Curriculum

ACADEMIC PROGRAM

Our program offers 15 positions in each of the three years. It is fully approved by the Accreditation Council on Graduate Medical Education as a categorical Emergency Medicine 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. We emphasize rotations that provide the skills and experiences needed for Emergency Medicine.

Highlights of our program include: Ultrasound training, Toxicology training, Pediatric Emergency Medicine training, a Research-Scholar program, two Level-1 Trauma Centers, a Simulation Center, exposure to EMS systems & 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 provides 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 maintain and hone their skills in subsequent ED rotations by using EMBU when clinically indicated. In comparison to many other programs, it is fair to say that our Ultrasound Rotation is relatively intensive. The goal is to go beyond a mere modicum of proficiency and attain a degree of mastery in bedside sonography. With such a goal, our graduates, rather than being “glorified sonography technicians,” will be in possession of a diagnostic tool that is an integrated part of their thought process and clinical practice as physicians. 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 will allow them to apply the modality innovatively in the clinical setting, and understand technologic advances in the future.

With this philosophical approach to resident training in EMBU, and the autonomous and well-established clinical use of ultrasound in our Emergency Departments, we have become a center of excellence in this area. Residents with special interest 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. The Department also offers a Fellowship in Emergency Ultrasonography (Click here for further information.)

TOXICOLOGY
The Division of 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 rotate on the Toxicology service and during that time are taught directly by Toxicology Division faculty in formal thrice-weekly conferences. The resident works closely with the Toxicology Fellows in writing in-patient consults and participates 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 didactic teaching conferences on topics relevant to medical toxicology for the EM residents. Information about the Medical Toxicology Fellowship is available (Click here). The division has hosted visiting Fellows from Thailand and India.

PEDIATRIC EMERGENCY MEDICINE
Often a deficiency in Emergency Medicine programs, the exposure to Pediatrics in our program is varied and extensive. More importantly, you will care for children on every Emergency Medicine rotation during your training. This continued exposure allows complete comfort in managing pediatric emergencies. This pediatric experience is complemented by four rotations in the Emergency Department at St. Christopher's Hospital for Children. During the second year, there is a rotation in the Neonatal Intensive Care Unit. It is here that pediatric airway and resuscitation skills are further developed. In the third year, the resident spends time on the anesthesia service at St. Christopher’s Hospital where the art and science of intubating children is finely honed. There is a Pediatric Emergency Medicine Fellowship available for interested graduates (Click here for further information).

CRITICAL CARE UNIT
Our program is truly unique in offering experience in a Critical Care Unit run by the Department of Emergency Medicine at Mercy Philadelphia Hospital. Rather than simply 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, allowing them to hone their clinical skills while in this highly acute setting. 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 that residents derive optimum educational and procedural benefits from their critical care rotation.

RESEARCH-SCHOLAR PROGRAM
This program is meant to introduce the resident to research and the scholarly process - exploration of a specific area in emergency medicine, active study of that area with recorded findings, and sharing of those findings with the academic community via the written word. Within the first month, the resident will join a research group and collaborate with other members of the team on a project that the group is working on. 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 the procedures – such as chest tubes, central venous access, etc. Because Hahnemann University Hospital is in Center City and receives MedEvac flights from the surrounding area, the trauma is well mixed, including substantial numbers of both penetrating and blunt trauma.

SIMULATION CENTER
This high-tech lab uses medical simulators and computers to provide high-quality learning outside of the direct patient care environment in all three years. It enables the resident to gain and demonstrate competency in the performance of Emergency Medicine procedures, to practice the performance of rare and infrequent procedures, and provides the opportunity to practice clinical resuscitation cases and demonstrate knowledge of the critical actions needed in such cases.

EMS & SPORTS MEDICINE
Every resident spends one week each on 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 readily available and helicopter experience is available 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 will see patients in the offices and clinics of the 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 & Mortality Review, Grand Rounds, Pediatric Emergency Medicine conference, Joint Trauma conference, Joint Critical Care conference, Journal Club, and an individual conference.

Our Case Conference is the original one 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. Morbidity & Mortality conference occurs instead of case conference about once a month and discusses serious cases, including deaths, call-backs, and multiple visits (bounce-backs). The cases are anonymously presented with the intent to help improve practices for all members of the department.

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 that the resident is responsible for completing each week. The purpose of this individual conference is to ensure that all residents receive the same baseline of didactic knowledge over the course of the three years of the residency program. This conference utilizes the Med-Challenger online computer program.

Compare Programs: Our Department vs. Others
Our department encourages acceptance of Emergency Medicine as a valid field of its own and, 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.

As you make your comparisons, be sure to note the number of weeks in the rotation blocks of each discipline. Remember, each numbered block in our Department's EM Residency Program covers approximately 3 weeks, and most sections cover multiple blocks. The EM Residency Rotation Charts show as many blocks as there are residents for the year.

Use this chart to help you compare our program with others.

	A Drexel University College of Medicine Dept. of EM	B	C	D
Length of program	3 years
EM department status	Full dept.
Research exposure	Dedicated 9 weeks
Critical Care exposure	EM residents run intensive care unit
Ultrasound exposure	Dedicated rotation with superlative faculty and a new fellowship
Toxicology exposure	Three board-certified toxicologists with longstanding fellowship
Pediatrics exposure	Dedicated children’s hospital with EM/PEM faculty and fellowship
Trauma exposure	Two urban university centers
EMS exposure	Exhaustive, with aeromedical transport experience available
Academic Medicine practice	Yes
Community Medicine practice	Yes
First exposure to critically ill patients	1st year of residency
Training primarily by EM physicians	Yes
Rotations in general med & surgery	None
Toxicology fellowship	Yes
Pediatric EM fellowship	Yes
Ultrasound fellowship	Yes
Number of graduates/faculty who are department chairmen	7

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Rotations