Q & A

Q: Do you learn more from didactics or shift work, or is it a good mixture of both?
A: Our residency program emphasizes experiential learning:

• Shift Work: Residents gain hands-on experience during 12-hour shifts in a collegial environment. Unique pathologies and supportive attendings enhance learning.
• Didactics: Weekly sessions and resources like Tintinalli’s and the ROSH review question bank support academic growth.
• Simulation Facility: High-fidelity simulations refine critical skills.
• Flexibility: Residents balance shift work with at-home study, ensuring a comprehensive learning experience.

 

Q: Could you expand on the TECHS simulation lab?
A: The TECHS center is a high-fidelity simulation lab that replicates real-life emergency scenarios:

• Skill Development: Interns practice intubations, central lines, and other critical procedures during their first month.
• Teaching Opportunities: Residents lead simulations for medical students, enhancing both teaching and technical skills.

 

Q: How often are you evaluated, and how are evaluations conducted?
A: Residents receive regular evaluations:

• Shift Evaluations: After every shift, attendings complete an evaluation form.
• Annual Reviews: Faculty advisors conduct face-to-face annual reviews to discuss overall performance.
• On-Shift Feedback: Attendings provide real-time feedback during shifts when possible.

 

Q: How are the relationships and teaching moments with your attendings?
A: Attendings foster a supportive and educational environment:

• Journal Club: Monthly gatherings at attendings’ homes to discuss emergency medicine research.
• On-Shift Learning: Residents work closely with attendings in the doc box, encouraging real-time teaching moments.
• Approachability: Attendings are accessible both on- and off-shift.

 

Q: If you are on another service, do you still attend didactics?
A: Yes, Thursday morning didactics are protected educational time. Exceptions are made for night shifts to ensure compliance with duty-hour regulations.

 

Q: How is the feedback between residents and attendings? Is there a formal learning hour?
A: Feedback is integral to our program:

• Didactics: ACGME requires five hours of weekly didactics.
• Shift Evaluations: Residents receive feedback after every shift.
• Advisor Meetings: Quarterly meetings with faculty advisors and biannual evaluations with the PD/APDs ensure continuous improvement.

 

Q: Is there a deadline to take step 3? 
A: Yes, Step 3 must be passed to proceed to PGY3:

• Deadline: Scores must be submitted by February of PGY2.
• D.O. Residents: Passing Level 3 is sufficient for D.O. residents.

 

Q: Do you have a resident mentoring program?
A: While there is no formal mentoring program, residents benefit from:

• Faculty Advisors: Quarterly meetings with assigned advisors.
• Peer Support: Seniors are approachable and provide informal mentorship.

 

Q:What kind of non-clinical responsibilities do residents have outside of shift hours?
A: Non-clinical responsibilities include:

• Didactics: Five hours weekly on Thursday mornings.
• Journal Club: Monthly sessions.
• Simulation Center: Monthly training.
• Administration Training: A dedicated month in PGY3 to learn departmental operations.
• Scholarly Activity: Residents complete a performance improvement project and engage in research.

 

Q: Can you talk about didactics and what it generally looks like?
A: Didactics are comprehensive and interactive:

• Schedule: Thursdays from 7 a.m. to noon.
• Content: Includes simulations, grand rounds, M&M sessions, and oral board practice.
• Simulation Training: High-fidelity cases and oral board prep tailored to each year of residency.

 

Q: During residency, do you get an advanced wilderness life support certificate?
A: Yes, AWLS certification is part of the curriculum:

• Timing: Obtained during orientation month in intern year.
• Optional Certification: Residents can pursue AWLS instructor certification in later years.

  

Q: How do residents get feedback?
A: Feedback is provided through:

• Shift Evaluations: Online forms completed by faculty.
• Advisor Meetings: Quarterly meetings with faculty advisors.
• PD/APD Evaluations: Biannual reviews for in-depth performance discussions.

 

Q: What board prep initiatives do you have in place, and do you anticipate any upcoming changes?
A: Board prep is a priority:

• Resources: Free access to Peer and Rosh Review question banks.
• Focus: Didactics emphasize test prep in the months leading up to the ITE.

 

Q: How is the faculty-to-resident ratio in your program? Do you have repeated shifts/weeks with the same faculty?
A: Faculty schedules are independent of residents’:

• Variety: Residents work with multiple faculty members, gaining diverse perspectives.
• Learning Opportunities: Exposure to different practice styles helps residents develop their own approach.

 

Q: Can you tell me more about the journal club and what it entails?
A: Journal Club is a monthly event hosted by attendings:

• Content: Residents present and discuss 2-3 articles relevant to their rotations.
• Support: Ph.D. research faculty assist residents in analyzing articles.

 

Q: How much time do you spend with students?
A: Students typically work with senior residents during shifts. Qualified residents can also pick up extra shifts to teach MS1 and MS2 students at the medical school.

 

Q: Do you feel the faculty and leadership are receptive to resident concerns?
A: Yes, faculty and leadership are highly responsive:

• Example 1: Residents raised concerns about not seeing COVID-19 pediatric patients in the children’s hospital ED. Within two days, the issue was resolved.
• Example 2: Residents were not getting enough intubations during the internal anesthesia rotation. Faculty arranged an offsite rotation at Texas Tech in Lubbock, TX, significantly increasing intubation opportunities.  

 

Q: What is the responsibility of the emergency department and hospital for treating both legal and illegal immigrants?
A: The ED treats all patients equally, regardless of immigration status. Social workers assist with post-discharge prescriptions and follow-up care for patients unable to afford them.

 

Q: How is it for residents to learn to speak Spanish?
A: Learning Spanish is highly encouraged and supported:

• Supportive Environment: Nurses, staff, and fellow residents are always willing to help.
• Resources: Translator iPads with 24/7 access to multiple languages are available.
• Progression: By the second year, most residents can conduct patient interviews in Spanish.

  

Q: How many residents do you have that don’t fluently speak Spanish?   
A: Most residents do not speak Spanish fluently when they start. By graduation, they are comfortable conducting patient interviews in Spanish.

  

Q: How do you deal with Spanish-speaking patients during time-critical situations such as trauma?
A: The program ensures effective communication:

• Translator iPads: Readily available for all languages, including Spanish.
• Support: Faculty and staff who speak Spanish assist as needed.
• Gradual Exposure: Interns are not expected to handle critical Spanish-speaking cases independently at the start.

 

Q: How does getting patients from Mexico affect how you manage their care? Do you incorporate Spanish into your curriculum?
A: The program provides extensive exposure to Spanish-speaking patients:

• Equal Care: All patients are managed the same, regardless of background.
• Spanish Curriculum: Medical Spanish is introduced during orientation and reinforced throughout training.

  

Q: Are there any formal programs for students to learn/practice Spanish or certify bilingual?
A: While there is no official certification, the program offers:

• Orientation Month Training: Focused on functional medical Spanish.
• Immersion: Daily practice with Spanish-speaking patients helps residents improve quickly.

 

Q: How is medical Spanish integrated into your program?
A: Spanish is integrated from the start:

• Orientation Month: Training focuses on medical Spanish for history-taking and physical exams.
• Supportive Patients: The patient population is kind and encourages residents to practice Spanish.

Q: How many patients per hour do residents see?
A: There is no strict requirement for the number of patients residents must see:

• Intern Year: Typically, around one patient per hour.
• PGY2 and PGY3: Patient load varies depending on the department's busyness.

 

Q: How many patients do you have to pick up as an intern?
A: There is no specific requirement for the number of patients interns must pick up:

• Autonomy: Interns are given significant autonomy with their patients.
• Support: Attendings and senior residents are always nearby to provide assistance.
• Teamwork: Emergency medicine emphasizes collaboration and teamwork.

 

Q: Does the rule of the 80-hour work week apply?
A: Yes, the program adheres to ACGME guidelines:

• Emergency Medicine Rotations: Capped at 60 hours per week.
• Off-Service Rotations: Follow the 80-hour work week rule.
• Additional Rule: Residents cannot work more than five consecutive days.

 

Q: How is the acuity at the hospital, and how are traumas run with surgery?
A: The hospital is the only Level 1 trauma center in the region:

• Patient Population: Includes critically ill patients from El Paso and Cd. Juarez.
• Trauma Management: EM is responsible for airway management, while other medical patients are handled independently.
• Collaboration: The program has a strong relationship with the surgery service.

 

Q: What has it been like to transition from PGY2 to PGY3, and in what ways are you learning to run a department instead of just seeing patients?
A: The transition involves increased responsibility:

• PGY2: Focuses on patient care and building clinical skills.
• PGY3: Residents manage moderately critical patients and oversee the flow of the zone. They also mentor interns, preparing them for ED management.

 

Q: Is it a graduated responsibility model, or can first-years see the sickest of patients with supervision as well?
A: Yes, the program follows a graduated responsibility model:

• Training: After ATLS and other training, first-years can manage sicker patients with supervision.
• Support: Seniors and attendings are always available to assist.

 

Q: Are there any problems getting enough procedures?
A: No, there are ample opportunities for procedures:

• On-Service Rotations: Faculty ensure residents get hands-on experience.
• Off-Service Rotations: MICU and SICU rotations provide additional procedural opportunities.

 

Q: How are traumas run? Who leads? Does EM take the airway?
A: Trauma management is collaborative:

• Airway Management: EM always manages the airway.
• Level 1 Trauma: Co-run with the trauma surgery team, with EM taking the lead on airway and trauma taking the lead on other aspects.
• Other Trauma Levels: Managed by EM unless a consult is required.
• Rural Rotation: Residents gain additional trauma experience in Artesia, New Mexico, with single EM coverage and a general surgeon.

Q: Since your program is the only Level 1 trauma center within the region, do residents feel experienced with managing trauma by graduation?
A: Yes, residents are well-prepared:

• PGY1: Introduction to trauma management begins mid-year, with shadow shifts in the resuscitation zone (R zone).
• PGY2: Residents manage 2-3 R zone shifts per month, handling trauma bays and critical rooms with attending support.
• Graduation: By the end of PGY2, residents feel confident managing trauma cases independently.

 

Q: What is the sign-out culture of your program? Do all patients have to have a disposition prior to you leaving?What is the sign-out culture of your program? Do all patients have to have a disposition prior to you leaving?
A: The program has a supportive sign-out culture:

• Flexibility: It is acceptable to sign out patients without a final disposition.
• Timing: Sign-outs occur at 6:45 a.m. and 6:45 p.m.
• Collaboration: Residents help each other reassess patients after sign-out.
• Procedures: Residents avoid signing out procedures unless the oncoming resident agrees to take them.

 

Q: What EMR system does your hospital use?
A: The hospital uses Cerner as its EMR system.

 

Q: Can you talk about the unique pathology and unexpected events you see due to your border location?
A: The hospital’s proximity to the U.S.-Mexico border brings unique cases:

• Examples: Falling trauma from border wall jumps, submersion injuries, advanced surgical complications from Juarez, TB, neurocysticercosis, black-tar heroin abuse, wound botulism, and malaria.

 

Q: How much autonomy do you have when it comes to procedures?
A: Autonomy depends on the resident’s experience and faculty comfort:

• Goal: Residents quickly become comfortable performing procedures independently.
• Support: Faculty are always available for assistance when needed.

 

Q: Do you get admitting privileges with medicine?
A: Yes, the ED has the authority to admit patients:

• Collaboration: Hospitalists and teaching teams rarely push back on admissions.
• Efficiency: Consultants often allow residents to text them, speeding up the process.

 

Q: You say that first-year residents have decision-making. What do you mean by that?
A: First-year residents are encouraged to develop their decision-making skills:

• Process: Residents see patients, formulate plans, and present them to attendings for feedback.
• Support: Faculty and senior residents are always available to answer questions.

 

Q: For a med-control cardiac arrest call, who makes the decision to stop CPR? The resident or attending?
A: After five supervised med-control calls, residents can make decisions:

• Supervision: Attendings are always nearby and calls are broadcast in the resuscitation zone.

 

Q: What is the relationship with SANE nurses in your department?
A: The program has a strong relationship with SANE nurses:

• Availability: SANE nurses are available 24/7.
• Collaboration: All management occurs in the ED, ensuring seamless care.

 

Q: Do you have any midlevel providers in your ED?
A: Yes, midlevel providers play a supportive role:

• Responsibilities: Triage, fast track, and relieving residents during didactics.

 

Q: How much time do you spend charting after shift?
A: The goal is to complete charting within the 12-hour shift:

• Initial Adjustment: New residents may take up to an hour after shifts to finish charting.
• Efficiency Tools: Dragon (talk-to-text software) significantly reduces charting time. 

Q: What are the unique and distinctive aspects of the program?
A: El Paso offers a unique training environment:

• Patient Population: Residents work with underserved patients who are highly appreciative of the care they receive.
• Border Health: Exposure to conditions rarely seen elsewhere in the U.S. due to the proximity to the U.S.-Mexico border.
• Cost of Living: Affordable housing and no state income tax in Texas contribute to a good work-life balance.
• Spanish Proficiency: Residents have the opportunity to improve their Spanish skills, which is valuable for patient care.

 

Q: At what point in your residency did you feel comfortable having a patient encounter in Spanish?
A: Comfort with Spanish varies by individual:

• Immersion: Residents are immersed in Spanish from the start of residency.
• Orientation Month: Includes opportunities to practice and grow medical Spanish skills.
• Progression: Residents who actively practice Spanish during shifts typically feel comfortable by their second year.

 

Q: What kind of natural disasters are there in El Paso, and what type of training experience do you have for them?
A: El Paso is fortunate to have minimal natural disasters:

• Disaster Preparedness: Residents participate in disaster drills and interprofessional training.
• Community Events: Some residents assist with local marathons and other events.

 

Q: What are some unique community health problems in El Paso?
A: El Paso’s location on the border presents unique health challenges:

• Border Health: Residents encounter pathologies not commonly seen in other parts of the U.S.
• Examples: Advanced surgical complications from Juarez, TB, and other conditions related to underserved populations.

 

Q: Are there any community outreach programs?
A: Yes, the program emphasizes community involvement:

• Daily Impact: As a county hospital, the program serves medically underserved and financially disadvantaged patients.
• Volunteer Opportunities: Residents can volunteer at low-cost or free medical clinics in the El Paso community.

 

Q: What brought you to the El Paso program specifically?
A: Residents are drawn to the program for various reasons:

• Location: The only Level 1 trauma center within a 300-mile radius.
• Weather: Sunny weather year-round, with opportunities for outdoor activities like hiking, skiing, and climbing.
• Cost of Living: Affordable housing and no state income tax.
• Community: Grateful patients and a supportive environment make El Paso a great place to train and live.
• Retention: Many graduates return as faculty or part-time staff due to their positive experiences.

 

Q: How is life generally in El Paso? Did you find there was anything tough or difficult to adapt to? How is the housing situation?
A:  Life in El Paso is enjoyable and affordable:

• Amenities: The city offers big-city amenities like Top Golf, indoor skydiving, and shopping, while maintaining a small-town feel.
• Traffic: Minimal traffic allows residents to live up to 20 miles from the hospital and still commute within 25 minutes.
• Outdoor Activities: Nearby opportunities for skiing, snowboarding, and hiking.
• Housing: Affordable options include renting a three-bedroom house for around $1,200 or luxury apartments with amenities.

 

Q: How often do you get snow in El Paso?
A: Snowfall is rare and light:

• Frequency: About 4-5 times a year, with snow melting by the afternoon.
• Nearby Skiing: Ski resorts in New Mexico are just three hours away for those who enjoy snow activities.

 

Q: Do the El Paso public schools have a dual language program for kids, and if so, is it very difficult to get into?
A: Yes, dual language programs are available:

• Accessibility: These programs are relatively easy to enroll in.

 

Q: What is the relationship between residents and ancillary staff (nursing, phlebotomy, transport, etc.)?
A: The program fosters strong relationships with ancillary staff:

• Collaboration: Residents and staff work together efficiently as a team.
• Understanding Roles: Interns spend time with charge nurses or triage to better understand their processes.
• Communication: Regular staff meetings allow residents to voice concerns and learn from staff perspectives.

 

Q: When medical errors happen, do you feel supported, and what resources are there for residents?
A: The program provides strong support for residents:

• Follow-Up: Faculty offer proactive feedback and support after errors.
• Learning Opportunities: Residents can review cases in a private room (docbox) for one-on-one feedback.
• Procedure Day: Dedicated time to address errors and learn how to prevent them in the future.

Q: What is the schedule/work-life balance like?
A: The program prioritizes work-life balance:

• Days Off: Residents can request five days off per month. If working two months back-to-back, they can request eight days off.
• Protected Education Time: Thursdays from 7 a.m. to noon are reserved for didactics.
• Shift Distribution: Each month is split into two weeks of days and two weeks of nights. Residents can request one month of days and one month of nights if working consecutive months.

 

Q: Can you comment on the shift times?
A: Shifts are structured to maximize efficiency and learning:

• Standard Shifts: 12-hour shifts from 7 a.m. to 7 p.m. and 7 p.m. to 7 a.m.
• Moonlighting: Internal moonlighting shifts (12 p.m. to 12 a.m.) are available for second-year residents in good standing.

 

Q: What do the shifts look like? What are the hours?
A: Shifts are designed to ensure compliance with national guidelines:

• Duration: 12-hour shifts, with a maximum of five consecutive days.
• Weekly Cap: Emergency medicine rotations are capped at 60 hours per week.
• Flexibility: Residents often take advantage of five consecutive days off to travel or relax.
• Consistency: Shift schedules minimize flip-flopping by aligning the end of one month and the start of the next.

 

Q: Are the attending schedules mirrored, or do you have multiple attendings?
A: Attendings have varied schedules:

• Mirrored Shifts: Some attendings work 12-hour shifts that align with resident hours.
• Shorter Shifts: Other attendings work 8-hour shifts.

 

Q: How are you able to balance wellness without sacrificing education during didactics?
A: The program incorporates wellness into the schedule:

• Wellness Days: Residents receive a Thursday morning off for wellness every 2-3 months.
• On-Shift Learning: Teaching occurs during shifts, supplemented by resources like Rosh Review and PEER.
• Extra Opportunities: PGY2 and PGY3 residents can pick up additional shifts for extra pay and learning under an attending’s license.

 

Q: When was the last time you had two days off in a row?
A: Residents regularly have time off:

• Monthly Breaks: Up to five consecutive days off per month.
• Shift Handoffs: Patients are handed off to the next team, ensuring residents can leave on time.
• Efficiency: New residents may initially stay late to finish charting, but they quickly adapt and complete work within their shifts.

 

Q: How respected are the residents by attendings outside of the ED?
A: Residents are highly respected across the hospital:

• Reputation: Known for their hard work and positive attitudes.
• Collaboration: Other services appreciate their proactive approach and willingness to assist with procedures.

 

Q: What do your spouses think of the residency program and El Paso?
A: Spouses have positive experiences:

• Community: They find jobs, make friends, and connect with co-residents’ families.
• Schedule: The 15-shift-per-month schedule allows residents to spend quality time at home.
• Family-Friendly: El Paso offers good schools and a supportive environment for families.

 

Q: Is there a support program for spouses?
A: Yes, the program supports spouses:

• Activities: Spouses can meet others from the department and other residencies.
• Community: The program hosts activities to foster connections and provide support.

 

Q: How do residents feel about their work-life balance?
A: Residents report excellent work-life balance:

• Time Off: 12-hour shifts allow for more days off to spend with family or pursue hobbies.
• Wellness Focus: The program prioritizes resident wellness, ensuring they can relax and recharge.
• Comparison: Residents note that their peers in other programs often feel overworked, while they enjoy a balanced lifestyle.

 

Q: Where do residents usually live? Do they buy or rent? Any advice?
A: Residents have affordable housing options:

• Buying vs. Renting: Some residents buy homes, as mortgages are comparable to rent. Others rent luxury apartments for around $1,200/month, including amenities.
• Location: Most residents live on the west side of El Paso, but all areas are within a 20-minute commute due to minimal traffic.

 

Q: How do shift trades work at your program?
A: Shift trades are flexible but regulated:

• Same PGY Level: Trades must occur within the same PGY level and zone.
• Restrictions: Residents cannot work more than five ED shifts per week or violate duty-hour rules.
• Extra Shifts: Residents can work extra shifts early to accommodate future time off, such as for pregnancy.

 

Q: How are vacations and break times taken?
A: Vacation policies are resident-friendly:

• Monthly Breaks: Up to five consecutive days off per month during ED rotations.
• Extended Breaks: Residents with back-to-back ED months can request eight consecutive days off once a year.

 

Q: How is the ultrasound curriculum?
A: The program provides robust ultrasound training:

• Dedicated Months: Two months of ultrasound training during residency.
• Faculty Expertise: Two faculty members specialize in ultrasound, including one fellowship-trained.
• Hands-On Practice: Interns complete at least 100 scans, while PGY2 residents complete 200 scans. Ultrasound machines are readily available in the ED.

 

Q: How is your critical care training, and do you have dual-trained faculty in critical care?
A: Critical care training is comprehensive:

• Rotations: Residents rotate through the medical ICU, surgical ICU, cardiac ICU, and neuro ICU during their first and second years.
• Faculty: None of the faculty are dual-boarded in critical care.

 

Q: Are there opportunities to work with EMS and/or flight?
A: EMS opportunities are available:

• EMS: Residents can work with EMS, and one faculty member serves as the medical director for Border Patrol in the El Paso area.
• Fellowships: Many residents pursue EMS fellowships after graduation.
• Flight: There are currently no flight opportunities.

 

Q: How does your residency apply ultrasound to practice? Do most residents feel confident performing ultrasound? Does the simulation lab have the capacity to practice ultrasound?
A: Ultrasound is an integral part of the program:

• Encouragement: Attendings encourage residents to use ultrasound during patient care.
• Training: Two months of dedicated ultrasound training provide one-on-one learning with specialized faculty.
• Simulation Lab: The lab includes models for practicing ultrasound skills.

 

Q: What elective opportunities are available for residents?
A: Residents have diverse elective options:

• Examples: Pediatrics in Houston, hyperbaric and marine envenomations in Hawaii, rural EM in Alaska, wilderness medicine in Taos, New Mexico, and EMS in El Paso.
• Flexibility: The department is open to setting up new rotations based on resident interests.

 

Q: How do you deal with Spanish-speaking patients during time-critical situations such as trauma?
A: The program ensures effective communication:

• Translator iPads: Available for all languages, including Spanish.
• Support: Faculty and staff who speak Spanish assist as needed.
• Gradual Exposure: Interns are not expected to handle critical Spanish-speaking cases independently at the start.

 

Q: How does getting patients from Mexico affect how you manage their care? Do you incorporate Spanish into your curriculum?
A: The program provides extensive exposure to Spanish-speaking patients:

• Equal Care: All patients are managed the same, regardless of background.
• Spanish Curriculum: Medical Spanish is introduced during orientation and reinforced throughout training.

 

Q: Are there any formal programs for students to learn/practice Spanish or certify bilingual?
A: While there is no official certification, the program offers:

• Orientation Month Training: Focused on functional medical Spanish.
• Immersion: Daily practice with Spanish-speaking patients helps residents improve quickly.

 

Q: How is medical Spanish integrated into your program?
A: Spanish is integrated from the start:

• Orientation Month: Training focuses on medical Spanish for history-taking and physical exams.
• Supportive Patients: The patient population is kind and encourages residents to practice Spanish.

Q: What kind of feedback are you getting from graduates from your program?
A: Graduates consistently report feeling well-prepared after completing the program:

• Program Improvements: Feedback from graduates has led to changes, such as adding community and rural EM rotations, which have received positive reviews.

 

Q: What are the most important characteristics you are looking for when granting interviews for candidates?
A: The program values:

• Hard Work: Candidates who are diligent and embrace the culture and patient population.
• Team Players: Individuals who collaborate well and avoid stepping on others to excel.
• Spanish Interest: While fluency is not required, a willingness to learn Spanish is highly valued.

 

Q: Do you have a cutoff for board scores?
A: No strict cutoffs, but:

• Holistic Review: Applications are evaluated as a whole.
• Exam Performance: A history of difficulty with exams may indicate challenges with residency and in-service exams.

 

Q: What subspecialties and fellowships do the faculty have?
A: Faculty interests and subspecialties can be found on the program’s website:
Faculty Page

 

Q: What are your preferences in the selection process?
A: The program takes a holistic approach, considering:

• Fit: Whether the applicant aligns with the program’s culture and values.
• Diversity: Residents come from all over, and the program is not regionally focused.

 

Q: What is the biggest stress in your workday?
A: Common stressors include:

• Sign-Out: Ensuring all patient updates and results are shared accurately.
• Resuscitation Zone: Managing critical cases, though nearby residents always help.
• Off-Service Rotations: Interns may find decision-making stressful, but seniors and attendings provide support and guidance.

 

Q: What is in place to ensure that I leave this program/residency a strong physician?
A: The program provides:

• Comprehensive Training: Rotations in rural medicine, simulation labs, oral board practice, and regular feedback.
• Spanish Proficiency: Graduates leave with strong medical Spanish skills.
• ITE Performance: Residents consistently score above the national average.

 

Q: What does border medicine without borders mean? And what difficulties have you faced in order to practice border medicine?
A: The program emphasizes treating all patients equally, regardless of background:

• Challenges: Patients under Border Patrol custody or from Mexico may face barriers to follow-up care and medication access.
• Solutions: Social workers play a critical role in overcoming these challenges.

 

Q: Do you feel anything is missing from your residency?
A: Pediatrics EM training could be stronger:

• Current Structure: Dedicated pediatrics months occur in PGY2 and PGY3, but there are no scheduled pediatrics shifts in PGY1.
• Elective Opportunity: Residents can choose a third-year elective at a children’s hospital for additional exposure.

 

Q: Are you open to D.O. or IMG students?
A: Yes, the program values diversity:

• D.O. and IMG Friendly: Faculty includes D.O.s and IMGs.
• OMT Practice: Faculty are open to residents incorporating OMT into their practice.

 

Q: Outside of orientation month, what do you recommend an incoming intern do to be best prepared to begin residency?
A: Recommendations include:

• Resources: Familiarize yourself with emergency medicine resources like EMCrit, RebelEM, and ALiEM’s Bridge to EM.
• Wellness: Take time to relax and focus on self-care before starting residency.

 

Q: How many SLOEs are required to apply?
A: The program does not have a minimum requirement:

• Guidelines: No more than one EM SLOE and a maximum of four letters of recommendation.

 

Q: Do you have a cutoff graduation date for IMGs?
A: No exact cutoff, but:

• Texas Medical Board Permit: Late graduation may delay the permit process, which could be a significant obstacle.

 

Q: How regional is your selection for the program?
A: The program is not regionally focused and considers all applicants.

 

Q: Can you speak to what you are looking for in residents, and who would not fit in your program?
A: Ideal candidates are:

• Hard-Working and Teachable: Willing to learn and receptive to feedback.
• Culturally Sensitive: Interested in learning Spanish and connecting with the patient population.
• Team-Oriented: Collaborative and supportive of peers.
• Poor Fit: Those uninterested in learning Spanish or who prioritize individual success over teamwork may struggle.

 

Q: How family-friendly is this program?
A: The program is very family-friendly:

• Supportive Environment: Many residents have families, and the program fosters a close-knit, family-like atmosphere.

 

Q: What is the greatest weakness of the program, and what are you doing to strengthen or fix it?
A: Pediatrics exposure is a challenge:

• Current Efforts: Dedicated pediatrics months in PGY2 and PGY3.
• Elective Option: Third-year residents can choose a pediatrics rotation for additional experience.

 

Q: What is one thing you wish you knew prior to starting residency?
A: Residency involves a steep learning curve:

• Orientation Month: Helps residents acclimate to the ED system and graded responsibilities.
• Supportive Faculty: Residents receive guidance and support to succeed.

 

Q: I haven’t been offered an interview by your program. Should I be concerned?
A: No, the process is ongoing, and many applications are still under review.

 

Q: Are you happy as a resident?
A: Yes, residents enjoy:

• Work-Life Balance: Time for family, hobbies, and travel.
• Benefits: Comprehensive health, dental, and vision coverage at no cost.

 

Q: Is there a screening or cutoff number for USMLE or COMLEX Step 1 scores?
A: No specific cutoff, but:

• Typical Candidates: Scores within one standard deviation of the average are preferred.

 

Q: Any unique benefits to the program being in El Paso, Texas, directly on the border?
A: Unique benefits include:

• Patient Population: Exposure to diverse and underserved populations.
• Outdoor Activities: Proximity to New Mexico’s mountains for camping and skiing.
• Convenience: An easily accessible airport with direct flights to major cities.

 

Q: Are there IMGs in your program?
A: Yes, the program includes IMGs and D.O.s, including the program director and a chief resident.

 

Q: Who would do well in your program?
A: Residents who are:

• Hard-Working and Humble: Willing to serve underserved patients with care and sensitivity.
• Team-Oriented: Collaborative and supportive of peers.

 

Q: Is the program open to new ideas for community service?
A: Yes, the program welcomes new ideas for community outreach.

 

Q: Do you feel you will be prepared to take on a self-practicing role when you graduate?
A: Yes, residents feel confident transitioning to independent practice.

 

Q: What social services do you have available in the department? Are they available 24/7?
A: Social workers are available 24/7:

• Daytime: A dedicated ED social worker is available.
• Nights/Weekends: Social workers are shared throughout the hospital.

 

Q: Are there opportunities available for residents in advocacy and leadership during training?
A: Yes, residents can:

• Advocacy: Participate in TCEP and state-level initiatives.
• Leadership: Join the house staff organization to address residency-related issues.

 

Q: Where do the majority of residents end up after graduation?
A: Graduates pursue diverse paths:

• Community Practice: The majority enter community practice.
• Academics and Fellowships: Some pursue academic positions or fellowships in EMS, toxicology, global health, and more.

 

Q: Can you comment on what internal moonlighting is at your institution and how it works?
A: Internal moonlighting offers:

• Extra Shifts: Available to PGY2 and PGY3 residents who meet criteria.
• Independence: Residents work with more autonomy under attending supervision.

 

Q: What benefits are offered to residents?
A: Comprehensive benefits include:

• Insurance: Health, dental, and vision coverage for residents and families at no cost.
• Professional Resources: Subscriptions to Rosh Review, PEER IX, and MD Challenger.
• Financial Support: Book allowance, funded conference for senior residents, and meal stipends.
• Additional Perks: Lab coats with laundry service, free parking, and medical Spanish classes.