Match, Program Director Interviews, Medical Students

Program Director interview with Dr. Casey MacVane, Program Director at Maine Medical Center in Portland, ME

In the latest installment of our PD Q&A series, we are highlighting the Maine Medical Center EM Residency Program. We spoke with the current PD Dr. Casey MacVane, about what makes her program unique and what she looks for in potential residents.

What sets your program apart from others?

One of the main things that is unique about our program is the fact that our residents practice in a tertiary care environment without a great deal of competition from other subspecialty services. Maine Medical Center (MMC) does not have Orthopedics, Ophthalmology or Otolaryngology residency programs and we only rarely have Plastic Surgery fellows. This means that our residents do a ton of fracture reductions (think lots of summer tourists doing fun outdoor activities and slippery winter mornings), drain their own peritonsillar abscesses and perform lateral canthotomies themselves (with help from attendings, of course). Our residents like to say that they are “doers and not callers”. Because of this training over 3 years, our residents feel very confident taking care of any patient who presents with any complaint. Our graduates often take jobs in remote locations where they are able to function without a large amount of consultant support.
Some other unique aspects of the clinical experience at MMC are related to the fact that MMC is the only Level 1 Trauma Center in Maine and the only major academic center. Because of this, our residents see an incredible mix of patients receiving high-level medical care for complex trauma, LVADs, transplants, neurointerventional stroke, congenital heart patients, etc. However, since MMC is the community hospital for Portland, the largest city in our state, our residents are also exposed to a great deal of bread and butter complaints such as abdominal pain and pneumonia. Importantly, MMC residents also take care of pediatric patients every day on
every shift, as opposed to Pediatrics being a stand-alone rotation.
Lastly, I truly believe that a lot of what sets our program apart is the amazing people here. MMC faculty are incredibly dedicated to teaching and mentoring. In my opinion, our residents are the best in the country (maybe I’m biased). They are engaged, enthusiastic and compassionate.

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

There is no doubt that an extra year of training provides residents with more time to develop clinical skills. That being said, the main argument for doing a 4 year program is usually to develop an academic niche, which can certainly be accomplished through completing a fellowship. In the end, I usually advise students to choose a program that they are excited about and will be happy at, regardless of duration since there are many different pathways to success and happiness in EM.
In our program we strive to graduate residents in 3 years who are clinically excellent and well prepared for careers in either community or academic Emergency Medicine. Our faculty represent a broad diversity of interests in emergency medicine and residents have the opportunity to work closely with all of them from the first day of their training. Because of this, we have found that our residents have been incredibly successful in achieving their preferred jobs and fellowships out of residency with an average of 1/3 of our  raduates pursuing fellowship each year.

What is something students may not know about your program?

One of the biggest surprises for our applicants and new residents is usually how diverse Portland, Maine is. Portland has been a major immigration resettlement city for many years and has recently had a large influx of refugees. For many years, Portland welcomed people from Southeast Asia and Eastern Africa, but recent arrivals are primarily from the Democratic Republic of Congo and Angola. This means that our residents use interpreters each and every shift and relish the opportunity to care for people new to the US with medical and social needs that are different from those of other patients. We are very fortunate to have such diversity in our patient population which makes the experience of both working at MMC and living in Portland, Maine much richer. This is coupled with an emergency department and hospital system committed to providing effective and accessible care to all of our patients. We are fortunate to have the resources we need to meet the medical and social needs of our patients.

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

We are committed to holistic review of applicants to our program in an effort to identify those students who will be most successful in our program and who will contribute to our mission of providing high quality clinical care, meeting the needs of our community, fostering a culture of wellness, and developing life-long learning skills. Because of this, we do not have a certain score that we require applicants to have achieved. We look broadly at each applicant’s entire application and make a determination as to whether they an achieve competency and be successful both in our program and in passing the boards. Once we make the determination that an applicant can do the academic work we require, we look to other aspects of the application to determine who to invite for an interview.

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

We have an incredible number of research opportunities for residents at MMC, due mostly to our incredible research director, Dr. Tania Strout. We require all residents to complete a scholarly project and see large variety in the type of projects completed. Recent  projects have focused on diverse areas including the physiologic effects of shift work on pregnant workers, the experience of non-English speaking patients in our emergency department, stigmatizing language in patient records, ultrasound education and regional anesthesia, EMS provider experience and education around death notification, post-cardiac arrest cooling, and stroke outcomes amongst other topics. We love when applicants have exciting EM research projects they have participated in and can discuss with us. however, we understand that Covid made being part of research projects difficult and many students have not had the opportunity to partake in research. We are primarily interested in applicants who show enthusiasm for EM and will contribute to our specialty and field in all different ways.

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

We have had many residents participate in global health initiatives over the years and continue to encourage and support residents in participating in these experiences.

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

We are looking for residents who want to be engaged in a program and have interesting experiences and backgrounds to enrich our program. There is no one type of applicant we are interested in and in fact we hope to have residents from different backgrounds and geographic areas and who represent different areas of interest. We strive to find residents who have demonstrated hard work, the ability to work well within the team environment, enthusiasm, teachability and resilience, among many other attributes. Most of all, we know that residents who are motivated to engage with us actively in all aspects of the training program, both clinical and non-clinical are those most likely to be successful.

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