York Hospital (Pennsylvania) Residency Reviews

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dwgs

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Hi all,

Figured it would be useful to give everyone a "heads up"about these two programs having recently interviewed at both.

York- Wow. Nice, nice program. PD is INCREDIBLE and TOTOALLY devoted to resident welfare. Interview day begins early with a 1.5 h informal lecture about the basic program stats- chock full in information and not at all boring. Brief interviews with 3 attendings and one resident. Painless questions, ie no clinical questioning. Hotel is great and paid for by the program. Also, dinner the night before is GREAT. Nice Italian place and TONS of residents/spouses/children showed up for the festivities. Plan to rank EXTREMELY high, if not #1.

Christiana- Gorgeous facility. Very impressive ED. Attendings are friendly, but did experience some "awkward silences" during interviews. There is no introduction to the program. Day begins with 1 hour conference (5 days/week), then on to a series of five 30 minute interviews with no breaks in between. Felt quite tired by the end. Day ends with a quick catered lunch in the department and tour. Done by 2 pm. Need to do your research beforehand as there was no introduction lecture to fill you in on all the "vital statistics." All in all, a solid program.

Happy to take any questions.

Dwgs

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I'm going to cover a few in rapid succession here:

YORK

PGY 1-3

All of the faculty are very professional and do a good job of promoting the program. The PD spent 4 years at Northwestern (Chicago) and 8 years at Emory (Grady, in Atlanta). He has a great program in place that really doesn't need much tinkering.

The hospital has a high volume at 70,000, the 4th-busiest in the state with 11 EM residents and ~28% admit rate. During the dinner the night before, the residents were raving about how much they get to do and see. The trauma is 90% blunt and 10% penetrating. It is a level 2 center, but the PD went to great length to explain why that's not a weakness. There are no nearby Level 1 centers so York sees everything, and they're planning on getting the Level 1 designation within the next few years anyway. I don't think there's any shortage of action here.
There is a Medical SimCenter under construction - a separate facility that looks like it's going to be very nice.

Overall, York is a rural community hospital program with emphasis on getting residents up to speed to practice in community hospital EDs. It meets all the RRC requirements for research, of course, but I didn't get the impression that it was a focus. One of the biggest things you'll have to consider about the program is its location. The area is within a couple hours drive of some cities, but the immediate location is basically a small city in the Pennsylvania countryside.

MUSC

PGY 1-3

This program will be accepting its second class of residents with our year. That means there are no senior residents, and some of the kinks will have to be worked out of the program, but I was very impressed with the faculty and think they have a great model.

The ER does not currently have departmental status, but it's moving in that direction. The Division Director and Program Director are completely behind the residency and supportive of the residents. They have met with the residents frequently this year to assess the early stages of the program and get feedback. Trauma delineation is systematized and there were no complaints from the residents about issues with the trauma service. The ED handles all airways.

The physical set-up at their main ED is a bit convoluted, and there are plans to update it, but that won't happen for a few years. I didn't hear any complaints from the residents about it though. The residents all came out for the pre-interview dinner and were a great group. Very relaxed and fun to hang out with.

Charleston is one of the most gorgeous little cities I've ever seen. Resident salaries can afford small places on or near the beach. I mean, come on, how sweet is that?! The culture is very Southern. College football is huge and people are friendly and courteous. Yes ma'am, no sir. All that jazz.

Shifts are 18 12's. Volume is >50K.

Overall, I think this program has a lot of potential in a very fun place to live. It has some unavoidable drawbacks due to its age (lack of seniors and curriculum tweaks), but I think anyone who matches here will be well-trained after three years, tanned and happy. Not a bad deal.

EVMS

PGY 1-3

I was very impressed with this program. The program director was professional and polished, but definitely approachable. The primary ED (Sentara Norfolk) is a Level 1 with 51K volume. A fairly low admit rate from what I've seen, at 20%. but the residents had no complaints about seeing enough patients or getting experience at procedures. The 23 8-hr shifts allow for more free time per day than your 12-hrs, and the program emphasizes reading and research to supplement your ED work. I was surprised at the friendliness of the residents and the amount of things to do in the Norfolk area. Virginia Beach is only 15-20 minutes away, and there is affordable housing to rent or buy within a quick drive.

Overall, I think I'd like to go back for a second look to make sure the ED is busy enough and residents are getting enough action. But otherwise, the faculty, education, facilities and lifestyle seem excellent and I would be happy to match here.

A couple more coming soon...
 
I wanted to check out a community program to see whether I was more interested in a community program vs. an academic one. As far as community programs go, this is a fantastic one!

Residents: 11 residents per year. One of the aspects of this program that attracted me was that they seemed to be willing to give "different" applicants a chance; there was a splattering of DOs and FMGs, so it makes for some interesting conversations! There were a few residents that came to the pre-interview dinner. Everyone was really nice, but there seemed to be a large number of "married with children" residents. The residents do play a large role in the selection process, and one of your interviews is conducted by the chief resident; although this interview felt more like a "do you have any questions, this is for you" interview. Everyone seemed to be really happy, and the ones I talked to chose York first because they rotated there through med school and loved it. Most people live nearby, and a large amount of them own houses because of the reasonable prices!

Faculty: Everyone I met was incredibly nice! Everyone was incredibly friendly. Everyone is interviewed by the PD who knows the strengths and weakness of the programs and is very straightforward about the place. It is obvious that he places a high emphasis on the residency program and the general well being of the residents. I didn't really get to meet anyone other than my two interviewers, so I think i'll leave this part open for other people to comment on.

Hospital:
The ED is very pretty and shiny. The also have a brand new computer system which will make for much more organized charting. I was very impressed with how organized the ED itself was! They even have a seperate room with computers for the consults to sit in. There's also free food in lots of little nooks, (peanut butter, bread, etc) for when the cafeteria is closed.

The hospital itself is very nice, and several departments do not have residents, therefore as a rotater you end up having more responsibility and first dibs on many of the procedures. They also have the only Tox ICU, which is one of the largest pros of this program I believe. They have several on call rooms reserved for ED residents for when they are on off service rotations which you can also crash in if you are stuck late in the ED or it's raining and you can't get home. These rooms are lovely!

There are opening up a new sim center in a few months and they plan on doing procedure competence as well, which seems like a great idea!

Curriculum: 3 years, with several off service rotations, and one month at CHOP. Because this is a community program, they don't have a seperate peds ER, so you see children on a regular basis every day, which may be a pro/con depending on where you want to practice in the future.

York: The hospital is in a little town, not really the most happening place in the US, but it is a beautiful little nook, with a very affordable cost of living, the residents comfortably own houses, and are able to save money that way. Apparently the school system is also fantastic, and it is pretty close to other big cities like Baltimore and DC, but with a two hour drive, I'm not sure how feasible it would be to drive that far often.

Negatives: While they do have a diversity in the patient population that they see, it's no where near as diverse as other places in larger cities... you won't see many patients with HIV or IVDU. It is a community program, so while they say nobody has problems getting a job, I'm not sure how easy it would be to go from a community type training and work in an academic hospital, the people I met said they didn't think it would be a problem at all.

Overall: It is def. a strong EM program and the residents here are VERY well taken care of with lots of little perks (free food always in cafeteria and in little kitchenettes, low cost of living, very family friendly program.) If you are interested in a big name ED where all of the residents come from big name schools, this program is not for you. BUT, if you are looking for a friendly place where you will get good training, York does a great job with that.
 
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"Nice program. PD is INCREDIBLE and TOTOALLY devoted to resident welfare."

Residents:very happy and have alot of benefits. Said ancillary staff is good. Attendings good, helpful, always have the residents back.

Benefits: In add'n to 3wks vacation they get 8 days during Christmas, all meals paid and family meals when on call, free parking, & annual retreats w/ family invited. Moonlighting within facility $70/hr

Work: First yr 20-12's, 2nd 19-12's, 3rd 18-12's (they said first yr is more like 18-19 shifts). Children's EM rotation in Philly (house provided & meal allowance). International connections for electives. Paper charting

Facility: Curtain rooms (no hard walls), observation area very new and nice. Will be remodeling ED in a few years but no hard plans yet.

Interview: Dinner the night b/4 informal, paid for nice hotel & shuttle to hospital for interview day. Interview day w/ intro to program/stats, then interviews w/3 attendings and one resident, Short tour through ED, and lunch. Painless questions, ie no clinical questioning.

Former posts: http://forums.studentdoctor.net/showthread.php?p=1008780&highlight=york#post1008780 (2003); http://forums.studentdoctor.net/showthread.php?p=5894951&highlight=york#post5894951 (2007);
http://forums.studentdoctor.net/showthread.php?p=5999645&highlight=york#post5999645 (2007)
 
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"Nice program. PD is INCREDIBLE and TOTOALLY devoted to resident welfare."

Residents:very happy and have alot of benefits. Said ancillary staff is good. Attendings good, helpful, always have the residents back.

Benefits: In add'n to 3wks vacation they get 8 days during Christmas, all meals paid and family meals when on call, free parking, & annual retreats w/ family invited. Moonlighting within facility $70/hr

Work: First yr 20-12's, 2nd 19-12's, 3rd 18-12's (they said first yr is more like 18-19 shifts). Children's EM rotation in Philly (house provided & meal allowance). International connections for electives. Paper charting

Facility: Curtain rooms (no hard walls), observation area very new and nice. Will be remodeling ED in a few years but no hard plans yet.

Interview: Dinner the night b/4 informal, paid for nice hotel & shuttle to hospital for interview day. Interview day w/ intro to program/stats, then interviews w/3 attendings and one resident, Short tour through ED, and lunch. Painless questions, ie no clinical questioning.

Former posts: http://forums.studentdoctor.net/showthread.php?p=1008780&highlight=york#post1008780 (2003); http://forums.studentdoctor.net/showthread.php?p=5894951&highlight=york#post5894951 (2007);
http://forums.studentdoctor.net/showthread.php?p=5999645&highlight=york#post5999645 (2007)

Hey, I am a current 1st year EM resident at York. Just a quick correction to a few things in this review
1) Our shifts in first year are all 10's, 2nd and 3rd year are 8's and 10's with predominance of 10's. We don't do 12's.
2) In the ED, we are fully computerized charting with Cerner Powerchart. we also have new voice recognition software (Dragon Dictation) to dictate directly into our computeized notes. We also do CPOE (computerized physician order entry), and currently only write med orders on paper, which will hopefully be computerized by the time this year's intern's come through.
3) In addition to curtain rooms, we do have glass rooms, as well as single rooms for OB/Gyn stuff, Gyn, and we do have isolation capabilities

PM or let me know via this forum if anyone has any questions about us, or anything about match/residency in general!
 
Hey, are there any residents/graduates/medical studens (who did a rotation) out there from any of these programs? I only have two interviews left and I still don't have a warm fuzzy feeling about any of the programs. I'd love to hear some inside info. I have NO idea of how to rank these programs.
I'm an intern at York, and I'd be more than happy to answer any specific questions you have, feel free to PM me.

As far as a general impression goes, I do agree with an above review that our residency director is 100% resident oriented, and goes to bat for us on every occasion. Even in my 6 months, he has stepped up in our favor a bunch.

Another perk is the skills you'll get here. Not a ton of other residencies, so you'll actually get to do reductions, splinting, lines, and a ton of other procedures. We also have fantastic ancillary staff and are rediculously busy (75 K last year, on track to see more this year, ~ 1500 to 2000 traumas/year).

I also love the location. Close enough to go to Philly or Baltimore if needed, close enough to go to the middle of nowhere or go somewhere to ski, and nice area with affordable housing, very family friendly residency.

As always, I'm open to more specific questions. Best of luck to everyone!
 
York: The hospital is in a little town, not really the most happening place in the US, but it is a beautiful little nook, with a very affordable cost of living
Negatives: While they do have a diversity in the patient population that they see, it's no where near as diverse as other places in larger cities... you won't see many patients with HIV or IVDU. It is a community program, so while they say nobody has problems getting a job, I'm not sure how easy it would be to go from a community type training and work in an academic hospital, the people I met said they didn't think it would be a problem at all.

York is a small city. We do have a city population that act like the city population of any larger city. I went to med school in North Philadelphia and the trauma, assaults, drug use, gang shootings and rapes here sometimes make me feel like I'm back in Philly, so I don't know that I would agree with the "little nook" characterization (although the suburbs here are nice).

As far as diversity is concerned, we probably have a more diverse population than most. While we do have inner city issues and indigent care issues, like any other ED, we also have a unique blending of city & rural populations; this is a level of diversity rarely seen elsewhere (ethnic, racial, socioeconomic, you name it). Our peds & adult populations are mixed...your next patient could be 8 or 80 years.

We're an academic community program with >21 years of producing board certified EM physicians. I'm a senior resident at York; PM if you'd like to know more. ;)

Good luck in matching where YOU want to be.
 
Often times, the real gems for EM are, in fact, exactly the hospitals that would never ever make a US News ranking of the best hospitals . . .[

People are always posting and referencing these "hidden" gems of em residencies but no one ever wants to name them. Why is this? Drop names people!:)
I can tell ya 2 programs that are definitely stellar programs, and what I would consider "hidden" gems because they're not huge names, but provide you with an AWESOME experience.

1) Wright State - Dayton, OH. I read & heard about it, and interviewed there as well, and was thoroughly impressed. http://www.med.wright.edu/em/res/

2) York Hospital - York, PA. I'm about to start my 3rd (and final) year there. I rep the hell outta the program every chance I get, because I genuinely believe it's an *amazing* program. http://www.yorkhospital.edu/default.aspx?program=2

To address some of the points/questions that Amaranthine mentioned, with respect to my program:

1) NUMEROUS times I've had rotating and interviewing med students tell us our residents were the happiest they've ever met of any program.

2) There's a ton of autonomy, especially in your 2nd year, and definitely during your 3rd year - while ensuring you have appropriate Attending supervision as needed/requested/appropriate. And upper levels (2nd & 3rd year residents) often walk 1st year residents through sicker/critical patients, without stealing experiences from them.

3) The volume is HUGE (around 80,000/yr), with only 33 residents in the program. The result is you get your butt whipped into shape, learning how to manage a very high volume of patients, and master the skill of multitasking and prioritizing. But volume is nothing without acuity. We have a VERY high acuity of patients. York County nationally has one of the greatest percentage of obese residents, which translates to the vast majority of our patients having a ton of co-morbidities (DM, CAD, PVD, CHF, OSA, COPD, etc). Our admission rate is about 30%, well above the national average. Sick for us is SICK.

This doesn't interfere with teaching time, either. Attendings STILL make the time & effort to teach, instruct, and provide feedback, even in the crazy busy environment we have. And that's unique, because we have a major urban experience/environment in the setting of a community hospital. So we have the funding (more on that later) without the overbearing fellows coming down to steal procedures from us - in fact, we do pretty much all of our own procedures with our EM faculty, and only consult if/when appropriate/needed.

4) Our attendings are from all over. We have a bunch of local Yorkians and former residents of our own program, as well as others from all over. We have some 30+ year faculty as well as some "fresh blood" from top programs like Christiana. We have some traditional EM docs, a few former Internal Medicine, a few former Surgeons, a few Paramedics, etc. ALL are EM Board Certified. But quite a varied background, for a variety of approaches & strengths. And we have young and old, including Ultrasound-trained fellows + U/S Fellowship. So diversity isn't a problem here.

And for me, who wants to go down south, our attendings and former residents have placed throughout the US. So I often hear from attendings about job opportunities in areas I'd like to practice, the ppl they know there, and how they can talk to people to get me interviews etc. Def. a positive to know that no matter where you wanna practice, we have Alumni there and/or current faculty with connections to there.

5) Our Program Director (who's been the same program director for over 20 years) is VERY receptive to change based on faculty & RESIDENT feedback. As such, we've ditched low-yield rotations (so we no longer have any floor months of anything), and custom tailored several off-service rotations so we get the experience we want & need, without having to do all the crappy scuttwork to achieve it. He makes sure our residents are the best taken care of in the hospital. The PD is also one of the Oral Board Examiners as well as on the Board of Examiners (so he writes questions for the board exam). In fact pretty much our entire Program Leadership are nationally recognized "big-wigs." So their letters of rec carry sig. weight.

6) Despite what you're interested in, we have people that do it, and will help you do it as well. AND, we'll front you the money to help you do it to boot. We get over $1,500 spending cash on pretty much anything medically related/yr, from textbooks & iPhone apps (including PEPID, etc) to whatever course/conference/experience you'd like to attend. Ultrasound, Wilderness Medicine, Tactical & Prehospital (like me), International, you name it, we do it.

On that note, Wellspan (the healthcare group that owns the hospital and several surrounding it) is the 4th largest employer in the state, so it has TONS of money. So in turn, we as residents get one of the highest salaries of any residents in the country - save places like NY, where all your salary's gonna get spent on your apartment rent anyway. This also means the HOSPITAL has tons of money. So with our crazy volume, we have the MONEY for techs, aids, support staff, and equipment! So you don't waste your time doing non-doc stuff (like pushing patients to imaging, drawing your own blood, getting your EKGs etc), albeit there are merits to learning how to do so. But by in large it is NOT your responsibility, and you can rest assured it WILL be done by the appropriate staff.

In addition, since Wellspan is so huge, the vast majority of our patients (I'd argue above 90%) have electronic medical records readily available. So I can look up PMH, meds, allergies, surgeries, previous EKGs, studies, labs, etc from their PCP and specialists, before I ever set foot in the room. And that is NICE.

7) The program (attendings) challenge you to do things diff ways, to get out of your comfort zone & learn how to approach problems in different ways. And they themselves have very different prespectives. Some guys are very hands-on, others are more laxed. Some are super thorough and detail-oriented, and others are minimalists. So you really see the different ways to skin a cat, and develop an arsenal of how to solve a particular problem, while developing your own preference of how you'd like to do things as an attending in the future.

9) Our residency is certainly the strongest in the hospital, without a doubt - despite it being a Level I Trauma, Peds, Stroke, Cath Lab, etc, so we have the full range of services & residencies (Medicine, FP, Surgery, etc). And on a regional & national level, our residents have won several awards for their research & presentation. No surprise there.

10 ) Lastly there are a ton of perks, like unlimited free food for residents, free for resident families while on-call (off-service) or on the weekends, program coverage for all sorts of medical-related expenses, free Rx as long as it's written by a doc within the Wellspan network, etc etc.

Alright, I think that's long enough haha. You get the idea.
 
I used past posts about people's thought on the programs on their rank order list to help formulate my own preferences in the programs I interviewed at so I thought I would pass my thoughts along about the programs on my ROL, now that all interviews are said and done. Be forewarned: I'm not very picky about where I do my training, so I ended up making a lot of decisions based on gut feeling and eccentric preferences.

1. JPS, Ft Worth: Really clicked with the faculty and residents. Hospital and program is very well funded and the EM program has a lot of pull and respect within the hospital. Really like the city for its size, low cost of living, and reasonable traffic volume. Almost all the training (except three months) is at their hospital.
2. Christiana, Delaware: Very well respected program that's been around a long time. I did a rotation there and its clear that many of their residents are very strong. Has many of the same qualities I liked about JPS (strong and respected program within the hospital), but I grew up in the area and am hesitant to move back. Has two training sites that are 20 minutes apart.
3. Ohio State, Columbus, OH: Really liked a lot of the residents I met. Had trouble clicking with some of the faculty, but did get to sit in on a small group session with one of their younger faculty members leading who was a phenomenal educator. Columbus seems like an awesome town. Just a little hesitant about the separate training sites.
4. Summa, Akron, OH: The nicest cafeteria I've ever been to. New YMCA connected to the hospital. Maybe that shouldn't have influenced me so much, but it did.
5. York, PA: I was really into the program director's pride in having a strong sense of community in the program. I also thought their simulation and other educational programs sounded really engaging.
6. Baylor, Houston, TX: Assistant residency director (Tyson Pillow) was the most personable, fun, and candid person I met the entire interview trail. Would love to work under him.
7. Jefferson, Philadelphia, PA: Three different training sites, some of which appeared to be long commutes. Really cool neighborhood for the university hospital, but pricey. Awesome airway course included with the education.
8. Little Rock, Arkansas
9. CHRISTUS Spohn, Corpus Christi, TX: Program director seemed a bit awkward and not very personable, but the assistant program director and a lot of the other faculty seemed cool. Didn't really click with any of the residents. Seemed like they have a cool simulation experience.
10. St. John's, Detroit, MI
11. UTSW: Very cool residents. Did get the impression that their training experience was a bit skewed to free labor taking priority over education side of things. Clerkship director was very arrogant. Very insistent on his excellent clinical and educational abilities.
12. Metro/Clevland Clinic: Great reputation, but many of their residents seemed burnt out and dissatisfied. They were also the only place where the residents didn't seem to hold their program director in especially high regard.
13. New York Hospital Queens: The fact that this is one of the most ethnically diverse areas in the US makes me think I'm going to have to use a translator way too much.
 
York
.This was my first interview and consequently the hardest to remember.
.
.Residents: They all struck me as very friendly and open except for one in particular that seemed to have an axe to grind. She seemed to be unhappy with the faculty for not being responsive in fixing issues that the residents had on off service rotations. All the other residents seemed very pleased with the responsiveness of the program to their complaints. The program director seemed very interested in fixing the resident's issues..

.Lifestyle/City: Reasonable work hours 20-10s, 19-10s or 8s, 18-10s or 8s, but you may need to travel for your big–city requirements. Not a deal breaker for me, but you know who you are, city-people. This was by far the most remote place that I interviewed, but I am told they have a mall (!). Pay is the highest I saw at 54-59K..
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Curriculum: This program is a community ED in a relatively small city with a large catchment that drives up the acuity. The PD described about 6 or 8 different educational events that happen every month and extensive methods for tracking resident performance and providing feedback. This was clearly the result of decades of fine tuning since this program's inception. They have five (mostly new) faculty dedicated to their ultrasound program—sounded very robust. I was very impressed with their wilderness medicine program as well. They have a formal fellowship and teach a course on the property of one of the faculty, but the opportunity to complete enough credits to get fellowship credit exist in residency as well. Another potential perk is the relatively unopposed nature of the program (if that's what you're looking for).

Facilities: The PD made big deal of the financial health of the hospital. It must be true because the residents are paid well. The ED is brand new and the inside of the hospital seems recently remodeled in the parts that I saw. Documentation is done via EMR with dragonspeak. The support folks were also universally regarded as excellent.

Interview Day: They do the standard dinner, interviews, tour routine. I had a bit of an odd interview with the PD who asked if I had any questions, but seemed a little put off by the ones I asked. He had given a very complete presentation immediately prior and I fell for the dictum that you should always ask a question. In this case, I think he had tried to head off every question and my asking was annoying. In spite of not really clicking with him, I was very impressed by changes that he had made in the program and his dedication to the residents. The faculty seemed very pleasant and the interviews were low stress. I enjoyed talking to all the residents that were around. .
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Summary: I think this one could be an amazing place to train. The people seemed great, and if I hadn't had a weird interaction with the PD (maybe by fluke) I probably would have ranked them higher. I was very excited to see this place based on the things I had read on SDN, and it didn't disappoint..
 
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Hi All,
Currently considering York high on my list. Curious as to how traumas are managed in the ED? And how does the ED staff interact with the surgical service during the traumas?

Thanks!
PNN
 
Hi All,
Currently considering York high on my list. Curious as to how traumas are managed in the ED? And how does the ED staff interact with the surgical service during the traumas?

Thanks!
PNN
Can't tell you 100% for sure, cuz I'm a few years removed now, but I can tell you this. While I was there, all we did was airway (as is with the vast majority of EM Residency Programs), unless you were the EM resident rotating on Trauma, in which case, you ran the trauma.

As for how the surgical staff (ie Attendings) interact with EM Attendings & residents, for YEARS it was a disaster because of the Director of Trauma, who had Intermittent Explosive Disorder (dead serious), rediculous anger management issues, etc, and essentially wouldn't hesitate to drop F-bombs to even the EM Attendings (none of whom wanted to confront him or say anything). But after a lot of indirect complaints and issues, he finally left and went to a different hospital. From the remaining guys, I think the guy who took the lead still had a pretty crappy attitude toward the EM guys, but he was alone; the other 2 Trauma Attendings were really easy to get along with, and one of those 2 was actually really really nice.

Again, I don't know who's running Trauma Services there now, but I can't be any worse than it was previously, that's for sure. Ask Lambofbob; I believe he still works @ York.
 
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