In this months installment of our Resident Q&A series, we are highlighting the Maine Medical Centers Emergency Medicine Residency Program. We spoke with the Chief Resident, Katie Toth, MD, about what makes their program unique from a Residents perspective.
What made you choose your program? Was a 3 year or 4 year program a factor for you when applying?
I chose Maine Med because after my interviews I saw myself thriving the be the best ER doctor I could be here. From my first interactions with the program, I could tell how down-to-earth, supportive and close the entire residency was. People were so good and so humble. I sensed the competence and confidence of the senior residents and knew that was a reflection of the “doers not callers” mentality that is present here. I saw it as the perfect mix of a community/ county/ academic program under one roof that could set me up to work in any job I wanted.
I did not have a strong preference over 3 vs 4 years. Most important to me was where I saw myself fitting in best and used that to drive my rank list.
How does your program provide wellness measures? How would you describe your program culture?
The culture of our program is very much “doers not callers.” We pride ourselves on getting a community training without subspecialty residents and fellows such as ortho and optho and managing our own patients rather than immediately referring to specialists right away. We have a strong culture of support and respect throughout the ED and rest of the hospital.
Many of our wellness measures have been resident driven which results in wellness initiatives that are actually important to us residents, rather than mandated wellness initiatives from outside of the residency. Two large wellness initiatives, amongst many others, include resident breaks on shift and near weekly group therapy/ processing group.
How does your program support you in your career goals - i.e working in the community, preparing you for fellowship, etc.?
MMC supports us in our various career goals in several ways:
1. Many of our attendings work at other hospitals in the community or rural settings. On shift they will push us to think through how care would be different at these various sites to prepare us who plan to practice in community jobs.
2. Many of our faculty are fellowship trained or involved in other medical responsibilities outside of the ED including: critical care, toxicology, PEM, ultrasound, EMS, wellness, MedEd, palliative care, wilderness medicine, geriatrics, administration, global health and research. Because of this, we get exposure to each of these subspecialties throughout our training and opportunities for mentorship and further exploration if we are interested
3. In addition to informal mentoring that inevitably happens from the closeness of our group, there are also formal mentors and tracks that we elect depending on our personal interests
4. We have 2 elective months, one during 2nd and one during 3rd year to explore areas of interest
5. MMC has a very large and vast alumni presence to help network job and fellowship opportunities
Is your program a community based or academic based program? What is the advantage of your program’s setting?
This is one of the areas where Maine Med is very unique, and I think one of the best places to train. We have the perfect combination of an academic and community-based program. We are the only major academic hospital in all of Maine, however we do not have many subspecialty residencies and fellowships that many other large academic institutions have. Therefore, the hospital does not feel overrun with learners and we EM residents take on much more ownership of our patients and procedures because of it, giving more of a community feel. For example, we do not have an ortho residency and therefore we do all reductions and splinting ourselves in the ED.
Faculty at MMC have chosen to be at the largest academic institution in the state and therefore everyone genuinely enjoys and prioritizing teaching. Didactics and on shift teaching are cutting edge and well thought out. One very cool and unique training that we are getting as a result of our highly regarded academic ED Ultrasound faculty group is the use of resuscitative TEE during cardiac arrest. Starting our second year, we learn how to perform a resuscitative TEE and do so during cardiac arrests in the ED.
What is something students may not know about your program?
We are genuinely a very close group of people who come from all over but were all drawn to this special, difficult to qualify beautiful feeling that MMC gave us and continues to give us. My co-residents are some of my closest friends, my attendings are my biggest role models and nurses/ techs/ pharmacists/ other ED staff are some of my favorite people. MMC EM is truly such a special place.
What is something medical students can do to help prepare for residency?
During fourth year rotations, start changing your mindset to that of a resident- thinking about the patient in front of you rather than the textbook. Ask tons of questions and try your best, don’t be afraid to fail. One of the most liberating parts of residency is no longer being under the microscope and just focusing on learning how to be a doctor and take care of people rather than worrying about everything else. The sooner you are able to do that, the more you will learn!
Residency is hard. The same way you would rest before a big athletic race, I think it is imperative to rest and reset before starting residency. If able, prioritize doing the things you love with the people you love. Time becomes limited during residency, and nothing is guaranteed so any down time leading up to residency is truly precious!
And finally, you’ve made it this far. Relax and enjoy :)