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Program Director Interview Series: Michael A Schindlbeck MD, FACEP, FAAEM | EM Residency Program Director at Cook County in Chicago, IL

In the latest installment of our PD Q&A series covering the Midwest, we spoke with Michael A Schindlbeck MD, FACEP, FAAEM, program director at Cook County in Chicago, IL, about the community of his program and what type of residents get attracted to this county setting.

What sets your program apart from others?

There are so many fantastic residency programs out there, each with its own unique character and feel. Everybody knows that "county" programs are defined by the significant level of volume, autonomy, and acuity that we afford our residents, but there is so much more. When I speak to interested candidates every year, I emphasize that the best way to try and understand Cook County is to take a look at the people who call this place home. And by this, I really mean three things. First of all, our residents. We are so fortunate to match 17 phenomenally talented, driven, and diverse residents every year who choose to come to CCH and spend four years not just learning emergency medicine but also lending their personalities to the fabric of our program. Number two, our faculty. We are so fortunate to have 30 of the best and brightest minds in emergency medicine working hand in hand with our residents every day, lending their experience and expertise to the education of our students and residents. And finally, I mean the patients. We are so lucky to work in the safety-net hospital for the 3rd largest metropolitan region in this county, and I always tell my residents that it is a privilege not just to take care of our patient population — but also to learn emergency medicine from them. At the end of the day, they are by far the best teachers that we have.

What is the relationship like between Cook County and the community it serves?

In one form or another, Cook County Hospital has been safeguarding the medical needs of the underserved members of the greater Chicago community for over 150 years. Everybody in a 100-mile radius knows what this institution means to the community, and one wouldn't exist in the same iteration without the other. I frequently have patients in the emergency department joke with me that they were born at the county and that they're going to die at the county, and I joke right back that while that might be true, it won't be in my ED. I have residents in my program who were born at CCH. My assistant program coordinator was born at CCH — my program coordinator gave birth to her there. This place has touched so many lives, and it's so humbling to be part of that legacy.

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

We're very fortunate to have a such a well-recognized and respected name in emergency medicine, which results in so many immensely talented individuals apply to our program every year. Students ask me every year what I'm looking for in an applicant, and I always explain to them that the answer is very simple. Show me you care about my patient population. Show me what you do when you're not in the classroom. Are you working in the student-run free clinic? Are you involved in community outreach programs? Are you working on policy reform to benefit underserved and indigent populations? CCH is a very challenging place to work, and the only true predictor of success in my residents is that, first and foremost, they come here because they believe in the mission and care about what we do.

What range of USMLE/Complex Step 1-2 scores do you look for in an applicant for the program?

USMLE scores are but one piece of a given application and we view them exactly in this light. While they might predict eventual success on one's board exams, they aren't necessarily reflective of the clinical skills and potential that a given applicant may possess. We try to give all of our applicants a very holistic review, with said scores representing a single data point. As such, outside of passing the exams, we do not have absolute cutoffs for our applicants.

What kinds of opportunities for research exist?

One of the real misnomers about training in a county program is that you'll see a lot, do a lot, but not be taught a lot. This fallacy holds true with regards to research as well. What applicants don't realize is that we are truly an academic department with lots of opportunities for scholarship. While we don't have a faculty full of the world's preeminent bench researchers, there is a lot of opportunity to get involved in meaningful and practical patient and population-centered research. We are the host program for a trio of fellowships in Emergency Ultrasound, Medical Toxicology, and Simulation, a setting which affords our residents numerous opportunities to explore their interests in some of EM's subspecialties. Over the past three years, our residents have averaged 15 unique PubMed-indexed publications annually. Roughly 1/3rd of our graduates every year go into fellowship training of some sort with another one or two heading directly into academic faculty positions across the country.

Do you look for residency candidates with research experience?

Research experience, much like the USMLE scores referenced above, is another datapoint in the holistic review of a given applicant. Applicants with research experience tend to have a natural level of intellectual curiosity and drive that will serve them very well in residency and beyond, but that is not at all to say that we don't seriously consider applicants without said experiences. The key to success, in medical school, residency, and beyond, is to follow your interests. If those lie in medical research, great. If not, show us what other talents you have.

What do you think fosters such a strong relationship between residents?

Residency is an exceptionally challenging period in your life, in fact it's often the most challenging time that many of our residents have ever faced. It will bring out the best and worst in you, and at the end of it you might learn just as much about yourself as you do with emergency medicine. Like any such challenge, it also tends to bring out a lot of camaraderie amongst those going through it. As I said above, we are so fortunate to match such a large class of very diverse applicants every year. But the one unifying feature of everyone in this program, from the faculty to the residents to the ancillary staff, is that first and foremost we are all here because we believe in the mission of the institution. That is by far the single most significant credo that binds our residents together.

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