PGY-1Orientation (4 weeks)- You will work half-time during the first month of your residency, giving you time to get acquainted with Rochester and your fellow residents. On the work side, orientation includes:
EM (16 weeks) - The bulk of our shifts in the ED are on the West Side of the department, where we work with rotating residents to handle mid- to upper-level acuity patients, commonly including stable MI's, chest pain, abdominal pain, change in mental status, isolated long-bone fractures, etc. The patient flow is run by the upper-level third-year EM resident in conjunction with one to two attendings (who also cover the trauma bay). Patients are admitted with a single phone call to the admitting attending and are transferred to the Observation Unit or East Side, where they are covered by PAs if in-patient beds are not available. Sign out is prompt, generally well under an hour after change of shift. During adult EM months, you work 18 to 20 ten-hour shifts per month. PEDS-EM (6 weeks)- The Pediatrics section of the Emergency Department is attended mainly by fellowship trained and boarded Peds-EM faculty with an active Peds-EM fellowship. It is also covered by pediatrics and emergency medicine residents and emergency pediatrics nurse practitioners. The department contains 20 beds (10 monitored) plus a pediatric resuscitation room. We are blessed with child life specialists who are well versed in keeping kids and families happy and safe through procedures or while awaiting evaluation and disposition. Pediatric trauma is initially stabilized in the trauma bay by the pediatric trauma team in conjunction with the trauma bay EM resident, with supervision from pediatric surgery and Peds-EM attendings, fellows, and residents. Again you work 18 to 20 ten-hour shifts. Urgent Care (2 weeks) - Because our ED has such a large capacity, lots of the day and evening minor/non-acute patients are triaged to the South side of the unit, which sees Urgent Care-type patients. These two weeks will be scheduled like a typical Adult ED rotation. EM Ortho(4 weeks)- The EMO (Emergency Medicine Ortho) month allows you get first crack at every orthopedic injury entering the ED. You are called to every part of the department including Peds, Trauma, and the South Side to stabilize orthopedic injuries. This is your opportunity to cherry-pick the best and most interesting cases in the department. You work alongside the ED based orthopedic resident and get to perform many procedures including fracture and dislocation reductions, conscious sedations, complex suturing, tendon lacerations, and even an intubation or LP. The EMO (Emergency Medicine Ortho) month has you working 19 nine-hour shifts in the Emergency Department. MICU (4 weeks) - The MICU rotation is an intense rotation in our large medical ICU. The EM resident is an integral part of the team which covers as many as 20-24 patients at a time. Many procedures are available under supervision of critical care fellows and attendings. The month is Q 3 day call, strictly following work hours regulations. Anesthesiology (4 weeks) - This rotation offers and opportunity to work closely with attending faculty from the Department of Anesthesiology. It allows you to gain critical experience in multiple airway techniques (including BVM, LMA, direct and indirect methods of intubation) in a controlled setting and under the guidance and supervision of an anesthesiologist. Additionally, this rotation allows you to review cardiac and respiratory physiology. You will also explore pain management issues, including how pain affects physiologic parameters and how various adjuncts are useful in helping patients through such issues. This is a Monday through Friday rotation with no call. The typical day ends in the mid-afternoon. OB/GYN (4 weeks) - This is our only off-site rotation, which takes place at Highland Hospital, a Strong Health community hospital affiliate located within a mile of Strong. During this experience, you are an integral part of the team made up of Family Medicine, OB, and EM residents. About 3,000 deliveries a year are performed at Highland and most are low-risk. Overall, residents feel like they are a welcome addition to the team and are given appropriate levels of supervision and access to both deliveries and assessment of women with labor and its complications. There is a rotating shift and call schedule. Ultrasound (3 weeks) - This block is your introduction to clinical U/S using our two new Sonosite hand-held ultrasound machines. The goal is to become comfortable with and certified in ED U/S per SAEM recommendations. This rotation enables you to gain U/S skills that you will apply the skill of U/S to patient care for the remainder of your residency. Probes to use include transabdominal, cardiac, procedure/skin, and endovaginal. This is a Monday-Friday daytime rotation with no call. You will review your images with Dr. Svengsouk, who will provide real feedback on your U/S skills. Vacation (4 weeks)- Four weeks of vacation split up into one- or two-week blocks. Psych-ED (1 week) - In the psychiatric emergency center, R1's learn to differentiate psychiatric illness from delirium and get experience managing acute psychiatric emergencies. This is a day rotation with no call.
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