Didactics

Morning Report
Morning Report is a daily session of interactive case-based learning. It is “protected time” and takes place every weekday morning (except Wednesday due to Conference). Senior residents and faculty present cases, using a blend of didactic and Socratic reviews of clinical cases to facilitate discussion. Morning report often includes a variety of topics. Each day focuses on a different element of a case such as EKG, radiology interpretations, or case presentations. We round out the week with a set of Kahoot-style board review questions that have historically gotten very competitive.

Weekly Conference
Wednesday Conference covers the core content of the American Board of Emergency Medicine (ABEM) Model of Clinical Practice while teaching residents how to integrate practical applications of knowledge. The core content is covered over a 24-month cycle, enabling it to be covered twice during the four-year residency. It is taught at two levels: junior resident level and senior resident level. This allows for a foundational curriculum during the first two years and an advanced curriculum during the senior years. Wednesday Conference is also considered “protected time”. We use a variety of formats including faculty and resident lectures, small group discussions, case conferences, cadaver procedure labs, simulation, wilderness activities, escape rooms, oral-board review cases, and regional city-wide conferences.

Simulation Training
We run monthly 4-hour simulation conferences where teams of residents tackle complex clinical cases to enhance team dynamics and resuscitation and procedural skills. Our active simulation team also runs in situ surprise simulations in the Trauma bay so that our teams can sim with our nursing and ancillary staff as well as practice in our clinical environment. The simulation center hosts frequent post-conference procedure skills labs for residents who want to practice their skills.

Morbidity & Mortality Conference
A monthly one-hour M&M is held to discuss specific cases to highlight various educational focuses. M&M conference (we call it “Peer Review”) is led by our chief residents and is well attended by faculty both from the Emergency Department and other departments within the hospital. These conferences allow all our patient care team members to follow the case presentation and discussion with an analysis of standard set of factors that contribute to errors in the emergency department. This involves a systems-based approach, which is analyzed not only for errors in judgment or decision-making, but also for contributing factors such as breakdowns in teamwork and communication, availability of departmental and institutional resources, and societal factors that led to a particular outcome. These sessions help make recommendations to our clinical leadership to remedy identified deficits.

Journal Club
Monthly journal club focuses on the ability to read, interpret and evaluate current literature in the field of emergency Medicine. Some journal clubs are hosted by our Specialty Tracks, providing an insight into current research in different niche fields of Emergency Medicine. Other journal clubs are hosted during Wednesday conference, training residents on the skills to read and evaluate a paper in real-time.

Resident “Shout Outs” and Good Saves
The field of Emergency Medicine is challenging and often without resolution what to a critically ill patient. We generally treat our patients for a brief period of time to stabilize and then hand them off to our colleagues to continue care. What happens to those patients who we help? Good Saves recognizes residents and their achievement in outstanding work in the department. This is often paired with a presentation of the case discussing the pathology and to showcase the excellent work and dedication of our residents. This is presented in a similar format to an M&M, but instead focuses on the successes in the department.

Clinical Curriculum

 

Residency Block Schedule

PGY 1 28 weeks Emergency Medicine 4 weeks Pediatric Emergency Medicine at SBH 2 weeks Ultrasound 4 weeks Medical ICU 4 weeks Internal Medicine 4 weeks Trauma 2 weeks Labor & Delivery 4 weeks Vacation (divided into two 2-week periods)	PGY 2 28 weeks Emergency Medicine 4 weeks Pediatric Emergency Medicine at SBH 2 weeks Ultrasound 4 weeks Medical ICU 4 weeks Trauma 2 weeks EMS (FDNY Headquarters) 2 weeks Anesthesia 2 weeks Elective 2 weeks Pediatric Emergency Medicine at CHAM 4 weeks Vacation (divided into two 2-week periods)
PGY 3 26 weeks Emergency Medicine 4 weeks Medical ICU 4 weeks Trauma 4 weeks Pediatric ICU at CHAM 4 weeks ED Administration 4 weeks Toxicology (at NYC Poison Control Center) 2 weeks Specialty Track 4 weeks Vacation (divided into two 2-week periods)	PGY 4 28 weeks Emergency Medicine 4 weeks Pediatric Emergency Medicine at SBH 10 weeks Specialty Track 2 weeks Pediatric Emergency Medicine at CHAM 2 weeks Cardiology 2 weeks of any Elective 4 weeks Vacation (divided into two 2-week periods)

* CHAM = Children’s Hospital at Montefiore
**FDNY = Fire Department of New York

First Year
The first year of training provides residents with the skills and knowledge they need to become well-rounded physicians. Residents begin with a one-week orientation program, focused on basic communication skills, procedural skills, team-building activities, a scavenger hunt, using the EMR, and more.

After orientation, first-year residents are collectively started in the emergency department for the first block of residency to work directly with seniors and faculty members to develop foundational skills in clinical decision-making, patient stabilization, and resuscitation. While assuming primary responsibility for patient care, first-year residents receive close supervision and clinical teaching.

Second Year
The second year of training builds on the foundations established during the first year. Residents’ responsibility increases as they gain more experience in caring for critically ill patients. Second-year residents also begin to assume responsibility for teaching medical students and working most closely with first-year residents.

Third Year
Third-year residents hone their clinical skills and continue the training needed to become qualified emergency medicine specialists. Additional elective and track time is provided for further pursuit of clinical or research interests, which lays the foundation for the fourth-year track time. Third year residents train as resuscitation team leaders on-shift.

Fourth Year – “Mock Attending Year”
The final year of residency is individualized depending on the interests of the residents and what track they have chosen. Residents serve as mock attendings and play a more supervisory and teaching role in the department. During the fourth year, they are also able to explore their specific niche interests in the field of Emergency Medicine with extensive dedicated Track and Elective time.