Daniel N. Jourdan, MSIV, Brody School of Medicine at East Carolina University
EMRA MSC Southeast 1 Representative 2019-20
This month our Program Director Interview Series is focused on the Southeast. We spoke with Richard W. Stair, MD, Program Director of the Emergency Residency at East Carolina University about this what this rural, high-volume program has to offer.
What sets your program apart from others?
One of the most distinguishing characteristics of our program is its rural setting. This and our vast catchment area of 1,800,000 people mean our emergency department is busier and sicker than many comparable urban programs. In addition, because our hospital is medical school affiliated but separately owned, our program is more reflective of private practice while still maintaining many of the resources available to academically oriented programs. For example, because we don’t have residencies for anesthesia and orthopedics, our residents are provided opportunities to conduct procedures and skills that other programs may farm out to other specialties such as orthopedic reductions and difficult airways. This allows our program to better reflect and better prepare residents for what can be expected beyond residency. With that said, our program has many more similarities to other programs than differences.
What are the benefits of attending a three- vs. four-year EM residency program?
Obviously, the biggest difference is one less year of training. I’m currently unaware of any data supporting clinical differences in graduates of four-year versus three-year programs. So really the difference is what the specific resident makes out of the extra year of training. Individuals must determine what they will get out of any program they are considering, three- or four-year, and have a plan about how to achieve it. Fourth years do allow residents to become more specialized or develop a niche within emergency medicine, often serving as a potential pseudo fellowship, though without the formal recognition.
What is something students may not know about your program?
Probably everything. I think it’s impossible to convey via a website or social media what a program will be like. One of the hardest things during the interview process is having a four hour visit to a program and correlating that to what a three- or four-year experience will be like. What I will say is that I am honest and upfront about our program. If someone asks me what the strengths and weaknesses of our program are, I tell them. I hope by doing so, they can help us improve in some of our weaker areas. In turn, I expect candidates to be frank as well so that we can assist them in improving on their weaknesses. One thing our program does stress is that we are diligent about ensuring that every resident completes every stage of training on the appropriate timeline. Additionally, I believe some people are surprised to find that our patient population is not reflective of the small city in which we reside. While our catchment area is largely rural, our patient population is more reflective of an inner city both in patient population and acuity.
What range of USMLE/COMLEX Step 1 scores do you look for in an applicant for the program?
As a general rule of thumb, to quote Apollo 13, “failure is not an option.” Otherwise, we look at all aspects of an application. I personally take the time to review every applicant that submits to our program without screening out based on scores. We have even matched residents who have failed a USMLE Exam the first time and had them successfully complete our program. Just be sure that you have some lessons learned messages regarding any low or failing scores.
What kinds of opportunities for research exist? Do you look for residency candidates with research experience?
We do not specifically screen applicants for previous research experience, though it can be beneficial in the overall assessment of a candidate. We do have a research requirement as part of our program. Some places allow academic projects without a substantial level of rigor. Ours are required to complete an IRB and at least produce an abstract suitable for submission to a national meeting. We have a vast array of ongoing research projects including many in coordination with other centers on the national level. These include areas such as stroke identification and treatment, toxicology, EMS and prehospital treatment, and trauma.
Do you have opportunities to explore global health at your institution?
While we do not have a specific global health program established with outside areas, we do have many residents participate in global health projects across the globe during their elective periods.
What are some qualities that your program looks for in applicants?
We do not have a specific “type” of candidate. We take everything into account. Someone who scores well, can knock it out of the park clinically, who is academically curious, who can dive into literature, does research projects, and bakes cookies on Sunday for homeless kittens would be ideal. But we recognize that all the above is not achievable. The more skills and attributes you can bring to the residency, the more appealing you appear; the better you achieve the triple threat – clinical acumen, leadership skills and research abilities – the more attractive you become to residencies. Something we do look for is involvement outside of medical school. As well, someone who is well rounded while able to focus on completing projects as opposed to just being tangentially involved. We also look for candidates who have direction, someone who has a goal or goals they are working towards achieving.
Can you describe any attributes and qualities that make applicants stand out?
Work habits - I don’t necessarily need you to be the smartest, but I want to see that you can make up for it with work. Someone who takes the work exceptionally serious but their self – not so much. I also like eclectic people, someone who appears genuine versus fulfilling some sort of emergency medicine stereotype. I am searching for candidates who take ownership, are driven to make stuff better, and who can come to our program and leave it better than they found it.