Match, Program Director Interviews

Program Director Interview Series: Braden Hexom, MD | Emergency Medicine Residency Program Director at Rush University Medical Center, Chicago, IL

Samuel Southgate, MSIV, University of Connecticut School of Medicine
EMRA MSC Editor, 2019-20

We are back in the Midwest for our Program Director Interview Series this month, featuring Braden Hexom, MD, EM residency program director at Rush University Medical Center. He spoke to us about the opportunities available at this relatively young program and gave us advice as to how applicants can make themselves stand out.

What sets your program apart from others?

We focus on small teams and personalized mentorship. Residents often work directly with attendings so even as interns you are getting to see the sickest patients. We start our interns in the ED, rather than having you spend your first year on many off-service assignments. I'd rather you spend more of internship in an environment where you get to see real Emergency Medicine and learn from our faculty – rather than from faculty from the upstairs services. That way when you go to the cardiac ICU or medical ICU you have a bit more knowledge to bring, you can ask better questions, and feel less lost. You also learn confidence and independent management right from the start, with individualized guidance from our faculty. That mentorship translates into career planning as well. We allow a flexible elective schedule to encourage residents to get involved in other activities, pursue academic interests, and develop their niche. We have sought out other ED experiences that augment learning so that by the time of graduation, residents have experienced the full range of ED possibilities, from community sites to urban trauma to complex tertiary care.

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

Rush University Medical Center is one of the safest, most efficient university-based hospitals in the country. As such, we know we can train excellent emergency physicians in three years. Our residents hit the ground running, managing sick patients early in intern year. By second year, residents are managing an entire zone. And by third year they are developing content expertise and leading teaching modules. And throughout they are learning to be fast, efficient emergency physicians. We are metrics-based and data driven. So of course we are a 3-year program. That being said, we also offer fellowships in ultrasound, simulation, and addiction medicine that allow graduating residents to develop further specialization. As a newer program, our graduates have yet to fully enter practice, but I anticipate about half of our residents will enter fellowship or academic practice.

What is something students may not know about your program?

Rush is Chicago’s emergency response center and we are able to convert the ground floor of our hospital into a treatment facility in the case of a large-scale health emergency.

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

We take both USMLE and COMLEX and have no set cutoff for either. We look at a student’s whole application when considering whether they will be successful in our program. I am more interested in the unique skills or experiences that applicants might bring to our program. Innate leadership skills, self-motivation, and the ability to communicate with a wide diversity of people are much more important to me than licensing scores. But being able to pass the ABEM exam is important too...

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

We have numerous research opportunities and we are at the leading edge of clinical research in informatics, quality improvement, addiction, ultrasound, and simulation. In our first year as a residency program, all 12 of our interns were involved in peer-reviewed publications, which exceeded my wildest expectations. Residents interested in research will find dedicated mentorship and opportunities to publish. While previous experience in research is not needed coming into residency, having an inquisitive mind and being able to ask tough questions is expected and encouraged.

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

Through Rush Global Health we are developing close relationships with partners in the Dominican Republic and Haiti. Our department consults on toxicology, EMS, and simulation, and we have hosted trainings for emergency providers in the Dominican Republic. We have implemented a novel Community and Global Health curriculum for interested residents that connects those interested in global health with other residents focused on domestic health disparities in Chicago and elsewhere. We are also partnering with other global health-interested residents and faculty in Chicago to share ideas, collaborate, and create a cohesive community. Chicago is truly an amazing place to be an emergency medicine resident interested in global health.

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

First and foremost, I look for inherent leadership qualities. That doesn't necessarily mean you have to have been a leader in some organization, but simply that applicants possess the drive, communication skills, and humility to become a leader. Because that is eventually what an Emergency Physician must be: the leader of the department, the person that sets the tone and direction for everyone else in the ED. And that takes empathy, confidence, an even temper, deep knowledge of medicine, and an ability to roll with the punches. Applicants don't need to come in with all of those things, but they must have the potential to grow into them. So, ultimately, it takes self-reflection and the ability to let yourself be fundamentally changed by the process of becoming an emergency physician.

Can you describe any attributes and qualities that make applicants stand out?

It's really hard to do this, since so many applications start to look the same. I have little patience for personal statements that begin with, "I knew I wanted to be an emergency physician ever since I saw a really sick patient in the ER that one day..." Instead, tell me about who you are, what makes you special, what makes you resilient? I don't care if you don't mention the ED at all. Tell me something that you've learned about life. What experience has had a formative impact in how you see the world? One of my residents discussed in his application how he ran a fitness center and then a successful property maintenance company for several years so his family could eat - and how putting his family first made him doubly motivated to be a physician when the time came in his life to be able to pivot. That's the kind of self-motivated, future leader I see doing well at Rush.

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