Throughout your four years of residency, you will complete a comprehensive, multi-modality curriculum in emergency medicine. The foundation of our didactic program is our weekly Wednesday morning conferences. The conferences consist of core lectures, weekly grand rounds, interactive case discussions, debates, procedural sessions, simulation cases, morbidity and mortality, as well as technology and evidence-based medicine discussions.
Our curriculum is divided into modules based on organ systems or common themes (for example, Cardiovascular, Trauma, Gastroenterology, etc). Integrated throughout is a comprehensive pediatrics curriculum taught by pediatric emergency physicians from CHOP. Core content is delivered over a two-year time frame, allowing each resident to review content twice during their training. Each module is accompanied by required and recommended reading from textbooks and journals, learning technology (such as podcasts), case-based discussions, and online board review questions.
Our four-year curriculum allows residents to grow from learners to effective teachers. Senior residents, along with faculty, play a vital role in presenting the curriculum. We also have a senior-directed curriculum during which PGY3&4 residents will break away to hold nuanced discussions about complex clinical topics, as well as learn about topics such as finances, public speaking, job hunting, and billing and coding. We are continuously introducing new and innovative approaches into our curriculum, and encourage resident feedback and input.
Grand Rounds
State-of-the-art discussions of important topics relevant to the practice of emergency medicine are delivered by departmental faculty and visiting professors.
Evidence in the ED
These are 15-minute "best available evidence" presentations that seek to answer specific questions relevant to clinical practice. Recent examples include the following: "Does platelet transfusion improve outcomes in patients with spontaneous or traumatic intracerebral hemorrhage?" and "Can we safely discharge low-risk patients with febrile neutropenia from the ED?"
Clinically-relevant epidemiology or statistics concepts may be reviewed (for example, likelihood rations or sensitivity and specificity). A number of these reviews have been accepted for publication in prominent EM Journals.
Journal Club
Hosted on a semi-monthly basis at a faculty member’s home, faculty and residents select current, relevant articles for review and discussion over dinner and drinks.
Core Lectures
Presented by EM faculty and residents, these are the "meat and potatoes" of residency didactic education. Lectures are succinct and to the point, incorporating board-style questions and utilizing audience response systems to engage learners. Examples include complications of dialysis, "approach to" ataxia, and endocrine emergencies.
Clinical Case Conference
Senior residents present a case piece-by-piece to a first or second year resident, requiring the resident to "think out loud" and work through the case as if he/she is evaluating the patient in the ED in "real time." As the case unfolds, a faculty member facilitating the discussion may ask for the reasoning behind a particular action or therapy, to highlight a core EM concept.
Procedure Conference
Faculty and residents review and demonstrate both common and uncommon (but important) ED procedures such as mock pediatric and adult codes, decontamination for mass casualty disasters, and epistaxis management.
Technology Discussion
Podcasts, blog entries, and recorded lectures from national conferences, specific to the module, are selected by residency leadership for review and discussion by the residents and faculty. This allows residents to learn from experts outside of our own institution, and to develop life-long learning skills necessary to practice emergency medicine.
Diagnostics/ECG Workshops
Each month, a designated faculty member compiles cases with interesting radiographic images or ECGs for review and discussion. During these workshops, not only are important findings presented, but also systemic approaches to reading radiographs and ECGs are reviewed.
Interdisciplinary and All-Philly Conferences
We hold regular joint conferences with trauma surgery, internal medicine, radiology, and pediatrics to discuss interesting cases and relevant topics that cross these disciplines. We also conduct joint trauma video review jointly with trauma surgery to discuss interesting and challenging cases in the trauma bay. Four times per year, we attend or host joint conferences with the other EM residency programs in Philadelphia. These conferences have themes such as EMS, toxicology, and wellness and feature top speakers from all institutions in the city.
Debates
A favorite among the residents and faculty these debates are exactly as they sound. There is a mock clinical case where the clinical management strategy is debated by two teams: a senior-level resident and attending team debating against another senior-level resident and attending team. A moderator introduces the topic and poses questions to the debaters as well as the audience participants. The teams have 15 minutes each to present their opposing views for the diagnosis, treatment, and/or disposition of commonly encountered emergency department (ED) presentations using the best available evidence. Following this, the audience participants have 15 minutes to discuss the opposing viewpoints and to determine if a consensus can be reached. Occasionally operational protocols have been developed in our department based on discussions at these debates!
Simulation
Throughout the year, we spend several entire conference days running through cases and procedures at the Penn Medicine Clinical Simulation Center, an off-site 22,000 square foot facility with multiple high-fidelity simulators and partial task trainers. We have also brought simulation to the bedside, conducting mock-codes in the emergency department with all members of the ED staff. We are in the process of constructing an on-site simulation center within our educational space adjacent to the Emergency Department. This will complement the current curriculum and allow increased frequency of simulation cases during weekly conferences and for reference prior to performing procedures in the ED.
Others
Other regular conference events include Morbidity & Mortality, Pediatric Core Conference, Mock Oral Boards, and Toxicology Conference.