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Emergency Medicine - Frequently Asked Questions

Is the program ACGME accredited?

The program has ACGME accreditation.  It received initial accreditation the first time it applied.  We are in the initial accreditation phase.  Previously, it was a DO-only program and was in good standing with the Osteopathic accrediting body, the AOA, since 2004 when the residency started with the foresight to include all ACGME requirements, should the 2 accrediting bodies ever merge or change.  Ever since the movement to have all prior DO-only programs become ACGME accredited, we now accept Medical School Graduates from both MD and DO medical schools.

Will I be able to meet the residents in the program?

You should be offered the opportunity speak to the program’s residents, without the presence of faculty. There are some questions that can really best be answered by residents. This opportunity generally presents itself on interview day. Be wary of a program where the opportunity does not exist. It usually means that residents are not given the opportunity to speak freely for concern about what they may have to share or that the current residents are just not committed to the program. The GSHMC EM program always set aside time for the candidates to meet informally and interact with current residents.

What is the role of the emergency medicine residents in trauma care?

Senior EM residents have the role of Trauma Team Captain while the junior EM residents perform the technical procedures. In our ED, there is no “turf war” for trauma cases as we have no surgery nor anesthesiology residencies. Since emergency physicians always need to be prepared for whatever comes through the door, we prepare our residents to be able to perform advanced invasive procedures as well as basic stabilization and team leadership to ensure that very little is out of their scope of practice.

Who directs other ED resuscitations?

The Emergency Department team is responsible for all medical resuscitations. Senior EM residents have the role of directing the resuscitation (with an Attending present) while the junior EM residents perform technical procedures. Our residency encourages juniors to become proficient at procedures as soon as possible. As our senior residents gain comfort with their technical skills, they transition to a leadership role during resuscitations and coordinate care for complex medical cases. This process results in competent young physicians capable of managing critically ill and unstable patients. 

Am I going to be exposed to a significant number of pediatric emergency cases?

At GSHMC, we have a Pediatric ED that sees one of the highest volumes of children in NY. We place a strong emphasis on pediatric clinical education. Adequate exposure to pediatric emergency medicine is essential. Rotations of acceptable quality and frequency ideally in a dedicated pediatric ED is the optimum route to exposure.

Is there adequate Ultrasound Exposure?

In emergency medicine, ultrasound is a modality that has become indispensable and in many cases, the standard of care. It is tested on the emergency medicine board exams and is a required part of EM education. In our ED, we have credentialed most of the faculty for Point-of-Care ultrasound with a direct link to store and interpret studies in our PACS system.  We perform many studies that are not done by radiology such as the FAST, RUSH, Focused Echocardiography, Head and Neck, Airway, Lung, and procedural guidance.  Should there be any concern about obtaining our own adequate images for studies that are also performed by radiology, we have 24/7 radiology performed ultrasound. We provide regular lectures and practical sessions in addition to the routine clinical applications in conjunction with our fellowship in Emergency Ultrasound.

Is there graduated responsibility as you advance in PGY?

The more experience and skill that residents obtain, the more proficient they become at independently assessing and rendering treatment. Graduated responsibility over the course of a residency program is required to produce competent self-sufficient emergency physicians. A program should have clear defined goals for their residents and just as importantly a defined method of ensuring residents meet those milestones to continue advancing.

Why should I go to a four year program, when I could go to a three year program?

Advantages of a Fourth Year:

The foremost advantage is an additional year of administrative and clinical training. These graduates are exposed to a more comprehensive and in-depth training program. Additionally, they are generally more confident and more competitive applicants on the job market.  They have more time to refine their skills, are generally published more and will have developed specialized interests during their residency. Make sure the fourth year curriculum, however, offers additional training that interests you and provides the opportunity and format to explore your interests through venues like elective rotations.

Is the Emergency Department operating under the Department of Emergency Medicine?

This might sound like an obvious question, but some institutions do not have a Department of Emergency Medicine. In those instances, the ED operates under another specialty such as the Department of Surgery or Department of Medicine. In the latter, critical administrative decisions are made by people other than emergency physicians. Additionally, many resources may be scarce and must be shared with other programs/departments. At Good Samaritan, we are a fully accredited department with representation on the hospital’s medical board.

What are the relationships with the other services?

We have a very collegial relationship with the other services.  Most of the other services do not have residents and the specialist attending physicians directly care for their own patients.  As such, residents have a lot of face time with our specialists who go over important teaching points from interesting cases.  We have multiple guest lecturers from the other specialties contributing to the enhancement of resident conference as well.  Through the Department of Graduate Medical Education, there is at least monthly collaboration and sharing of information and resources to enhance the program.  Furthermore, the department’s administration has full representation on the hospital’s medical board where they are on equal footing with all other departments. 

Who has the final say when admitting patients?

At GSHMC, the ED has the final say. There is no fight or debate about it. There is no “MAR” or “admitting hospitalist” that can “block” your admission.  This is an important question to ask elsewhere, as our setup is not always the case.

What is the relationship like between the residents?

Your co-residents and interns become a very significant part of your life. We do not have a sense of competition or conflict between our residents, but rather have a supportive environment that is conducive to education. Residency involves a large commitment of time and hard work. You need to be surrounded by people who interact well and are supportive of each other. During the day of your interview, you can get a feel for this, but often the best way is to do a rotation in the hospital to which you are considering.

What is the relationship like between the attendings and the residents?

One of the built in features of our program is to foster positive relationships between our residents and attendings. These interactions include one-to-one mentor meetings, social events and informal opportunities. You should ask: Do they get along together? Do they have a good time together? Do they dislike each other? Are these the kinds of people that you are going to enjoy working with for four years?

What is the workload like? Who makes the schedule and is it fair and reasonable?

Our chief residents make the schedule, which is then reviewed by an attending, to assure that it is fair and reasonable. Our patient load is sufficient for you to develop procedural and clinical proficiency as an emergency physician. At GSHMC, we have a comprehensive patient mix with a reasonable workload and many interesting clinical cases but allowing for enough time for academics and other interests.

Is there any support for you and your family?

Residency is a full-time job and then some. No matter what field or institution you choose, you are going to spend a lot of time away from home. In our program, we regularly organize special events where residents, their immediate families and/or significant others can participate. It gives a chance for the most important people in our lives to be included in our residency family. At Good Samaritan, we also foster relationships through regular individual resident meetings with a faculty mentor and Big Brother/Big Sister program, as well as general residency meetings where there is a forum to discuss issues which the residents would like addressed.