Learning from others

Johns Hopkins University

Kuan-Fu Chen

Content
Evolution of Hopkins Residency curriculum FAST Tract ED Conference Resident research

Evolution of Hopkins
Establishment of research enterprise Re-organize faculty member Transition to 4-year residency program Development of brand new residency program Development of fellowship program

Residency curriculum
1st year
Orientation: 4 wks Special lectures/hands-on series Basic medical topics: chest pain, toxidromes, airway management & sepsis, Basic procedural skills: splinting, suturing & ultrasound, Miscellaneous topics: charting, billing & coding, professionalism & communication skills.

Residency curriculum
1st year
JH ED 18 wks JH Ped ED 4 wks Howard County Hospital Ped ED 4 wks JHCCU 4 wks JH MICU 4 wks Anesthesia 4 week OB - 4 wks JHTrauma 3 wks JH Bayview Medical Center-Burn Unit2 wks Ophthalmology / UltraSound - 2 wks Vacation - 3 wks

Residency curriculum
2nd year
JH ED 30 wks JH PICU 4 wks University of Maryland Shock Trauma 4 wks JHTrauma 2 wks Ped Anesthesia 2 wks EMS 2 wks JHBayview Medical Center - HandUnit 2 wks UltraSound 2 wks Vacation - 4 wks

Residency curriculum
3rd year
Serves as a Senior Administrative Resident (SAR) Functions as a junior attending physicians Developing skills of Teaching Supervisory Department management

Residency curriculum (U of A)
Chief resident duty
Case discussion before morning meeting Communicate with training committee Residents retreat Education & administration Social events

Mentorship
Observer program

Residency curriculum
3rd year
JH ED- 24 wks JH Bayview Medical Center ED 8 wks Howard County Hospital ED 8 wks Elective 4 wks Toxicology 2 wks Research 2 wks Vacation 4 wks

Residency curriculum
4th year
FAST Tract Focused Advanced Specialized Training Different from fellowship 48 wks with 20 clinical hours/wk, 4 wks vacation

FAST Tract
Administration Research Critical Care Disaster Medicine EMS International Emergency Medicine (Relief / Policy) Medical Legal Observation Medicine Ped Emergency Medicine Research Special Operations Medical Education Ultrasound

 Conference

 Conference
EM Didactics Highly-interactive teaching Mortality & Morbidity conference Core lecture series Ultrasound curriculum Trauma conference Journal club Board review Grand rounds Chairmans hour Simulation curriculum

 Conference (1/6)
EM Didactics American Board of Emergency Medicine (ABEM) core 24 months cycle twice in the 4-year residency format Protected Friday mornings Formats: lectures, small groups discussions, simulation labs, anatomy labs and evidence based reviews

 Conference (2/6)
Highly-interactive teaching
Hour 1:

faculty led didactic session, focuses on approach to a pt with a specied chief complaint. cover differentials, use of ancillary tests & how these test can narrow differential
Hour 2 & 3:

small groups stations, focus on certain diagnoses. Sessions run by faculty /c interactive discussions using patient cases & simulation
Hour 4:

Residents led discussion answers focused questions with EBM approach Residents present short synopses of articles discuss how may change clinical practice

 Conference (3/6)
Mortality & Morbidity conference
One hour M&M every other month Discuss suboptimal outcomes cases Systems based approach Analyze medical errors in judgments & decision making, Also contributing factors teamwork and communication, availability of departmental and institutional resources and societal factors Help make recommendations to remedy decits identied

 Conference (4/6)
Core lecture series
Core content EM2: 30 min talk, EM3: 60 min talk 1:1 faculty assistance for content, slide preparation and lecture skill. EM4: 60 min talk from their FAST topic

Ultrasound curriculum
Lectures and skills sessions Four full-days content covered during 24 month period Supplement the ultrasound experience during 1st and 2nd years

Trauma conference
Join-led conference held every other month

 Conference (5/6)
Journal club
Five times a year Focused on teaching basics of searching & reading medical literature

Board review
Held annually for both oral and written exam Simulated oral boards cases with faculty A full-day interactive session prior annual In-Service Exam

Grand rounds
Every 6 weeks Experts in the eld of EM invited to discuss areas of interest

 Conference (6/6)
Chairmans hour
Ten times a year devoted to interesting and/or difcult management problems Cased presented by EM1 and discussed by chair

Simulation curriculum
In small group teaching Year-long simulation case-based teaching focused to year of training Voluntarily sign up Simulation center

 Conference (U of A)
Half-day meeting
1st hour Junior R 2nd hour VS talk 3rd hour Senior R

 Conference (U of A)
Other activities
Critical appraisal Journal club Senior R interactive discussion: Rosen textbook Junior R interactive discussion: Tintinalli round Exam/board preparation Research day/workshop (next day)

Resident research
One of FAST tract Monthly journal club Resident & faculty research presentations Paired with a faculty member since EM1 Submit manuscript by end of 3rd year