1. What makes your program different from
other programs, or what made you choose your program?
I
wanted to learn Spanish; about 40% of our patient do not speak
English. Also our acuity is very high because no one has
insurance, a PCP, or is an American citizen, so they do not
qualify for basic services such as dialysis or cancer
treatment. Although we are full of level one blunt trauma we
see few stabbings and shootings. Therefore we go
to St Josephs hospital in Phoenix for 2 months of 80 hour per
week, on call q3, 20 admits per night, list of 60 patients, uh,
fun.
2. If not
answered above, what's the best aspect of your program?
As
above plus the broad spectrum of disease - "incidental finding"
of cystercircosis, amoebic liver abscesses, botched Mexican
surgeries brought here intubated by private car...we also get
tons of procedures (I had everything I needed to graduate by the
2nd month of my 2nd year). There is no hierarchy for
procedures, so if the patient is yours, you get the tube,
central line, and anything else necessary. Senior residents
often give away procedures to junior residents as well. We also
have paid moonlighting in our own ED on the weekends and nights.
It is an urgent care type setting and you present to attendings
the same as if you were working a regular shift. This currently
pays $70 per hour.
3. Are there any
major upcoming changes to your program?
Not
that I know of at this point, however we will have a new ED
director as of Jan 07, so who knows.
4. Is there
anything you would change about your program if you could?
Too
many patients with too few residents. Although we only see
about 75K per year, we have 24 total ED residents.
5. How much are
you responsible for blood draws, putting in IVs, etc.?
Never. Not foleys, no transporting, no splinting (once you have
your quota - i.e. the end of your first month). The nurses will
even get your suture trays for you.
6. Do you learn
mostly from attendings, other residents, or textbooks?
I
don't learn from reading (remember this is a basic psych
question) so luckily for me, our attendings and other residents
do most of our teaching.
7.
Does this vary when you do off-service rotations?
Yes,
and it depends on your attending. I think this is universal.
8. How does EMed
rank in your hospital's hierarchy?
The
top by a smidge over surgery (we are NOT a part of surgery)
9. What are the
perks that your school provides (PDAs, textbooks, conference
fees, meal tickets, etc.)?
$440
in free food per month if you keep your charts up to date (the
ER coders bring all ER charts to you which helps with this a
lot) - I have never spent more than $300 and that was my 80 hour
per week 3 meal a day SICU month. You get either Rosen’s or
Tintanelli plus $100 per year. Board review in third year is
paid (we all go to Vegas because, well, what's there to do in
Ohio?) also, if you are interested in other conferences you can
pretty much go if you have the time.
10. How do you
rate your rotations outside of the emergency department?
Some
are great, some so-so. Again it depends on the attending (had
one great MICU month, one fair).
11. What's the
best elective you've done?
We
do most electives 3rd year so I can't say, but we do have the
option to go to Hawaii for hyperbaric medicine with flight, car
and apartment paid. We are working on a similar thing in the
Virgin Islands and/or
Puerto Rico.
12. How much does
your program focus on research?
Too
much for me because I don't like it. Basically you can get tons,
but the minimum you have to do is take 2 statistics tests, a
performance improvement project, a research project, and a CAT.
13. What do you
love and hate most about the city you're in?
Truthfully, I do not like the city, it's too far away from my
family and the only thing to do when you are working nights and
have a "day" off is go to Walmart because it is the only thing
open after 10pm. There are also very
few non-Mexican food restaurants and only 3 major movie theaters
(for a city of about 700k). But, it is never colder than about
40, and if you park in the shade you car is cool even in the
summer since there is no humidity (which does mean you must buy
lots of lip balm and get a few bloody noses the first few months
here). Also, my 3-2-2 2100 sq foot house on the good side of
town cost $120,000.
14. Please
describe your typical month in terms of work hours and days off.
We
work 16, 12 hour shifts per month, no more than 5 in a row,
usually one switch between night and day shifts (so 2 weeks of
each) you can request one week off per month in the ED (and
usually get it). So there is no 3 weeks vacation per year, just
work all 16 shifts in 3 weeks and get 4-8 weeks off depending on
how many ED months you have.
15. How much time
do you spend off-duty with the other residents?
A
lot of our residents are great friends and go to Mexico and
movies together. We also have quite a few parties. We all joke
around constantly as well. Our Dr’s lounge in the ED is where
our computers are and where we present cases. It is private so
we always have fun even on the worst level 1 trauma and medical
days.
16. Do you have
any international experience?
Our
whole residency is an international experience. But we can go to
San Miguel but you will not be covered by insurance (which does
not matter in Mexico because they cannot sue the doctors there)
and you may not get your monthly paycheck.
17. What are your
plans after residency?
Move
to my home town in Texas and work in a level 2 trauma center
(surgeons take over the level 1's).
18. How prepared
do you feel?
I
have only seen one sickle cell patient, about 3 clotted dialysis
caths, and a dozen COPD exacerbations, but other than that I can
take on the world.
19. Is there
anything you'd like to tell us that we haven't asked?
We
have few subspecialists here. We decide if thrombolytics are
needed and give them, we treat potassium of 8 in renal failure
and put in the quinton caths, we reduce fractures, use the sono
machine for trauma, ob, and gallstones daily. VERY important -
if you do not want to treat illegal aliens or learn Spanish do
not apply, you will make your life and the life of those around
you miserable. Also, our ED is divided into "women with
abdominal pain/vag bleed and kids" and "everything else". There
are not separate surgical ED, psych ed, or trauma ed. You do it
all every day.
20. Do you have
any advice for current applicants, or is there anything you wish
you'd known when you were applying?
48
residents seeing 100k patients is very different from 24 seeing
75k. Also, if the program has every subspecialty ask if you
will ever get to thrombolyze an MI, put in a quinton cath,
consious sedate and reduce fractures - if not, you are severely
missing out.