Our overall clinic curriculum is shown below. All of the rotations consist of 4-week blocks rather than monthly schedules, or thirteen 4-week blocks per year. The clinical shifts are 10 hours across all 4 years. In Emergency Medicine rotations, PGY-1 residents work 20 shifts, PGY-2 residents work 19 shifts, and PGY-3 residents work 17 shifts. In order to optimize your pediatric experience, we have dedicated Pediatric Emergency Medicine blocks, but also two of the shifts for each ED block are worked in the Pediatric ED.
Our curriculum places emphasis on building a solid foundation in Emergency Medicine in the PGY-1 year. All incoming residents have their first rotation in Emergency Medicine. There are fewer clinical shifts with an increased number of small group conferences, labs, and simulations. This introductory month is designed to address basic emergency medicine principles and skills while also allowing you to learn the system and get to know each other. The remainder of the PGY-1 year builds your knowledge base and expands your ability to manage individual cases. PGY-1 residents always will be working with a junior or senior resident in the department.
The PGY-2 level of responsibility focuses on the refinement of patient management and expansion of responsibilities. Additional responsibilities include running resuscitations, airway management in "trauma alert" resuscitations, teaching, and critical care rotations. PGY-2 residents also begin to have "just you moments," late night/early morning periods in which only the PGY-2 resident and one attending are staffing a section of the emergency department. PGY-2 residents also have a consultant role on the toxicology rotation, evaluating and recommending management for patients with toxic exposures in the ED and throughout the hospital, staffed with one of the department's three toxicologists. PGY-2 residents will also begin to respond to EMS online medical direction. PGY-2 residents have one elective to pursue an independent interest.
The PGY-3 level of responsibility places emphasis on managing multiple patients and the further development of skills required for independent practice. While there are fewer clinical shifts in the ED, more responsibility is required. PGY-3 residents are expected to manage patients independently, and to help teach more junior residents and medical students, both during daily shifts and during a dedicated teaching rotation. PGY-3 residents also have an elective to pursue an independent interest, perform research, or prepare for fellowship.
We have also developed a reading plan that spans all three years of residency. Rather than just providing a study guide or having residency-wide textbook reading lists, we have developed a reading plan that coincides with your individual clinical schedule. This plan both reinforces concepts that follow your clinical work, but makes the task of acquiring the vast breadth of emergency medicine far less daunting. In short, the plan covers any of the major textbooks twice over a three year span. There are assigned review questions that then allow you to self-assess how well you are assimilating what you have read, and get practice in preparing for in-service examinations and the written certifying examination.
The residency program holds its didactic conferences on Tuesday mornings, with 4 hours of scheduled conference and one hour of asynchronous learning. Didactic conferences include lectures on core topics, Emergency Medicine Grand Rounds, joint conference with Trauma Grand Rounds, morbidity and mortality conferences, Toxicology Grand Rounds, case conferences, EKG interpretation, radiology, simulations, skills labs, and journal clubs. We are growing our number of small group exercises in an effort to get away from traditional Powerpoint presentations. Junior and senior Emergency Medicine residents develop several of our recurring conferences, such as Toxicology case conference, Grand Rounds, and Toxicology Grand Rounds with some guidance provided by faculty members.