Emergency Medicine - First Year

Institution: Regions Hospital

Educational objectives:

Develop competency to practice in any emergency department environment. This is accomplished by graduated responsibility and is done under the supervision of attending staff.

Description of clinical experiences:

All patients in the ED are triaged into a resuscitation area, acute area, or intermediate acute area.  The ultimate patient care responsibility is the staff physician’s.  Residents have the opportunity to see all types of patients.  They are supervised by attending staff and have graduated responsibility.  Critically ill patients are assigned two codes depending on severity.  A code blue needs a team physician response to a critical patient such as during a cardiac arrest.  A code red needs an immediate individual physician response.  Examples would include acute pain syndromes, acute dyspnea, and acute CVA.

PGY-1:

The resident sees acute, stable patients with non-life threatening problems under supervision by faculty or Senior (PGY-3) resident.  The resident’s primary responsibility in the department is to gain facility with patient care and procedures under senior resident and faculty supervision.  During the first few months in the Emergency Center, the resident is designated to evaluate both patients with acute stable or quasi-stable medical problems with potential life threats (Code Reds).  The residents are supervised by the faculty or senior residents.  When the resident has achieved a level of procedural competency with these cases, then during the last 1-2 months in the department the resident may assume the role of the PGY-2 resident. The PGY-1 resident has no assigned supervisory responsibility.

Description of didactic experiences:

Residents attend 5 hours of conferences per week. See Section 9.

Evaluation process:

Residents receive written evaluations after completing rotations to the ED. They are evaluated on their knowledge base, facility to perform procedural skills as appropriate for their level of training and professional attitudes. Residents are responsible for keeping track of all procedures performed. These logbooks are reviewed at least twice a year by the Program Director.  Annual oral examinations, the national in-service examination, and case presentations at conference are also used to evaluate residents.

Feedback mechanisms:

Immediate feedback is provided by the faculty on duty in the Emergency department.  Such feedback is considered most important in the resident’s education.  Several times during the year residents meet with their preceptors.  In addition, the Program Director meets with each resident twice each year to review the department’s evaluation of the resident.