Emergency Medicine Residency: Rotation Schedule and Descriptions
|HCMC Emergency Medicine||NMMC Emergency Medicine||HBO/NICU||MICU||Surgery||Toxicology, EMS, Specialty Clinics, QI, Ultrasound||Internal Medicine||OB/GYN|
|HCMC Emergency Medicine||NMMC Emergency Medicine||Ortho / Resuscitation||Surgery|
|Pediatrics/Cardiology||Senior EM Selectives|
About Our Rotations
Our residents take an early and active role in patient care and obtain decision-making roles quickly. Within the Emergency Department, residents direct the initial stabilization of all critical patients, including trauma cases, and oversee all critical care. Residents manage all airway interventions, procedural sedation, orthopedic reductions and stabilizations, and other key procedures.
Third year residents put their clinical training, communication skills and team leadership into practice with the year-long "Pit Boss" responsibilities. This invaluable opportunity allows PGY3's to supervise junior residents, PAs and students, and coordinate Emergency Department operations.
Emergency Medicine Rotation Descriptions
PGY-1 residents provide care to all non-critical patients in the Emergency Department. Residents take a history, perform a physical examination, and formulate a diagnostic workup and management plan. PGY-1 residents present every patient to a senior resident or faculty, and procedures are performed with an appropriate level of supervision.
North Memorial Medical Center Emergency Department
North Memorial is a private, community based Level I Trauma Center in the Twin Cities. This experience provides exposure to a different patient population and system of operation with great critical care opportunities.
Undersea and Hyperbaric Medicine (HBO) / Neonatal Intensive Care Unit (NICU)
The first week of this rotation is Hyperbaric Medicine, allowing PGY-1 residents to learn the basics of Undersea and Hyperbaric medicine as well as dive with patients in our state-of-the-art hyperbaric chamber.
The subsequent three weeks of this rotation are spent in the Neonatal ICU, giving residents the opportunity to care for sick neonates and obtain increased experience and comfort with procedural skills in this population. All residents complete the Neonatal Resuscitation Program (NRP) prior to this rotation.
During one of the most highly praised off-service rotations, residents will work on a team with a second year EM resident and critical care fellows and attendings. Call is every fourth night and opportunities for acute care, resuscitations, and invasive procedures abound.
General and Trauma Surgery
At HCMC, general surgery is trauma surgery. Residents take trauma call every fourth night with the surgical team. Residents care for trauma cases as well as emergent and elective surgery patients, both on the floor and in the Surgical ICU. There is ample opportunity for invasive procedures during this rotation.
Toxicology, EMS, Specialty Clinics, QI, Ultrasound
TOXICOLOGY: One week is spent in the Minnesota Poison Control Center, learning various aspects of emergency toxicology through didactic and experiential learning activities. The MN Poison Center provides support for Minnesota, North Dakota, and South Dakota.
EMS: An understanding of Hennepin EMS dispatch and ground services is acquired and includes an ambulance ride-along and an optional air medical experience.
QUALITY IMPROVEMENT: A Quality Improvement (QI) project of the resident's choice will be designed and completed, and subsequently reviewed by a QI faculty member.
SPECIALTY CLINICS: Several half-day specialty clinic experiences have been developed, where procedures and management strategies important to emergency care are emphasized.
ULTRASOUND: One week is spent with dedicated EM ultrasound techs and ultrasound faculty, allowing for development and refinement of basic and advanced bedside ultrasound skills.
This is an inpatient service where residents are responsible for the evaluation and management of patients admitted to the inpatient telemetry unit. The experience of continuing care for these patients in the hospital affords our residents an understanding of longitudinal care as well as inpatient capabilities, allowing incorporation of this knowledge into future disposition and management decisions in the ED.
The majority of time in this rotation is spent on labor and delivery, where residents are supervised by OB/GYN senior residents and attendings. Responsibilities include managing acute obstetrical concerns in patients greater than 20 weeks gestation, as well as patients in labor through delivery. Clinic time is spent assessing and treating patients with obstetric and gynecological problems.
PGY-2 residents exercise more independence and are responsible for primary patient evaluation and managing non-critical and semi-critical patients. PGY-2 residents initiate evaluation and treatment independently, with oversight from senior residents and faculty. PGY-2 residents assist PGY-3 residents in managing critically ill or injured patients and perform procedures commensurate with their level of training, under close supervision by PGY-3 residents and faculty. Efficiency, departmental flow and task-switching skills grow significantly during this year.
North Memorial Medical Center Emergency Department
Residents broaden their experience with different patient populations and operating procedures during this rotation. This is a continuation of the first year rotation, with an even greater opportunity to undertake procedures and manage critically ill patients.
Abbott Northwestern Hospital Emergency Department
Abbott-Northwestern (ANW) is the largest private hospital in the Twin Cities. It is home to the 'Minneapolis Heart Institute', one of the world's leading heart institutes, and is the busiest cardiac center in the upper Midwest. ANW is also one of six comprehensive stroke centers in the Twin Cities. The hospital treats many complex medical patients including heart transplantation and ventricular assist device recipients.
At ANW PGY-2 residents work with one to two attending providers during each shift. The rotation provides residents the opportunity to expand their approach to the high acuity patient as well as provide exposure to an additional community Emergency Medicine experience.
Residents also develop competency in working with scribes to provide and document patient care.
ORTHO: Acting as a primary ED-based orthopedic consultant, residents consult and manage all patients with orthopedic issues, including fractures, dislocations, joint aspirations, tendon repairs, and other injuries. Residents also attend a half-day sports medicine clinic experience on Monday mornings.
RESUSCITATION: Residents primarily manage critical care patients in the stabilization room two days per week, including all airway interventions, supervised by PGY-3 residents and faculty. Residents also often assist with critical care procedures and cases during the remainder of the week.
HCMC operates a Level I Trauma Center widely recognized for outstanding neurosurgical care. PGY-2 residents handle all Emergency Department and hospital consults, and diagnose and treat neurosurgical emergencies from across the Twin Cities and the state. As patients with significant neurosurgical injuries are often also critically ill or injured, both critical care and neuroimaging interpretation skills can be expected to grow tremendously during this rotation.
EM Subspecialty PGY-2 Selective
Residents have the unique opportunity to explore an EM subspecialty that may be of interest in their PGY-2 year. All of HCMC’s fellowship programs (Undersea and Hyperbaric Medicine (HBO), Emergency Medical Services (EMS), Toxicology, Ultrasound, Simulation/Education, and Research) offer two-week selective experiences.
General and Trauma Surgery
Residents will be part of a team comprised of a chief surgical resident and two interns, handling all Emergency Department and hospital consults, as well as evaluating and admitting all trauma patients while on call, and co-managing SICU patients.
PGY-2 residents rotate for two weeks at the University of Minnesota Masonic Children’s Hospital Emergency Department (UMCH ED). The UMCH ED, staffed with high quality board certified pediatric emergency medicine physicians, allows residents the opportunity to see a broad range of pediatric patients, from those with acute injuries or illnesses to those with chronic and rare conditions.
EM PGY-2 residents serve as the senior resident on MICU teams. Responsibilities include providing and overseeing care for all critically ill patients on that team, often supervising both an EM intern and a medical student. Call is every fourth night.
PGY-3 residents in the "Pit Boss" role evaluate and manage all patients in their team center within the Emergency Department. PGY-3 residents supervise all patient care delivered by medical students, physician assistants, and junior residents, and provide care directly to a small number of patients. Supervision of care includes verifying important aspects of the patient’s history and physical examination, and being involved in all diagnostic and therapeutic management decisions made by junior residents, PAs and students. This also includes supervising procedures, triaging patients on arrival to the team center, managing overall patient flow, teaching other trainees, and providing medical control to Hennepin EMS. Faculty supervise PGY-3 residents.
PEDIATRICS: Residents continue their experience at the University of Minnesota Masonic Children’s Hospital Emergency Department (UMCH ED) with another 2-week opportunity to care for sick children.
CARDIOLOGY: For the other two weeks of the rotation, residents act as cardiology consultants for the entire hospital.
Senior EM Selective
Choose a selective in anesthesiology, community emergency medicine, critical care, EMS, radiology, research, toxicology, simulation / education or another pre-defined subject. Or, create your own selective with program director approval. Three international selective slots are available annually, with resident salary and benefits included.