1. What makes your program different from
other programs, or what made you choose your program?
I’m
from Chicago, and Christ
Hospital is just outside the South Side of Chicago, close to where I grew up.
It’s where a lot of my relatives had gone when they were sick
and I knew it had a great reputation. Christ is located in a
nice suburban community with a varied ethnic makeup.
I also got a
great feeling from the residents when I interviewed. I was able
to have lunch with a resident who was a friend of a classmate of
mine. Basically, our program has a laid-back atmosphere with a
large number of patients, phenomenal trauma exposure, excellent
pediatric exposure, and a well-rounded group of residents with
excellent camaraderie. We are all a very close group and get
along great with our attendings both at work and outside of
work.
2. If
not answered above, what's the best aspect of your program?
The
friendliness inherent in our program’s atmosphere immediately
comes to mind. Residents and attendings are on a first-name
basis from day one, which further makes it a really nice place.
Everyone tries to make you feel at ease right away. In addition,
our conferences are excellent. We have five hours of completely
protected time every Tuesday morning, and our conferences
include great guest lecturers, study guides with assigned
readings, and faculty lectures on a comprehensive range of
topics. We also have regularly scheduled oral examinations, which
provide our residents with superb practice for the actual ABEM oral
board exam. The attendings always review the cases and provide
valuable feedback. I think that’s one of the reasons why Christ
residents consistently do very well on the ABEM oral boards.
Our
residents have achieved a 100% first time pass rate.
Throughout all levels of training, we get great teaching with
the right amount of autonomy.
3. Are
there any major upcoming changes to your program?
Our
residency program director is very responsive to our
suggestions. For example, we recently changed the pediatrics
rotation from 7 weeks to 4 weeks of floor time plus 2 weeks of
well-baby nursery. This is a unique and valuable educational
experience because it provides our residents with hands-on
neonatal resuscitation exposure since the well-baby service at
Christ responds to all difficult deliveries in the non-high risk
labor and delivery area. We also recently changed the general
surgery rotation from 6 weeks to 4 weeks at the residents’
suggestion.
Something else that’s exciting is the return of Dr.
Michael Lambert. Mike Lambert is nationally renowned in the
area of emergency ultrasound. We’ve also upgraded to
state-of-the-art ED ultrasound equipment. Our ED ultrasound
fellowship is extremely well-reputed and I’m sure that we
benefit as residents from the leadership that Mike Lambert and
the U/S fellows provide. Our program has also acquired
high-fidelity adult and pediatric medical simulators and is
actively integrating them into our curriculum.
4.
Is there anything you would change about your program if you
could?
I don’t think so.
The second year rotations, in particular, stand out in my
opinion. We do a month of orthopedics and two separate 4 week
blocks of trauma that are awesome. On the trauma service, we get
outstanding exposure to managing traumatized airways, leading
trauma resuscitations, placing chest tubes, performing
thoracotomies, performing DPLs, and FAST U/S scans in addition
to other procedures. We also do one month in the PICU, which is
a very high-yield rotation. Finally, we get to do one four
week elective and one month of neurology. Given the growing
emphasis on tPA therapy in the ED for acute stroke, our
program’s inclusion of a neurology rotation is somewhat
innovative and farsighted.
5.
How much are you responsible for blood draws, putting in IVs,
etc.?
We’re never required to do any blood draws or start any IVs. We
have ED-based phlebotomists and our nurses are responsible for
starting IVs. If residents wish to gain experience in starting
IVs, the nurses are willing to teach us. If the nurses are
unable to obtain IV access, then residents usually place U/S
guided peripheral IVs or central lines as needed.
6. Do
you learn mostly from attendings, other residents, or textbooks?
Does this vary when you do off-service rotations?
I
think this is person-dependent. I learn the most from managing
specific patients at the bedside, and the attendings in our ED
are outstanding clinical teachers. They’re all highly
experienced and have different teaching styles. We also read the
Tintinalli text for the didactic component of our curriculum.
Senior residents are very helpful to new interns in terms of
logistical orientation, especially at the beginning of the year.
While the seniors are always available to answer questions, all
residents present to attendings, not to senior residents.
7. How
does EM rank in your hospital's hierarchy?
We’re a very large community-based tertiary care center for both
adults and children. The ED is the main source of patient
admissions and plays an essential role in the overall
functioning of Christ. EM residents are extremely well-respected
throughout the hospital. Our residents have earned an
outstanding reputation for our program over the years through
their off-service interactions and leadership. We rotate through
the MICU, SICU, and PICU and share the same responsibilities as
our colleagues.
We’ve all had a lot of experience with central lines
and airway management. Sometimes we are more experienced than
residents from other departments, and accordingly more is
expected from us as a result. Even though Christ is a big
hospital, we still get to know the residents from other
departments very well.
8. What
are the perks that your program provides (PDAs, textbooks,
conference fees, meal tickets, etc.)?
We
get free parking, meal tickets in quantities that are the envy
of the hospital, two lab coats per year, and $2400 to spend on
anything educational (books, conference fees, PDAs, laptops,
etc.). We also get additional funding for flights, hotel
expenses, and a stipend for any conference where we present. As
far as time off, each resident gets 4 weeks of vacation per
year. In addition, 2nd and 3rd year residents also get an extra
week off to attend a national conference.
9. How do
you rate your rotations outside of the emergency department?
As
an intern, you spend 2 months in the MICU, which are excellent.
We’re equal to anyone else on the medicine team there, and we
perform all the procedures for our patients. We also do one
month of OB, but we get to focus on vaginal deliveries instead
of going to the OR if we want. We recently shortened our surgery
rotation to 4 weeks. Our surgery rotation includes coverage of a
thoracic surgery service, which provides us with the opportunity
to perform tracheostomies in the OR and allows us to learn the
placement and management of chest tubes from thoracic surgeons.
We rotate through pediatrics at Hope Children’s Hospital, which
is really good. They have great specialists, especially
pediatric cardiology and oncology. The intern year also includes
2 weeks of anesthesia and we get to do all of the intubations
since there are no anesthesia residents. During our 3rd year,
we do one month of hand surgery, which is extremely useful given
the high frequency with which hand injuries present to the ED.
Most importantly, we’re well-respected on all of our rotations.
10.
What's the best elective you've done?
EMS
is the best elective I’ve done. At Christ, you can tailor the
EMS rotation to your specific interests and get what you want
out of it. We’re one of the regional hubs for EMS, as well as a
major EMS training center. We get a lot of the base calls and
give medical direction over the radio. We also participate as
instructors in the EMT training courses. Toxicology is also very
popular, as are the ED administration rotation, EM research, and
dive medicine. Some people have also gone abroad to
Africa, Nepal, and Australia for
elective experiences.
11. How
much does your program focus on research?
The
good thing about Christ is that there is minimal pressure to do
research, but our department definitely has the material and
expertise to provide us with the resources to perform a wide
variety of clinical research. As with all other EM programs,
residents are required to complete at least one scholarly
project, but some people complete 3 or 4. We clearly have the
clinical material/data available for those who wish to work on
multiple projects. Four of our residents presented at SAEM this
year.
One of our
3rd year residents from last year, Greg Roslund, won
the SAEM prize for “Best Resident Presentation” in May 2006.
12.
What do you love and hate most about the city you're in?
I’m
from Chicago, so I’m biased. It’s a great city with a large
metropolitan area and tons of things to do. We have great summer
festivals, Cubs baseball, no shortage of sporting events,
several theaters and comedy clubs, the symphony, world-class
museums, great restaurants, and an eclectic cultural heritage.
Chicago itself and the surrounding metropolitan area both have
an abundance of nice neighborhoods. As for things I don’t love,
the winter can get a little long and it can get pretty cold. As
with other major cities, the traffic is painful sometimes.
13.
Please describe your typical month in terms of work hours and
days off.
In
the ED, all residents work eighteen 10-hour shifts over the
course of a 4-week block. We also have completely protected
time for conference every Tuesday, regardless of which rotation
you’re on. I probably end up working approximately 50-55 hours
per week. We also have the opportunity to moonlight in the
cardiac observation unit to make $500-$700 per shift depending
on whether you’re an intern or a senior resident. I’ve never
had any issue with work-hours violations while off-service
either. I averaged about 70 hrs per week while off-service.
14. How
much time do you spend off-duty with the other residents?
I’m
married, so my time off is mostly spent with my wife. But, I
also went on a trip with my class to an EM conference, and we
often hang out after shifts or go out to eat.
Sometimes, attendings will come with us and occasionally treat us to
breakfast or dinner.
We also have a lot of social events, going away
parties, graduation dinners, Cubs games, etc. About half of our
residents are married, and some have kids, but all of us get
along very well.
15.
Do you have any international experience?
I’ve traveled
extensively, but not during my residency. Other residents have
done international rotations in Africa, Australia, Turkey, and at
one of the base camps of Mount Everest. Some of our attendings
just climbed Mount Kilimanjaro.
16.
What are your plans after residency?
I
plan to look for a job in or around Chicago, but I’m also
considering applying for our ultrasound fellowship.
17. How
prepared do you feel?
I
still have almost half my ER shifts ahead of me during my 3rd
year, and I believe that you can always learn more, but I feel
quite confident now managing patients in the ER. I’m currently
rotating in the PICU, and it’s making me feel much more
comfortable dealing with critically ill kids in the ED. I’m very
confident that my residency training will provide me with the
skills I need to be an exceptional emergency physician.
The way
that our program is structured, we see 1000-2000 ED patients our
1st 2 years, and we see about 1500-2000 more during
our EM 3 year. This year 11 people graduated in June and they
were all ready to practice independently.
18. Do
you have any advice for current applicants, or is there anything
you wish you'd known when you were applying?
Most of the programs will teach you emergency medicine, so to
choose a program you really need to find a place where you think
the residents are happy. Watch how they interact with each other
and if they are available to spend their free time with the
applicants. Also ask a lot of questions and do some
research on each program before you interview there.
At Christ,
we have websites for both students (chicagoem.org) and residents
(christem.org) to learn more about our program. We have been
told by several students that we have the best medical student
website out there.
