1. What makes your program different from
other programs, or what made you choose your program?
This is one of the
busiest community hospitals in the nation with a fascinating
variety of pathology. The program is predominately resident run
which gives you some freedom that you don’t necessarily have in
other programs. At the end of your intern year, you will have
done more procedures than many have done in their entire
residency. If you want to train in a place where you will have
to work hard for three years but that at the end you will know
you can handle anything that comes through the door then this is
the place.
2.
Are there any major upcoming changes to your program?
Simulations are becoming a larger and larger portion of
our didactic experience. We currently have two sessions a month
where difficult airway, ACLS, ATLS, pediatric resuscitations,
obstetric difficult deliveries, toxicologic exposures, disaster
medicine, and chemical warfare cases are performed. Our
simulation lab features high-fidelity models that can mimic
almost any human physical condition, complete with monitors and
standard resuscitation equipment. This 7,000 square-foot area
occupies a former hospital emergency department located next
door to the main hospital.
3. Is there
anything you would change about your program if you could?
I think we have a great program here in
Jacksonville. As chief
resident, I am always looking for ways to improve things. We
have quarterly meetings with the residents only (no attendings)
to discuss anything that needs to be improved. One example
recently was the addition of new computers and new paint in the
EM resident lounge.
4. How much are
you responsible for blood draws, putting in IVs, etc.?
You are the go to guy when the nursing staff fails to
get access. This gives you the opportunity to perform multiple
external jugular attempts, central lines, and ultrasound guided
peripheral access. As far as routinely drawing blood, starting
lines, EKGs, etc. our nursing staff and tech staff are great and
for the most part you will rarely perform any of these
procedures.
5. Do you learn
mostly from attendings, other residents, or textbooks? Does this
vary when you do off-service rotations?
This is a resident run Emergency Medicine Program,
therefore a lot of your learning does come from the chief
residents and third year resident staff. However, three times a
day there are extensive rounds on all of the patients in the
Emergency Department that are lead by the attending staff which
offers a great didactic experience. The attendings are always
available and interacting with the residents during their
shifts. During rounds, one resident is assigned to present a
short discussion on a topic that he or she has read recently.
This was initiated by the residents themselves, and provides a
great addition to the academic focus of this program.
6. How does EMed
rank in your hospital's hierarchy?
In the top if not at the very top of the hospital’s
hierarchy. We run traumas, codes on the floor, and when ICU
services need airway help on difficult cases we are called – not
anesthesia!
7. What are the
perks that your school provides (PDAs, textbooks, conference
fees, meal tickets, etc.)?
All first year residents receive a new PDA, book
stipend, yearly meal tickets, conference fees, scrubs, an EKG
book, an Introduction to Clinical Medicine book, and lab
jackets. Health insurance is free for residents and their
family members, and it pays 100% within the UF system, 80% out
of network. For example, I did not have to pay a single penny
for my wife’s prenatal care, childbirth, or my child’s pediatric
visits – something you appreciate more when you see the amount
of the bill!
8. How do you
rate your rotations outside of the emergency department?
Our ICU rotations are incredible! During the
anesthesia rotation you have the opportunity to intubate
neonates. We perform all deliveries on our Obstetrics
rotation. IM, Ortho, and other off service rotations are
excellent as well. We are incorporated as an essential part of
the team and really get to participate (as opposed to observe)
in patient care.
9. What's the
best elective you've done?
As a second year resident I haven’t had an elective
yet, however my best rotation was managing a medical intensive
care unit for a month.
10. How much does
your program focus on research?
All residents are required to perform a scholarly
project. For those residents interested in performing
additional research during their three years the faculty are
very eager to help in designing studies, IRB approval, and
publication of the projects.
11. What do you
love and hate most about the city you're in?
Jacksonville is located on the beach, can I say more!!! It is
the largest city in the United States which means that it is
very spread out which can leave you driving across town on many
occasions. However, traffic is still much better than in other
large cities in the USA.
12. Please
describe your typical month in terms of work hours and days off.
Interns work 21 – 23 twelve hours shifts (about 25% of
these are actually 8 hour shifts), second years 18 – 20 eight
hour shifts, and third years 14 – 16 eight hour shifts. There
are three vacation weeks throughout the year and our program
strictly follows ROC Emergency Medicine Resident Duty Hours
Requirements (i.e. always less than 60 hours a week).
13. How much time do
you spend off-duty with the other residents?
Living in a beach town there is always something to
do. Generally there are at least two to three days a week that
the residents do something. Being a larger residency program,
you never have a hard time finding someone to go out and do
something with.
14. Do you have any
international experience?
One of our faculty members has just started our International
Emergency Medicine Experience which will be offered to residents
interested in international medicine.
15. What are your
plans after residency?
Academic Faculty Position
16. How prepared
do you feel?
Shands Hospital is a community program with 100,000 annual volume and a
Level
One Trauma
Center. By the end of your second year, you have run innumerous medical,
pediatric, and trauma resuscitations. You have learned not only
how to handle the sickest patients but also how to handle 8 of
them at one time. Starting my third year I know I still have a
lot to learn but I know that I am able to manage patient flow
through one of the busiest Emergency Departments in the nation.
17. Is there anything
you'd like to tell us that we haven't asked?
This is one of the busiest community hospitals in the
nation and we work hard. At the end of three years you will
know without a doubt that you can handle the sickest patients,
proficiently perform procedures, manage difficult airways,
manage the sick infant, and what is more important – you will
know how to do all that while running an entire Emergency
Department. This program is not for everyone, these patients
have amazing pathology but there are always five more of them
waiting to be seen, so if you are looking for a slower pace this
may not be the program for you. That being said, there isn’t
another place in the nation where I would rather train!!
18. Do you have any
advice for current applicants, or is there anything you wish
you'd known when you were applying?
Don’t stress about the process. Find a place that fits your
personality – you’re going to be there for at least three
years. If you are really interested in a program, make sure you
spend some time there so they get to know you. It definitely
helps when it comes to the programs ranking applicants.
