Resident Education

Our emergency medicine residency program is fully accredited (with zero citations) and conforms to the curriculum requirements of the Accreditation Council for Graduate Medical Education as set forth by the Residency Review Committee.

The residency adheres to a PGY 1 - 2 - 3 format with 14 residents per year in addition to fellowship positions in research, toxicology, global medicine, emergency medical services, ultrasound, Operational /Disaster medicine and pediatric emergency medicine.

Residents in emergency medicine learn the practice and art of emergency medicine in a busy urban medical center that has a good blend of private and under-served patients. They are supervised 24 hours a day by experienced academic and clinical faculty who are actively involved in bedside teaching. Residents spend an average of 50 hours per week managing patients during emergency department months. Coordinated scheduling of medical students and residents at each postgraduate level allows for graded responsibility and teaching.

Our block conference schedule includes four hours of didactics per week in addition to high quality opportunities for I.I.I. (Individualized Interactive Instruction). The lecture curriculum includes core EM topics, weekly M & M conferences, a monthly evidence-based medicine series, interdepartmental conferences, ultrasound and clinical case conferences. There are dedicated symposia each year for ECG interpretation, airway management, wound care, shock and risk management.

The majority of conferences are given by emergency medicine faculty. Residents are responsible for one formal didactic presentation in each of the PGY-2 and -3 years. PGY-2's will also present a conference during their Orthopedic month.

Journal club is held monthly at an attending physician's home and is both a time for learning and enjoying each other's company.

During the year, we have a Visiting Professor program in which distinguished and nationally recognized emergency physicians are invited to join us for bedside teaching, conferences, and socializing.

Current rotations for our emergency medicine residents include:

PGY-1

• 1 month orientation in emergency medicine
• 4 months in the emergency department (adult and pediatric)
• 1 month in Trauma Emergency General Surgery (TEGS)
• 1 month in orthopedics
• 1 month in the medical intensive care unit
• 1 month in OB/GYN
• 1 month in pediatrics
• 1 month in ultrasound / anesthesia
• 1 month in cardiology

PGY-2

• 6 months in the emergency department (adult and pediatric)
• 1 month in the cardiac intensive care unit
• 1 month in the medical intensive care unit
• 1 month in the trauma intensive care unit
• 1 month in children's emergency department
• 1 month in toxicology
• 1 month in EMS

PGY-3

• 8 months in the emergency department (adult and pediatric)
• 1 month in the pediatric intensive care unit
• 3 months elective

Each resident is assigned a faculty advisor. The faculty advisor is available for counseling, conducts semiannual evaluations with his or her advisee, and assists the resident with the selection of curriculum electives, CME, as well as the development and completion of a publishable manuscript which is a requirement of the residency.

The emergency medicine resident spends much of his or her first year of training with other specialties acquiring skills and knowledge that are fundamental and essential to the practice of emergency medicine. Because most services take care of their own patients in the intensive care units, the PGY-1 resident will have an opportunity to be involved with the management of critically ill and injured patients. Additionally, the first-year residents have early critical care exposure for a month in the MICU.

In the PGY-2 year, the emergency medicine resident has increased responsibilities during the five months spent in the emergency department. Individual patient management is stressed, and opportunities to perform major procedures are provided. In addition, the resident acquires skills in the care of critically ill cardiac, medical, trauma and poisoned patients. All trauma or critically ill patients are initially evaluated and stabilized in the emergency department. Residents from other services are not present in the emergency department unless consulted or completing an elective in the department.

The specialty rotations during the second year are aimed at broadening the emergency physician's ability to handle acutely ill patients, while offering initial exposure to other surgical subspecialties and continuing exposure to pediatric patients. Instead of doing EMS in the second year, the resident may choose to do a month of research or elective and take EMS during the third year (in place of an elective month in the third year). This allows the resident important educational flexibility and the opportunity to initiate an elective research project early in the second year of training.

The PGY-3 year involves increasing emergency department responsibility for teaching in addition to the management of critically ill and injured patients. A PGY-3 resident is present and responsible for managing the Major Treatment area at all times. The resident will also provide online medical control for both ground and aero-medical emergency medical services.

Simulation

Simulation: Emergency medicine, by nature, is filled with critical, low-frequency procedures and patient presentations. At CMC, we supplement the residents' robust clinical experience with a high-fidelity simulation curriculum to ensure that learners are comfortable with the full-spectrum of our specialty. The curriculum uses a combination of high-fidelity mannequins with touch-screen technology, task trainers for procedures, standardized patients, and actors that play the part of nurses and family members. We concentrate our efforts on making the experience as realistic and high-yield as possible.

Once per month, residents attend a half-day session that is a combination of clinical cases and procedures. Multiple faculty members attend as well, giving give real-time teaching and feedback. Twice per year, we also have a block session in which each resident gets his or her own case and small group feedback session. The time during the block session is protected, and all residents attend - even if off-service. This July, we had our first "Second-Year Critical Care" session, in which each second year resident had the opportunity to run codes and critical care cases. In the future, we are planning to explore adding to our curriculum wilderness medicine cases, resident-written cases, and optional simulation.

Read more about the program.