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Curriculum
Over half of the residency curriculum occurs directly in the emergency department (ED) and its associated rotations. Our premise is that residents require multiple patient encounters in a high-volume setting to become strong clinicians, able to work in any emergency facility upon graduation.
Curriculum Quick Facts: |
Our curriculum is heavily weighted towards critical care. A relatively large percentage of our institution’s initial critical care occurs in the ED, and residents experience multiple off-service rotations in critical care. As a result, our residents are highly proficient with critically ill patients and critical procedures.
Emergency Department (Adult) 
All months in the adult ED are at Shands Jacksonville, which has an annual patient volume of over 95,000. The ED is separated into three areas according to level of acuity (Emergency Critical Care, Flexcare and Resuscitation). The ECC area is used to treat all high-acuity emergent illness; it is attached to our medical and trauma Resuscitation areas. The Flexcare is utilized to treat low and moderate acuity illnesses, and is designed to “flex” up to see some higher acuity during periods of increased patient volume. Second year residents begin their administrative role in managing Flexcare, instilling leadership skills early during residency training. Third year residents manage the entire department with the supervision of attendings. There is a high acuity of patients at Shands Jacksonville, with more than a 30% average hospital admission rate, and an estimated 4-5% ICU admission rate.
Emergency Department (Pediatric)
Our Pediatric ED sees approximately 20,000 patients per year staffed by board certified pediatric emergency physicians, board certified emergency physicians, pediatric emergency medicine fellows, and EM and pediatric residents. During the first and second year residents have dedicated pediatric ED months. In the third year residents have a longitudinal experience, with 3-4 shifts every month in the pediatric ED.
Coronary Care Unit
The resident works as part of the cardiology team. Residents experience strong exposure to the medical and interventional management of ACS, arrhythmias, decompensated heart failure, and other cardiovascular diseases.
MICU
Every month the ED provides a junior/senior resident team that works alongside IM residents in the MICU. It is highly regarded as one of the best rotations in this residency.
PICU
Second year residents spend a month at Wolfson Children’s Hospital in Jacksonville working with pediatric critical care specialists. This affords the opportunity to care for children with severe cardiac, pulmonary and metabolic disease.
Internal Medicine (IM) Consults/Subspecialty Clinics
This is a new addition to the curriculum as of 2009. The first year resident is part of the IM consult team. During the afternoons, they are exposed to various disease processes by participating in subspecialty clinics.
OB/GYN
As part of the labor and deliver team, the resident assists in deliveries and hones skills with transvaginal ultrasound at L&D triage.
Orthopedics
A month is spent with the orthopedic trauma team for intensive exposure to fracture and dislocation identification, reduction, and splinting techniques.
Trauma Surgery
As Jacksonville’s level-1 trauma center, there are more than 2000 trauma activations yearly. Residents acquire trauma center exposure in all three years. As first year residents they work as part of the trauma team on the wards. Second years run trauma codes during the resuscitation month. Third years split time in the trauma center and the Trauma ICU.
EM/Ultrasound
This is another rotation that combines skills. Residents work shifts in the emergency department, as well as having dedicated time to obtain emergency ultrasound experience.
Toxicology
Residents field toxicology consults in the hospital with pharmacology and emergency trained toxicologists and answer calls in the regional poison center that serves over 6 million people.
Emergency Medical Services (EMS)
This is our opportunity to ride in ambulances and see Jacksonville from above with the flight team. Each resident interacts with the region’s EMS system with a combination of direct patient care with Jacksonville Fire-Rescue, along with committee meetings and didactics, to expose them to a wide variety of EMS issues.
Elective
Ultrasound, abroad rotations, research and simulation are among a few. With enough preplanning a number of possibilities exist.
Rotation Schedule
Our academic schedule is divided into three 12-month sections:
| EM-1 |
|---|
| Adult Emergency Department (4 months) Pediatric Emergency Department EM/Ultrasound Coronary Care Unit Internal Medicine Consults/Subspecialty Clinics Medical Intensive Care Unit Obstetrics and Gynecology Orthopaedics Trauma |
| EM-2 |
| Adult Emergency Department (7 months) Pediatric Emergency Department Trauma/Emergency Medical Resuscitation Medical Intensive Care Unit Pediatric Intensive Care Unit Toxicology |
| EM-3 |
| Adult Emergency Department (9 months) with monthly Pediatric ED shifts Pediatric Emergency Department Pre-Hospital/Emergency Medical Services Elective Trauma Intensive Care Unit |