The most important aspect of any emergency medicine training program is the quality of the experience in the emergency department. In addition to OHSU University hospital, four emergency departments in Portland have been selected to participate because they offer unique settings, patient populations with a wide variety of medical problems, and excellent clinical faculty. They provide state-of-the-art emergency care and are staffed 24 hours a day by board-certified emergency physicians.
In July of 1997 the Department of Emergency Medicine opened a 10-bed, monitored observation unit. Emergency Medicine residents are involved in many aspects of this state-of-the-art unit, extending patient care beyond traditional ED evaluation.
Trauma management is taught with a step-wise increase of resident responsibilities. EM-I residents begin with one month as the admitting intern on the Trauma Service and four months of Emergency Department experience evaluating injured patients not formally entered into the trauma system.
All EM-I residents become Advanced Trauma Life Support (ATLS) certified by the end of the first year.
EM-II and EM-III residents spend seven months in the Emergency Department at OHSU Hospital, a Level I Trauma Center, where they attend to all trauma system patients.
EM-II and EM-III residents alternate the responsibilities of trauma team leader with PGYV Surgery residents. Responsibilities at this level include fully evaluating each trauma patient, documenting injuries and care provided, and performing various procedures and tasks during the resuscitation, including invasive procedures and the FAST exam. An additional month in the Surgical ICU rounds out the trauma experience in the EM-II year.
It is essential that emergency physicians be competent in managing pediatric emergencies. Residents train for 23 months in emergency departments serving both adult and pediatric patients. Residents also spend four months specifically dedicated to pediatric emergency care. EM-I residents rotate through the Pediatric Intensive Care Unit at Doernbecher Children's Hospital.
EM-II and III residents each year spend one month in Doernbecher Peds ED (several shifts during each adult university month) and one month in Emanuel Peds ED. Didactic sessions in pediatric care are organized by Drs. Garth Meckler and David Spiro, emergency medicine faculty members, board-certified in both emergency medicine and pediatrics.
Pediatric emergency care M&M conferences are held monthly with the Department of Pediatrics and are followed each month by a mock pediatric code and/or selected Peds didactic topic.
Participating EM faculty who are also board-certified in both pediatrics and emergency medicine are Drs. Robert Cloutier, Helen Miller, Craig Warden and fellows Matt Hansen and Esther Yue.