Curriculum

We have provided a detailed list of all the rotations our residents will attend throughout their residency training. Our curriculum is designed to provide our residents with all the skills necessary to become an exceptional and well-rounded clinician. Next to each rotation, there is a detailed explanation of the educational experience provided. Thank you again for your interest in the Penn State Hershey Emergency Medicine Residency!

 

Rotation
Brief Description of Educational Objectives
Anesthesia
The Anesthesia rotation is primarily geared toward the peri-operative anesthetic management of patients undergoing surgery. Residents are assigned to work under the direct supervision of an attending anesthesiologist who oversees their participation in 4-6 cases per day. Responsibilities include performance of pre-operative history and physical examination, induction and maintenance of anesthesia, airway and ventilator management, intra-operative monitoring and post-operative evaluation. There is no required in- house call during this rotation.
Cardiology
This cardiology rotation is primarily geared toward the evaluation and management of in-patient cardiac illness. The Emergency Medicine Resident functions as the primary physician for cardiology specialty patients admitted by the senior resident or faculty. Senior residents and faculty directly supervise the resident on-site. The faculty are available on-call and make daily teaching rounds and receive morning report. The resident may respond with team leaders for emergency and inpatient consultation requests. There are no clinic or critical care unit responsibilities.
ED at Penn State Hershey
Five months are spent in the emergency department during the PGY-1 year, including the orientation month in July. The rotation is primarily geared towards learning the evaluation and management of minor acute and non-emergent conditions as well as assisting in the management of acute life-threatening conditions. The resident will see all non-emergent patients in order of triage or as directed by the attending or senior resident. After evaluating the patient, the resident will present the patient to the attending or PGY-3 senior resident on duty before initiating any diagnostic or therapeutic plans. Since residents progress at different rates and faculty have different supervisory styles, it is understood that this description may be altered in certain cases at the discretion of the attending. All procedures will be done under the direct or indirect supervision of the attending on duty.
ED Orientation
July of intern year is orientation month. All ED interns work a reduced number of shifts during this month and experience a curriculum designed to facilitate a smooth transition into residency. The interns participate in a number of different labs including splinting lab and suture lab. There is also an ultrasound course, a robust clinical simulation experience and certification in PALS, ATLS and ACLS.
MICU
The Medical Intensive Care Unit (MICU) rotation is geared toward the evaluation and management of the critically ill medical patient. The resident assigned to the intensive care unit will be supervised by senior medicine residents and the MICU attending. The critical care teams serve as primary physicians to all of the unit patients, making daily rounds.

Obstetrics and Gynecology

The Obstetrics-Gynecology rotation is primarily geared toward the obstetric and gynecological management of patients undergoing labor or related gynecological issues. Residents are assigned to work under the direct supervision of an attending gynecologist and or senior resident. Goal is to have a good working knowledge of, and demonstrate skill with, uncomplicated and complicated labor and delivery, common and important gynecologic emergencies as well as develop expertise in the diagnosis and management of emergent complications of pregnancy and management of emergent gynecologic conditions.
Orthopaedics
The Emergency Orthopedics, ophthalmology and dental rotation focuses on the emergency department evaluation and management of musculoskeletal injury and problems, eye complaints and evaluations and dental emergencies. The resident works under the direct supervision of Emergency Medicine faculty and senior residents in conjunction with, when indicated, residents and faculty from the Department of Orthopedics or Ophthalmology. In emergency department, the resident is responsible for the primary evaluation and diagnosis of orthopedic and ophthalmology patients and whenever possible will perform a variety of procedures (reduction, splinting, foreign body removal, etc.) under direct or indirect supervision of the faculty.
Pediatrics
The Pediatric rotation is geared toward the inpatient management of pediatric medical ward patients. The resident is responsible for direct patient care assignments, including admission H&P's daily progress notes, daily presentations on rounds, discharge instructions, discharge prescriptions, discharge summaries,and other in-patient management, as assigned. Senior residents and pediatric faculty directly supervise the resident. There are no clinic responsibilities
Trauma Surgery (TRACS)
Every resident will be a member of the Trauma Surgery/General Surgery team and participate in emergency operating procedures, with primary emphasis on pre-operative evaluation, resuscitation, and post-operative monitoring and care. Proficiency in manual skills and surgical procedures is taught through the consulting service procedures and emergency operating room cases. The resident is primarily responsible for all patients assigned to him/her and is supervised and evaluated on-site by his/her team leader (senior surgical resident) and team faculty.

 

 

Rotation
Brief Description of Educational Objectives
ED at Penn State Hershey
Eight months are spent in the emergency department during the PGY-2 year. The rotation is primarily geared towards learning the evaluation and management of emergent and life-threatening conditions and more efficient delivery of patient care. The resident will see all emergent patients in order of triage or as directed by the attending physician. Non-emergent patients will also be seen if no emergent patients are awaiting evaluation. After evaluating the patient, the resident may order x-rays and basic lab tests, but must present the patient to the attending before ordering any more invasive/expensive tests or initiating therapeutic interventions. The attending must be notified promptly of all unstable patients. Since residents progress at different rates and faculty have different supervisory styles, it is understood that this description may be altered in certain cases at the discretion of the attending. All procedures will be done under the direct or indirect supervision of the attending on duty. 
The resident is responsible for properly documenting all historical, physical exam and diagnostic test findings and for assuring that the attending has the opportunity to review and discuss the documentation.
ED – Pinnacle Health
Harrisburg Hospital
6 weeks are spent in the Pinnacle Health System Harrisburg Hospital emergency department (ED) during the PGY-2 year. This is a community hospital in Harrisburg, PA. The rotation is primarily geared towards learning the evaluation and management of emergent and life-threatening conditions in a non-tertiary care setting. The resident will see all emergent patients in order of triage. Non-emergent patients will also be seen if no emergent patients are awaiting evaluation. 
EMS
This PGY-2 level EMS rotation is primarily geared towards educating the resident about the structure and function of EMS and the role of the emergency physician in interacting with pre-hospital providers. The resident will work under the direct supervision of the attending physician or senior healthcare provider (RN or paramedic) on scene.
Surgical Anesthesia Intensive Care Unit
A one month rotation at the EM-2 level in the Surgical Anesthesia Intensive Care Unit is required of all residents. The rotation is geared toward the evaluation and management of the critically ill trauma and surgical patient. The resident assigned to the intensive care unit will be supervised by senior surgical and anesthesia residents, the surgical critical care fellow, and the SAICU attending. The EM resident will spend two weeks on the Anesthesia Critical Care Service and two weeks on the Surgical Critical Care Service. The critical care team serves primarily as a consult service to all Anesthesia Critical care patients. The admitting service (e.g. Surgical Oncology, Colorectal Surgery, Orthopedics, etc.) will remain as the primary service. The Surgical Critical Care Service functions as a closed ICU service. The SAICU team will round daily on all patients. Once transferred from the unit, the ward team assumes patient care. Residents on this rotation will take overnight call approximately every fourth night.
Ultrasound
All PGY-2 residents have a dedicated 2 week ultrasound rotation under the direct supervision of the Ultrasound Director.  The rotation better prepares the resident for independent practice by furthering their skills in ultrasound image acquisition and interpretation.

 

Rotation
Brief Description of Educational Objectives
ED - Penn State Hershey
Ten months are spent in the emergency department during the PGY-3 year.  The rotation is primarily geared towards honing the clinical skills developed during the first two years and developing supervisory and administrative abilities.  The resident will learn to run the emergency department.  The resident will see emergent patients in order of triage or as directed by the attending physician.  Non-emergent patients will also be seen if no emergent patients are awaiting evaluation.  After evaluating the patient, the resident may initiate a diagnostic and therapeutic plan, but should inform the attending promptly of all unstable patients.  All patients must be presented prior to disposition.  Since residents progress at different rates and faculty have different supervisory styles, it is understood that this description may be altered in certain cases at the discretion of the attending.  All procedures will be done under the direct or indirect supervision of the attending on duty.  The resident is responsible for properly documenting all historical, physical exam and diagnostic test findings and for assuring that the attending has the opportunity to review and discuss the documentation.  PGY-3 residents will run resuscitations and cardiac arrests.  PGY-3 residents will respond to EMS radio calls.
      MICU     
Harrisburg Hospital PinnacleHealth System
A one-month rotation at the EM-3 level in the Medical Intensive Care Unit is required of all residents.   The rotation is geared toward the evaluation and management of multiple critically ill medical and surgical patients. The resident assigned to the intensive care unit will be supervised by the MICU attending. The EM-3 resident serves as primary physician to 4 to 8 of the unit patients, making daily rounds. The EM-3 resident may be involved in cardiothoracic consults each day, emergency department and floor to ICU admissions on Tuesdays and Thursdays. Once transferred from the unit, the ward team assumes patient care.
Elective
All residents have a one-month self elected rotation in their PGY3 year. You may arrange an elective within the PSUHMC system or you may gather information on an outside rotation and apply for approval through the GME office.