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.
Emergency Medicine
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.
Lecture Series
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.
Breakout small group sessions to discuss bread and butter EM topics with faculty facilitators.
Each session is then wrapped up with a short resident run session with board style
questions.
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.
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.
An emphasis is now placed on III. 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.
Emergency Medicine/Internal Medicine
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.
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 EM Categorical Didactics
Emergency Medicine/Internal Medicine/Critical Care Medicine
The Critical Care Track of the EM/IM Combined program provides extensive ICU experience
at all three of our rotation sites as well as research and elective time.