Do your residents see enough patients?

Answer: Absolutely!  When considering total volumes at a potential residency training program, please keep in mind several things. First, remember that the patients per hour per resident is much more important than the total volume for any given ED or health system.  The literature has shown that an average EM resident will see close to 1 patient per hour as an intern, progressing to close to 2 patients per hour by the time they are ready to graduate.  Our residents easily see these average numbers per hour throughout their residency training.  The second consideration is the number of additional providers present in the ED also evaluating patients.  Our EDs are primarily resident driven, meaning that the residents do the majority of initial patient evaluation and provision of care.  There are no physicians in triage, attendings primarily evaluating patients, or a large number of midlevel providers to compete with.   Bottom line--you will see a large number of patients, many of whom will be critically ill, and exceed the national averages for procedural volume during your training at WVU.

Why do you do medicine night float?

Answer:  Simply put, medicine night float has been a resident favorite for years.  Unlike standard ward rotations, residents work autonomously with supervision from senior residents, interfacing with the emergency department for admissions and responding to emergencies on the floors during cross coverage.  This rotation allows EM residents to develop rapport and working relationships with our medicine colleagues and become familiar with standard inpatient treatment plans that are initiated for specific ED patient complaints.  Every year when this rotation is reviewed, the residents feel very strongly in favor of keeping it a part of our program. We currently combine a half month of night float with a half month of MICU, for an all-around fantastic general and critical care medicine experience.

What do your graduates choose to do after WVU?

Answer:  Anything they want!  We believe strongly in our mission to train residents to practice in any emergency setting.  Our graduates have an amazing track record of being able to secure highly sought-after academic positions throughout the country—including academic positions within our own institutions, as well as other elite institutions, including, but not limited to, Brown University, University of Kentucky, St. Louis University, and the University of California at San Diego. Additionally, residents have secured coveted fellowship positions in a variety of niches, including ultrasound, sports medicine, EMS, education/administration, international emergency medicine, both at WVU and across the country. We also have a large percentage of graduates that pursue practice in the community, rural, and hybrid EM settings, and have been incredibly successful in all arenas. Our widespread alumni and maintenance of close ties, enables our graduates to network and secure faculty positions across the country—east to west, from Denver, to Phoenix, to Miami, to Dallas/Fort Worth, etc.

Do your residents get enough procedures?

Answer:  Absolutely! Rest assured, you will meet and exceed national averages for all procedures during training at WVU.  Our department firmly believes in owning all procedures within the scope of EM practice.  While we consult when appropriate, the vast majority of procedures are performed primarily by EM residents.  Additionally, having many types of practice sites (i.e. academic, community, and rural) exposes our resident to procedural opportunities across sites, with some having very minimal consultant specialties and therefore, no competition for procedures.

How do residents receive feedback? 

Answer: We feel that effective feedback is essential to making you the best emergency physician you can be.  Frequent feedback is the norm, not the exception.  Residents receive feedback in multiple formats including—informal, real-time discussions, daily formative evaluation cards, post-resuscitation debriefings, summative monthly evaluations (EM and non-EM rotations),  360 degree evaluations (peers, nursing, patients, ancillary staff, medical command, care management, etc), and, more formally, during semi-annual reviews with the PD and/or APDs.  In addition, our culture supports the theory that feedback is a gift, is done in a constructive, nonjudgmental manner, and is readily available upon resident request if there is a specific area the resident would like feedback in.  Additionally, our program relies heavily upon the feedback of our trainees and considers ourself a very dynamic program—with the majority of changes to the program being driven by resident-initiated feedback.

Is there a USMLE score cutoff?

Answer:  We do not use a minimum score cutoff to select applicants for interview.  Board scores are simply a piece of the entire application, and while important, we review the entire application prior to making an interview invite decision. Rather than specific scores, we look at an applicant’s overall application and track record of academic performance to ensure success in training and beyond.

What type of resident is successful in your program?

Answer:  There is no stereotypical WVU EM resident.  In general, residents who are successful in any program are those who are willing to work hard, learn as much as they can, maintain the track record of our amazingly strong rapport within our institution, while ensuring their own personal wellness and professional development.  Our residents are always willing to lend a hand to their colleagues when they experience difficulty and work together as a team. 

What is the reputation of the ED at WVU?

Answer: Our department enjoys a strong reputation as a clinical department within the WVU Medicine system. Our faculty are highly respected within the institution and are often called upon to fill advanced and noble leadership positions. Our residents are well respected on off-service rotations for their diligent work ethic, impeccable clinical acumen, an “all-in” mentality, and team player attitude—serving as incredible ambassadors for our department. As a department, we are financially sound, clinically productive, and lead by departmental leaders that are incredibly supportive of the residency as the “jewel” of the department—allowing for additional departmentally funded opportunities—inclusive, but not limited to, PGY-1 travel to SAEM, PGY-3 travel to ACEP, sponsorship of residents presenting scholarly work—all in addition to the standard CME provided.

Do your residents pass their boards?

Answer: Yes, our residents graduate ready and able to pass both their written and oral exams and achieve ABEM certification. Both our oral and written board rolling 5-year average pass rates are well above the national averages. Residents are prepared for taking these exams during residency training, via oral board preparation sessions regularly scheduled in our didactics, including preparation for the new E-Oral Format.  In addition, for written boards, there are regularly scheduled board review sessions longitudinally throughout our annual didactic schedule and each resident gets a subscription to Rosh Review, an interactive EM board question bank. Residents enjoy this departmentally sponsored subscription during each year of training as they prepare for in-service examinations, as well as for 1 year after graduation, leading directly up to the ABEM written qualifying examination.

Are residents allowed to moonlight?

Answer: Yes. PGY-3 residents who are in good standing in the program and have made adequate progress on the annual in-training examination are permitted to moonlight. Our program supports moonlighting as an opportunity for resident autonomy, independent decision making, and a look at real-life EM practice after graduation.

Who runs the traumas?

Answer:  Our relationship with trauma surgery is very collaborative.  All airways in trauma are performed by the emergency medicine resident under the supervision of the emergency medicine attending.  The EM resident works alongside the trauma team to help direct the resuscitation and perform indicated procedures, including central line placement, ultrasounds, and chest tube placement.

What is your EMS experience like?

Answer: EM residents experience longitudinal pre-hospital medicine experience during their training at WVU, starting in the second half of intern year. Components of the EMS experience include:

  • Regularly scheduled EMS “experiences” per quarter, which can include clinical experiences via ground or air shifts (Health Net aeromedical services), administrative EMS experiences, mass gathering EMS coverage, didactic EMS/teaching opportunities, EMS related QI opportunities, etc.
  • Medical command physician experience on every shift as a PGY 2/3 resident.  WVU serves as the home for Medical Command for all EMS crews in a 27-county region throughout Northern, Central, and Eastern West Virginia.  You will learn how to help direct the prehospital care of critically ill patients and forge strong working relationships with EMS providers.
  • Development of EMS fellowship, slated to start in Summer of 2021, and a dedicated fellowship emergency response vehicle, giving residents more exposure to pre-hospital medicine alongside fellows and EMS board certified EM faculty.

Are international rotations supported by your department and institution?

Answer: Yes. Our department and institution fully supports the opportunity to participate in global health opportunities. There are multiple pre-approved sites for potential rotation.  Residents typically use an elective month in order to participate in international opportunities, and as with all elective months, we are usually able to be flexible in scheduling. 

What do residents typically do on their elective rotations?

Answer:  Anything they want!  With all honesty, residents do a variety of elective rotation types and are usually individualized to meet the personal career goals and interests of the particular resident.

EM elective options in both PGY-2 and PGY-3 years, with opportunity for flexible and personalized electives, including but not limited to, administrative EM, medical education focused electives, international EM, research, palliative Care, research, teaching month, focused intensive care month, REMI opportunities, simulation elective, etc. You also have the opportunity to create your own elective experiences with appropriate GME approval and EM faculty oversight.

What do your graduates say about their training once they are in the “real-world”?

Answer:  We unanimously receive very positive feedback from our graduates regarding the training that they received during their residency. Our graduates feel that they have been trained to be successful in caring for patients, regardless of practice type or patient population.  Although pediatric training in EM is one of the more nationally recognized weak spots of the specialty, our graduates report that they feel extremely competent in caring for critically ill pediatric patients and actually report their longitudinal pediatric training as a strength of the program. Our residents truly are competent and capable of practicing in any environment that they choose after graduation, leading to our extensive network of alumni in a variety of practice settings across the country.

How do residents complete their scholarly project?

Answer: Whether as novice researcher or experienced scholar, residents are shepherded through the entire process of scholarship—beginning to end. We don’t force you to do the research already going on at WVU—although you are welcome to jump on board if interested. Residents are encouraged to find an area of interest within the specialty--because research is more fun when you are personally interested in answering a question that you have designed a project from--rather than just checking a box for graduation. Resident research efforts are supported from beginning to end by a team of supportive and invested EM faculty members and our research department known as the Scholarship Oversight Committee (SOC).