Medical Student Council, Medical Students, Advising, Match

Program Director Interview Series: Andrew E. Muck, MD | UT Health San Antonio Long School of Medicine's Emergency Medicine Residency

This month, our Program Director Interview Series features Dr. Muck and the UT Health San Antonio Long School of Medicine’s Emergency Medicine Residency.

What sets your program apart from others?

We are an academic emergency department with a large tertiary referral hospital that serves 17 different counties spanning from the Texas-Mexico border to the Gulf of Mexico to the Texas Hill Country. Despite that large area, we are very engaged with the community in San Antonio.  We know exactly what we’re about - bringing great care to under-resourced populations in San Antonio, South Texas, and across the globe.  We are a newer program that has no problems adapting to individual learners and are all about developing impactful, sustainable programs.

What are the benefits of attending a 3 vs. 4 year EM residency program?

A 3-year residency is built to streamline the residency education process and focuses very heavily on pertinent clinical care as it relates to emergency medicine. A 3-year program allows for graduating residents to get exposure to, and then enter and complete fellowship in the same amount of time as a 4 year residency. For those not interested in fellowship, a 3-year residency enables graduating residents to get out into the practice environment that much sooner.

What is something students may not know about your program?

As soon as a resident identifies where they are headed with their career, we target their experience going forward.  For example, when residents determine they are interested in global health equity, we have a longitudinal global health curriculum to provide focused education.  We provide opportunities locally to participate with global health populations in our San Antonio Refugee Health Clinic.  We then work to facilitate global health experiences for those interested residents. 

Similarly, we have developed an EMS/Disaster Medicine scholarly track for any residents interested in this subspecialty.  This longitudinal track includes monthly didactic meetings and allows the resident to tailor their quality improvement/research projects to this particular field, while giving ample opportunities to be involved in operational and administrative activities through our EMS fellowship.  These activities include medical director meetings, participation in event medicine such as the San Antonio Rock n’ Roll Marathon, Tactical Medicine training opportunities, and increased opportunities to have ride along time with San Antonio Fire Department. 

For residents who may be interested in education, we allow opportunities to participate in teaching of medical students and other residents in both formal and informal settings.  We encourage and mentor through the process of curriculum development for student and resident programs.  Our ultrasound training is unparalleled and focused education during our residency occurs similarly.  For our residents who determine they are interested in community medicine, we help get them to the best job possible.  While our program is based out of a large institution, we have several EM rotations at local community sites.  Our relationships with our community partners have enabled our graduating residents to start working immediately after residency and reducing the anxiety of finding a job after graduation 

How successful have we been with our intentions?  Last year, we had 5 of our residents achieve their first choice fellowship including fellowships in Global Health, Combined Ultrasound/Global Health, Education, and Palliative Care.  Our residents who chose to do community medicine were able to get their jobs of choice. 

What range of USMLE/COMLEX Step 1 scores do you look for in an applicant for the program?

Typically our lower cutoff for Step 1 is 210, but we understand that a score does not particularly define who a person is, so we do not have a hard cutoff.

What kinds of opportunities for research exist? Do you look for residency candidates with research experience?

As a young(ish) Department of Emergency Medicine, our research opportunities are increasing by the day. We have fellowships in Ultrasound, EMS, Global Health, Combined Ultrasound and Global Health, and many other research opportunities within those divisions.  We also have clinical ED, public health policy, and trauma research.  We have a PhD research coordinator and research nurse to aid in project development.

Do you have opportunities to explore global health at your institution?

Global health is one of the strongest features of our program. We have the mentality that global health is not a singular experience, it’s about building relationships with distant sites, building curricula, fostering relationships, and enabling local physicians to provide the best possible care for their patients.  You receive training in global health equity, as the lessons learned here will help you provide better care across borders.  The experiences you have internationally will help you provide better care to your patients in San Antonio and South Texas.  Your experiences in global health are shaped in a way that will impact the entirety of your career as your passion to serve under-resourced populations will be shaped into meaningful and impactful projects.  Our global health experiences are particularly targeted to education, training, and program development as this allows us to leave lasting impact.  In the past several years, our residents have worked on training, education, and system development in such places as Vietnam, Nepal, Peru, Zambia, and Guatemala.

What are some qualities that your program looks for in applicants?

Our program is one of service and we have a strong sense of community.  We consider residents who have a strong background of service and willingness to treat the underserved. We have a strong family bond amongst faculty, residents, and other staff, focusing on wellness and realizing that strong patient care begins with the individual.

 Can you describe any attributes and qualities that make applicants stand out?

Applicants that stand out are those who have shown a willingness to take care of those in need, providing high quality patient care while understanding issues within the healthcare system: disparities in care, access to care, and understanding of patient satisfaction and throughput. The strongest residents are able to provide high quality care by understanding the current climate of emergency medicine, access issues, and being able to be flexible in an everchanging healthcare environment.

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