Training

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 priority focus during emergency medicine training. This rotation is associated with Campbell’s Clinic which is one of the top training programs in the country for orthopedic surgery. Residents benefit from hands on instruction by senior orthopedic residents in the level one trauma center at ROH. There is also an option to attend sports medicine clinics for those who have a particular interest in sports medicine.

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, Baptist Memorial, and Le Bonheur offer resident exposure to highly complex and critically ill patients. Current ICU rotations include MICU, SICU, CVICU, NICU (neurocritical care), and PICU. Critical care exposure includes multiple active transplant services, regional stroke/neurological services, cardiac services (LVAD/ECMO), and the regional trauma service. Residents can expect to become comfortable managing the sickest patients on a routine basis. 

Residents will rotate with the OB/GYN service at Regional One, where they will have exposure to a large volume of both routine and high risk pregnancies and will serve both on the labor floors and in L&D triage, honing skills such as the identification of labor, fetal monitoring, and cervical exams. The primary role of the rotation is to ensure competence and volume in performing vaginal deliveries. We also have an OB standard and difficult/complicated delivery simulation laboratory that will allow simulated routine and breech presentations, as well as 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 the anesthesia month, residents are expected to log planned intubations each morning and then cover advanced airway techniques with anesthesia staff. Later, a wide assortment of additional advanced airway rescue techniques will be taught in simulation and implemented as called for in the ED. Surgical airways will also be covered. In the afternoon, residents will report to the ED and ultrasound patients with a variety of complaints alongside one of the ultrasound directors.