In the latest installment of our Program Director Interview Series, we are highlighting the Duke University School of Medicine EM program in Durham, N.C. We spoke with the current PD Joshua Broder, M.D., in 2023 about what makes his program unique and what he looks for in potential residents.
What sets your program apart from others?
I don't like to compare our program to any other, because there are so many wonderful programs, each with its unique features. We are very lucky at Duke to have incredible diversity in our program, as well as in the institution as a whole. 50% of our residents are women, and over a third are from groups underrepresented in medicine. Our current residents have ties to 16 countries on 5 continents and include members and allies of the LGBQT+ community. Our group is deeply committed to serving our community, both through efforts starting in the emergency department and through our outreach, which includes a focus on social determinants of health such as food and housing insecurity. Our residents and faculty mentor local students to open new paths to careers in medicine. Our medical campus adjoins the undergraduate and graduate schools, facilitating collaboration. And our faculty group includes many nationally recognized educators and researchers, with honors from the American College of Emergency Physicians, Council of Residency Directors in Emergency Medicine, Society for Academic Emergency Medicine, and the ACGME. Duke Health serves a diverse spectrum of patients from many backgrounds, and with health needs spanning from the core of Emergency Medicine (appendicitis, STEMI, stroke, sepsis, trauma) to the cutting edge of medical technology.
What are the benefits of attending a 3 vs. 4-year EM residency program?
Our program is a 3-year residency, with an option to add a dedicated research year between the second and third clinical years of training. Over the life of the program, we’ve seen our residents become outstanding clinicians and leaders in three years, supported by our faculty and the amazing clinical exposure in the ED and beyond. Some have chosen to extend training with specialty fellowships, while others have sought diverse careers immediately after graduation. Our graduates have thrived in academics, community roles, international work, and rural settings.
What is something students may not know about your program?
Duke is both a quaternary care center and the local hospital to the people of Durham, North Carolina. In the latter role, we’re the place where any patient may seek care if their day begins with right lower quadrant pain, an asthma flare, or a motor vehicle collision. In the former, we’re a hospital of hope for patients with complex conditions requiring breakthrough innovations. Our residents experience the best of both worlds.
What range of USMLE/COMLEX Step 1 scores do you look for in an applicant for the program?
We set no limits for either test and consider applicants from both MD and DO training programs, using a holistic approach. Our Chief Residents over the years have included MD and DO graduates, and our faculty also include physicians from both training paths.
Or alternatively, how do you feel about the change to pass/fail Step 1 grading?
Emergency Medicine requires a broad and deep knowledge base and the ability to apply that knowledge clinically. As we review an applicant’s record, we look for evidence of this, of which test scores are just one component. An applicant’s performance during Emergency Medicine rotations is often the most valuable illustration of their use of their knowledge.
What kinds of opportunities for research exist? Do you look for residency candidates with research experience?
Duke offers a wealth of research opportunities across the spectrum from basic science to clinical research. Our faculty are funded by NASA, the National Institutes of Health, the federal Substance Abuse and Mental Health Services Administration, and more. Residents and faculty have received grants from EMRA, SAEM, and the Emergency Medicine Foundation. In 2022, Duke was in the top 20 Departments of Emergency Medicine in the country for NIH funding. While many of our residents do have research experience, many do not – and yet have gone on to great success in research. One Chief Resident with no advanced research background had his interests piqued in residency and stayed as a faculty member, becoming a national expert in thrombosis and hemostasis (and learning to run an electron microscope here). Others without research training have chosen our research fellowship option (a decision that residents make after Matching, usually sometime in the 18 months of residency). Residents can work with Dan Buckland (our engineering rocket scientist who designs robots for space medicine), Stephanie Eucker (a SAMHSA-funded pain researcher), John Purakal (a leader in social determinants of health), Charles Gerardo (a national snake envenomation expert), Sam Francis (the aforementioned clot expert), Bruce Derrick (a guru on extreme environmental medicine), and many more.
Do you have opportunities to explore global health at your institution?
Duke offers premier opportunities in global health with our fellowship, the Duke GEMINI (Global Emergency Medicine Innovation and Implementation lab), and the vast resources of the Duke Global Health Institute. Our global health leaders, Catherine Staton and Julian Hertz, are NIH-funded researchers with programs spanning from Tanzania to the Brazilian Amazon. Our current Chief Resident and Resident Research Fellow, Lauren Coaxum, is traveling to Tanzania this year for her research.
What are some qualities that your program looks for in applicants?
Teamwork, positivity, empathy, resilience, service, and inclusivity are key features we seek – the same qualities that shine in our residents and faculty.
Can you describe any attributes and qualities that make applicants stand out?
Not every applicant has had a the same challenges along their path. We’re interested in learning about each individual, the course they’ve navigated, and their hopes and dreams for their career ahead. Our goal is to help our residents achieve those dreams – and then to extend the boundaries of what each can imagine for themselves, our field, our patients, and our communities.