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Department of Emergency Medicine
Residency

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Formal Education

The Dorrance Hamilton Medical Education Building
Home of the Thomas Jefferson University Hospital Emergency Medicine Simulation Program.

Equally important to the clinical experience in a resident’s education is the formal education experience.  This experience is composed of medical simulation, weekly conference, online learning activities, medical simulation, ultrasound, formal teaching blocks, and a scholarly activity work. The wide variety of experiences allow residents of all learning types to acquire the knowledge that they need to practice emergency medicine.

Conference       Topic Module       Simulations       Cadaver Labs       Ultrasound       Teaching       Scholarly Project       Scholarly Tracks

 Conference

Our conference curriculum is designed to cover the Core Curriculum of Emergency Medicine (as developed by the American College of Emergency Physicians and the American Board of Emergency Medicine). Each month covers a specific topic and an 18-month curriculum has been developed to assure coverage of the core curriculum topics. Four hours (8am to noon every Thursday) are devoted to covering the monthly topic and is done so with a variety of formats, including lectures, case discussion, critical review of the literature, combined specialty conferences, interactive question-and-answer sessions, small group sessions, and grand rounds.  While the majority of conference is conducted by faculty, EM residents, under the supervision of a faculty member, are expected to give lectures during each year of their residency. Assigned readings and monthly testing are used as adjuncts to the conference series in order to asure the acquisition of the knowledge needed for the practive of EM.

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Topic Module

To augment the weekly conferences, residents are assigned to complete one topic-based module per month.  Each module consists of up to 4 hours of online lectures and questions that are related to the assigned topic of the month.  Residents complete these assignments at their convenience.  All of the online resources are available at any computer with internet access and many of the lectures can be downloaded to personal devices such as iPods. The modules are constructed to augment the weekly conferences.

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Simulations

Simulation is an important aspect of medical education today. It allows a program to assure
that a resident will gain experience in a variety of emergencies (both common and rare).

We are one of the few Emergency Medicine residencies in the United States with direct access to a simulation center located on campus. Thomas Jefferson University Hospital and Jefferson Medical College is home to the Dorrance H. Hamilton Medical Education Building (top of this page).  Opened in October 2007, the Hamilton Building is home to a state-of-the-art simulation center that uses high and low fidelity simulators and standardized patients.  Additionally, faculty both within the Department of Emergency Medicine as well as faculty in Jefferson’s Clinical Skills Center participate in our resident’s education.  Our institution is also home to the Center for Bioterrorism and Disaster Preparedness, a federally funded entity with a mission to provide continuing education to the nation’s healthcare workforce and to teach the public about emergency procedures. These two resources together provide the resident with access to multiple adult, pediatric and obstetrical simulator mannequins to teach and evaluate EM residents on a variety of emergency conditions.  In addition, there are simulators for central line placement, lumbar puncture, umbilical vein and artery cannulation, pericardiocentesis, vaginal delivery, and endotracheal intubation.  The simulation curriculum helps to assure enough experiences to prepare them for a variety of emergent conditions and procedures that they may encounter during and beyond their residency training.  It also allows the faculty to assess the skills of the resident so that deficiencies can be addressed in a timely fashion.

Every Thursday afternoon, four residents participate in a simulation session.  Each resident serves as the team leader for a case while the other residents play a variety of roles. This allows a resident to be exposed to a total of four different critical care cases in a session. All sessions are videotaped and are reviewed with the resident by one of three faculty members to assure an in-depth learning experience. Residents participate in four simulation sessions per year.

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Cadaver Labs

Essential to the emergency medicine resident is the acquisition of procedural skills.  Procedural skills laboratories are held twice a year in the Jefferson Medical College’s Department of Anatomy cadaver lab.  In the fall of the academic year, residents teach surface anatomy to the first year Jefferson medical students and demonstrate invasive procedures.  In the spring, a dedicated procedural skills laboratory is done to teach and assess procedural skills.  Procedures include lateral canthotomy, needle and open cricothyroidotomy, pericardiocentesis, needle and open chest tube thoracostomy, and venous cutdown. These sessions afford our EM residents the opportunity to practice and perform needed skills.

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Ultrasound

Currently, our EM residents have 4 weeks of formal ultrasound training during their residency.  Residents have a two week rotation in their first and third years where they have at least 8 eight-hour scanning shifts and are paired with an RDMS ultrasonographer.  During the two week period, a number of ultrasound textbooks are made available for assigned readings. Each resident performs ultrasound scans on ED patients who require an ultrasound based upon their clinical presentation.  The ultrasonographer teaches the practical aspects of ultrasound performance.  All scans are recorded and saved for later review by one of two ultrasound-trained faculty. At least 6 hours outside of the scanning shifts are dedicated to in-person review of the resident-performed ultrasounds.  

In addition to the 4 formal weeks of ultrasound training, residents have access to three SonoSite MicroMaxx ultrasound machines (two are located at TJUH and the third is located at Methodist Hospital).  The machines include curved array, linear array, phased array and endovaginal transducers.  Residents are encouraged to use ultrasounds when clinically applicable.  All scans done in the EDs of Thomas Jefferson University Hospital and Methodist Hospital are reviewed by the EM ultrasound faculty. 

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Formal Teaching

Third year residents spend one month on the EM Administration and Teaching (EMAT) block.  During this time, the resident has a number of formal teaching responsibilities. The EMAT resident will prepare and present two lectures for the weekly conferences, prepare and present a critical review of the literature session, conduct a daily teaching session for the residents working in the ED, and will teach fourth year medical students in their required EM rotation. Jefferson Medical College fourth year students participate in a required four-week clerkship in Emergency Medicine. At the end of each of the first three weeks, medical students spend 3 hours in the class and 4 hours in the simulation lab learning EM. The EMAT resident teaches one lecture and one skill session per week in this course.  EM procedural skills such as lumbar puncture, central line placement, and suturing are covered by the resident during the skill sessions.   Additional EMAT duties during the rotation include participation in an ongoing continuous quality improvement (CQI) project, bedside teaching and procedures supervision of junior residents and medical students, and laboratory/radiology patient follow-up.

Second year residents spend two weeks on an EMAT block.  During this time, the resident completes a module in Evidence Based Medicine (EBM). This module involves the completion of assigned readings on the process of EBM, the development of a question relevant to the practice of emergency medicine, a literature review, and a presentation, during our weekly conference, of an interactive session where the resident leads a discussion on the topic.  Other duties during this block include teaching in the ED and teaching in the fourth year medical student course.

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Resident Scholarly Project

A formal scholarly project is a residency requirement. Residents may accomplish in a number of different ways such as collaboration with a faculty member in clinical or laboratory research, epidemiologic surveys, written case reports, or book chapters. The Department of Emergency Medicine is home to two laboratories devoted to basic science research in neurologic and cardiac injury research and provides a unique opportunity to the resident interested in a laboratory experience.

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Resident Scholarly Tracks

Scholarly tracks allow residents to develop a deeper understanding of a specific area of interest during their residency.  It is designed to provide formal education along with experiences (often done during elective time) tailored to the resident’s interests and give them a level of expertise for use in their future careers. Each resident meets with one of the program directors to discuss specific areas of interest and determine the appropriate track.  Once decided, the resident works with the track’s faculty mentor to develop the specific experience and receive specific information to provide the formal education in that area. All tracks teach the resident skills in public speaking, scientific writing and presentation, education, and administration.  

TRACK	Faculty Mentor (Click faculty to view profile)
Administration	Rex Mathew, MD
Health Care Advocacy	Ted Christopher, MD
Medical Student Education	Paul Kolecki, MD
Toxicology	Paul Kolecki, MD
Simulation	Ron Hall, MD
CNS Injury Research	Ray Regan, MD
Cardiac Ischemia Research	Xin Ma, MD, PhD
International EM	Harsh Sule, MD
Resident Education	Bernie Lopez, MD
Clinical Research	Bernie Lopez , MD
Ultrasound	Bon Ku, MD
Disaster/EMS	Ed Jasper, MD
Wilderness Medicine	Liz Edelstein, MD

As an example, let's say that a resident is interested in the International EM track. The resident would choose a medical experience in a foriegn country and spend their one month of elective time in that location. The resident would also meet with Dr. Harsh Sule (the faculty mentor for the International EM track) to receive formal education in topics (such as politial climate, cultural considerations) pertaining to the establishment or enhancement of emergency medicine in a country different from the United States. This combination of experience with formal education from a faculty with expertise in the area gives the resident a level of expertise in a topic of the individual resident's interest.

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