Rotation Curriculum

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We work on thirteen 28-day blocks in the year. The HO1 year is designed to expose our interns to the broad range of conditions you will be confronted with during your career. You are also given ample opportunity to hone basic procedural and management skills. Pediatric experience is focused in two dedicated months in the pediatric ED. HO2 is the critical care year. This is the time we expect our residents to become comfortable caring for critically ill patients and applying the skills refined in intern year. Pediatric experience is integrated with periodic shifts in the peds ED scheduled along with main ED shifts to better reflect community practice. In the HO3 year, goals are to consolidate your knowledge base, refine management skills, supervisory and teaching skills, experience other models and roles of provision of emergency care (community, triage) and explore areas of special interest through electives.
HO1 HO2 HO3
  1. Orientation to Emergency Medicine
  2. Emergency Department (4)
  3. Pediatric Emergency Medicine (2)
  4. TSICU
  5. Toxicology/Ultrasound
  6. Obstetrics/Gyn Consult
  7. Anesthesiology/VA EM
  8. Medical Intensive Care Unit
  9. Cardiology Consult: 2 weeks
  10. Peds Anesthesia: 2 weeks
  1. ED/Peds ED (integrated) (8)
  2. EMS/US
  3. Medical Intensive Care Unit
  4. Neurosurgical ICU
  5. Cardiology
  6. Orthopedics
  1. ED/Peds ED (integrated) (8)
  2. New Born ICU (2 weeks)
  3. Elective (2)
  4. ED Community/Rural (2)
  5. Medical Intensive Care Unit

Roles in the ED

The two Main ED pods are each staffed by an attending, a senior resident and an intern or PA/NP. The pods work relatively independently. Critical patients are seen in the resuscitation area and are split between the two pods except when there is a dedicated resuscitation team scheduled. Psychiatric or intoxicated patients are placed in a locked down unit and these patients are also split between the two Pods.

All patient airways are managed by the Emergency Medicine team. Anesthesia, ENT or Trauma Surgery back up is available at the discretion of the EM team. Chest tubes on Trauma activated patients are placed either by the Trauma team or the Emergency Medicine team depending on the condition of the patient and experience of the residents involved. All chest tubes for non-Trauma active patients or medical patients are placed by the Emergency Medicine team.

A dedicated Resuscitation team is scheduled every weekday evening to focus on the most critically ill and injured patients and allow the rest of the department to function smoothly. The team is made up of an attending, senior resident, and in the second half of the year, an intern.

All interns in the Emergency Department are treated equally in terms of schedule, responsibilities and authority. Interns generally see one patient at a time, present to the attending immediately, and develop a plan of care. They respond to resuscitations with their team to help develop the skills needed for the transition to the second year.

HO2 residents are senior residents in the department. They are working on multitasking and management skills with guidance from the faculty. They are expected to manage several patients simultaneously, hone their resuscitation and procedural skills, and begin developing their situational awareness within the department.

HO3 residents in Emergency Medicine should begin to take more of a role in managing the ED while still having primary responsibility for a wide variety of patients in the ED. The HO3s help the attending triage incoming ambulances, triage patients to monitored beds, facilitate flow of patients in the ED and supervise procedures being done by more junior residents. HO3 residents are also expected to help to integrate EM interns into patient care in the trauma/resuscitation areas. This is an opportunity to develop critical bedside teaching skills. To further facilitate HO3s supervising and teaching skills, each resident is scheduled for teaching shifts when they do not see their own patients but focus instead on teaching students and interns.
Curriculum