Non-VSAS Rotation Option

This time of year many applicants are frustrated by their lack of progress getting EM Away elective rotations scheduled.  Looking at non-VSAS sites can work really well.  And this service we just heard about might help too.

Robyn Hoelle, the program director from North Florida Regional Medical Center in Gainesville sent this out:
I wanted to make sure that all of you out there who are mentoring students looking for EM rotations knew that many of us have withdrawn from VSAS. We are a part of Clinical Nexus which manages our rotations. There are 60 Hospitals on this system and the students only have to put in one application to be able to apply for rotations in all of the participating hospitals. It is free for the students. 

We don't know much about this resource, but it could be really helpful to those looking for rotations in the Southeast. Please share your experiences using Clinical Nexus in the comments.  

EM Rotations - getting in and getting it right

This data driven guide will walk you step by step through your EM application
The active hyperlink is below

Getting In:
If you haven't already you should be applying to and beginning your EM rotations ASAP. Data supports doing two EM rotations at programs with residencies between May and October. This allows you to have 2 SLOE included in your application, which is what program directors look for and trust as a reflection of your strength within EM.

Current map of open positions in June through September

If you haven't already used EMRA Match Clerkship to look for open rotations - there is a feature that will actively update open spots so you can apply to programs that have openings. If you are having trouble getting two rotations look in the Southeast, Midwest, and Southwest as these locations have more open positions for visiting students.

This filter allows you to search for programs that will
offer and interview with your number of SLOE

If you will only have one SLOE on September 15th - use the EMRA Match Residency filter to search for residencies that review applications with one SLOE and strategize to apply to these rather than programs that are less likely to review your application.



Getting it Right:
SLOE letter writers want to see rotators who perform well clinically, have no professionalism issues, and actively apply feedback.

The secret to performing well clinically is easy - learn to give a great EM presentation. Succinct, EM directed, focused on worst first differential for this patient's chief complaint. After giving a great presentation own your patient - know the labs, recheck interventions, review radiographs and be one step ahead.

This video does a great job of summing up all you need in your presentation and is worth the watch

Be Professional - show up early, never lie (even when you forgot to ask or look - acknowledge and correct), be eager at all times. This includes non-clinical responsibilities as well as clinical. It is just as important to ask questions and appear interested even during the less engaging didactics - that teacher likely still has a lot to share.

Feedback - If you can accept and actively apply feedback you are teachable and can improve from whatever level you are currently performing at. If you can't, you may never get better than your current level. Those who are hard to teach are going to receive poorer letters because the ceiling on their EM trajectory is low. Listen, Accept, and Apply the near constant feedback you are getting. It may not seem it but you are always getting feedback, it may not be overtly labeled as feedback. The supervisor who is typing, texting or dictating while you are presenting is not engaged. You aren't telling the story in a way to gain their attention. Pay attention to tone, facial expressions and spoken feedback. You are getting feedback all shift long - notice it and act.

Lucienne Lutfy-Clayton is an APD and Education Fellowship co-Director at UMMS Baystate
She has sat through approximately 10,000 lousy disengaging presentations and literally jumps for joy when she hears a good one - make her happy

New Program in Pennsylvania - Recruiting for THIS JULY?

A new Emergency Medicine residency program just announced receiving accreditation and are considering recruiting a class to start THIS JULY (2019). 

From their PD:

I am happy to announce that UPMC Pinnacle (located in Harrisburg, Pennsylvania) has received Initial ACGME Accreditation for a new, 3-year EM Residency program for a total of 18 residents.  The residency will be based at UPMC Pinnacle Harrisburg Hospital.  Our team has been providing bedside teaching and EM-training to medical students, off-service residents from within our own institution, and EM-residents from a neighboring program for many years and has now taken the next step to start our own residency!

We are considering the possibility of accepting residents starting this July.  If you are aware of any interested candidates for an EM residency beginning this summer, please share with them this opportunity and my contact information.

https://www.pinnaclehealth.org/professionals-and-job-seekers/graduate-medical-education/emergency-medicine-residency-program/directors-welcome

 

We are incredibly excited to start training our own residents and look forward to working together with all of you!

Sincerely,

Erik

Erik Kochert, MD, FACEP

Emergency Medicine Residency Program Director

UPMC Pinnacle

Department of Emergency Services

111 South Front Street

Harrisburg, PA 17101

Erik.kochert@pinnaclehealth.org

T (717)782-5206

C (267)254-7378

F (717)782-5716

New Program: Orange Park Medical Center in Florida

Here is the information from a flyer sent out by Dr. Steve Warrington, the Program Director of the new EM Residency at Orange Park Medical Center.  They are now in ERAS and are looking to match their first class this year:

Orange Park Medical Center

Orange Park, FL (Southwest corner of Jacksonville)

Highlights:

·      Volume ~115k between main campus and freestanding ED (~10 min drive)

·      Level 2 trauma center with helipad

·      Comprehensive stroke center with neuro-interventional

·      Chest pain center

·      Facility has its own PICU

·      Level 3 NICU to be completed spring 2019

·      Second FSED opening up in March 2019

·      Integrating advanced technology throughout the institution.  Some of the examples include:

o   RFID tracking

o   Electronic communication boards in patient rooms integrated with RFID tracking and EMR (i.e. Dr. X entered the room, 1/3 test results are back)

o   Hand sanitizers linked to register badges nearby when used

o   https://orangeparkmedical.com/campaigns/hospital-of-the-future is a link to a video that shows some of the capabilities for those interested.

·      Attendings from (15+) different EM residency programs provides exposure to different practice styles and approaches

·      FL has no state income tax

·      Located 45 minutes from the beach

·      Located 45 minutes from the airport

·      Only 2 weeks are scheduled outside of OPMC, and those are at Memorial Hospital ~30 minutes away.

Other Residency / Fellowship programs:

·      Approved: FM, IM, TY, Psych, Derm, Cardiology, Palliative care

·      Awaiting decision: GS, Clinical informatics

Residents are provided:

·      Laptop

·      Smartphone

·      Meals in cafeteria (not limited such as ‘on-call meals’)

·      Along with general / competitive resident stipends / benefits

Schedule on 13 blocks:

PGY-1: Orientation/EM, T/SICU, P/NICU, Anes/US/Res, OB/CT, EM

PGY-2: T/SICU, MICU, US/EM/Res, Elective, EM

PGY-3: ICU-elective, US/EM/Res, Admin/EM, EMS/Education/EM, Elective, EM

Steven Warrington, MD, MEd
EM Residency Program Director
Orange Park Medical Center 
Orange Park FL
SWarring@neomed.edu

The Making of a Rank List

As interview season comes to an end it is time to think about what you need and want, and begin putting your rank order list together. First make sure you know the process and important dates. This year the Rank Order List Certification Deadline is FEB 20 at 9pm ET. Go over how to input your rank order list into R3(NRMP Registration, Ranking, and Results).

In recent years we have covered composing your rank list in great detail, go ahead and review the data and approaches you can take. This was written by Tony Zhang, an Emergency Medicine Education Fellow and member of the CORD Advising Student Committee in EM. A version of this guide is part of the CORD SATF Applying Guide to Emergency Medicine.

Last year EMRA published something similar using a survey of residents training in Emergency Medicine and drawing themes from those responses. They do a nice job showing the variety of different viewpoints and approaches that can be taken in creating a Rank List.

No two people approach their rank list the same way for good reason. This is all about you and your best fit. Many of you are starting to second guess your top programs. This is normal. Everybody does this. You hear from friends, advisors, and deans, and they all have different opinions on where you should go. Remember to focus on what YOU want, above all else.

Think about the top 3-4 programs on your list. Picture them in your mind and see which one causes the biggest smile to split across your face. That is your number one. Stop perseverating - that is YOUR number one. 

When deciding the order of the next few programs, continue to follow your heart. The Match is student weighted, so you get preference. The order you rank the programs matters. You want your list to reflect your true desire to train at the program. Put the spreadsheet down, stop talking to everyone, and focus on how you feel overall about each program. Above that, these are the common pitfalls to avoid:

Squirrel - Being distracted by shiny objects 

Many of the superficial attributes of a program are not going to determine if you are satisfied with your experience training there. You will spend the bulk of your time in the ED, focus on how that learning environment will work for you. 

Location is really important for most people. Though being in a location that others think is cool, but you don’t see yourself in, shouldn’t count as an asset. 

Glossing over glaring negatives

There are only a few things in a program that will have an enormous impact on your training experience:

Program Director - If you didn’t click with the PD- think hard before ranking this program highly. This is not a person you can avoid.

Residents - If they weren’t really happy, or you don’t see yourself as a part of their group, this is not the program for you.

Curriculum - ensure the educational approach, the design of the rotations, and the responsibilities on shifts match up with your needs.

Being Flattered by attention

Be careful to not allow a program’s perceived response to you influence your ranking. Many programs purposefully withhold telling students how well they were liked, while others may overestimate where you are on their rank list. This is a time to trust yourself and be wary of being influenced.

In the end you need to trust your gut, rank your programs in the order you want to be there. Keep in mind more than half of you will get your top choice, and 80% will get in your top 3. You have the control. Use it wisely.

New Program: Southside Hospital on Long Island, NY

Here is a message to the CORD-EM mailing list from the APD of a new EM Program in the 2018-19 Match:

We are very excited to announce that we are recruiting for our inaugural class for the new EM Residency at Southside Hospital in Bayshore, New York. Southside is part of Northwell Health and is a rapidly expanding tertiary care facility in Suffolk County, NY. Our first class will comprise of 6 residents, and the program will be for three years. We are currently ACGME certified and listed on ERAS for application purposes. Our state of the art ED just finished construction last year, and we are eager to begin educating the next generation of EM physicians!

Southside Hospital is the tertiary referral center for Northwell Health's eastern Long Island region and receives transfers of patients from community hospitals throughout the area. The Department is an American College of Surgeons level 2 trauma center, with in-house trauma surgeons 24 hours a day. Our hospital is recognized by the American Heart Association as Gold awarded STEMI institution, with 24-hour cardiac catheterization lab availability. We are also recognized by the American Heart Association as a Gold-Plus Quality Achievement, Stroke Elite-Plus Honor Roll Award for our Stroke care. Our hospital has comprehensive Cardiology and Cardiothoracic services, Orthopedics, Women's Health, Neurosurgical services, receives patients from the Northwell Imbert Cancer Center, and transfers from community hospitals throughout Long Island.

Twitter: EMSouthside
Website: BayshoreEM.com

------------------------------
Andrew Mastanduono
Associate Program Director
Southside Hospital

Great Question! - Cancelling excess interviews?

A fortunate student who received a lot of early interview offers asked...

I’m thankfully in a position where I have gotten a lot of interviews offers, including many of my top choices.

I’m starting to make a more concise top choice list of programs and want to begin releasing interviews that I am less interested in to make room for other applicants. 

I’ve read varying things about releasing interviews, with some suggesting you just cancel on interview broker and some suggesting you should email programs explaining as well. 

• Do you know which programs prefer? 
• Should I preemptively withdraw from any programs I have not heard from that are lower on my list than my current interviews?

These are great questions and I am glad you are thinking about purging your interview list.  

You can withdraw from programs lower down your list that you have not heard from, or simply wait to decline until they offer you a spot.  Waiting does not interfere with others getting interviews. 

You can just release/cancel interviews in ERAS or interview broker.  I would only email them if they handle all their scheduling themselves.  Nobody needs more email or phone calls this time of year.  Programs appreciate you giving us as much notice as possible to find someone else to fill that interview spot.  

- Adam