Curriculum & Rotations

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Curriculum

This program is designed for adult learners. Therefore, the extent of your reward, or education gained, is highly dependent on your input and effort. We do not attempt to teach as much as we attempt to assist you with your learning process. Each adult learner will have unique strengths and needs. A large portion of our evaluation process is based on helping to identify these opportunities.

These training objectives provide a reasonable set of expectations for various levels of residents. They are not meant to be restrictive in the separation of responsibility. Residents who exceed the expectations for the training year are permitted to assume greater responsibility, provided that they are not competing with the senior resident’s responsibilities. Many of our residents can perform at levels higher than those dictated by the training objectives for the year. This well-defined responsibility, based on year of training, serves to provide organization and direction to the emergency department and makes optimal use of skills previously acquired by the resident.

PGY1: The first year of the emergency medicine training concentrates on developing skills in individual patient evaluation. The resident should begin to go from novice to advanced beginner. Focusing on the basic principles of decision making in emergency medicine, and acquiring the central knowledge base are the primary educational objectives. The resident should become thorough and efficient in the performance of the history and physical exam, and should begin to develop skills in the use of diagnostic tests, initiating treatment, requesting consultation, developing a treatment plan and arranging appropriate follow-up. The focus is on providing high quality care, with an emergency medicine approach to patient complaints to avoid the misdiagnosis or delayed diagnosis of life threatening conditions. The residents are expected to see a reasonable number of patients, and begin to develop efficiency as they acquire the basic familiarity with common emergency department presentation. The first year residents are not primarily responsible for the care of critically ill patients. The focus of their effort is not on the volume of patients, but the efficacy and accuracy of patient evaluation. They are expected to learn appropriate medical record keeping and documentation. Basic procedural skills are acquired with encouragement to use the resources available in the simulation lab, as well as from direct bedside supervision.

PGY2: As residents progress into the second year of residency it is expected that an increasing level of independence will be warranted. It is at this level that the resident is expected to go from advanced beginner to competent. The PGY2 resident will be expected to not only increase in medical knowledge, but also in procedural expertise. Continued use of the simulation lab is encouraged as new skills and procedures are added to your knowledge base. The PGY2 is also encouraged to use this resource to review and practice those skills learned in the PGY1 year. Advancing to this level also carries with it added responsibilities. The resident will be assigned increasing duties to teach. These will include presentations in the new resident orientation and, if selected, instructorship in the American Red Cross courses, as well as ATLS. Other opportunities will present, and should be welcomed as a means to develop these important skills, not the least of which will include the opportunity to assist, (while not supervising), the intern class. PGY2 residents will also be tracked as to their proficiency in managing patients. Progress in the number of patients seen will be monitored through the patient logs and management statistics. It is at this level that life-long skills in communication and disposition are beginning to be developed.

PGY3: The third year emergency medicine resident concentrates on expanding and refining patient care skills. It is at this level that the resident is expected to go from competent to proficient. The resident begins to focus on developing an efficient approach to patient care, and learns the skills needed to manage several patients simultaneously. They are expected to see a larger number of patients to broaden the base of experience. Participation in major medical and trauma resuscitation is expected. The third year resident is introduced to advanced procedural skills and encouraged not only to avail themselves of the simulation lab for review and development of these skills, but also to teach and assist junior residents to develop their skills. As they have now begun to gain increased autonomy and knowledge, it is expected that the resident at this level will assume increasing responsibility while on service. The residents develop skills in problem-solving, patient disposition, efficient delivery of emergency medical care and teaching. Increasing teaching responsibilities occur at this level and include presenting lectures, supervising junior residents, and assisting with procedures and medical management of emergency cases. Leadership abilities should be developed at or before this level. It is expected by the third year of post-graduate training the resident will have become a model for more junior residents, exemplifying those qualities so sought after in our profession.

PGY4: The fourth year emergency medicine resident concentrates on broadening exposure and developing efficiency. It is at this level that the resident is expected to concentrate on those skills lacking proficiency and begin to develop expert standing. Life-long learning practices and habits, which will have been introduced earlier in training, now become individually resident-driven. The resident will increasingly share experience and knowledge with junior residents and medical students. The resident is primarily responsible for the most critically ill patients in the emergency department, and directs and assists junior residents with medical resuscitation. This should include demonstrations of mastery in clinical procedures, as well as the ability and willingness to teach those that follow, both at the bedside and in the lab. The PGY4 resident functions as an integral member of the ICU and trauma resuscitation team. Residents will participate on an EMS rotation to gain exposure to the vital role played by EMS in the field in emergency situations. The PGY4 residents assume ever-increasing academic responsibilities, providing lectures and conferences as part of their regular academic activities. The resident continues to develop skills and confidence in problem-solving, patient disposition, efficient delivery of emergency medical care and teaching. Overseeing the operation of the emergency department and ensuring that all patients receive appropriate care are of paramount importance. The PGY4 residents will be afforded greater opportunity to provide lectures, presentations, and conferences to the faculty and junior residents as part of their regular academic activities. Leadership roles are expanded to include scheduling of resident shifts and lectures.

Rotations

Residents will benefit from rotating through Merit Health Wesley hospital departments including:

• Surgery
• Anesthesia
• Internal medicine
• Intensive care
• NICU
• Orthopedics
• Emergency medicine
• Cardiology
• ED administration
• Research
• Emergency medical services
• Ultrasound

Electives are available in disaster medicine, neurology and other areas.

The following rotations will be held at the partnering hospitals listed below.

• Trauma Services – University of Mississippi Medical Center, Jackson, MS
• PICU – University of Mississippi Medical Center, Jackson, MS
• Pediatric Emergency Medicine – University of Mississippi Medical Center, Jackson, MS
• Obstetrics/Gynecology – Merit Health Central, Jackson, MS