Program Director Interviews

Program Director Interview Series: Bonnie Kaplan, MD | EM Residency Program Director at Denver Health Emergency Medicine Residency, Denver, CO

In this month’s addition to the Program Director Interview Series we got to chat with Dr. Bonnie Kaplan to learn about the Denver Health Emergency Medicine Residency Program

What sets your program apart from others?

I’d say a few things. Number one are the people, I know everyone says that, but we have an incredible group of residents, faculty, consults, collaborators, nurses, techs, and attendings that are all here for the residency. We’re super resident-focused and driven, which helps us stand out in important ways. Equally, we take a lot of pride in who we take care of. Denver Health’s catchphrase is “Level one care for all,” and we live it, breathe it, and believe it. Finally, in order to make these incredible clinicians that can go wherever they want, we have a graduated level of responsibility that focuses on clinical responsibility, management, leadership, and teaching.

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

A lot of people joke that the optimal length of a residency is 3.6 years. From our perspective, it is the graduated level of responsibility into the management and leadership training that sets us apart and makes our fourth year important. The ability to explore all of the aspects of emergency medicine with the elective time also makes the fourth year worthwhile. All of that aside, I have to tell you, there’s something to be said for seeing so much. None of our patients read the textbooks, and so getting that volume, the breadth of experience, teaching and managing it, and having the time to do that in the structure of residency can set you apart when you are graduating.

What is something students may not know about your program?

I think one thing they might not know is the diversity of the patients we get to care for. At Denver Health about 40% of the patients we care for identify as Hispanic, and we have a huge refugee population. So students may not realize the depth and the breadth of who we are privileged to take care of. That’s a little bit because of Denver and the stereotypes around the city. 

The other thing that people might know, but I don’t think I was savvy enough to realize the importance of when I was going through the process, is that Denver is a resident-driven program, meaning residents are the ones taking ownership and making decisions. For example, our fourth years are running the Emergency Department, they have the appropriate amount of ownership of their patients, they are making decisions, nurses and techs go to them. Even more broadly, our best ideas for improving our program come from our residents. There are places that might be more fellowship-driven, or attending-driven and they’re all great. I’m a little bit biased, but from my perspective, I think it’s really great that we are resident-driven hospitals, resident-driven programs, and resident focused.

What kind of wellness initiatives do you have for residents at Denver?

There’s been pushing within our residency leadership around wellness initiatives, and we actually think that combines with our diversity, equity, and inclusion initiatives as well. We have a social worker on board with our program who functions as a coach. During didactic, residents get pulled out to get an opportunity to chat about the real deal that happens in residency-- financial struggles, relationship struggles, work stresses. We’re humans, we’re going to make mistakes, but we want our residents to be able to talk about and process those issues. He’s also there for brighter times like career planning and thinking about what you want to do after graduation. We have a number of other great initiatives, like no sick call payback which allows you to just be sick and not worry about having to “payback” a shift later. We have a Lyft program where if you feel too tired to drive after a shift the residency will pay for your Lyft home and back to the hospital. But we also see wellness as remembering that driving force that brought us into medicine. Before COVID, we used one of our conferences to teach CPR to people in our community, and we often volunteer together.

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

We revamped how we review applications this year. Ideally we’d love you above 215 either on Step 1 or Step 2, but it’s not the end all be all. We’ve diminished how much the score factors in. If you do fail Step 1, we like to see a big improvement, but again, it’s just one part of the application.

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

There are a wide variety of opportunities at Denver Health and at the University. Basic science lab facilities are available at the University of Colorado. Multiple large databases for retrospective studies (including the Colorado trauma database and the Kaiser outcome database) are available. There are also numerous clinical study possibilities with an annual combined census of over 250,000 in the participating institutions. The DHREM staff and residents are prolific researchers. More detailed information can be found on our research website.

As far as research for residency candidates, we have started to look at values and attributes more generally. Sure, we’d love you to have some research experience. We’d also love you to have some leadership experience. We are looking for people that really love the area they go into. So if you only do research, but you love that research, can talk about, and have excelled in it, we think that’ll be interesting to get to know you. But we also look for people that love community service or leadership or have prior life experience that brings a different perspective to the table.

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

Absolutely, we have a Global Health Section that has faculty from Denver Health and the University of Colorado. They do everything from policy with the WHO to education to EMS work. We have a couple residents each year that are pretty active in Global Health initiatives, do electives, research, and are go down the Global Health career path. We also have a fellowship in Global Health. 

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

I talk a lot about the humble, hardworking, team player. That’s my quick explanation, but here’s what I mean. We want people without an ego. We have incredible ancillary staff, incredible consultants, incredible patients, and incredible residents, so there’s always a learning opportunity. We are looking for people that are willing to embrace those opportunities. While we work about the average number of shifts for a program, the intensity of the work on shift and the number of patients residents see is up there. So we’re a place where you need to learn by doing. If that’s who you are and how you work, Denver is great for you. Finally, we’re looking for people that are really mission-driven and want to take care of our patients.

How has COVID-19 impacted training and how has your program adapted?

We have a lot of the same restrictions as other programs. So our conference has become totally virtual, residency interviews are virtual, and there are pros and cons to both of those. One of our big challenges is that a lot of our residents are transplants from outside of Denver, and they get really close and social, so it’s been hard to not have those chances to become more of a family in person. We’ve worked to combat that by utilizing small groups with our weekly conferences. When it was okay to do things outdoors, we did as much as we could outdoors in small groups. For the clinical side of training, so far (knock on wood), Denver has been doing really well. At the height of the pandemic we offered shift relief for our COVID areas, we pushed the hospital to make free food available to all of our residents, and we have made sure we’ve had a good supply of proper PPE. 

If you could describe the culture of DHREM in three words, which three would best represent your program?

Passionate, outspoken, mission-driven.

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