Overview
The Washington Hospital Center, in collaboration with Georgetown University, is pleased to introduce a new residency program in emergency medicine. The program, which will welcome its first group of residents in July 2006, is a three year training program emphasizing critical care, trauma management, and pediatrics. Additionally, as an academic leader in the fields of medical informatics and emergency preparedness, the Washington Hospital Center Department of Emergency Medicine offers unique training opportunities in these areas.

The program's goal is to produce exceptional emergency physicians, clinicians capable of responding to urgent needs for medical care with speed, skill, and efficiency. The Washington Hospital Center (WHC) is committed to this endeavor; the program has the support of the hospitals administration, other clinical departments, and its own distinguished faculty.

Clinical training occurs in a variety of settings in the D.C. metropolitan area. The ability to treat a diverse patient population served by different types of institutions (i.e., urban/suburban, tertiary care/primary care, academic medical center/community hospital) guarantees an exciting, challenging, and rewarding training experience. Close to half of the residents training is scheduled at the Washington Hospital Center. WHC is the largest hospital by a factor of three in the District of Columbia. It has the busiest emergency department, most active trauma center, largest cardiac service, and is the regional burn center and the National Institute of Healths designated regional stroke center. Incoming residents join a team of professionals that treats over 70,000 patients per year with more than 18,000 hospital admissions. Its Level 1 Trauma
As a jointly sponsored program, residents combine the benefits of training at a large teaching hospital with the resources of a leading academic medical center, the Georgetown University Hospital. Besides clinical training opportunities and shared conferences, the affiliation provides residents access to the Georgetown University School of Medicine faculty, research facilities, and library.

Curriculum
The curriculum includes extensive training in critical care, trauma management, and pediatrics, as well as special training opportunities in the emerging fields of medical informatics and emergency readiness. The training is structured to allow progressively independent experience and to meet yearly educational objectives.

Critical Care
Residents spend five months training in various critical care venues.

* Pediatric Intensive Care Unit - 2 months

* Coronary Care Unit - 1 month

* Medical Intensive Care Unit - 1 month

* Surgical Intensive Care Unit - 1 month

Trauma
The Washington Hospital Center trauma unit, MedSTAR is a level I trauma center with 24 hour in-house coverage by trauma surgeons. In 2003, the center cared for an average of 10 trauma patients per day. As the regional burn center, the trauma center sees a high volume of burn victims, approximately 400-450 patients in 2003. The trauma unit provides residents with extensive and progressively independent experience in treating trauma patients.

* First year residents serve four weeks as a team member

* Second year residents respond to trauma codes during 16 designated shifts

* Third year residents are assigned to the unit for six weeks; senior residents initiate trauma evaluations and resuscitations

Pediatrics
Pediatrics is an essential component of emergency medicine training. The clinical schedule incorporates pediatric training in a variety of settings to create a diverse and comprehensive experience. A total of four months are spent in pediatric rotations.

* Two one month rotations (PGY1, PGY3) are spent in the Pediatric Emergency Department at Shady Grove Adventist Hospital, a community hospital in Montgomery County, Maryland. The Pediatric Emergency Department is dedicated solely to treating children and is staffed by physicians who are board certified in pediatric emergency medicine.

* Two one month rotations (PGY1, PGY2) are spent in the Pediatric Intensive Care Unit at Childrens National Medical Center providing experience with very ill children and the procedures involved in their care

* Rotations at the Georgetown Medical Centers Emergency Department; approximately 15% of their annual census are children and its CYAS clinic provides urgent evaluation of pediatric patients

Medical Informatics
A required first-year rotation, MedStar Healths Institute for Medical Informatics provides a general introduction to the field of medical informatics including detailed knowledge about the various information tools available to an emergency physician. Residents are trained in the use of the Azyxxi information system, a database that documents over 1,000,000 patient visits to the emergency departments of hospitals in the MedStar Health System. This early introduction to the field, and specifically to the Azyxxi system, enables residents to use it as a data source when preparing their Quality Improvement project as a PGY-2 and may be the basis for the Scholarly project required in the PGY-3 year. For more information on the Institute for Medical Informatics, please visit http://www.imedi.org/ .

Conferences
Regularly scheduled conferences are an integral part of the training program. Weekly conferences of 4-5 hours convene every Friday morning and rotate between Washington Hospital Center (1st, 3rd & 5th Fridays) and Georgetown University Hospital (2nd & 4th Fridays). Conferences will include Grand Rounds, Core Topics, Case Reviews, Morbidity & Mortality and In-service Review. Monthly, joint conferences are scheduled with the Department of Pediatrics at Georgetown and Trauma Surgery at Washington Hospital Center.

In addition, residents attend a daily Clinical Pearls Conference from 7:00 7:30 a.m. during emergency department rotations at the Georgetown University Hospital and Washington Hospital Center. The conference is an opportunity for residents and attendings to present interesting and challenging cases for group discussion and review.

Residents also participate in monthly journal club meetings. The meetings serve several purposes. They support the review of significant historical work; they encourage a greater understanding of research methodologies and statistical analysis; and they keep residents updated with respect to advances in medicine and their affect on emergency medicine practice.

Research
Residents will have a diverse array of research opportunities through the department, medical school and MedStar Research Institute. In addition, residents have the unique opportunity to participate in research conducted by MedStar Healths Institute for Medical Informatics, a center for research and development in emergency medicine informatics. The Institute is the recipient of a $6.5 million research grant from the National Library of Medicine (Project Sentinel) to develop advanced biosurveillance data techniques and data visualization that unites clinical and non-clinical data from the District of Columbia and its environs.

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