Medical Students, Program Director Interviews, Match

Program Director Interview with Dr. James Willis, Residency Program Director for Kings County Hospital - SUNY Downstate

In the latest installment of our PD Q&A series, we are highlighting the Kings County Hospital - SUNY Downstate Emergency Medicine Residency program. We spoke with the current PD Dr. James Willis about what makes their program unique and what they look for in potential residents.

What sets your program apart from others? And to piggyback: Among the many programs in New York City, what's something that distinguishes your program from other local programs?

There are so many amazing programs in NYC and the country. The integrated SUNY Downstate
and Kings County Emergency Medicine program is part of the County cohort of Emergency
Medicine Residencies. This can mean many things to various programs but for us it comes
down to mission and the institutions we serve. Kings County is part of the largest public hospital
system in the country, Health + Hospitals in NYC. This is the primary clinical site, it's a city
funded hospital with one of the highest volumes in the country. The Sponsoring Institution and
Academic site is SUNY Downstate which is part of the State Health System and is the only
Undergraduate Medical Education institution in the borough of Brooklyn, the 4th largest city in
the country (if it was its own city). Both institutions are funded by the government with the
primary mission of public health and service. The mission of public health and service is always
at the core of all Emergency Departments but our program embodies these characteristics in
our academics, clinical experience, administration and scholarly work.

How does your 4 year EM residency program compare in experiences to other 4 year programs? And more close to home, how does your program overlap (or not) with the combined EM/IM and EM/IM/CC programs at Downstate?

The curriculum for the four years includes off service rotations and dedicated ED subspecialty
rotations to expand knowledge and experience. Our residents do a 4 week rotation in Internal
Medicine, ED based rotations in trauma, orthopedics, stroke/neurology. We have a dedicated
ED run observation unit where our senior residents learn observation medicine. Our residents
do 6 additional weeks of pediatric EM experience above what is required by the ACGME with
longitudinal exposure as a senior resident. We have 6 dedicated weeks of ultrasound clinical
experience. During the fourth year the residents take on the role of a pre-attending where they
precept junior and rotating residents in the ED to start learning skills of an academic attending
and supervising other providers in the ED. There are 12 weeks of elective time during the four
years where residents pursue clinical experiences around the world and country, produce
scholarly work and develop capstone projects. The experience and competency our residents
gain with four years of residency training makes them into the clinical monsters our institution is
known for.

The EM/IM residents are very much ingrained into our residency with their involvement in all our
mini-fellowships, didactics and leadership opportunities. Their experience and expertise only
enriches our residents' education. An EM/IM resident is considered a junior resident in the ED
until their PGY4 year.

What's something students may not know about the program?

Some unique opportunities available to our residents are an Emergency Medicine Forensics
Fellowship. This is the only fellowship of its kind in the US and gives our residents access and
training in the advocacy for victims and vulnerable populations (see the EMRA post about the
Forensic Fellowship). Another opportunity is our Social Emergency Medicine Division with
resident curriculum focusing on social determinants of health, engagement with our community
outside of the hospital and scholarly work and policy implementation working with leaders in
NYC health leadership. There is a unique opportunity with the Health + Hospitals Healthcare
Administrator Scholarship Program (HASP) that residents can enroll in during residency to get
mentorship, education and work on a project making policy change in a H+H facility or system

Our program’s training produces leaders. On average 60% of our graduates go into academics
and fellowship training. Within ten years of graduating residency 25% of our graduates (5
individuals) are in leadership positions and 50% within their career. Our alumni have recently
formed a society to promote engagement between the alumni as well as stay engaged with the
residency, supporting research, social gatherings and wellness in the program.

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

Our departmental research division has four dedicated faculty with protected time to promote
research activity through our faculty and residents. There are opportunities beyond the
department through the State University network and the other colleges at Downstate including
PhDs, a school of public health, nursing schools and more, working on basic science and
medical education research. Residents have 4 weeks of dedicated research time in their
schedules as well as opportunities throughout their four years to work on projects.
Research on candidates' CV is always appreciated but not mandatory. Students with a focus on
public service, education and advocacy are highly valued.

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

Yes we have four dedicated Global Health faculty with a Global Health fellowship and
departmental division. Many of our other faculty are involved in international work and there are
many global health projects with affiliations throughout the world. There is also a non-for-profit,
EMEDEX, with availability for funding resident and faculty projects. We also have an affiliation
with SUNY Public Health school. Our residents have rotated and worked on projects in Haiti,
South Africa, Brazil, India, Sri Lanka, Rwanda, Ghana and many more.

How does your program support residents in pursuing other opportunities, whether it be moonlighting, policy and advocacy, medical education, or any other interest?

This is encouraged and a core aspect of our curriculum. We push residents to get involved in
other extra-clinical pursuits and ask every resident to fulfill a capstone project. The residents
have the opportunity and resources of the mini-fellowships in policy, administration, medical
education, social emergency medicine, ultrasound, simulation, wilderness medicine, sports
medicine and more. These mini fellowships provide residents education, mentorship and
resources to start their career path while still in residency. The clinical responsibilities and hours
are set up in the four years to provide more opportunity and time for engagement in these
activities as the resident becomes more senior.
Moonlighting is available as a resident for additional funds and graduating residents can
moonlight as an independent practitioner at outside institutions with approval.

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

Training at Kings County and Downstate is an amazing but challenging experience. At the core
of the experience and our values is service. Applicants have to show us that this is something
they are passionate about and have a high level of compassion for the patients they care for.
We look for applicants who are dedicated to advocacy, have experience with diverse patient
populations and want to work with the underserved. An interest in education and mentorship is
something we love to see and many medical educators have had their careers started with
training in our program. We look for leadership and a distinct goal of our program is to produce
leaders in emergency medicine.

Can you describe any attributes and qualities that make applicants stand out, either on their application or during an interview?

An attribute that I think makes applicants and residents in the program stand out is being a self
starter. Showing that you have an inner motivation to accomplish goals and break through
barriers will serve you very well in our program. Another attribute that is critical is a commitment
to your community and the underserved. We value students that not only want to become the
best clinicians, but want to affect change outside the hospital walls as well. Having exposure to
community outreach projects as well as work towards improving diversity, equity, and inclusion
are experiences we value highly.

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