EM Categorical Didactics
Emergency medicine is uniquely challenging because of the breadth of material its practitioners are expected to master. The most valuable learning experiences in medicine occur at the patient's bedside. However, these experiences need to be supplemented with regular readings and a formal didactic curriculum to ensure that residents develop without knowledge gaps.
We are continually incorporating new and innovative education techniques into our curriculum each academic year. Our weekly conference is 4 hours every Wednesday morning and is supplemented by a diverse individualized interactive instruction (triple I) program to ensure all topics are covered while addressing the different needs and learning styles of all residents. Additionally, our curriculum is covered in modules that allow for in-depth understanding and review of the pathology related to each organ system. A strong emphasis is placed on evidence-based medicine through case-based learning sessions and triple I activities. Residents and faculty share responsibility for the preparation of these conferences. This provides residents an opportunity to research topics deeply and become comfortable organizing and presenting lectures to large groups. The curriculum has been organized so that the core-content of emergency medicine is covered biannually.
Residents work in teams to develop clinical scenarios and related questions on core emergency medicine topics. They then find current literature to answer these questions. During conference, these questions are used to drive faculty led small group discussions. This leads to the use and awareness of current literature, increased exposure to faculty for in-depth discussions, and a more interactive format for learning.
Lectures are given by directors of various divisions within the department of emergency medicine. This gives our leaders the opportunity to pass on valuable knowledge gained through many years of experience.
This conference is an opportunity for senior residents to draw on their knowledge of evidence-based medicine to settle controversies in management and diagnosis.
EM Topic Review:
Lectures covering core topics in emergency medicine. This series will fill in gaps missed by other lecture series during a given module and ensure all topics are covered biannually.
Pediatric and Adult Journal Clubs:
The latest literature is discussed and scrutinized using the tools of evidence-based medicine. Conclusions are drawn about the need for further research or a change in clinical practice.
These are ten minute lectures based on recent clinical encounters. The goal of each ten minute lecture is to teach one important point. Not only is this an effective way to learn, it also teaches residents to be efficient when presenting.
Cases from our own department are used to drive in-depth lectures on various critical care topics. This series is always well liked and helps solidify the lessons we learn from treating many critically ill and injured patients at our institutions.
These lectures are geared towards understanding the basic science, diagnosis, and treatment of commonly encountered diseases. EM/IM residents typically present these lectures.
M and M:
Unfortunately, we sometimes have bad outcomes in the emergency department. However, it is crucial we learn from these mistakes. Cases are presented and an attempt is made to find systemic problems and issues with regard to medical decision making.
The departmental CPC is an eagerly anticipated annual event in which the most mystifying cases of the year are presented as unknowns and then solved using brute intelligence. The best presenter or discussant is then selected to represent the residency at the national CPC competition.
Juniors and seniors are sometimes split into two groups. Juniors typically receive basic lectures on core content topics. Seniors are given lectures on topics ranging from the business of EM to oral board preparation.
High quality, nationally renowned speakers are regularly brought into the department to give grand rounds lectures.
Individualized Interactive Instruction:
An emphasis is now placed on triple I. We feel strongly that adult learners often require varied and individualized tools to reach their highest potential. On-line learning modules, evidence-based review articles, simulation, board review sessions, and procedure labs will all be used to supplement our Wednesday conference. Residents can draw from these various activities to enhance their educational experience.
Simulation sessions are regularly scheduled for residents after Wednesday conference. These sessions are faculty led and are a tremendous asset for improving both procedural and resuscitation skills. We have two facilities and are excited about the opportunities this division provides for our residents and students.
Bi-weekly board review sessions are held after Wednesday conference. These groups are also faculty led and are designed for in-service and board examination preparation.
Regular procedure labs are scheduled for residents to help teach splinting, slit lamp use, and other skills.
EM / IM Combined Didactics
The Combined Emergency and Internal Medicine program provides a unique opportunity to train in two specialties. However, the breadth of information across the two disciplines can sometimes be overwhelming. At Kings County Hospital / Downstate Medical Center, there is a wealth of didactic opportunities to enlighten emerging doctors.
The Internal Medicine residency features a systems-based curriculum. Each month a specific system is emphasized and the resident is expected to independently study. Biweekly noon conferences further reinforce this learning. Conferences cover essential core topics and by the end of the month housestaff are well prepared to sit for a review exam.
For the intern, weekly Intern-Morning reports allow integration of academics with patient care. Anyone from a chief resident to department chair will lead and facilitate discussions on a particular topic or a case presentation. This is a valuable time where junior house-staff have the opportunity to develop differential diagnoses and approaches to complicated cases.
For the resident on the inpatient service, there are triweekly Resident-Morning reports. Chief residents, Attendings and the Chief of service all present for these gatherings. A variety of topics are covered from hospital policies and practices, integration of evidence-based medicine, and the discussion of complex patient presentations. Round table meetings often move to the patient’s bedside to incorporate Hippocratic-style teaching into the academic discussions.
Morbidity and Mortality Conference is once per month and helps to highlight safety issues while reviewing a case in which different approaches to management are discussed. These conferences are well attended by faculty and chairs from the various medicine subspecialties. These conferences are prepared and presented by medical housestaff.
Grand Rounds combines didactics with state of the art research and technology. Once weekly, an invited speaker will discuss a particular topic in medicine. This is usually an update on where we are in the state of medicine and the advances on the horizon. Grand Rounds are held in the Alumni Auditorium to facilitate the enormous audience which this presentation draws.
To ensure coverage of the core topics of emergency medicine, there is a weekly conference each Wednesday morning that is comprised of lectures and specialized case conferences on a variety of topics. Residents and faculty share responsibility for the preparation of these conferences. This provides residents an opportunity to research topics deeply and become comfortable organizing and presenting lectures to large groups. The curriculum has been organized so the core-content of emergency medicine is completely covered every two years. Additionally, senior residents attend other specialized lectures. These are geared to advanced practitioners and cover topics in greater detail (eg. Medico-legal topics, contracts, billing, and EM leadership).
EM/IM residents take part in all the same educational experiences as the categorical residents while on EM rotations. EM/IM residents take active leadership roles in the critical care conference series and core content series. See above section on EM categorical didactics for more information.