Curriculum

 

Curriculum

The Emergency Medicine Residency curriculum emphasizes broad-based training during the first year followed by concentration in emergency medicine and critical care thereafter. All residents will become certified in ACLS, ATLS, and PALS during their residency orientation period.

 

PGY-1 Clinical Rotations Return to top
Introduction to Emergency Medicine
(1 month)
All first-year EM residents participate in the Introduction to Emergency Medicine rotation during July (i.e. their first rotation). This orientation rotation consists of morning didactic sessions along with an abbreviated clinical schedule. Basic principles of emergency care are emphasized. The abbreviated clinical schedule allows time for reading and getting settled into residency as well as the Charlottesville area.
Emergency Medicine
(Four 1 month blocks)
PGY-1 residents from Emergency Medicine as well as Internal Medicine, Family Practice, Ob/Gyn, Psychiatry, and Surgery work in the Emergency Department. Shifts for EM residents include the adult and pediatric portions of the ED at UVa.
Pediatric Surgery
(1 month)
Historically, a rotation the residents consider a strength of the program.  Residents participate on the pediatric trauma team as well as care for children in clinic, the OR, the ward, the PICU and the NICU.
Critical Care: MICU or CCU
(1 month)
Interns will spend one month in the medical intensive care unit (MICU) or Coronary Care Unit (CCU) caring for critically ill patients, allowing for many invasive procedures and complex resuscitations throughout the rotation.
Cardiology Consult Service
(1 month)
The cardiology consult service focuses on presentation and management of acute chest pain in the ED setting. The service enables interns to gain experience managing a broad spectrum of cardiac disease, including the workup and management of patients with unstable angina, acute arrhythmias, and other cardiac problems.
General Medicine
(1 month)
The general medicine service entails care for a broad spectrum of disease in ward (non-ICU) patients. Residents will gain experience managing COPD, CHF, pneumonia, and other common hospital illnesses.
Trauma
(4 weeks)
On the trauma service, the PGY-1 resident works in the STICU with senior residents. While on call, the intern also responds to all trauma alerts and is actively involved in the diagnostic workup of all major trauma patients.
Anesthesiology
(1 month)
Interns work in the OR with either an upper level anesthesia resident or a CRNA. Experience in intubations, rapid sequence induction, and starting lines is the focus of this rotation.
EMS
(2 weeks)
1 week is spent riding in an observer capacity with the Charlottesville Albemarle Rescue Squad (CARS) ground EMS units. The 2nd week is spent in a similar capacity with the Pegasus Critical Care Transport.

Ultrasound
(2 weeks)

 Interns will practice emergency sonography skills, with particular focus on the FAST exam, gallbladder and aorta scans. The rotation begins with a didactic curriculum followed by clinical practice at patients' bedside in the Emergency Department.
PGY-2 Clinical Rotations  Return to top
Emergency Medicine
(Eight 1 month blocks)               
PGY-2 EM residents concentrate on procedure skills and broadening their patient contact abilities while providing some supervision and teaching in the latter part of the year. PGY-2 residents also handle all ground EMS medical command as well as trauma alert intubations. Shifts include the adult and pediatric sides of the ED at UVa.
Ob/Gyn
(2 weeks)
Two weeks will be spent in the Ob/Gyn clinics on the evaluation of patients with normal pregnancies as well as those with obstetrical complications and gynecological disease. Includes time in labor and delivery.  This rotation is at Portsmouth Naval Hospital.  Housing is provided.
Research
(2 weeks)
Dedicated time is allotted for PGY-2 residents to structure research projects and develop their residency-required scholarly activity. Presentation at national conferences is encouraged and supported.
Toxicology
(1 month)
Rotation dedicated to the recognition and management (ED and in patient) of toxicological emergencies. Rounding on relevant hospitalized patients, responding to toxicological emergencies in the ED and ICU's, and working with the staff of the Blue Ridge Poison Control Center compromise the bulk of this month.
Surgical ICU
(1 month)
ICU management of critically ill patients on the surgery services.
Orthopedics
(1 month)
One month spent in the orthopedic clinics evaluating patients (both pre and post-operative) with orthopedic injuries or disease. Provides opportunity for follow-up on patients initially seen and treated in the Emergency Department.
PGY-3 Clinical Rotations Return to top
Emergency Medicine
(Seven 1 month blocks)
PGY-3 residents are expected to supervise patient care and flow in the ED. They will direct medical and trauma resuscitations and supervise junior house staff and medical students. Shifts include the adult and pediatric sides of the ED at UVa.
Trauma ICU
(1 month)
ICU management of critically ill trauma patients on the trauma surgery service. The PGY3 resident responds to all trauma alerts and is in a leadership role in the diagnostic workup and treatment of trauma alerted patients.
Elective
(Two 1 month blocks)
Available electives include community emergency medicine, burn ICU, ENT, neurosurgery, thoracic-cardiovascular surgery, wilderness emergency medicine, and accident and emergency department in Edinburgh, Scotland. Please see the Away Rotations section for a complete list of available electives.
Pediatric ICU
(1 month)
ICU management of critically ill children with complex medical condition (includes trauma as well as medical patient
Community Emergency Medicine
(1 month)
A one month rotation in the Emergency Department at Culpeper Regional Hospital, a community hospital located near Charlottesville.

 

Emergency Medicine Conferences Return to top

Didactic conferences meet every Wednesday (7-12 pm), and procedure labs are offered monthly to augment didactic time.  Conferences are presented by faculty and residents from the Department of Emergency Medicine, faculty from other Emergency Departments, and guest lecturers from other Departments at UVa. The didactic curriculum is based on the ABEM Emergency Medicine Core Content and will be covered every 18 months. Additional conference topics regularly covered every month include:

  • Morbidity and mortality (adult, pediatric)
  • EKG case conference
  • Trauma case conference
  • EM-PICU joint conference
  • Pediatric Infectious Disease
  • Pediatric Case Conference
  • Radiology Conference
  • Musculoskeletal
  • Toxicology
  • Resident Follow-up
  • EMS QI Conference (quarterly)
  • Resident Conference (quarterly)
  • Resident Faculty Conference
  • Curriculum Review (yearly)

The didactic program is supplemented with a monthly journal club. Each session focuses on a particular topic in emergency medicine and is usually hosted at a local restaurant. Papers are distributed ahead of time for critique and review during the session.

A series of mock oral board sessions are also provided twice a year, primarily intended for the graduating PGY3 residents in preparation for their upcoming board certification examinations.

Procedure workshops are held on a monthly basis, and allow for discussion and practice of critical emergency procedures. Prior workshops have included Mock Code Practice, ACLS, PALS, Emergency Ultrasound, ENT & Ophthalmologic procedures, ATLS, ED Equipment and ECG, Mass Casualty & Disaster Drill and Difficult Airway Skills.

Emergency Medicine residents on rotation in the Emergency Department are free of clinical duties in order to attend conference (i.e. attendance is required). Residents on "off service" rotations have individual schedules based on agreements with their off-service department.

Longitudinal Education Tracks Return to top

The UVA Emergency Medicine Residency Program is unique in offering longitudinal tracks for interested upper-level residents (PGY-2 and PGY-3). These tracks are designed to allow opportunities for learning geared towards a particular interest or subspecialty in emergency medicine. Participation in the tracks is not required, but dedicated time to pursue track activities is provided for participating residents. The following longitudinal tracks are available:

  • Medical Education Track: geared for those with an interest in educating students and residents or for those seeking experience with a career in academic EM
  • EMS Track: for residents with interest in prehospital care and medical direction
  • Administrative Track: provides resident exposure to ED operations and management of an academic department
  • Disaster & Emergency Preparedness Track
  • Public Health Outreach Track: provides residents with public health concepts, planning and execution of a rural outreach clinic in southwest Virginia and Guatemala

Further information about the longitudinal tracks may be obtained at any time by contacting the residency program director.

Away Rotations Return to top

Upper level residents have 1-month blocks dedicated for electives. Available offerings include:

  • ABC News (New York, NY)
  • EMS and Disaster Medicine (Univ. of New Mexico, Albuquerque, NM)
  • Pediatrics (St. Mary's Hospital, Richmond, VA)
  • Medical Clinic of Big Sky (Big Sky, MT)
  • Lifeguard 10 Flight Elective (Roanoke, VA)
  • Trauma & Critical Care Resuscitation (Univ. of Nevada, Las Vegas, NV)
  • Rural Emergency Medicine (Tuba City Regional Health Care, Tuba City, AZ)
  • Wilderness EM (Fairbanks, Alaska)
     

International Offerings are available any where around the world that is not on the federal government do not travel list. Here are a few locations that our residents have already visited:

  • Accident and Emergency Department: Royal Infirmary of Scotland (Edinburgh, Scotland)
  • University of Padua Emergency Elective, Padua, Italy
  • Children's Hospital in Costa Rica

 

Electives  Return to top

  • Administrative Elective 
  • CCU 
  • Dermatology Clinic
  •  Emergency Radiology 
  • Medical Simulation 
  • Medical Toxicology 
  • NETS 
  • Neurosurgery 
  • Ophthalmology Clinic 
  • Otolaryngology Clinic 
  • Palliative Care 
  • Pediatric Sedation Team 
  • Pegasus elective 
  • Radiology Research 
  • Space and Aeromedical Sciences  
  • Thoracic-Cardiovascular Surgery 
  • Ultrasound

Electives are flexible in that residents with a particular interest in an EM subspecialty are encouraged to design a unique experience suited to their interests. This is subject to the residency program director's prior approval of the elective.

Evaluation and Feedback Return to top

Residents will be evaluated by supervising residents or faculty on off-service rotations and by EM faculty on EM rotations. Residents will evaluate each rotation and will evaluate the entire program, including curriculum and faculty on a semi-annual basis. Each resident will be evaluated by the residency director on a semi-annual basis. The program has moved towards 360 evaluations in which the resident is being fully evaluated, covering all basis.

Each resident also takes the yearly Emergency Medicine In Service Training Exam administered by the American Board of Emergency Medicine.