Curriculum

Residency

The Newark Beth Israel Medical Center EM Residency is accredited by both the ACGME and AOA. Historically, the NBIMC AOA program began in 1993. In 1995-1996 it merged with the AOA accredited program at Union Hospital that had been established in 1980 to create a single osteopathic program. Allopathic (ACGME) accreditation was obtained in 1998.

As of 2012, the osteopathic program, which is four years, will be partnering with Nassau University Medical Center (NUMC) in East Meadow, NY. NUMC is a tertiary care Trauma level 1 hospital with extensive specialty training including, trauma, burn, and neurosurgery. The osteopathic interns (OGME1) will be training mostly at NUMC with 8 weeks of emergency medicine at Newark Beth Israel and continue with the emergency training at Newark Beth Israel Medical Center as OGME 2.

All residents rotate at all the affiliated hospitals but spend the majority of their clinical time at NBIMC. Off-service rotations in trauma are conducted at Newark's UMDNJ-University Hospital and at Jersey City Medical Center. The toxicology rotation takes place at the New York Poison Control Center in Manhattan. Monmouth Medical Center serves as a site for EMS rotation. Multiple sites provide the residents with a socioeconomic and demographic variety, while broadening their clinical exposure.

The goals of the emergency medicine residency are to provide a supportive environment that encourages the acquisition of knowledge and develops the clinical judgment and skills needed to practice state of the art emergency medicine. The department encourages the development of compassionate physicians who have a sense of responsibility to the community and to their profession.

The department considers an environment of scholarly inquiry to be an essential part of residency training. Residents are encouraged to engage in research and initiate their own projects with supervision by EM faculty and leadership from the program's research director and vice-chair for academic affairs.

The Training Program

As of 2012 the Osteopathic Program, which is four years, will be partnering with Nassau University Medical Center. The majority if the OGME1 year will be performed at Nassau University Medical Center (NUMC) in East Meadow, NY. NUMC is a tertiary care Trauma 1 Level hospital with extensive specialty training including, Trauma, Burn, and Neurosurgery to name a few. We welcome you to learn more about Nassau University Medical Center by visiting their website at www.numc.edu. The majority of the OGME 2-4 years will be spent at Newark Beth Israel Medical Center.

Newark Beth Israel Medical Center is the primary residency site for the training program in emergency medicine. Residents are also assigned to the emergency departments of Jersey City Medical Center and St. Barnabas Medical Center in order to provide a well balanced and more diversified experience. Residents rotate on the trauma service at Newark's University Hospital, New Jersey's busiest level 1 trauma center. The toxicology rotation takes place at the New York Poison Control Center in Manhattan. Intense and broad based clinical exposure with a socioeconomic and demographic variety is a major advantage of training in a variety of sites.

The program is a 36-month curriculum with a PGY 1-3 structure. Osteopathic residents start at the PGY-2 following the completion of a traditional rotating internship, while allopathic residents usually start at the PGY-1 level. The year is divided into 13 four-week blocks.

The First Year

Residency in the first year is focused on learning basic patient management skills and providing the wealth of knowledge needed to practice Emergency Medicine. Six 4-week blocks are spent in the Adult Emergency Department under the close supervision of both attending physicians and senior EM residents. Additional blocks are provided in Trauma, Anesthesia/Dentistry, Medical Intensive Care, Orthopedics, Ultrasound and Pediatric Emergency Medicine. The emphasis of this year is learning and building confidence. As the year progresses, the expectations will be on managing multiple patients in an efficient and timely manner.

The Second Year

The second year of residency is focused on expanding resident knowledge, improving patient management and procedural skills, mastering multi-task skills and utilizing time more effectively. As the year progresses, the expectations will be on managing multiple patients in an efficient manner. Additional time is allocated to pediatrics, with 2 blocks in the pediatric emergency department and 1 block in the pediatric intensive care unit. Critical care experience is emphasized with additional blocks in trauma and cardiac critical care. Additionally, time is spent in Radiology/Ophthalmology and Emergency Medical Service (EMS) during the second year.

The Third Year

In the third and final year of residency supervisory and administrative skills are acquired along with an emphasis on coordination of patient care, direction of traumatic and medical resuscitations, and management of the emergency department. Senior residents also assist in teaching junior residents medical students. The senior resident makes a gradual transition into a supervisory role and learns to manage the ED on a daily basis. Teaching and research opportunities along with elective time allows the senior residents to formulate a wide, in-depth knowledge of emergency medicine while continuously sharpening their clinical skills and administrative abilities. The majority of the final year is spent in the emergency department. Senior residents rotate through the adult and pediatric emergency departments throughout the year in order to give continuous exposure to children. Also Toxicology rotation is completed through New York Poison Control Center in Manhattan, NY.

Conferences

In addition to scheduled clinical rotation blocks, there is a weekly block of didactic/educational conferences held every Wednesday from 07:30 -13:00. These conferences concentrate on the core content of emergency medicine and attendance of all residents is mandatory. Except for the trauma rotation at University Hospital, residents are excused from all clinical responsibilities in order to facilitate attendance. Audiovisuals and handouts frequently accompany these conferences to improve the quality of the conference.

Residents sit through an oral exam annually. Physicians from other institutions are frequently invited to lecture, and often provide an alternative view of a familiar subject. Once per block, joint lectures are conducted with the Department of Internal Medicine and the Department of Pediatrics. Joint conferences are also held with other departments on an intermittent basis.

Journal Review is held once per block. Controversial subjects are discussed in an evidence based medicine approach, utilizing articles published in medical journals. Journal Review provides with an opportunity to critically review the literature and learn the essentials of research methodology and biostatistics.

Daily Didactics

Morning reports take place four days a week in one hour blocks prior to the beginning of the morning shift. Morning report consists of oral board cases on Monday, mock codes on Tuesday, radiology conference on Thursday and adult and pediatric case reports on Fridays.

Medical Library

The Medical Library has an extensive collection of bound periodicals, textbooks, audio and video cassettes. Computerized literature searches are also available in over 100 of the most widely used databases. The active interlibrary loan service is computerized as well, providing access to the resources of most medical libraries in the metropolitan area.

Residents also have access to a wealth of educational resources at the University of Medicine and Dentistry of New Jersey - New Jersey Medical School.

Medical Students Rotation in Emergency Medicine

Applicants should be fourth year medical students in good standing, at either an LCME or AOA approved medical school. Applicants should have completed all core clinical rotations prior to their emergency medicine elective. Rotations are usually scheduled to begin the first Monday of the month, but other schedules will be considered. Students who are contemplating a career in emergency medicine will be given priority. We also offer electives in Pediatric Emergency Medicine and EM ultrasound. As with emergency medicine applicants, pediatric EM applicants should be fourth year medical students who have completed their core rotations and are considering emergency medicine, pediatrics, or pediatric emergency medicine as a career.

Please send any requests as early as possible, because often the schedule is made before your arrival. We will try to send you a copy of the schedule prior to your arrival. You will work 16 to 18 shifts during a 4-week rotation. This will consist of 12 to 14 8-hour shifts in the adult ED, and 4 12-hour shifts in the pediatric ED. Each Wednesday we have conference in the D-10 Conference room from 8:00 am to 1:00 pm. There will be student-based lectures on Wednesdays from 1 to 3 PM.

During your rotation in the ED, you will function as a Sub-Intern. You will see, evaluate, and try to develop a care plan for your patients. You will be supervised at all times. These are your patients and you will be expected to follow and manage them. Your immediate supervisor in the ED will usually be the senior resident, EM3, on duty. You should present to the senior resident, try to develop a differential diagnosis, formulate a plan of diagnostic tests, and try to develop a care plan. Then you and the senior resident can present to the attending. If there is no senior resident quickly available, then you can present directly to the attending. There will be at least one attending and as many as four working at the same time in the adult ED. While in the pediatric ED, you should present directly to the attending.

Prior to seeing any patient, you should bring the chart to your supervisor, so they can assess the acuity. If the patient appears to be high acuity or in extremis, you may still see the patient, but the resident or attending should accompany you to the bedside. While in the ED we do want you to become involved with high acuity patients, but with a team approach.

Applications for rotations should be directed towards Cheryl Robinson, Medical Student Coordinator at CHrobinson@barnabashealth.org.

If you have any questions, please contact us.

Nicole Maguire, DO, Director of the Emergency Medicine Student Rotation at nmaguire@barnabashealth.org.