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, evidence-based medicine discussions, simulation and procedural training, and more.
Our curriculum is divided into modules based on organ systems or core topics (i.e. cardiovascular, EMS, trauma, pediatrics, etc.). 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 an asynchronous curriculum that includes podcasts, textbook chapters, boards questions, and other learning resources that can be accessed anywhere and anytime.
Our four-year curriculum allows residents to grow from learners to effective teachers. Our residents, along with faculty, play a vital role in presenting the curriculum. Junior residents work with faculty to teach core content, and as residents progress through residency, they are tasked with delivering interactive/hands-on content, evidence-based medical discussions, critical care topics, morbidity and mortality conference, and resident grand rounds. We also have a senior-directed curriculum during which senior residents will break away to hold advanced discussions about complex clinical topics, as well as learn about topics such as finances, job hunting, billing and coding, and more. We are continuously introducing new and innovative approaches into our curriculum, and encourage resident feedback and input.
Grand Rounds
Every conference day at 11am, we hold our Grand Rounds talk, which involves advanced discussion and presentation of topics relevant to the practice of emergency medicine. These presentations are delivered by departmental faculty and visiting professors. Furthermore, each PGY-4 resident gives a Grand Rounds talk on a topic of their choosing.
Morbidity & Mortality Conference
Each PGY-4 resident is tasked with presenting a Morbidity & Mortality conference, where we run through a recent ED case(s) to identify systems issues that may have contributed to outcomes. The resident works directly with a faculty member from our quality and safety team to understand the critical issues that contribute to adverse outcomes and identify ways to improve our delivery of care to patients. Our residents also participate in a yearly Mock RCA (Root Cause Analysis), giving our residents a chance to take a problem and break it down into contributing factors (using a fishbone diagram and other core principles in quality and safety) to find ways to improve our operations.
Core Lectures
Presented by EM faculty and PGY-2 and PGY-3 residents, these are the "meat and potatoes" of residency didactic education. Lectures are succinct and to the point, incorporating board-style questions, case examples, and hands-on experiences to engage learners. Examples include complications of dialysis, heart block/transvenous pacer placement, bowel obstruction, and more.
Critical Care Case Conference
PGY-3 residents present an ED critical care case from presentation to outcome, encouraging the listeners 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, the faculty mentor is there to highlight core learning points and encourage discussion among the residents.
Evidence in the ED
These are 15-minute "best available evidence" presentations that seek to answer specific questions relevant to clinical practice. Residents work with a research faculty mentor to identify clinically important topics, perform a literature review, and present the data to help answer the clinical question. Clinically-relevant epidemiology or statistics concepts are reviewed to ensure our residents have a solid understanding of how to interpret research and data to deliver the best care possible.
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. Our journal clubs foster are a great way to bond as a team while also learning about the latest studies related to our specialty.
Radiology Conference
Each month, our colleagues from radiology come to conference to go over high-yield imaging studies from real ED patients. During these workshops, residents learn core concepts regarding imaging interpretation as well as diagnosis of common and uncommon emergency department diagnoses.
Consultant Series
Each month, we invite faculty and fellows from consultant services relevant to our organ block (i.e. ortho during musculoskeletal, cardiology during cardiovascular) to review important teaching points related to their specialty. We often identify topics by asking our consultants, “What do you wish our residents knew when consulting you?” In addition to a recurring EKG series with cardiology and pharmacology series with our pharmacists, we cover all areas of medicine relevant to EM (examples include approach to hepatitis, transfusion medicine, vaccine-preventable illness, and more).
Simulation
Throughout the year, we spend several entire conference days running through cases and procedures at the Penn Medicine at Rittenhouse Simulation Center, an off-site 22,000 square foot facility with multiple high-fidelity simulators and partial task trainers. In addition to adult and pediatric EM cases, we incorporate procedural training (recent topics including Minnesota tubes, pigtail catheters, subclavian central lines, and more), hands-on ultrasound training, advanced airway practice, and more. Additionally, we have a small simulation area adjacent to our conference room where we run small group simulation and procedural training, as well as space in the HUP ORs where we frequently run sim cases.
We also have several “gamification” days at the sim center each year, including our annual Penn EM SimWars (a fun, over-the-top simulation-based competition) and Penn EM SonoGames (our yearly ultrasound competition based on the yearly SAEM event). We have also brought simulation to the bedside, conducting in situ simulation (i.e. mock codes/resuscitations) in the emergency department with all members of the ED staff; several residents have been interested and helped design and run these simulations through the last several years. 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.
Bootcamps
As our trainees progress through residency, we use simulation and hands-on practice within small groups to deliver core skills to our residents. Several half-day sim- and procedure-based seminars are scheduled throughout the four years of residency, focusing on critical knowledge important for each level of training. Our interns get early exposure to key EM topics during their Intern Procedure Bootcamp, Critical Care Bootcamp, and Intern Airway Bootcamp. PGY-2 residents focus more advanced techniques during Difficult Airway Bootcamp, and learn how to lead codes/resuscitations during Resuscitation Leadership Training (RLT). Our resuscitation skills are further honed during PGY-3 year with the second day of RLT with a focus on ventilator management, and get exposure to rare procedures during their PGY-3 Cadaver lab. Furthermore, all our budding senior residents go through Senior Resident Bootcamp which focuses skills such as triage assessments, precepting learners, bedside and procedure teaching, and other senior resident duties. Finally, we are designing a PGY-4 Oral Boards Bootcamp based on the new ABEM Certifying Oral Exam in emergency medicine.
All-Philly Conferences
Multiple 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 ultrasound, and feature top speakers from all institutions in the city.