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R1 Objectives

Emergency Medicine

R1s are assigned to the SMH ED daily for 4 weeks. They will work an average of four 10-hour shifts over 7 days.

Medical Knowledge

  • Develop a core knowledge in nonobstetrical/nongynecological emergencies
  • Efficiently assess and develop a differential diagnosis for the common medical conditions/symptoms that present emergently such as:
    • Headache
    • Syncope/dizziness/seizures
    • Cardiac arrest
    • Hyper/hypoglycemia
    • Nausea/vomiting/diarrhea
    • GI bleeding
    • Fever
    • Shock
    • Arrhythmias
    • Chest pain
    • Allergic reactions
    • Muscle weakness/paralysis
    • Shortness of breath
    • Asthma
    • Urinary tract disorders
    • Thrombotic/hemorrhagic events
  • Initiate first line therapy in common medical and surgical emergencies
  • Recognize surgical and gynecological emergencies
  • Differentiate between patients who need outpatient versus inpatient services

Patient Care

  • Perform a history and physical examination on a patient with a medical or surgical emergency
  • Order and interpret diagnostic tests on patients with a medical or surgical emergency
  • Correctly interpret electrocardiograms and cardiac monitoring data
  • Perform:
    • ECG
    • Arterial blood gas
    • Suturing and stapling of lacerations
    • Intravenous access on difficult patients
    • Intubation
  • Participate in code situations

Interpersonal and Communication Skills

  • Consult appropriately with additional hospital services for provision of patient evaluation/care
  • Communicate effectively with other members of the team
  • Provide adequate sign-out to team members to insure good continuity of care

Professionalism

  • Increase sensitivity to drug and alcohol abuse and the effect it has on patients, their health and families
  • Accept value systems that differ from your own
  • Gain an understanding of reasons patients utilize the emergency department for their medical care

Practice Based Learning

  • Gain a working knowledge of the admissions process
  • Use information technology to support your own education on common medical and surgical emergencies

System Based Practice

  • Gain an appreciation of uninsured patients that must use the emergency room as their primary care clinic
  • Begin to understand the cost of tests that are ordered and how it will impact patient management

Learning Resources

  • Residents will attend ob/gyn conferences on Thursday mornings
  • UpToDate is available online hospital-wide. EM faculty will recommend additional educational resources.
  • The interns’ best resources are each other and their upper-level residents; they are encouraged and expected to ask questions.

Evaluations

  • Faculty and resident colleagues are encouraged to provide direct verbal feedback so that resident performance can be commended or improved during the rotation
  • Residents are evaluated in writing at the end of each rotation using a standardized evaluation form given to supervising ED attendings and upper-level residents. These evaluations are compiled for the resident's semi-annual review.
  • Problems, which appear to be of a more urgent nature, will be brought immediately to the attention of the resident and residency program director for discussion.
  • Residents will receive a form at the end of each rotation soliciting feedback regarding the rotation and faculty. This information is shared anonymously and used for course/faculty improvement activities.