Emergency Medicine Curriculum
The Emergency Medicine educational curriculum consists of over 650 hours of lectures and demonstrations, as well as bedside teaching, patient encounters, and pre-hospital-care field experience.
The didactic material is presented during two three-hour conferences each week conducted by the Emergency Medicine Department. Residents also receive teaching through specialty conferences given during off-service rotations and electives.
During Emergency Medicine conference time, attending staff assume all patient care responsibilities so residents are free to attend conference.
Presentations include Emergency Medicine grand rounds, morbidity and mortality conference, combined Surgery/Emergency Medicine trauma conference, and pre-hospital-care conference. Also included are radiology conference, ultrasound conference, Tintinalli study guide review, journal club, and the Base Station Physician Course. All residents receive graded responsibility for teaching and supervising junior residents, clinical clerks, and paramedic trainees within the Emergency Department.
While in the Emergency Department, residents spend a minimum of 60 hours per week toward residency activities. Of this, approximately 40 hours per week, divided into eight-hour shifts, are spent on patient care. The remaining 20 hours are devoted to research and purely educational activities including conference attendance and personal reading.
The Kern Medical Emergency Medicine Residency Program has 13 four-week rotations during the year. All rotations are within Kern Medical for inpatient and outpatient services except for the Cardiac Care Unit (CCU) rotation, which is conducted at Cedars-Sinai Medical Center in Los Angeles; Pediatric ICU (PICU), which is at Valley Children’s Hospital in Madera/Fresno; and elective rotations, which may be conducted at any outside facility with prior approval.
Courses of particular interest to Emergency Medicine Residents are given at specific times throughout the residency, usually in PGY 1. Formal certification is provided upon completion of a given course. They are:
- Advanced Cardiac Life Support (ACLS)
- Advanced Trauma Life Support (ATLS)
- Pediatric Advanced Life Support (PALS)
- Neonatal Resuscitation Program (NRP)
|Intensive Care Unit||4|
|Cardiac Care Unit||4|
|Intensive Care Unit||4|
|Intensive Care Unit||4|
|Pediatric ICU (PICU Madera)||4|
Cardiac Care Unit
The CCU rotation occurs at Cedars Sinai Hospital (www.cedars-sinai.edu) in Los Angeles during PGY 1. For four weeks the resident functions as a member of the CCU team. Residents gain invaluable experience managing acute myocardial infarction, cardiogenic shock, arrhythmias, congestive heart failure, and the cardiac transplant patient. Our residents often find themselves running the multiple code blue resuscitations that occur daily. There is more than ample opportunity to place central lines and PA catheters and to intubate patients. While in Los Angeles, the resident can stay in a private Westwood apartment that is maintained by the Kern Medical Residency Program. Meals and parking are paid for at the hospital. Call is every third night.
Intensive Care Unit
There are three four-week rotations on the MICU. During the residents’ PGY 2 and 3 they will function as the senior residents on a team. During this rotation the resident manages critically ill patients on a closed MICU. This is a prime opportunity for the resident to fine-tune the subtleties of ventilator management. Like the CCU rotation, opportunities for critical care procedures are abundant during these rotations. Teaching rounds occur daily. During PGY 1 residents will also spend four weeks on internal medicine wards.
There are two four-week rotations on Trauma Surgery, one during PGY 1 and the second during PGY 2. During the eight weeks, the EM resident responds to all trauma activations with a senior surgeon. The EM resident is responsible for all procedures during the resuscitation such as chest tubes, diagnostic peritoneal lavages, central lines, etc. The EM resident also works as an integral member of the team by caring for inpatients (both in the SICU and on the floor), seeing clinic patients, and answering consults from the Emergency Department. EM residents are not expected to scrub-in for operating room cases, but are welcome to do so if they desire. There is no overnight call. PGY- 1 residents will also spend four weeks on general surgery. During weekends and nights these residents will also be responsible for assisting with the trauma service.
PGY-3 residents rotate in the Pediatric ICU at Valley Children’s hospital (www.valleychildrens.org) for four weeks. PGY-1 and -2 residents rotate on the pediatric service and NICU, where they work directly with staff attendings. Between these dedicated pediatric rotations and the mix of pediatrics seen in the main ED, our residents see far more children than is required by the RRC for an EM training program.
The Neurosurgery rotation is during PGY 2. Residents work very closely with the neurosurgical attendings during this month, caring for patients on both an inpatient and outpatient basis. Inquisitive and dedicated residents have found that the teaching occurs literally 24 hours per day. Vital emergency skills learned on this rotation include interpretation of CT scans, management of subarachnoid hemorrhage, acute stabilization of the spinal injury patient, placement of external ventriculostomy drains at bedside, and skull trephination for epidural bleeds. There is no overnight call.
During PGY 2 residents will do ride-alongs with ground ambulance crews and the county fire department. Residents can also do medevac helicopter ride-alongs, however these are optional. During this month residents will also be assigned to quality improvement projects.