Medical Student Council, Medical Students, Advising, Match, Program Director Interviews

Program Director Interview Series: Jessica L. Smith, MD | Brown University's Emergency Medicine Residency Program

This month our Program Director Interview Series turns to the Northeast. We spoke with Jessica L. Smith, MD, FACEP, Program Director of  Brown University’s EM residency, about the opportunities available in Rhode Island.

What sets your program apart from others?

I think what makes us unique and special is just the sheer amount of opportunity we have available to our trainees. We pride ourselves on our ability to develop amazing clinicians, scholars, and leaders in EM. Whether you know exactly what you want to cultivate during your time with us, or if you are open to anything and everything, we have a strong track record of taking your game to the highest level you desire.

It starts with an outstanding clinical environment, where our residents have exposure to more than 250,000 patients per year with every type of pathology imaginable. With the area’s only Level I Adult and Pediatric Trauma Centers, we are considered “the only game in town,” and our residents can’t help but leave here extraordinarily well-trained in EM. But they also have outstanding professional development in clinical and academic niches. Our 4-year longitudinal curriculum allows residents to find themselves during training, at a rigorous but manageable pace, so no one is chewed up and spit out during the process. We set our residents up for success in whatever type of practice environment they will choose upon graduation, and they have all found their top choice jobs across the country post-residency.

What are the benefits of attending a 3- vs. 4-year EM residency program?

Aaah, the age old question. There’s no right answer, and there’s no one-size-fits-all model, which is why EM still offers these two options. One thing to weigh heavily is how the curriculum is actually structured, since you will learn EM in either path, but HOW you learn it will be different not only in the different models, but even across Programs of equal length. At BrownEM, we developed a longitudinal 4-year curriculum with increasing elective time further along in training after the basic foundations have been built. This allows us to maintain a model of graduated responsibility, but gives residents ample opportunity to “choose their own adventure” during training to develop a niche, take coursework towards an advanced degree, develop advanced skills in various EM subspecialties, or dive into a big academic project.

The decision of “3 vs. 4” can seem like a big one, but in the grand scheme of things, the most important factors to consider are different and personal for everyone, especially when you think about the long EM careers that await you after training. You owe it to yourself to get the best training possible, in a place with the right fit, with the opportunities available that make sense for you to support your lifelong commitment to EM. So instead of asking yourself 3 vs. 4, ask yourself, is this the place where I will be able to become the best version of myself as an emergency medicine doctor?

What is something students may not know about your program?

We are the best kept secret on the East Coast! We have all the volume, grit, and clinical pathology of a County program, backed with the financial support and academic rigor of the Ivy League. We also have one of the largest academic EM faculties in the country, who represent a massive depth and breadth of experience in almost every EM niche imaginable. 

We serve a diverse patient population, and as the safety-net hospital of the region, we serve a huge catchment area that includes the entire state of Rhode Island as well as parts of Connecticut and Massachusetts, so we see not only the complex medical and surgical patients who are referred to our tertiary center, but we also see indigent care, and the full range of socioeconomic classes in our EDs. Our residents also run the codes, do the intubations, and run the traumas for our ED patients. 

Our hospitals are top-ranked, and we have all the bells and whistles needed to provide world-renowned care. As an example, at our main teaching site, we have a Cath lab in the ED, an MRI in the ED, we are the state’s only designated Comprehensive Stroke Center, and we have some of the fastest door-to-balloon and door-to-needle times in the country.

Outside the clinical environment, Providence is a fun, very affordable, livable city, with little to no commute time, a great culinary scene, and tons of outdoor activities to enjoy in all 4 seasons...and everything you need is less than 15 minutes away. Our residents are laid back and know how to have fun, and although they come from all parts of the US, they quickly become great friends with each other during their time here at BrownEM. We believe in teamwork and collaboration, and we all enjoy being a part of the close-knit family of BrownEM. Each year the interns have the same week off after finishing PGY1, and this year they are headed to Belize to celebrate together. Year after year when they decide to take a trip together, we consider it a great sign of how well our residents are bonding with each other.

What range of USMLE/COMLEX Step 1 scores do you look for in an applicant for the program?

We recognize USMLE scores as only one small part of an otherwise massive application, which we review in its totality. We do expect all applicants to take (and pass) Step 1 (as well as the remaining USMLE Steps along the way). If there is a wide discrepancy in the score vs. the rest of the application, we would expect that to be explained somewhere, like in the personal statement. That being said, most new interns we Match score above the national USMLE averages.

What kinds of opportunities for research exist? Do you look for residency candidates with research experience?

We have so many opportunities for research here! We are amongst the top tier NIH funded universities in the US, and we have faculty mentors with K and R01 funding, an army of research assistants, and there is active bench, clinical, medical education, global health, and EM subspecialty scholarly productivity (and more) going on around every corner. Many of our faculty have won national research awards for their expertise and mentoring. Residents all have different interests, levels of experience, and desire for exploration, and have mentors for small and large projects. There are so many different ways to define scholarly productivity these days, and our residents run the gamut.  No matter your interest, you will likely get inspired here, even if you don’t think “research” is your thing. Research experience is certainly not a prerequisite for consideration for an interview with us, but much like every other part of the application, it is yet another piece for us to weigh in the totality of an applicant’s materials.

Do you have opportunities to explore global health at your institution?

Absolutely! We have a Division of Global Health, a Global Health Fellowship, active Global Health research, as well as fully funded opportunities for residents to explore Global Health in many different ways. In addition to the multiple core EM Global Health faculty, we work with adjunct faculty in other departments, and residents can join the interdisciplinary BRIGHT (Brown Residency International Health Training) Pathway to earn a Distinction in Global Health upon graduation. Our core sites include Rwanda, Kenya, American Samoa, and Colombia, and we have faculty working in Belize, Ecuador, Bangladesh, and Liberia - among many other places. Our Global Health experiences are some of the most beloved opportunities our residents take advantage of here at BrownEM.

What are some qualities that your program looks for in applicants?

There’s no one “type” of resident we are looking for to join our team. We want to build a diverse group of well-rounded residents who represent all parts of the country, who have various interests, coming from various backgrounds, who represent our diverse patient population. We especially want intelligent and motivated folks who are ready to be shaped and molded by an extraordinary network of peers and mentors. We value hard work, service, leadership, and scholarship, with a commitment to learning and giving back to the community.

Can you describe any attributes and qualities that make applicants stand out?

As we are a “liberal arts” EM Program, anything goes! We want humble, mature, smart, genuine folks who would be considered “salt of the earth.” We are always impressed with folks with life experience or who experienced hardship/demonstrated resilience, which is likely a good predictor of doing well in residency training anywhere. BrownEM is great at harnessing potential, so if you have a fire in your belly, we are here to fan the flames. Having a passion about something, and being open, ready, and mindful of the road ahead during training goes a long way to make an applicant stand out.

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