The IUSM EM Residency
- Established in 1976 at Methodist Hospital of Indiana
- Became a part of The IU School of Medicine in 1999
- Expanded to a two campus system in 2000/2001
- R 1-3 Format: 19 residents per year
- Two campus system, 3 ED's (total of 250,000 visits/year)
- Combined program in Pediatrics-Emergency Medicine: - 2 residents per year. The oldest in the nation.
- "Full ongoing accreditation" status by the Residency Review Committee for the past 5 site surveys.
- "Full ongoing accreditation" status granted in the year 2011 for 5 full years.
What is Emergency Medicine
Emergency Medicine (EM) is a distinct specialty that focuses on the initial evaluation, diagnosis, and stabilization of patients with acute illnesses or injuries. In addition, the EM physician initiates treatment, involves consultants, makes disposition decisions and appropriate follow-up arrangements for patients discharged from the emergency department (ED). Emergency Medicine became the 23rd recognized specialty in 1979. There are at least seven areas of specialized expertise separating the EM specialist from other disciplines:
- EMS systems design and supervision
- Disaster management / Mass Gathering
- Environmental emergencies
- Acute Pain Management
- Wound Care
The underlying philosophy of the residency is optimal learning comes first and foremost by evaluating and treating patients. This clinical experience is strongly supplemented by formalized didactics and case-directed readings.
- Recognize, evaluate, and treat all patients with life or limb threatening conditions presenting to the ED.
- Make a timely and appropriate disposition for all patients presenting to the ED.
- Manage and direct mass casualty situations and participate in disaster planning.
- Develop teaching skills suitable to disseminate information to all levels of care providers, particularly prehospital personnel.
- Interact effectively with prehospital care providers and function as a Base Station physician.
- Effectively perform administrative tasks necessary to manage an emergency medicine service including scheduling, risk management, continuous quality improvement, and the handling of patient complaints.
- Pass Part I (written) and Part II (oral) Emergency Medicine Boards on the first attempt.
- Enter the career pathway of your choice clinical, administrative, fellowship and sub- specialization, academic (tenured or clinical track), or research.
- Develop competence in evaluating the medical literature and understanding research methodology.
- Develop a system for life-long learning to meet your professional goals after residency.
We have created a work environment designed to create opportunities for you to learn and develop your skills as an EM specialist. Residency is not easy, for there is an incredible amount of information and experience that must be gained in preparation for a successful practice, passing the ABEM certification examination and assuring longevity in your career.
We practice EM as a team. Likewise, our residency is constructed to build on teamwork and camaraderie. Many of the innovations in the residency developed through the contributions and work of those who proceeded you. We anticipate that you too will adopt these attributes and work with us in the ongoing development of your residency.
A residency program is a transitional period to the clinical practice and academic pursuit of Emergency Medicine. What you accomplish depends largely on your aggressiveness in pursuing the opportunities that have been created for you! The Directors and Faculty will assist you in achieving this goal by helping you define personal goals, setting standards and deadlines, providing you feedback on your performance, and serving as role models. Only in this way can you gain the rewards you deserve for three years of hard work and dedication. Ultimately, you have the responsibility for your education as a specialist in Emergency Medicine. Our charge is to assure the existence of an environment conducive to that end.
Your time in the residency will be governed by an Honor Code. Physicians must not be "selectively dishonest". Ethical conduct in one's interaction with peers, employees, and residency requirements reflects the tremendous moral and ethical responsibilities inherent in our caring for patients. It resides as one of the cornerstones of professionalism. Lying, cheating, stealing and patient abandonment are incompatible with a successful practice of EM.
High Volume Emergency Department
Our residency encompasses two high volume, high acuity general Emergency Departments that manage patients of all ages with every type of medical condition and a moderate volume pediatric Emergency Department. The combined Eskenazi/Methodist/Riley ED census of over 250,000 patients has a wide socioeconomic variety, with opportunities to care for celebrities and homeless patients alike.
Wide Exposure to a Variety of Providers
Another unique aspect of our residency is the wide exposure to a variety of "provider / consultants". At the Eskenazi site the more traditional housestaff hierarchy serves as the initial resources for admissions and consultations. At the Methodist facility, one third of the admissions are handled by the traditional housestaff teams, while two-thirds of consultations and admissions occur directly with the patient's attending physician or a designated staff hospitalist team.
Advanced Computer Technology
All 3 facilities use advanced computer technology, including a completely computerized triage and tracking system, immediate access to discharge, operative and consultation reports, laboratory data and ED records (directly entered through our dictations), and digitized radiology.
Mass Gathering Events
We have numerous opportunities for involvement in the planning and provision of care for the many mass gathering events in the Metro area (see below). While we have had a historic involvement in the Life Line helicopter transportation service, the proliferation of competing services and poor safety profile of medical helicopters throughout the US makes the decision to fly one that should not be taken lightly.
Our Toxicology experience is truly exceptional. We house the Indiana Poison Center, the only one in the entire state and one of the overall busiest in the nation.
Events on the National Stage
In the area of Mass Gathering Medicine, we have a wide variety of opportunities including planning and providing care at the Indianapolis Motor Speedway (Indianapolis 500 , Nascar Brickyard 400 and North America Formula One races), the Indianapolis Mini-Marathon, events in the Lucas Oil Stadium and Murat Theater, several PGA/WPGA tournaments, the National Rowing championships, numerous NCAA events, and the 2012 Super Bowl.
EM Pediatrics Residency
Pediatrics is a major focus of our residency. Since 1991 we have sponsored the oldest combined EM-Pediatrics combined residency in the nation.
In 2009 we introduced two "Tracks" into our curriculum. (The Academic Track and the Scholars in Advocacy Track). Each affords additional "value added" opportunities for participants. We have since added an Out-of Hospital medicine Track. Our curriculum remains innovative and undergoes continuous evolution with an eye to future graduate needs. We continuously seek opportunities for improvement, and our residents are integral in the continuous improvement process.
Graduation Rate & Career Success
Our record for graduates is excellent, with a 99% pass rate on both parts of the ABEM certification examination for all classes since 1984. Our graduates have had uniform success accessing the career pathway of their choice, be it academic, fellowship, or community practice.
Personal and Professional Development
Finally, although the 3 years of post-graduate study in EM is challenging and busy, we have not lost sight of the need for your personal as well as professional development during this time. We believe that optimal learning occurs not in a stiff, hierarchical system, but instead in one that values collegiality and camaraderie. We view our residents as our future peers, and place emphasis on maintaining non-abusive work environments and maximizing resident input into their education process.
Your input into the residency is not only desirable, but also critical to its ongoing growth and development. You may anticipate that the program from which you will graduate in three years will be different from the one you enter today. This will be a reflection of changes enacted with your input and participation. This is YOUR PROGRAM; you own 49% of the shares. It is encouraged that you aggressively participate in refining and supporting the residency.
In one attempt to formalize the critical role residents play in the management of your residency, we have established a resident committee structure. A resident chairs each committee, and the membership selected on a volunteer basis from all 3-year levels. A faculty member serves as a liaison. The agenda is developed conjointly by the committee and Program Directors. Historically, the Education Committee has enacted all formal proposals presented to it by the committees.
Our residents participate in all important decisions in the residency. In fact, participation is expected. This includes hiring of new faculty, the interview process, the rank list, and selection of Chief Residents. Resident evaluation of their educational experiences is likewise critical to the ongoing development of our residency.
Involvement in the residency should be paralleled by participation in the national organizations that represent Emergency Medicine. These include:
- American College of Emergency Physicians (ACEP, the "political" branch of the specialty
- Emergency Medicine Residents' Association (EMRA)
- Society of Academic Emergency Medicine (SAEM, The "academic" organization of the specialty
- American Academy of Emergency Medicine (AAEM, Membership is limited to ABEM certified EM Physicians, resident category is available.)
Those with special interests should consider the National Association of EMS Physicians or the Wilderness Medical Society.
The Indiana Chapter of ACEP reserves an active position on the Board of Directors for one of our residents. In addition, one resident should be active as our representative to EMRA.
You are expected to subscribe to the Annals of Emergency Medicine sponsored by ACEP (the subscription is included in your ACEP/EMRA dues) and Academic Emergency Medicine sponsored by SAEM (covered by your SAEM dues). Over the next three years selected books will be purchased for you. Finally, you are encouraged to purchase a personal computer (PC) for word processing, literature searches, and research. Ample resources and training opportunities exist in the program to allow you to become proficient with a PC. It is important to maintain your involvement with the organizations supporting Emergency Medicine.