Curriculum and Rotations

Approximately 1/3 of all community ED presentations are pediatric patients. This component of Emergency Medicine training is one seldom sought after by EM residents, but nearly every poll of recent EM residency graduates identifies pediatrics as an area new attending physicians wish they had more exposure to during training. Memphis is very lucky to have both Le Bonheur Children’s Hospital as part of the Methodist hospital system and St. Jude Children’s Research Hospital. Residents will receive training at Le Bonheur where there is also an active Pediatric Emergency Medicine Fellowship, who jointly rotate in the adult setting alongside our residents.  Residents who are interested in pediatric research have both St. Jude and Le Bonheur to work with on projects ranging from simple surveys to advanced cancer research. This is an unmatched training experience that will pay off for the rest of your career.

Orthopedic complaints make up a large percentage of chief complaints at any community ED, yet it is seldom given much training time during residency programs. The Department is associated with Campbell’s Clinic at Methodist University, which is one of the top training programs in the country for orthopedic surgery. Residents in the program will benefit from hands on instruction by senior orthopedic residents and attending physicians as well as hands on programs like the Splint Application Seminar and didactic teaching from the best in the world. You will leave the program knowing you have state of the art information and techniques for a high volume and potentially high risk component of Emergency Medicine.

Emergency Medicine at University enjoys a special relationship with Neurology, not only in the chest pain/neurology center, but also in a joint research venture in emergent neurological issues. We are working closely with the Neurology Department to improve stoke care in an area that has one of the highest stroke volumes in the country. Our neurology colleagues report that we had the single largest number of TPA treated strokes in a single hospital, anywhere in the nation, in 2014.

Opportunities abound, including research and additional training in the Neurology ICU. Cutting edge technology like Transcranial Doppler Ultrasound of MCA strokes is being employed and the Neurology Department provides training to interested Residents. Our facility pioneered the first CT Angio-capable mobile stroke unit in the nation. Our residents have the opportunity to staff  the mobile stroke unit, and are supervised by experienced UT neurology faculty via telemedicine. Discussions for a fellowship in Neuro-critical care/Emergency Medicine are underway and additional training is available via elective for interested residents now. Visiting students interested in additional emergency neurological care should let program staff know and a meeting with the Neurology Department will be arranged, if desired.

Trauma training takes place at the Elvis Presley Trauma center, one of the most active trauma services in the United States with a heavy daily case load of both “penetrating” and “blunt” trauma. Residents will be integrated into the team as junior residents and begin running the trauma ER early on. From intern year through graduation, residents will spent multiple months each year running the traumas along side an attending. Cases include everything from minor sprains and lacerations up to major(level 1) traumas in which the entire Trauma Surgery team is activated. This environment pushes residents to learn time management as they will be the sole resident responsible for the 18 bed ER. In addition, PGY-2 and PGY-3 residents alternate with anesthesia with regards to airway management. All in all, these are uniquely challenging and busy months and will prepare them for any trauma patients they will see in the future.

This is an excellent and very busy rotation that will prepare our residents for the most challenging of trauma cases.

ICU rotations at Methodist, Regional One, and Le Bonheur offer resident exposure to highly complex and critically ill patients. Critical care exposure includes pediatric research facilities, multiple active transplant services, regional stroke, neurological services, cardiac services, and the regional trauma service. Residents can expect to become comfortable managing the sickest patients on a routine basis. 

Critical care exposure includes highly advanced medical management with substantial opportunities to hone procedural skills. Residents admit and follow these critically ill patients to the ICU for continued care, which, in turn, improves their initial emergent management of critical patients.

Residents in the department will have a unique opportunity within Emergency Medicine for their Ob-Gyn training. Residents will rotate at Methodist South with private Ob-Gyn attending physicians who have experience teaching Ob-Gyn residents but are now located at a community hospital. There are no other residents competing for procedures or deliveries, and teaching is 1:1 with an attending physician. This is designed to be a high-yield, high speed rotation that makes the most of your time, builds confidence dealing with difficult cases in a community setting and ensures far more than the minimum number of procedures to achieve competence. We also have an OB standard and difficult/complicated delivery simulation laboratory that will allow simulated routine and breach presentations, as well as allow for simulation of the emergent management of maternal complications.

EMS is an integral part of any Emergency Medicine Residency and EMS ride along time is part of the training. In addition to the normal EMS experience, residents receive specific training in medical control of field personnel via radio and phone. Residents also receive disaster training in the form of basic disaster response and protocols, Community Emergency Response Team Training and basic training on dealing with nuclear, chemical, and biological hazards. Advanced training is available as part of trainee’s electives and can include time at US National training centers for: Urban Disasters, Biological Agents, Chemical Agents, and Nuclear Accidents/Incidents.

This is an exciting and high yield month. Initial basic intubation and airway management is taught the very first month of the residency. During your anesthesia month, you will be expected to log planned intubations each morning and then cover some advanced airway techniques with anesthesia staff. Later, a wide assortment of additional advanced airway rescue techniques will be taught in simulation and cadaver lab and implemented as called for in the ED. Surgical airways will also be covered. In the afternoon, after intubating the early afternoon planned surgical candidates, you will report to the ED and ultrasound patients that have suitable complaints and who will be getting confirmatory chest x-rays, abdominal and pelvic ultrasounds and Ct scans. Residents will partake in routine quality assurance review. As always, simulation lab will precede your clinical experience so that you can make the most of the patient interactions you have.