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 and Columbia Memorial Hospital in Astoria 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 16-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 six 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 three months specifically dedicated to pediatric emergency care. EM-II residents rotate through the Pediatric Intensive Care Unit at Doernbecher Children's Hospital.
EM-I residents spend one month in Doernbecher Peds ED, while EM-II and III residents spend several shifts during each adult university month in the Doernbecher Peds ED and two months in the Emanuel Peds ED. Didactic sessions in pediatric care are organized by Pediatric Emergency Medicine faculty.
Pediatric emergency care M&M conferences are held monthly with the Department of Pediatrics and are followed each month by selected Peds didactic topics.
Oregon Poison Center
Oregon Poison Center, established by the Oregon Legislature in 1978, is a program of the OHSU Hospital and the Department of Emergency Medicine. OPC is a regional center that provides 24-hour comprehensive services to citizens and health care professionals throughout Oregon and neighboring states. The Department of Emergency Medicine and the OPC offer a two-year fellowship leading to board eligibility in medical toxicology. The fellowship offers experience and training in the diagnosis and treatment of toxicologic emergencies, critical care, occupational exposures and environmental toxicology.
Emergency Medicine interns (EM-I) spend one month on the toxicology rotation, serving as medical back-up to OPC, and providing telephone and bedside consultation and follow-up for patients with toxicologic illness throughout Oregon. The rotation also emphasizes extensive one-on-one and small-group teaching, as well as research into relevant topics. Residents present a toxicology M&M case during the rotation.
Emergency medicine research at OHSU is lead by Craig Newgard, M.D., M.P.H., a nationally recognized emergency health services researcher. Dr. Newgard is active in a wide range of clinical research activities including projects addressing EMS outcomes, medical ethics, trauma systems, medical informatics, poison center outcomes and medical education research.
The Department has received grants and contracts from the National Institutes of Health, Agency for Healthcare Quality and Research, Centers for Disease Control and Prevention, Environmental Protection Agency, Robert Wood Johnson Foundation, and numerous other foundations and government agencies. Computer hardware, software and research administrative support is available for resident projects.
There are multiple opportunities for residents to teach, both at the bedside and in the classroom. Our residents play an important role in the teaching of medical students, paramedic students, faculty and each other. All emergency medicine residents become ACLS instructors.