt grad who was doing a CC fellowship who also couldn't see 1.0/hr and would randomly just walk into the rooms of other docs while they were managing their cases like he was just being paid to observe. In all three cases, their numbers were so bad they were all asked not come back. I'm sure all 3 of those programs also produce some great talented residents. And I'm sure all 3 of those providers were probably pretty smart people but they couldn't practice EM in a community hospital competently at all. Many residencies get candidates that just are ill suited for practicing EM efficiently, its a skill that can't be tested and isn't predicted by board scores. Procedural skill and task managing are an unknown when you get your match list, and its very difficult to teach people how to be quick and efficient and resilient. This happens at both big name programs and lesser name programs. There are all star residents and residents that are slow, and its really hard to predict who is who based on a med school application.

That being said, residencies can make slower residents more efficient, and at least functional, if they have the volume to do so. When everyone is drowning, and there is always a patient to be seen, peer pressure winds up kicking in and slower residents get faster because they have to. But if its resident overload in the department at all times, its easy for slower or more timid residents to hide and never progress.

 

[namethatsmell]

That being said, residencies can make slower residents more efficient, and at least functional, if they have the volume to do so. When everyone is drowning, and there is always a patient to be seen, peer pressure winds up kicking in and slower residents get faster because they have to. But if its resident overload in the department at all times, its easy for slower or more timid residents to hide and never progress.

Totally agree.

I'm not the fastest doc and don't want to be. I'm probably a bit more thorough than the average doc and like to talk to my patients for an extra 5 mins as these two things keep me happy and let me sleep better at night. I was too slow starting out as a PGY3 and I got gently called out for it and my residency worked with me to improve my efficiency and it worked. My pph and numbers are in the middle/upper end of the pack at the places I work.

FWIW, I trained at a name-brand place and they too can produce very efficient docs. The fastest doc I've ever known was an attending from residency. Another example of how blanket assumptions about programs and docs are usually incorrect.

 

[TheComebacKid]

Your EM experience must be very homogeneous if you cannot tell the difference between practicing EPs. There's clearly a difference in comfort level with procedures and acuity. And I'll stop you right there, people are picking Stanford for the name. @TimesNewRoman is correct. Just because you meet ACGME standards to become a board certified EP, doesn't mean you're going to be a great one. It really comes down to high volume of high-acuity patients and procedures. You can circlejerk a bunch of bedside teaching and reading about your tube q3months at privileged academic center, but the guy that does one every other shift is just going to be better than you. There's very clear stark differences between clinical training at a variety of programs.

Sure there’s variation in the quality of EPs in practice. However, I don’t think you can tell who trained at the ivory tower and who trained at one of the SDN top five programs. Good and bad docs come from all programs. The quality of the physician is more based on the individual than it is on the residency program.

 

[gamerEMdoc]

Sure there’s variation in the quality of EPs in practice. However, I don’t think you can tell who trained at the ivory tower and who trained at one of the SDN top five programs. Good and bad docs come from all programs. The quality of the physician is more based on the individual than it is on the residency program.

I would agree with this statement. Which is why I usually stick to the belief that no matter where you go to train, you can turn into a good ED doc. Because its not necessarily the program as much as it is you, the physician, taking the opportunity the program gives you to develop your skills. Don't get me wrong, some programs are going to be better than others at giving you different opportunities, and dealing with residents who are not reaching their potential. But for the most part, much of how you turn out as a physician has more to do with you than it does with the individual program you attend.