In the latest installment of our PD Q&A series, we are highlighting the Met-Harlem Emergency Medicine Residency Program. We spoke with the current PD Dr. Christina Ciraco about what makes their program unique and what they look for in potential residents.
What sets your program apart from others?
We are a program deeply rooted in service to the underserved, with mission-driven faculty and residents who are passionate about making a meaningful impact in our community. At the same time, they receive top-tier education and training in one of the most dynamic and diverse cities in the world—New York! At Met-Harlem, we take immense pride in the diversity of our residents and staff, intentionally recruiting talent from around the world because we believe that different perspectives enhance our ability to serve our equally diverse patient population in Harlem. What truly sets us apart is the unique blend of experiences we offer. Our program operates in three distinct settings: the community medicine focus at Metropolitan Hospital, the county experience at our level 1 trauma center at Harlem Hospital, and advanced PICU, TICU, and PEM exposure at our tertiary care center, Westchester Medical Center. As part of New York Medical College, we also benefit from strong academic resources and funding, equipping our residents with everything they need to succeed. The opportunity to train in such varied environments, coupled with faculty and staff from diverse cultural and training backgrounds, ensures our residents are well-prepared to thrive in any situation.
What is something students may not know about your program?
One thing students may not know is that we offer scholarly tracks to help our residents build a tailored academic portfolio based on their post-graduation goals. Residents can sign up for multiple tracks, whether they’re interested in administration, PEM, Critical Care, Social EM, Research, etc. We help them shape non-clinical work—such as lectures and research—around their interests, connect them with networking opportunities, and even allow them to create electives or influence didactics. Examples include designing medical student curricula, running resident simulations, chairing wellness committees, or leading diversity initiatives. It's like a mini-fellowship within residency, all focused on preparing residents with unparalleled credentials for their next step.
How do you feel about the change to pass/fail Step 1 grading?
In Emergency Medicine, we’ve always placed more value on Step 2, as it better reflects clinical skills and decision-making abilities that are crucial for residency training. That being said, we have mixed feelings about Step 1 being pass/fail. Since there is no grade on the exam, students can pass with a minimal score and not realize that they may have been studying ineffectively, then subsequently not performing as well as they could on the Step 2 exam. This gives a false picture of the applicant with a less than optimal Step 2. We have seen this numerous times.
What kinds of opportunities for research exist at your program? Feel free to comment on additional opportunities for resident education.
Our department has a research director, associate research director, and director of evidence-based medicine. Residents have the opportunity to participate in research projects, QI projects, 3D-printed simulation model production research, and journal clubs for EBM discussion. We highly encourage publication and presentation, and our program covers expenses for residents to present their findings at local, regional, national, or international conferences. As a reward, residents who present have all of their costs covered. We also offer a dedicated Admin/Teaching rotation where senior residents take two weeks off from clinical duties to mentor junior residents and medical students, contribute to didactics, and gain insight into department leadership. It’s an excellent opportunity to build teaching skills, enhance their resume, and experience the administrative side of residency and also gives them an opportunity to contribute to our didactics.
What are the benefits and challenges of completing EM residency in New York City?
New York is one of the most dynamic, diverse, and fast-paced environments you can train in. The city also provides access to top conferences, professional opportunities, and a vibrant cultural scene. From Broadway shows and museums to incredible food from every corner of the world (many restaurants are open 24 hours!), there's always something to do and see on your time off. That being said, the fast-paced, high-pressure environment can be overwhelming, and for many, living and working in NYC can be a culture shock. We particularly value applicants who have had exposure to similar environments, as they tend to adjust more easily. Working in the public hospital system in NYC is also a crash course in advocacy, as we often serve as primary care providers and patient advocates—especially in settings where staffing can be limited. The intensity can be demanding, but they build resilience and prepare residents to handle any situation in emergency medicine.
What are some qualities that your program looks for in applicants?
We take a holistic approach to screening applications because it takes a unique individual to thrive at Met-Harlem. We look for applicants who have a genuine passion for Emergency Medicine, are well-rounded, and have demonstrated a commitment to serving underserved communities through advocacy or outreach. Humility, resilience, and the ability to perform under pressure are also essential. Additionally, we appreciate nontraditional applicants who bring unique life experiences that enhance their readiness for the challenges of Emergency Medicine.
Can you describe any attributes and qualities that make applicants stand out?
Applicants who have shown commitment, resilience, and a clear passion for Emergency Medicine after transitioning from both careers in healthcare and careers completely unrelated to medicine both may tend to stand out. For example, someone who moved from a career as a paramedic—or from a field entirely different from healthcare—brings invaluable real-world experience and problem-solving skills that enrich both our program and the field.