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The Emergency Medicine Residency Program at the University of Cincinnati Medical Center was both the first program in Emergency Medicine, and the first program to recognize the advantages unique to a four-year training program.
In July 1982 the residency expanded from a three-year format to the current four-year format, which we believe offers superior training and clinical excellence. Our curriculum is designed to develop clinical competence through hands-on training in a broad range of specialties pertinent to Emergency Medicine. Responsibility in the Emergency Department is graduated to allow continuous development as a clinician and teacher throughout the four years. Our graduated responsibility model is routinely lauded by our alumni as the pinnacle of our training program and critical to its continued success.
Despite being the first residency in Emergency Medicine, the University of Cincinnati takes pride in changing with the times to reflect the current atmosphere in Emergency Medicine. We continue to reevaluate our curriculum to make sure that we are providing our residents with a cutting-edge education, most recently adding rotation time with Critical Care Anesthesia to increase exposure to technology such as ECMO. In addition, as previously mentioned, residents have unmatched elective time to explore research or subspecialty interests including operations, administration, education, stroke, cardiovascular, wilderness, global health, social emergency medicine, sports medicine, critical care or any other interest they choose to explore.
Our curriculum supports a strong core of training in the Emergency Department with ICU training as well as subspecialty training in areas important to Emergency Medicine such as orthopedics, obstetrics & gynecology and plastic surgery. There are no
“scut rotations”. All our rotations are carefully chosen and regularly reviewed to assure that they are appropriate to training strong Emergency Medicine clinicians. The residents play a critical role in the continuing evolution of our
*After first 6 months of the first year, pediatric EM shifts are integrated in adult EM blocks. EMS ground shifts and Air Care aeromedical shifts are also integrated into blocks in the ED. After first year, Community EM shifts are integrated into every EM block, such that the total shifts for Community ED are at least 4 week equivalents per year.
** As of academic year 2019-2020, the CVICU rotation involves two weeks with Cardiology and two weeks with Critical Care Anesthesia, learning to care for critically ill cardiovascular and cardiac surgery patients, including those with LVADs and on ECMO.
The Grand Rounds curriculum is loosely based on a two-year revolving curriculum to maximize the exposure of all residents to the core content over their four years of residency. Leadership Curriculum Grand Rounds presentations occur quarterly and typically consist of a small didactic component on the given topic with significant emphasis placed on case-based learning and discussion in small groups with faculty preceptors. Recurring topics include: attitudes of a leader, how to pitch an idea, the finances of leadership, gender and age differences in communication, mentorship, etc. Novel content is occasionally introduced as well with some recent topics including: failure, performance improvement, styles of leadership, how to receive feedback, etc. The overall goal of the Grand Rounds curriculum is to provide residents with hands-on experience in the thought process of leadership as well as to build skills in collaborative problem-solving.
Grand Rounds Recaps and other content is available here on TamingtheSRU
In addition to Grand Rounds, our residents participate in daily Morning Report. Morning Report is an oral-boards format case presented by an attending each morning from 7:30 to 8:00 am.
During the 2011-2012 academic year, multiple residents came forward with the following question: If we have a reputation for developing future leaders in Emergency Medicine, then why do we not have a formal curriculum in leadership development? The question was a good one and prompted many meetings and much discussion over the next year in order to try to define how we developed residents into leaders. Ultimately, it was determined that this occurred in a passive fashion, primarily through the graduated responsibility model of our clinical training program. Led by Dr. Brian Stettler, the Program Director at the time, we then embarked on a plan to turn this passive leadership education into active leadership education. The result was the evolution of the Leadership Curriculum over the next few years. This started with the launch of a Grand Rounds curriculum in 2013-2014, which was followed the next year by the creation of specialized interest groups such as the Education and Operations Leadership Academies. These Academies not only created their own curricula through extracurricular meetings and workshops but they also provided the opportunity for residents to take on mentored projects in their area of interest under the guidance of leadership mentors. In 2017, we graduated the first class of the Leadership Curriculum, consisting of those fourth-year residents who had completed the pre-specified graduation criteria within their chosen Academy. While all residents are exposed to the Grand Rounds curriculum, more extensive involvement in the Leadership Curriculum is voluntary. Currently approximately 25% of the residents are actively involved in the Leadership Curriculum, supported by approximately 20 faculty.
Leadership Curriculum Faculty Leaders:
Founder: Brian Stettler, MD
Current Chair: Erin McDonough, MD
Chair, Education Leadership Academy (ELA): Jeff Hill, MD
Chair, Operations Leadership Academy (OLA): Rob Thompson, MD MBA and Hannah Hughes, MD MBA
Chair, Population Health and Health Services Leadership Academy (PLA): Kelli Jarrell, MD MPH
Grand Rounds Leadership Curriculum:
Those residents who wish to have deeper involvement in the Leadership Curriculum may join a special interest Academy. The current available Academies include the Education Leadership Academy (ELA), the Operations Leadership Academy (OLA), and the Population Health and Health Services Academy (PLA). There is also much opportunity in the area of Research as well (and to earn a graduation distinction in this, although this occurs through the previously developed Research Track offered by the Division of Research).
Residents who wish to join an Academy must identify a leadership mentor and a mentored-project within that Academy. Faculty within each Academy can help residents identify a project of interest. Residents should then meet with their leadership mentor at least 2 to 4 times per year to discuss the resident's progress in leadership development, reflecting on the resident's strengths and areas of focus as a leader.
Each Academy also produces quarterly workshops, also on a loosely revolving curriculum. These are scheduled outside of Grand Rounds, typically at a restaurant or faculty house. Residents within the particular Academy are strongly encouraged to attend, although these workshops are open to any resident or faculty member, even those not formally affiliated with the Leadership Curriculum. Residents can join more than one Academy as long as they complete the requirements of each Academy, including a separate mentored project.
ELA Recurring Curriculum:
Year 1 - Getting Academic Credit for your Work in Education/Education Research, Providing Feedback, How to Run a Meeting/Lead a Discussion Group
OLA Recurring Curriculum:
Year 1 - Leadership 101, Project Management, Patient Progression
Year 2 - Data & Analytics, Culture & Experience, Errors
Year 3 - Quality Improvement, Innovation & Design, Balancing Act (work-life balance/professional satisfaction)
PLA Recurring Curriculum:
Year 1 - Population Health Careers Panel, Community Engagement, Public Health Messaging
Year 2 - Networking and Net Worth, Advocacy Portfolio, Landing Your Dream Job
We have found the Leadership Curriculum to be a unique, rich experience that achieves the goal of turning leadership development from a passive process into an active one. The Leadership Curriculum was presented at the SAEM Annual Meeting in May 2015.
The Shock and Resuscitation Unit (SRU) in our Emergency Department is rarely quiet. Managed by the third-year resident, this busy area operates as both medical and traumatic resuscitation bays. R3s manage a large volume of critically ill patients in the SRU which allows them to further develop skills in critical care and resuscitation.
Procedural skills are developed throughout residency training; however, the second-year resident has a special role as the primary proceduralist in the SRU. This approach allows residents to perform a large number of procedures in a finite time period, so as to build permanent muscle memory. In addition to managing chest tubes, central lines, and arterial lines, all emergency airways are managed by an EM R2, with the EM R4 providing back-up. While second-year residents receive concentrated procedural training, residents perform procedures throughout all four years of residency.
UC Emergency Medicine is committed to training our residents as teachers. When you graduate from this residency, you will have first-hand experience as an educator at the bedside, at the lectern, and online. In Grand Rounds, residents prepare and deliver educational content through didactics, simulations, small group discussions, large group lectures, blog posts, and podcasts. Upper level residents and attending physicians help mentor junior residents in the development and delivery of their didactics and a validated assessment tool is used to provide feedback on lectures. In addition, residents are responsible for precepting third- and fourth-year medical students on rotation in the Emergency Department.
Ample opportunity exists for those desiring additional teaching opportunities. Residents may volunteer to teach in the College of Medicine’s First Responder Course for first-year medical students and the Department of Emergency Medicine’s fourth-year medical student elective Getting Ready for Residency. Residents are also actively involved in the College of Medicine’s Emergency Medicine Interest Group for medical students. Residents are also encouraged to participate in the training of paramedics, as well as becoming ACLS and ATLS course instructors. In addition, there are a number of teaching electives. These include the popular bedside teaching elective emphasizing self-evaluation and improvement of bedside and didactic teaching skills. Additional options include course design and curricular development for the Getting Ready for Residency elective, simulation, asynchronous education and more. Also, the fourth year represents an entire year of daily bedside teaching of both EM R1s and off-service residents. Plenty of other teaching/mentoring opportunities exist for interested residents.
In Cincinnati, we strongly believe in developing leadership skills and helping residents reach their full potential. Below is a list of some of the potential opportunities:
Available tracks are a way for residents to get exposure to longitudinal relationships with specialty mentors and unique clinical experiences. They may be done in conjunction with any of the Leadership Academies (see Leadership Curriculum).
The Residency Research Track is an individualized pathway by which interested residents can structure experiences and elective time in a focused and efficient way to achieve specific educational outcomes in research. This track offers intensive research education and exposure, and can result in significant development for those residents interested in a research career. Those in the track will use a significant portion of their elective time during residency to prepare for a potential career in research.
Every resident brings unique experiences and expertise which in turn requires individualized experiences to achieve the ultimate educational outcomes of the track. In general, residents complete an experience in both prospective and retrospective research methodologies, are closely mentored by multiple research faculty, spend additional time learning about basic research subjects (i.e. budgeting, human subjects protections, methodology, research career development, etc.), and attempt to select and coordinate their projects to create an area of concentrated academic/research focus.
Overall, this intensive experience provides more structure and direction than would otherwise occur and does so in a more longitudinal way. For those on the track, the primary goal is to shift from “completing a project” to using projects and other experiences as tools to achieve larger career-development goals that are specifically relevant to preparing for a research career.
Sponsors: Dr. William A. Knight, IV, Dr. Jared Ham, Dr. Natalie Kreitzer, Dr. Ryan LaFollette, Dr. Jordan Bonomo
This track is meant to offer longitudinal experiences in the locker room treating players and building independence and mentorship in sports medicine for both fellowship-bound residents and those interested in being a team physician.
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