Residents rotate on both of Oregon's Level I trauma centers at OHSU and Emanuel Hospitals. OHSU alone has just under 2000 admissions per year.

At OHSU, two R-4s are assigned to the trauma service as the team leaders. An intern also rotates on the trauma service and is assigned team duties leading to advanced experience and responsibility. At Emanuel Hospital, the trauma team consists of an R-1, R-2, and R-4.

Local ambulance services transport critically injured patients to both OHSU and Emanuel from the Portland metropolitan area. The city has a helicopter and fixed-wing ambulance service that provides statewide rapid transportation to the university.