Emergency Medicine Residency
At a Glance
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1020 Sansom Street
Thompson Building, Suite 1615
Philadelphia, PA 19107
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Formal Education
Equally important to the clinical experience in a resident’s education is the formal education experience.
The Dorrance Hamilton Medical Education Building Home of the Thomas Jefferson University Hospital Emergency Medicine Simulation Program.
This experience is composed of medical simulation, weekly conference, online learning activities, medical simulation, ultrasound, formal teaching blocks, and a scholarly activity work. The wide variety of experiences allows residents of all learning types to acquire the knowledge that they need to practice emergency medicine.
Our conference curriculum is designed to cover the Core Curriculum of Emergency Medicine, (as developed by the American College of Emergency Physicians and the American Board of Emergency Medicine). Each month covers a specific topic and an 18-month curriculum has been developed to assure coverage of the core curriculum topics. Four hours (8 am to noon, every Wednesday) are devoted to covering the monthly topic and this is done with a variety of formats, including lectures, case discussion, critical review of the literature, combined specialty conferences, interactive question-and-answer sessions, small group sessions, and grand rounds. While the majority of conference is conducted by faculty, EM residents, under the supervision of a faculty member, are expected to give lectures during each year of their residency.
To augment the weekly conferences, residents are given the flexibility to complete one topic-based module per month. Each module consists of up to 4 hours of online lectures and questions that are related to the assigned topic of the month. Residents complete these assignments at their convenience. All of the online resources are available at any computer with internet access and many of the lectures can be downloaded to personal devices such as iPods. The modules are constructed to augment the weekly conferences and may be used as credit towards conference attendance.
Residents are also given access through the residency to Rosh Review, a high quality question bank, and EMRA membership which includes access to the popular EMRAP series.
Simulation is an important aspect of medical education today. It allows a program to assure that a resident will gain experience in a variety of emergencies (both common and rare).
Thomas Jefferson University Hospitals and the Sidney Kimmel Medical College is home to the Dorrance H. Hamilton Medical Education Building. Opened in October 2007, the Hamilton Building is home to a state-of-the-art Dr. Robert & Dorothy Rector Clinical Skills & Simulation Center (RCSSC) that uses high and low fidelity simulators and standardized patients. Additionally, faculty both within the Department of Emergency Medicine, as well as faculty in the RCSSC participate in our resident’s education. Our institution is also home to the Center for Bioterrorism and Disaster Preparedness, a federally funded entity with a mission to provide continuing education to the nation’s healthcare workforce and to teach the public about emergency procedures. These two resources together provide the resident with access to multiple adult, pediatric and obstetrical simulator mannequins to teach and evaluate EM residents on a variety of emergency conditions. In addition, there are simulators for central line placement, lumbar puncture, umbilical vein and artery cannulation, pericardiocentesis, vaginal delivery, and endotracheal intubation. The simulation curriculum helps to prepare residents for a variety of emergent conditions and procedures that they may encounter during and beyond their residency training. It also allows the faculty to assess the skills of the resident so that deficiencies can be addressed in a timely fashion.
Every Wednesday afternoon, four residents participate in a simulation session. Each resident serves as the team leader for a case while the other residents play a variety of roles. This allows a resident to be exposed to a total of four different critical care cases in a session. All sessions are videotaped and are reviewed with the resident by faculty members to assure an in-depth learning experience. Residents participate in four simulation sessions per year.
Essential to the practice of emergency medicine is the acquisition of procedural skills. Procedural skills laboratories are held in the Jefferson Medical College’s Department of Anatomy cadaver lab. A dedicated procedural skills laboratory is done to teach and practice rare procedures. Procedures include lateral canthotomy, needle and open cricothyroidotomy, pericardiocentesis, needle and open chest tube thoracostomy, and venous cutdown.
Currently, our EM residents have two weeks of formal ultrasound training during their first year of residency where they have at least eight, 8-hour scanning shifts and are paired with a credentialed EM attending or fellow. During the rotation, a number of ultrasound learning materials are made available on a department issued iPad for assigned readings. Each resident performs ultrasound scans on ED patients who require an ultrasound based upon their clinical presentation and received real-time instruction on the practical aspects of ultrasound performance. All scans are recorded and saved for later review. Each Monday of the rotation the resident participates in a formal three-hour didactic session along with review of ultrasounds done by the ultrasound faculty and fellow. All scans done in the EDs of Thomas Jefferson University Hospital and Methodist Hospital are reviewed by the EM ultrasound faculty.
Residents spend 6 weeks on the EM Administration and Teaching (EMAT) block (2 weeks as a PGY2, 4 weeks as a PGY3). During this time, the resident has a number of formal teaching responsibilities including presentations at conference, organization and participation in Journal Club, bedside teaching of junior learners and didactic lectures and simulation skill sessions to rotating medical students. EM procedural skills such as lumbar puncture, central line placement, arthrocentesis and suturing are covered by the resident during the skill sessions. Additional EMAT duties during the rotation include participation in an ongoing continuous quality improvement (CQI) projects and attendance at departmental administrative meetings to better understand the business-side of emergency medicine.
A formal scholarly project is a residency requirement. Residents may accomplish in a number of different ways such as collaboration with a faculty member in clinical or laboratory research, epidemiologic surveys, written case reports, or book chapters. The Department of Emergency Medicine is home to two laboratories devoted to basic science research in neurologic and cardiac injury research and provides a unique opportunity to the resident interested in a laboratory experience.
With regards to elective time, there are 2 weeks in the second year and 4 weeks in the third year that can be used for a variety of activities. A resident may use that time to complete their scholarly project, receive clinical experiences to enhance their education, or travel for a medical experience.
Selective tracks allow residents to develop a deeper understanding of a specific area of interest during their residency. It is designed to provide formal education along with experiences tailored to the resident’s interests and give them a level of expertise for use in their future careers. Residents meet with one of the program directors to discuss specific areas of interest. Once decided, the resident is assigned to the track’s faculty mentor for specific assignments. All tracks teach the resident skills in public speaking, scientific writing and presentation, education, and administration.
| Track | Faculty Mentor |
|---|---|
| Critical Care | David Gaieski, MD |
| Wilderness Medicine | Lara Phillips, MD |
| Medical Education | Dimitri Papanagnou, MD |
| Research | Anna Marie Chang, MD |
| Ultrasound | Arthur Au, MD |