In the latest installment of our PD Q&A series, we are highlighting the Harvard Affiliated Emergency Medicine Residency at Massachusetts General in Boston. We spoke with the current PD, Daniel J. Egan, MD, in 2023 about what makes his program unique and what he looks for in potential residents.
What sets your program apart from others?
I think that we are lucky in having our program based at two large academic medical centers. As a result, the residents have access to more than 120 full-time faculty members, many of whom are national leaders in their subspecialty. Faculty represent all of the subspecialties in emergency medicine and residency have access to meaningful mentorship and opportunities for research and publications. With a commitment to residents having the time and opportunity to develop an area of interest in emergency medicine, there is significant elective time carved out in the program beginning in the second year. In terms of clinical practice, as large referral centers, residents are exposed to the full spectrum of emergency medicine in high acuity centers. We serve a large catchment area locally and then are the receiving hospital for a significant portion of New England.
What are the benefits of attending a 3- vs. a 4-year EM residency program?
There is a lot to learn in emergency medicine both in terms of the clinical practice of our specialty and also the identification of what one wants to do long term in their practice. Attending a 4-year program allows for a number of opportunities that may not be as readily available during 3 years. In the clinical space, a 4-year program allows for progression of responsibility over time such that by the last year, residents are able to assume a supervisory role after forming a solid foundation as a clinician before this point. As it relates to career development, the 4-year model gives residents sufficient time to explore an area of interest, particularly as one prepares for either a fellowship or academic job application. The added time allows for elective opportunities in a more robust way, and the chance to work on a meaningful scholarly project which often leads to national presentations or publications. This time allows you to build a portfolio that will position you for success when you are applying for the next portion of your career.
What is something students may not know about your program?
I think that many people have an assumption of what the culture of Harvard institutions may be. The truth is that while students who choose to come here for residency are highly motivated and successful students, the culture of our program is one of community and support. It is a place where residents are not competing against each other but rather amplify the success of their peers. Faculty members are extremely approachable and we have a great relationship between all work groups.
How do you feel about the change to pass/fail Step 1 grading? Has this changed the importance your program places on Step 2?
Our program has embraced a more holistic approach to screening of residency applications and recognizes that there are inherent biases in the standardized examinations. As such, we pay much more attention to the performance of students on their clinical clerkships and most importantly on their sub-internships in emergency medicine.
What kinds of opportunities for research exist? Do you look for residency candidates with research experience?
There are innumerable opportunities for research in our program. Both MGH and BWH have active research divisions across multiple disciplines within emergency medicine. We believe that advancing the scholarship in emergency medicine is critical for our specialty and this is a priority of our departments for our faculty. This is a program where residents with research interests can thrive. We do look for applicants who have had involvement in research as a predictor of future involvement in research. That being said, we also recognize that access to research is also influenced by the mentorship and opportunities available to a student and for some they may not have had the chance to get involved. However, if research is something of interest to a student, this would be a great place to train.
Do you have opportunities to explore global health at your institution?
We have a fellowship in International Emergency Medicine at Brigham and Women’s Hospital and with that many opportunities for involvement in global health. The faculty of our global health division are actively involved in projects around the world and welcome resident involvement in those opportunities. Additionally, the faculty can mentor a resident who has a new idea or finds an opportunity outside of their already established work. Several residents each year take part in international opportunities that include teaching, research and clinical medicine. We also have the benefit of the Harvard Humanitarian Initiative which is led by several members of our faculty. This also provides other opportunities for resident engagement around the world.
What are some qualities that your program looks for in applicants?
We are looking to train the next generation of leaders in emergency medicine. Applicants who have demonstrated leadership are likely going to continue that in the future and would do well in our program. We want our graduate to go on from the program and be change-makers in emergency medicine and the larger world of medicine in general. Applicants who bring a passion about some aspect of medicine do well in our program. We want to foster the growth of that passion through the pursuit of scholarship, development of expertise and work that can translate that passion in to products. As a program, we are committed to the values of equity and inclusion and want residents who will join in that mission of providing outstanding care to the most vulnerable and working to decrease disparities both in the patient care setting as well as in medicine.
Can you describe any attributes and qualities that make applicants stand out?
Applicants who have made an impact on their medical school or community are ones who stand out. In general, what people have done in previous stages of their life are somewhat predictive of what will happen during residency. It is great for someone to arrive to residency with the idea that they will leave the program different or better because they spent four years here. If someone has done that in medical school, it demonstrates their ability to lead and succeed which are outstanding qualities in a resident.