Our program offers 15 positions in each of the three years. It is approved by the Accreditation Council on Graduate Medical Education as a categorical emergency medicine residency program. Those successfully completing the entire program are eligible for credentialing and subsequent examination by the American Board of Emergency Medicine. Trainees enter directly from medical school or, occasionally, after the satisfactory completion of other postgraduate training.
The Department of Emergency Medicine provides a comprehensive educational experience to the trainee through clinical rotations and structured conferences. Highlights of our program include: intensive critical care experience, ultrasound training, toxicology training, pediatric emergency medicine training, a research-scholar program, two Level 1 Trauma Centers, a simulation center, exposure to EMS systems and sports medicine, and our weekly conference format.
Ultrasound
Our department is on the cutting-edge of emergency medicine bedside ultrasound (EMBU). Due to the broad range of skills needed for proficiency, we dedicate a full R1 rotation to EMBU.
A combination of written, visual and computer tools provide the cognitive foundation for extensive bedside scanning practice. The goal of performing at least 150 adequate scans during the rotation makes it possible to fulfill the minimum requirements recommended by the Society for Academic Emergency Medicine ultrasound task-force and the American College of Emergency Physicians.
After the rotation, residents hone their skills in subsequent rotations by using EMBU when clinically indicated. Compared to many other programs, our ultrasound rotation is relatively intensive. The goal is to attain a degree of mastery in bedside sonography, so our graduates, rather than being “glorified sonography technicians,” will possess a diagnostic tool that is an integrated part of their thought processes and clinical practices. By combining a conceptual understanding of ultrasound and anatomy, they will be able to analyze and interpret previously unencountered sonographic findings. This same conceptual framework allows them to apply the technique innovatively in the clinical setting and understand technologic advances in the future.
This philosophical approach to resident training in EMBU and well-established clinical use of ultrasound in our emergency departments, has led to our being outstanding in this area. Residents with special interest in ultrasound are encouraged to take part in a variety of projects investigating the many unanswered questions about this new and exciting modality in the practice of emergency medicine.
Toxicology
The Division of Medical Toxicology plays a major role in the Department of Emergency Medicine by providing bedside teaching for EM residents and medical students.
All second-year EM residents take part in toxicology rotations, being taught directly by toxicology division faculty conferences held three times a week. The resident works closely with the toxicology fellows, writing in-patient consults and participating in teaching rounds on the consult service and at the Philadelphia Poison Center. The Division of Toxicology handles roughly 1,000 cases per year via the toxicology consult service. In addition, members of the division provide monthly teaching conferences on topics relevant to medical toxicology for the EM residents. The department also offers a Medical Toxicology Fellowship.
Pediatric Emergency Medicine
Often a deficiency in emergency medicine residency programs, our pediatrics program is varied and extensive. More importantly, you will care for children on every emergency medicine rotation during your residency training. Four rotations in the emergency department of St. Christopher's Hospital for Children complement the program. During all three years the resident spends time on the anesthesia service at St. Christopher’s Hospital, honing the art of intubating children. Interested graduates have the option to pursue a Pediatric Emergency Medicine Fellowship.
Critical Care Medicine
Our program is unique in offering experience in a critical care unit run by the Department of Emergency Medicine at Mercy Philadelphia Hospital. Rather than joining a medical, surgical or trauma team to learn the management of the sickest patients, you will help to run a critical care unit with your peers – other Drexel emergency medicine residents.
The critical care unit at Mercy Hospital of Philadelphia is a 24-bed service with a high acuity and turnover rate. This allows the resident substantial exposure to critically ill patients, invasive monitoring and procedural skills. Because the setting is a community hospital, much of the care involves severe presentations of general medical problems.
The team includes four interns who are supervised by R2 and R3 residents. Leading this team is a faculty group of board-certified critical care specialists. Our interns perform all the procedures in the unit. Upper-level residents are responsible for consultations and admissions from the emergency department or other beds in the hospital. Direction and supervision by the Department of Emergency Medicine ensures residents derive optimum education from their critical care rotation.
Research-Scholar Program
This program introduces the resident to research and the scholarly process through the exploration of a specific area in emergency medicine. Active study is paired with recorded findings, which are shared with the academic community via the written word. Within the first few months, the resident will join a research group and collaborate with other members of the team on a project. The program also contains a two-week block in the R1 year, and a three-week block in the R2 and R3 years. In addition, the resident is actively involved in journal club.
Trauma
With two University-based Level I Trauma Centers (Hahnemann University Hospital and St. Christopher’s Hospital for Children), the exposure to trauma is extensive. Emergency medicine residents form one half of the trauma resuscitation team. Senior residents direct the resuscitations during the day and manage the airway at night. Interns perform procedures, such as chest tubes and central venous access. Because Hahnemann University Hospital is located in Center City and receives MedEvac flights from the surrounding area, the trauma caseload is diverse, including substantial numbers of penetrating and blunt traumas.
Simulation Center
This technologically sophisticated lab uses high-fidelity medical simulators and computers to provide hands-on learning outside of the direct patient care environment in all three years. It enables the resident to gain competency in the performance of both routine and rare emergency medicine procedures.
EMS and Sports Medicine
Every resident spends one week each on emergency medical services (EMS) and on sports medicine in the R1 year.
During the EMS week, there is a general orientation to EMS operations and the opportunity to ride with ALS squads of the Philadelphia Emergency Medical Services. Further ground unit exposure is available, with helicopter experience offered as an elective. The resident also has the opportunity to take a base station medical command course and participate in base station conferences and on-line medical command.
During the sports medicine week, the resident sees patients in the offices and clinics of various board-certified sports medicine attendings. Here the resident is exposed to the sub-specialty of sports medicine and will gain skill in the evaluation, diagnosis, and treatment of musculoskeletal injuries and sports-related illness. There is an opportunity to participate in game coverage if interested.
Conference
There are five hours of conference each week, including case conference, morbidity and mortality review, grand rounds, pediatric emergency medicine conference, joint trauma conference, joint critical care conference, journal club and an individual conference.
Our case conference was started by Dr. Wagner at the inception of the program. It is usually the first two hours each Wednesday. The chief resident is responsible for choosing cases and conducting them in the manner of the oral emergency medicine board examination with first-year residents as “examinees.” At the conclusion of the case, the chief resident presents a discussion with key teaching points. The morbidity and mortality conference substitutes for case conference about once a month, centering on discussion of serious cases (including deaths), call-backs and multiple visits (bounce-backs). The cases are anonymously presented with the intent to improve practices for all department members.
The third hour of weekly conference follows a rotating schedule of pediatric emergency medicine conference, joint trauma conference, joint critical care conference and journal club. The last hour of the conference day is a grand rounds presentation by speakers invited by the faculty and residents.
There is also one hour of individual conference the resident is responsible for completing each week. The purpose of this conference is to ensure all residents receive the same baseline knowledge over the course of the three-year residency program. This conference utilizes the Med-Challenger online computer program.
How We Compare
Our department encourages acceptance of emergency medicine as a valid field of its own. In so doing, it provides a system where the residents are, from the beginning, in a department of their own rather than subordinated as a division under surgery or medicine.
One important benefit of this focus is the ability to complete residency in three years instead of four.
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