Introduction to Emergency Medicine - 1 block

All incoming first-year residents begin their residency in July in the Emergency Department (ED) at University Hospital (UH). There is extra resident coverage in the ED during this month to allow an easier transition for first-year residents. The number of shifts worked are reduced to make room for an integrated EM Boot Camp which teaches basic core concepts in Emergency Medicine through lecture, small group sessions, skills workshops and simulation exercises.

Emergency Medicine (University Hospital) - 4 blocks

As a first-year resident, time spent in the ED is geared toward establishing a foundation of Emergency Medicine’s core concepts. The primary goals are to learn how to work up the basic chief complaints seen in the ED and learn to differentiate between the “sick” and “not sick” patient. Firstyear residents are encouraged and expected from day one to perform any and all procedures in the department including intubation, chest tube insertion, central line insertion, lumbar puncture, and laceration repair. These procedures are supervised by a senior resident or attending. Approximately 1-2 shifts during each block are spent in the Pediatric ED at UH, giving residents exposure to the variety of pediatric pathology spread across the calendar year. Residents will also spend approximately 1-2 shifts/block in the Fast Track area of the ED beginning August 2017.

Emergency Medicine (East Orange VA Hospital) - 1 block

This rotation affords the first-year resident an opportunity to learn and practice the basics of emergeny medicine in a smaller, community-based ED setting with one-on-one supervision from an attending physician. This experience also adds in some Fast Track experience so that residents become comfortable with bread-and-butter/basic EM pathology.

Pediatric Emergency Medicine - 1 block

This rotation is divided into two 2-week blocks, ideally one in warmer months and one in colder months so that residents gain exposure to the seasonal variation in pediatric pathology. The rotation is based at University Hospital's Pediatric ED, with primary supervision of residents provided by Pediatric EM-trained faculty.

Ultrasound - 0.5 block

Utilization of ultrasound in EM continues to grow and it is a core tool in our ED. During this dedicated two-week rotation, first-year residents learn how to use the ultrasound machine at a basic level on patients in the department - the physics of ultrasound, “knobology”, how to best capture and save images, etc. Upon completion residents are expected to have competence in using the ultrasound for procedures, along with exposure to key emergency studies. The first-year resident is paired with a senior resident for the rotation, and is overseen by our ultrasound faculty.

Emergency Medical Services (EMS) - 0.5 block

One week of this block is spent on the ground doing shifts alongside paramedics and EMTs in the ambulance as they evaluate and transport patients around Newark to various hospitals in the area. The other week is spent with NorthSTAR (Shock-Trauma Air Rescue). Flying on the helicopter for medical evacuations with flight nurses and paramedics is an optional experience.

Anesthesia (AM)/Procedures (PM) - 0.5 block

This block combines Anesthesiology in the morning along with Procedures in the afternoon. The Anesthesiology rotation provides first-year residents the opportunity to learn to manage the airway in a controlled Operating Room setting using a variety of modalities - BVM ventilation, direct and video-assisted laryngoscopy, LMA, etc..

While on the Procedures rotation residents focus on ED-based procedures while also working alongside a variety of consultants in learning procedural skills relevant to the acute management of ED patients. While on this rotation the resident fields consults from the ED related to a variety of specialties such as Orthopedic Surgery, Plastic Surgery, Ophthalmology, Otolaryngology, etc.. The resident works as a liaison and partner with the consulting service while learning and performing key procedures including fracture reductions, complex laceration repair and ophthalmologic procedures.

MICU - 1 block

While on the Medical Intensive Care Unit, first-year residents serve a primary role as part of the critical care team. The team is composed of ICU attendings, fellows, residents from multiple specialties and medical students. This rotation is a great setting to manage the sickest patients over their disease course. By the end of this rotation, first-year residents are comfortable treating conditions such as DKA, severe sepsis/septic shock, massive GI bleeding, and strokes. They also gain competence in placing central lines, managing a ventilator, and selecting/dosing vasopressors.

CCU - 1 block

While on the Coronary Care Unit, first-year residents serve a primary role as part of the Cardiology critical care team. The team is composed of Cardiology attendings, fellows, Internal Medicine residents, and medical students. This rotation particularly exposes residents to the management of very common, but life-threatening cardiac conditions such as congestive heart failure, myocardial infarction, and heart block. This allows for focused exposure to echocardiography, cardiac catheterization, pericardial windows, and pacemakers, among other things.

Trauma - 1 block

As northern New Jersey’s only level-1 trauma center, UH is a prime location for great trauma exposure including high speed motor vehicle accidents, falls from high elevation, burns, stab wounds, and gunshot wounds. Almost one-third of trauma activations are for penetrating injuries (significantly higher than comparable national trauma centers) and our Injury Severity Score for trauma activations is higher than our peer group of trauma centers. This dedicated rotation allows first-year residents to be part of the Trauma Team that responds to Priority 1 and 2 trauma activations in the ED, and care for the inpatient service. The team is composed of attending physicians, fellows, residents from various specialties, nurse practitioners and medical students. First-year residents perform primary and secondary surveys, FAST ultrasound examinations, and place chest tubes and central lines. Resuscitative thoracotomies are frequently performed in the ED Trauma-Shock Room. Trauma is also integrated within EM blocks during EM-3 and EM-4 years.

Addiction Medicine & Emergency Psychiatry - 0.5 block

During this rotation residents will work faculty and residents from the Department of Psychiatry in the psychiatric section of the Emergency Department. Residents will gain skills related to the evaluation of patients presenting with acute psychiatric conditions, psychiatric clearance and management of substance-induced psychiatric disorders. Residents will also spend two half-days in the Addiction Medicine clinic with faculty from both the Department of Emergency Medicine and the Department of Psychiatry as they evaluate and manage patients with a variety of addictions and substance abuse. This rotation allows residents to work directly with renowned experts in the field and participate in grant-funded research projects, while directly impacting our patients given the high rate of substance abuse and addiction in the Newark area.