Clinical Curriculum

This one month block is designated for all incoming interns each July. It is designed as an introduction month to help transition and integrate new interns into the department, and into residency as a whole. The block includes clinical shifts, didactics, hands on skills sessions and protected time to get to know your new co residents.

First year residents will spend the majority of their time working clinical shifts at our Level 1 trauma center which offers quaternary care as a premier cardiac, stroke, and transplant center. We have a busy, high acuity ED with a wide breadth of diversity and pathology. Interns work with seniors residents and attending, managing patients with appropriate oversight. You will also spend one month at Milford Hospital, our community site.

Rotating in the Cardiac Intensive Care Unit, you will care for patients with severe hart failure, cardiogenic shock and post cardiac arrest care. On this rotation you will have additional procedural opportunities for central and arterial lines on critically ill patients.

This block is designed to allow residents to spend time in the operating suites on multiple campuses to gain adequate experience with controlled intubations in both adults and pediatrics. Typically residents spend the mornings in the OR intubating, and afternoons with our ultrasound faculty learning hands on point of care ultrasound skills with our fellows and attendings. Our residents are ultrasound leaders in the hospital typically graduating with over 900 individually performed ultrasounds.

Interns will spend 4 weeks at our Memorial Campus working closely with our OB/GYN colleagues to care for both low risk and highrisk pregnancies in our tertiary Labor and Delivery division. This important block allows residents to feel comfortable with not only standard vaginal deliveries, but also emergent presentations such as preeclampsia, abruption, and post partum hemorrhages.

Interns will spend time in 6ICU, a 16 bed ICU, to expand knowledge on continued management of critically ill patients after they leave the ED. Residents work closely with their team and attending with primary ownership of their patients. Management of ventilators, vasopressors and multiorgan dysfunction are key skills learned on this rotation, along with procedural skills such as central lines, arterial lines, paracentesis and airway management.

Pediatric EM trained physicians will guide residents through the intricacies and nuances of managing the pediatric population in our 13 bed pediatric ED here at our primary University campus. To ensure exposure to a diverse range of seasonal presentation, residents are swapped into the Pedi ED intermittently throughout the year in addition to the month long block to care for summer injuries, and respiratory emergencies such as asthma, RSV and flu in winter months.

This block allows interns to choose from one of four electives highlighting emerging fields of EM in a structured manner and led by fellowship-trained faculty in the field.  Options are:

• Medical Education
• Health Equity
• Research Methodologies
• Health System Sciences

Second year senior residents spend 5 blocks at University, one block at Milford, and one block at Memorial Campus and progress to a more senior role including increased responsibility in the department, the chance to work with shadowing and rotating medical students, as well as increasing patient care autonomy and pod ownership. During these blocks residents will continue to grow in medical knowledge and patient management through experiential education and teaching responsibilities.

The NEXT pod is the newest addition to our training program and serves as the high acuity pod in the ED. Here you will work one on one with an attending and become experts in management of respiratory distress, sepsis, arrhythmias, traumas, strokes, cardiac arrests and all the procedures associated with these conditions. This rotation is an intense immersion into critical care and has been a favorite among current residents for its hands on experience and one on one teaching with attendings.

Second year residents rotate through 7ICU, a 16 bed Medical ICU. Residents this year take on a senior role on a medicine service with exceptional sick patients, include ill hepatic and pre transplant patients. This involves teaching interns and mid-levels, and taking on more critically ill patients. This resident also responds to rapid responses throughout the hospital.

This month, residents spend half the month rotating through the surgical ICU, and half rotating through our Neuro ICU. While in SICU, you will manage critically ill trauma and post op patients. You will gain experience managing chest tubes, and be exposed to advanced wound care. Our Neuro ICU provides experience managing hemorrhagic strokes, herniation, severe traumatic brain injuries, TPA and critical spine injuries.

As a second year resident in the Pediatric ED, you will have increased independence working with our PEM attendings in the management of the pediatric population and increased ownership of patient care.

This block allows residents to choose from one of four electives highlighting emerging fields of EM in a structured manner and led by fellowship-trained faculty in the field.  Options are:

• Medical Education
• Health Equity
• Research Methodologies
• Health System Sciences

This combo block includes 2 additional weeks in the pedi ED and also gives you time in the NICU allowing you to evaluate and treat high risk newborns. Residents attend high risk deliveries and participate in the resuscitation of neonates including intubations, and central lines.