Program Structure and Didactics

Didactics
Emergency medicine doctors Five hours of formal emergency medicine conferences take place each week, consisting of core curriculum lectures, case management conferences, research conferences, morbidity and mortality reviews, oral board practice cases, and grand rounds. All residents are released from emergency department duties to attend conferences. About 75 percent of lectures are given by faculty.

Journal clubs occur every other month and are held at the homes of faculty members.

Photo: Dr. Steve Green chiefs a resident on how to perform a venous cutdown on a trauma patient.

Examinations
The Emergency Medicine Residency Program administers written examinations two times a year and oral examinations twice a year. Feedback from these examinations aids residents in their personal reading and study programs.

Inpatient rotations
On average, emergency medicine residents take call on inpatient rotations every fourth night.

High-trauma volume
Both Loma Linda University Medical Center and Riverside County Regional Medical Center operate "trauma teams" which are activated for the most critical trauma patients. At both the Loma Linda University Medical Center and Riverside County Regional Medical Center the senior emergency medicine resident alternates days with the senior surgery resident in serving the role of ?trauma captain.? At both institutions, emergency medicine residents and faculty perform all trauma airway management. At both institutions, the emergency and surgery departments have excellent relations.

Emergency medicine residents are provided ample opportunities to perform a variety of procedures, including chest tubes, cutdowns, and central lines. Most residents perform a number of cricothyrotomies and emergency department thoracotomies prior to completing the program.

Ultrasound
The emergency departments at both LLUMC and RCRMC each have their own dedicated ultrasound machines for use during traumas and clinically indicated patient encounters. New US machines to replace older models were purchased within the past 1-2 years at both facilities and are made by different manufacturers to provide variety in the learning process.

At both institutions, emergency medicine residents and faculty perform all trauma airway management.

Pre-hospital care
Residents participate in "ride-out" experiences on paramedic ground ambulances during their PGY-2 EMS rotation. Ride-out experiences on helicopters are also available, but not required. Residents are actively involved in the training of local paramedics and EMTs, and in disaster planning and drills.

Exceptional leadership experience in critical care medicine
During the PGY-2 year, residents rotate through the busy MICU/CCU and pediatric ICU. On both services, emergency medicine residents rotate senior call with internal medicine and pediatric residents, respectively. While on call, the emergency medicine residents are the most senior in-house physicians for these ICUs. Extensive opportunities exist for leading resuscitations and performing critical care procedures. The Medical Center's pediatric ICU is among the busiest in the nation.

Electives
A total of two-and-a-half months are allocated for electives and research during the program. Possible electives include radiology, international emergency medicine, EMS, dental anesthesia, dermatology, or a variety of other areas. Off-site electives are also an option.

  Rotation
Months
Institution
PGY-1 Intro to emergency med
1
LLUMC
  Emergency department
3
LLUMC
  Emergency department
1
RCRMC
  Trauma surgery
1
LLUMC
  Coronary care unit
1
LLUMC
  Internal medicine
1
LLUMC
  Anesthesia
1
LLUMC
  Orthopaedics
1
RCRMC
  Obstetrics/gynecology
1
LLUMC
  EMS
1/2
LLUMC
   
 
 
PGY-2 Emergency department
2
LLUMC
  Emergency department
6
RCRMC
  MICU/CCU
1-1 1/2
JLPMVMC
  Pediatric ICU
1-1 1/2
LLUMC
  Elective/research
1
LLUMC
   
 
 
PGY-3 Emergency department
6 1/2
LLUMC
  Emergency department
4
RCRMC
  Elective/research
1 1/2
LLUMC