In the latest installment of our PD Q&A series, we are highlighting the University of Cincinnati College of Medicine Emergency Medicine Residency program. We spoke with the current PD Dr. Erin E. McDonough about what makes their program unique and what they look for in potential residents.
What sets your program apart from others?
I think that our residency has three very unique characteristics. First, we have a graduated responsibility model at our primary academic site designed to consolidate learning procedural (R2), resuscitation (R3), and supervisory skills (R4), so that residents get a lot of reps of each in a defined time period to build muscle memory and allow residents to incorporate recent feedback. Residents still get procedural and resuscitative experiences through all four years at our community sites, but the graduated responsibility model really reinforces learning those critical skill sets. Alumni feedback routinely states, "Whatever you do, do not get rid of the graduated responsibility model!" Second, we incorporate leadership development into our curriculum, as this is one of our core values as a training program. We believe leadership development is critical to being a well-trained Emergency Physician and so all residents get some element of intentional leadership development no matter what their potential career path may be. Lastly, our residency program is well integrated into our HEMS program, Air Care. Unlike many other residency programs with HEMS experience/exposure, all of our residents serve as members of the flight team, and the majority of Air Care flights in the Greater Cincinnati region carry a resident-nurse flight team.
What are the benefits of attending a 3 vs. 4 year EM residency program?
Ultimately, the decision on a training program is a very personal one and “fit” is often a gut feeling that shouldn’t be ignored. That being said, I am a big fan of four-year programs because they offer the opportunity for a deeper dive into both clinical training and professional development. There is a ton to learn these days in Emergency Medicine—much more so than way back when I was an Emergency Medicine resident. A four-year program offers time for more clinical experience, which is really more opportunity to practice with the benefit of the safety net of residency training. This includes more patient care touches, more procedural experience, and more exposure to subspecialties whose patients often start in the Emergency Department. We frequently talk about the stress and anxiety of transitioning to independent practice and a four-year program makes that transition less uncomfortable. Also, a four-year program often provides the benefit of more elective time. We encourage our residents to use elective time for professional development to explore possible careers/niches within Emergency Medicine and then subsequently develop the skills/experience to be successful in their chosen niche. In our program, we also use the fourth year to provide our residents with the opportunity to supervise and teach junior residents. This is a skill necessary for both academic and community-based careers, as most Emergency Physicians will find themselves in the supervisory role, be it medical students, residents, or advanced practice providers. My residents generally find themselves greatly appreciating, and not regretting, the fourth year as they become senior residents.
What is something students may not know about your program?
Our program prides itself on its family atmosphere. We treat each other and our families as part of our extended family. Whether we like it or not, life (good and bad) still happens during residency and we strive to support each one of our residents through everything that life throws at them. Residents’ significant others are often as deeply intertwined into the social structure of the residency program as the residents themselves. One of the most common points of feedback that I hear from applicants, particularly those who come for an in-person visit, is how surprised they are to see the extent of our family atmosphere and how truly genuine it is.
What range of USMLE/COMLEX Step 1 scores do you look for in an applicant for the program? Or alternatively, how do you feel about the change to pass/fail Step 1 grading?
We have never really placed much emphasis on Step 1 performance. We never had a cut off for Step 1 performance and so the change to pass/fail did not have any impact on our application review. We want you to be able to pass it, as then you are more likely to pass future tests such as Step 3 and the ABEM Qualifying Exam, but otherwise we have always placed more weight on cumulative performance rather than any one-day effort. Life, and career, is a marathon and not a sprint.
What kinds of opportunities for research exist? Do you look for residency candidates with research experience?
Research is not a “must-have” experience for us, either before or during residency. We look for residency candidates with leadership potential of any kind rather than specifically research experience, although we do have good support and infrastructure to support residents with an interest in research. In addition to having a resident research grant for which residents can apply, we also have a Resident Research Track, which is a pretty intensive program allowing a resident to earn special recognition and graduation with distinction. Residents who complete it do not necessarily have previous research experience and all of them have used it to help launch academic careers. Our Department also has its own research staff, including an amazing biostatistician.
Do you have opportunities to explore global health at your institution?
We have had a number of residents pursue global health experiences while in residency, some of whom go on to complete global health fellowships at competitive programs. We have an endowment that provides financial support for residents to pursue global health experiences and residents have used elective time to take the Clinical Tropical Medicine course at the University of Minnesota and subsequently take the CTropMed exam. Recent recurring trips have included programs in Tanzania, Guatemala, and Uganda, although we have also supported resident trips through other academic centers/organizations.
What are some qualities that your program looks for in applicants?
Overall, we are looking for applicants who have demonstrated strong clinical skills (particularly on Emergency Medicine rotations) and leadership potential as a medical student, although there is certainly more to it than that. I am also looking for strong work ethic, dedication to service, and those who value teamwork and the team over any self-interests. These are qualities that we look for in applicants but then work hard to further instill in our residents over their four years with us. I would like to think that these qualities define our program’s culture.
Can you describe any attributes and qualities that make applicants stand out?
Emotional intelligence is something that is very difficult to teach and often lends itself to enhanced insight into oneself and Emergency Medicine that those without it often never gain. This lends itself not only to leadership but also to having a growth mindset, and it always impresses me when it comes across in an interview (which is not easy to do).