1. Why should I choose this program?
There are many strong points in this program: the didactics, clinical experience, and the attending physicians come to mind first. What I believe truly separates us from 90% of the other programs is Life Flight. We are one of approximately five programs in the United States where the Emergency Medicine resident is the primary physician in charge of patient care on the helicopter. We are responsible for patients on scene runs as well as interhospital transfers.  Additional information is available throughout the web page.

2. What are the off-service rotations like?
The off-service attending physicians are extremely supportive and provide us with outstanding clinical teaching. Since we are the primary residency of the hospital, we have developed a special rapport with the off-service attendings.  As a result, they often try to tailor our experience towards an emergency medicine focus when possible. An example would be during our rotation on anesthesia. During that month, our primary goal would be to gain experience in the assessment and management of the difficult airway, ventilatory assistance, and, of course, endotracheal intubation. It is not uncommon for our residents to have well over one hundred successful intubations during that month alone.

3. Do you lose out by being at a community hospital as opposed to a University hospital?
We feel we have the best of both worlds here at St. V’s. A new family practice residency recently joined us at the Medical Center, and we also have residents from other hospitals and specialties rotating through on Surgery, Internal Medicine, Pediatrics, OB/GYN, Orthopedics, Plastic Surgery and Urology. The end result is that we have ample opportunity to interact with other residents and teaching attendings as well as with private attending physicians. Also, because we have long been the primary residency program here, the nurses in the hospital have come to know us and have a great deal of respect for our clinical skills and judgment. As a result, they are usually glad when "one of the Emergency Medicine residents" gets involved when a patient is not doing well on the regular floors or in one of the Critical Care Units.

4. Do you a get enough trauma experience?
We definitely get enough trauma exposure. When a Trauma Alert is called, an Emergency Medicine resident in the Emergency Department, an Emergency Medicine attending, and the 'Trauma Team', all respond. The Trauma Team generally consists of at least one, and often two, Emergency Medicine residents who are rotating on Trauma, another surgery resident and an attending trauma surgeon. The Emergency Medicine resident who is in the Emergency Department is the airway doctor. The other two residents become 'doc right' and 'doc left'. Doc left is either the second year Emergency Medicine resident or the surgery resident, and his or her responsibility is to run the alert. Doc right is responsible for the secondary survey and placement of chest tubes, central lines, and performance of any other invasive procedures that might be necessary. Both attending physicians usually take more of a supervisory position and give input only as needed. We also get tremendous trauma exposure on Life Flight scene runs. The distribution of our trauma overall is approximately 3/4 blunt and 1/4 penetrating.

5. What's the Emergency Department rotation like?
The Emergency Department at MSVMC is a Level I Trauma Center with a census of nearly 63,000 in 2003. Approximately 50% of the patients admitted to the hospital last year were admitted through the Emergency Department; and as you might expect, the acuity level is pretty high overall. We have 19 attending/faculty physicians, all of whom are Emergency Medicine trained and Board certified. We also have medical students, as well as residents from other specialties doing rotations in the Emergency Department.  As such, opportunities abound to teach and learn from other professionals in addition to the faculty attendings.

We work approximately 21 ten-hour shifts per month. Also, while in the Emergency Department, we respond to cardiac arrests on the floors which affords us additional opportunities to care for critically ill patients. Second- and third-year residents also serve as first call for Life Flight 1. Life Flight shifts are currently 12 hours with some clinical responsibilities in the Emergency Department, while on call for Life Flight.

6. How about didactics?
We feel that we have a very strong didactic program. We have five hours of protected lecture time each week at Emergency Medicine Grand Rounds every Tuesday morning. During that time, the Emergency Medicine attendings and attendings from other specialties, (such as cardiology, intensive care, and trauma surgery) lecture. We also have mock oral boards, breakout sessions, M & M, and Life Flight case reviews, just to mention a few. We have protected monthly Journal Club meetings and twice-monthly procedure labs. Three to four times a year we also have exams on assigned readings. By keeping up with the assigned reading, we should all get through the Tintinalli textbook three times during the three years.

7. How is moonlighting perceived?
Moonlighting is generally well accepted, as long as we keep up with our reading, continue to improve as Emergency Medicine physicians, and do not otherwise allow outside work to interfere with our responsibilities within the program.

8. What do graduating residents do after residency?
Our graduating residents have gone in many different directions. Recent grads have done fellowships in Pediatric Emergency Medicine, Emergency Medical Services, Education, and Administration. Others have gone on to work at community and/or university hospitals, and in locum tenums positions around the country.

9. What would you change if given the opportunity?
Hmmmm...less calls during off-service rotations, a gym in the hospital, and being paid by the hour as opposed to salary (especially during the off-service rotations)... basically the same complaints that all residents have in any program or specialty.

10. If given the opportunity, would you come to this program again?
ABSOLUTELY. We have a few simple themes:
Always 
     • do the right thing for the patient.
     • be fair.
     • work hard.
     • and don't be afraid to enjoy life!