Medical Students, Advising, Match, Program Director Interviews

Program Director Interview Series: Brian Tollefson, MD, FACEP l University of Mississippi Medical Center Emergency Medicine Residency

This month our Program Director Interview Series is Brian Tollefson, MD, FACEP sharing details about the University of Mississippi Medical Center. Dr. Tollefson tells us more about the opportunities available in Jackson, MS, and applying for residency in EM.

What sets your program apart from other programs?

Our program is very unique in that it is located at the only Level 1 Trauma Center in the state of Mississippi. As far as exposure goes, this is huge for training in EM. From day one our residents are exposed to an impressive variety of acuity and pathology. If you look at demographics within the state, there are a ton of rural areas with a lot of sick people. This provides a very unique experience for our residents. Oftentimes, our hospital is the only place close to the patient that can provide the necessary level of care. As a result, residents gain hands-on training with a lot of high-acuity patients and traumas from across the state. We are also home to one of the best TelEmergency programs in the nation. Residents have the opportunity to gain exposure in this area, which may not be available in all programs. Another benefit is the cost of living in Mississippi. It is pretty low compared to many states, which makes it easier for our residents to live comfortably off of their salary.

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

Our 3-year program provides residents with outstanding clinical training. Residents who attend 3-year programs are able to get out into the workforce sooner and explore their interests through fellowships. When we made the transition to a 3-year program four years ago, we found that we really could not notice a difference between the 3- and 4-year classes in terms of their clinical skills. We previously had our 4-year residents doing a mini-fellowship during their last year but decided it would be more beneficial to our residents to move to a 3-year program so that they could graduate and pursue their interests through full fellowships.

What is something students may not know about your program?

The number of fellowships we offer. We are one of the few places in the country that has a sports medicine fellowship run through the emergency department. We also offer fellowships in ultrasound, EMS, and we are one of only a few accredited research fellowships in the country. We are also planning to start a simulation fellowship within the next year or so.

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

EM is one of the more competitive specialties. Here at UMMC, how a student performs on these exams is definitely taken into consideration, but that is only part of it. I think some students have the impression that Step scores are very black and white, but it is really up for interpretation. A really high score or a really low score does not necessarily mean one thing or the other for certain. We have taken students with varied academic performance, so it is definitely not a hard-and-fast decision. Students with lower scores may just have to make up for this in other areas of their application.

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

There is a ton of research at UMMC that residents can get involved with. We have everything from multicenter trials to quick one-year studies. Our residents tend to get plugged in with ongoing studies within the department and can get more involved if they have an interest in research. I would say that research is not something we overly emphasize, but we certainly have the resources available within our program to help those with a strong interest in this area. It is not a requirement for candidates applying to our program.

What are some qualities your program looks for in applicants?

One of the missions of UMMC is to train physicians who will stay and practice medicine within our community and its surrounding areas. We do look closely at applicants and ask how likely they are to stay and practice medicine within the state. As far as what we look for in a specific applicant, we definitely want someone who is hardworking and a team player. I think the big difference between EM and other specialties is the necessity to be hands-on and make decisions quickly. You are expected to get in there, get dirty, work hard while you’re there, and juggle multiple tasks at the same time without getting overwhelmed. It is definitely a plus if an applicant has a history of participating in some type of team sport or prior work experience in EM. On the other hand, we also want people who will be able to handle the academic load, because there is a lot to learn.

What type of things helps an applicant stand out?

If someone is interested in EM, the earlier on they show their interest the better off they will be in the application process.  Prior experience is helpful, whether that be as an EMT or ED nurse. Also, those who have successfully completed other residencies typically stand out. Obviously, the large majority of our applicants do not have this type of experience, so it is not expected, but any leg-up is helpful.  

If you had to give one piece of advice to an applicant applying for residency, what would it be?

Every year we see some really quality applicants who move down the rank list just from the way they interact with others. Whether it’s during the pre-interview dinner, interview, or their 4-week rotation with us, I would suggest that, if an applicant is someone who knows they have a personality that may be a little abrasive, they seek coaching and perspective from other people. Know that no matter where you are, any interaction as an applicant should be treated as if it were a job interview.



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