Questions & Answers
Q: Do you learn more from didactics or shift work?
A: Both are emphasized. Residents gain hands-on experience during shifts, attend weekly didactics, and train in the TECHS Simulation Center.
Q: What is the TECHS simulation lab?
A: A high-fidelity center where residents practice procedures such as intubations and central lines. Residents also have the opportunity to lead simulations for medical students.
Q: How are residents evaluated?
A: Resident feedback is approached in a variety of ways.
- On-shift feedback: Attendings provide real-time feedback during shifts when possible.
- Shift evaluations: Attendings complete shift evaluations for residents after each shift.
- Quarterly advisor meetings: Residents meet with assigned advisors.
- Annual reviews: Faculty advisors conduct face-to-face annual reviews to discuss overall performance.
Q: How are the relationships with attendings?
A: Attendings are approachable and supportive. They provide bedside teaching, host monthly Journal Clubs, and are accessible both during and outside of shifts.
Q: Do residents attend didactics while on off-service rotation?
A: Yes, Thursday morning is protected didactics time. Exceptions are made for residents scheduled for back-to-back night shifts.
Q: Do residents have mentors or a mentoring program?
A: All residents will have a designated faculty advisor. Senior residents may also serve as informal mentors.
Q: Can you explain your didactics curriculum?
A: Didactics are on Thursday from 7 a.m. to 12 noon. We have a variety of opportunities such as grand rounds, M&M lectures, simulation sessions, and certifying exam preparation that are customized to the knowledge and skills expected at each level of training.
Q: What is Journal Club?
A: Journal Club is held monthly at different attending homes, with dinner provided. PGY-1 and PGY-2 residents present articles with support from Ph.D. research faculty.
Q: How often do residents work with medical students?
A: Medical students are paired with senior residents during shifts, giving residents the opportunity to develop and practice their teaching skills. Residents, starting in the second half of their intern year, may also teach MS1 and MS2 students on various topics, depending on the medical school schedule.
Q: What is the deadline for taking USMLE Step 3/COMLEX Level 3?
A: All PGY-1 residents must attempt to pass this exam by May 31 of their PGY-1 year. If a PGY-1 resident does not pass, they have until February of their PGY-2 year to successfully complete the exam. Failure to pass the exam by this time will result in non-renewal of the resident’s contract, and they will not be promoted to the next level of residency training.
Q: How do non-Spanish speaking residents learn to speak the language?
A: Learning Spanish is highly encouraged and supported.
- Spanish lessons: Provided during New Incoming Resident Orientation.
- Supportive environment: Nurses, staff, and fellow residents are available to assist.
- Resources: Translator iPads with 24/7 access in multiple languages are available.
- Progression: With time, many PGY-2 residents are able to conduct patient interviews in Spanish.
Q: Is leadership responsive to concerns?
A: Yes, program leadership acts quickly to address resident needs, such as increasing educational and procedural skills in different rotations.
Q: Do residents receive AWLS certification?
A: Yes, PGY-1 residents receive AWLS certification with the opportunity to become instructor certified as a PGY-2 or PGY-3.
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 while in the emergency department.
Q: What EMR system does your hospital use?
A: The hospital uses Cerner as its EMR system.
Q: 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 without a final disposition.
- Timing: Sign-outs occur at 6:45 a.m. and 6:45 p.m.
- Collaboration: Residents avoid signing out procedures unless the incoming resident agrees to take them.
Q: You say the first-year residents have autonomy to make clinical decisions. What is meant by this?
A: First-year residents are encouraged to develop their decision-making skills.
- Process: Residents see patients, formulate plans, and present them to the attendings for feedback.
- Support: Faculty and senior residents are always available to answer questions.
Q: Do you have any midlevel providers in your ED?
A: At UMC, midlevel providers only work in triage and see patients during residents’ protected didactic time. At El Paso Children’s Hospital, midlevel providers will see low-acuity patients while residents manage high-acuity patients with PEM faculty.
Q: How is the acuity rate at UMC hospital, and how are traumas managed with surgery?
A: As the region’s only Level 1 Trauma Center, residents care for critically ill patients from El Paso and Cd. Juarez. Both emergency medicine and trauma surgery are present for Level 1 traumas to ensure proper care. Emergency medicine is responsible for airway, FAST exams, and has opportunities to perform emergency procedures independently. Other trauma levels are run solely by emergency medicine unless the attending or resident deems it necessary to consult trauma surgery.
Q: How much autonomy do residents have with procedures?
A: Autonomy grows with experience. Residents are encouraged to perform procedures independently with faculty always available for support.
Q: What are the unique and distinctive aspects of the program?
A: Training in El Paso offers exposure to underserved, appreciative patients, rare border-health conditions, affordable living with no state income tax, and the opportunity to develop Spanish proficiency for patient care. Residents are also drawn to the program for its role as the only Level 1 trauma center within 300 miles, year-round sunny weather, supportive community, and positive training experience.
Q: Are there community outreach opportunities?
A: Yes. As a county hospital, residents care for underserved patients daily and can also volunteer at local low-cost and free clinics in El Paso and in Mexico. Residents are also encouraged to assist with local marathons and other events with faculty supervision.
Q: What unique community health problems do residents see in El Paso?
A: The border location exposes residents to uncommon U.S. pathologies, including advanced surgical complications from Juarez, tuberculosis, and conditions tied to underserved populations.
Q: What is the relationship between residents and ancillary staff, such as nursing, phlebotomy, and transport?
A: The program fosters strong teamwork with ancillary staff through collaboration and open communication both on shift and at regular staff meetings. Interns will also spend a four-hour shift shadowing nursing staff to better understand nursing processes and how residents can better support them in the emergency department workflow.
Q: What natural disaster training do residents receive in El Paso?
A: While natural disasters are rare in El Paso, residents participate in annual mass-casualty simulations and interprofessional disaster drills.
Q: How are residents supported after medical errors?
A: Residents receive proactive faculty feedback, one-on-one case reviews in a private setting, and dedicated procedure time to learn from errors. Texas law strongly protects medical providers, and legal action against residents is extremely rare.
Q: What are the typical shift times?
A: Standardized shifts are 12 hours, 7 a.m. to 7 p.m. and 7 p.m. to 7 a.m., with optional internal moonlighting, 12 p.m. to 12 a.m., available for PGY-2 residents with approval by the Clinical Competency Committee. Sign-out occurs promptly at 6:45 a.m. or 6:45 p.m., depending on which shift you are working.
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 two to three months.
- On-shift learning: Teaching occurs during shifts, supplemented by resources like ROSH Review and PEER Review Questions.
- Extra opportunities: PGY-2 and PGY-3 residents can pick up additional shifts for extra pay and learning under an attending’s license.
Q: How is the ultrasound curriculum?
A: The program provides robust ultrasound training.
- Dedicated months: Two months of ultrasound training during residency with ultrasound fellowship-trained emergency medicine attendings.
- Hands-on practice: Interns complete at least 100 scans and PGY-2 residents complete at least 200 scans. Residents must have at least 300 scans before the end of their residency. Ultrasound machines are readily available in the ED.
Q: Are there opportunities to work with EMS and/or flight?
A: EMS opportunities are available.
- EMS: Residents have some mandatory EMS shifts during their toxicology rotation. Dr. Baker, one of our faculty members, serves as the medical director for Border Patrol in the El Paso area and offers an EMS elective rotation.
- Fellowships: Many residents pursue EMS fellowships after graduation.
- Flight: There are currently no flight opportunities in El Paso.
Q: What elective opportunities are available for residents?
A: Residents have diverse elective options.
- Pediatrics in Houston
- Hyperbaric and marine envenomation in Hawaii
- Rural emergency medicine in Alaska
- Wilderness medicine in Taos, New Mexico
- EMS in El Paso
- Flexibility: The department is open to assisting in setting up new rotations based on resident interest.
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: Do you have a cutoff for board scores?
A: No strict cutoff, although applications are evaluated as a whole. Residents who have concerns about the In-Training Exam or boards can contact the chief residents for help with making a study schedule or tutoring. Chief residents also work with residents who have difficulty with the In-Training Examination to improve their preparation for their board exams.
Q: What subspecialties and fellowships do the faculty have?
A: Faculty interests and subspecialties can be found on the program’s Faculty and Staff page.
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 pediatric months in PGY-2 and PGY-3. PGY-1 residents will have a few shifts a month at El Paso Children’s Hospital starting in January.
- Elective options: PGY-3 residents can choose a pediatric rotation for additional experience.
Q: I have not been offered an interview for your program. Should I be concerned?
A: Yes, the program accepts M.D.s and D.O.s.
Q: Is the residency program open to new ideas for community service?
A: Yes, the program welcomes new ideas for community outreach.