Education

Orientation

Workshops and seminars on getting ready to be an EM resident that allows interns to hit the ground running.  ACLS, ATLS, NRP, PALS, and adult and peds simulation training.  Ultrasound, cadaver lab, airway, radiology, EKG, splinting, and wound care workshops.  Orientation shifts in the Stanford and Kaiser EDs.

4 weeks

Stanford Medical Center ED (adult & pediatric EM)

The goal for the intern Stanford ED rotation is to feel comfortable taking care of emergency department patients in a university hospital setting.  Emphasis is placed on becoming proficient with common ED procedures including lumbar punctures, intubations, central lines, and chest tubes, running minor traumas, and treating minor injuries.  In addition to core EM cases you will see a large volume of high acuity patients with complicated medical problems including complex cardiac, neurological, surgical, oncology, and transplant related complaints.

4 weeks

Kaiser Santa Clara ED (adult & pediatric EM)

In the Kaiser ED, interns have the unique opportunity to learn one-on-one with an attending and become proficient with core cases in emergency medicine in a state-of-the-art community ED.  Here you will have the opportunity to manage medical codes at an early stage in training under the direct supervision of an attending.  In this setting you will see what it’s really like to work in a busy community hospital.  This includes reading your own x-rays, seeing kids and adults in the same ED, interacting with attending consultants, not having specialists in house at night, and working collaboratively with primary physicians. 

5 weeks

Trauma Surgery - Stanford

On this rotation you are the primary intern on a busy trauma service.  Responsibilities include running minor traumas, trauma procedures (chest tubes, reductions, would care), managing trauma patients on the floor.  There is excellent teaching from trauma attendings and residents from a top surgery training program.  Stanford receives complicated trauma patients transported by helicopter from all over Northern and Central California providing exposure to rare and complex traumatic injuries. 

4 weeks

General Surgery – Santa Clara Valley Medical Center

You are the primary intern for a busy general surgery service that is also the trauma service at this county hospital.  Responsibilities include running minor traumas and trauma procedures.  You also have one week of operative experience in which you operate one-on-one with attendings doing procedures relevant to emergency medicine including complex I&D’s, mediport central line placements, and tracheotomies.  You also manage 25-35 floor patients providing ample exposure to management of common surgical problems. 

3 weeks

Internal Medicine – Stanford

You are an intern on the general medical service typically managing 5-8 patients.  Excellent teaching opportunities from residents and attendings from a top internal medicine program providing a solid foundation to the management of common medical problems. 

4 weeks

Intensive Care Unit – Kaiser

On this service you are the primary resident on a team consisting of one supervisory resident and a critical care attending managing up to 8 ICU patients in a 30 bed general ICU including medical, cardiology, and surgical cases.  There are extensive opportunities for ventilator management and for procedures including central and arterial lines and intubations.

4 weeks

Cardiac Care Unit – Stanford

Cardiology is a major strength at Stanford and you will be given the opportunity to learn from some of the best cardiologists in the country.  On this service you will primarily manage 2-4 CCU patients and 2-4 cardiology step-down and telemetry patients.  On call nights you will cover up to 40 telemetry and floor patients with frequent calls for acute arrhythmia and CHF management. 

4 weeks

Neonatal Intensive Care Unit – Kaiser

One of the unique opportunities offered in this program is the chance to take care of neonates under the direct one-on-one instruction of a neonatologist.  There are no other residents on service and thus you will have ample to perform procedures such as intubations, lumbar punctures, and central lines on the tiniest of patients.  The goal is to feel comfortable with neonatal resuscitation before your first neonate code in the ED.

2 weeks

Pediatric Emergency Medicine – Stanford

The goals of the intern rotation in pediatric emergency medicine are to feel comfortable taking care of common pediatric illnesses and feel comfortable with the pediatric assessment.  The Stanford Peds ED is unique in that it takes care of a blend of very high acuity complex patients as well as being a safety net for the local underserved Latino patient population. 

4 weeks

Orthopedics – Kaiser

The goal of the orthopedics rotation is to feel comfortable taking care of common orthopedic injuries and fractures.  The rotation is done in a setting where there are no other residents so all procedures are yours.  You will work one-on-one with an ortho attending and take ED consults for fracture management and difficult reductions and see patients in fracture, sports medicine, and podiatry clinic.

3 weeks

Obstetrics and Gynecology – Kaiser

On this high-yield rotation you will be proficient with delivering babies in a busy labor and delivery department.  Time is also spent performing ED gynecology consults and transvaginal ultrasounds. 

3 weeks

Anesthesia – Kaiser

On anesthesia you will become facile with airway management with opportunities to try alternative techniques under a supervised and controlled setting.  There are no other residents to compete with and 12 operating rooms going all day, with about 20-25% of cases being pediatric. 

3 weeks

Ultrasound - Kaiser

The goal of the Ultrasound rotation is to become familiar and proficient in performing emergency ultrasound in trauma cases; as well as using ultrasound as an adjunct to vascular access and central line placement. All resident instruction by ultrasound technicians and radiologists is focused on emergency medicine complaints.

1 week

Research

The goal of research week intern year is to develop a research or administrative project proposal.   The week is intended to provide time to perform a literature review and meet with mentors and the research director.  For those who are interested in carrying out a clinical research project, this also provides time for submitting an IRB protocol and grant proposal. 

1 week

Vacation

3 weeks

Stanford University Medical Center ED (adult and peds EM)

The goal of the R2 Stanford ED rotation is to become the workhorse of the department, especially in the front hall area, which includes the critical care and trauma beds.  There are times when the EM R2 is the most senior resident in the front hall and thus the learning curve is steep.  By the end of the R2 year residents will feel comfortable running codes and major traumas and will be skilled with major procedures. 

14-18 weeks

Kaiser Santa Clara Medical Center ED (adult and peds EM)

At Kaiser as an R2, you will be seeing all patients primarily and work on increasing throughput while continuing to work one-on-one with the attending.  A significant proportion of the shifts are done as the Emergency Physician In Charge (EPIC) in which the resident and attending take incoming calls, decide when to place the department on diversion, and direct the overall flow of the department.

10-14 weeks

Santa Clara Valley Medical Center ED (adult and peds EM)

In this rotation, you will see what it’s like to work in a busy county trauma center serving an extremely diverse patient population with a high volume of recent immigrants, many without health insurance or primary care.  You will see many delayed presentations of chronic disease as well as rare diseases.  As an R2 you cover “The Wall” and area of 11 beds that you are primarily responsible for including the trauma bay and major med rooms.   While in the department you are in charge of all trauma airways and you will also be pulled to perform major procedures on other patients who you are not seeing primarily.  

8-12 weeks

Pediatric Emergency Medicine – Stanford

As an R2 rotating in the peds ED, emphasis is on increased throughput, taking care of critically ill children including pediatric trauma patients and codes. 

3 weeks

Medical Intensive Care Unit – Stanford

The MICU rotation provides the opportunity to refine critical care skills.  During this rotation you will manage 4-8 primary patients and cross cover up to 25 ICU patients when on call providing ample opportunity for more procedures and ventilator management.  There are also daily radiology and critical care teaching conferences taught by ICU attendings and fellows.  Additional exposure is provided in managing complex patients transferred from hospitals all over the West Coast and Pacific.  As a capstone to the critical care experience, the EM ICU resident will present an interesting case that began in the ED and admitted to the ICU at the monthly EM/ICU conference. 

4 weeks

Surgical Intensive Care Unit  - Stanford

During the SICU rotation you will refine critical care skills in taking care of very sick trauma and surgical patients.  This includes being the lead resident on the trauma team for major traumas as well as taking call in the SICU without a fellow in house.  Residents gain much more experience with trauma procedures such as subclavian central lines and chest tubes. 

3 weeks

Research

This week provides extra time for writing and submitting grant proposals, submitting IRB protocols, and performing research and/or working on an administrative project.

1 week

Vacation

3 weeks

Stanford University Medical Center ED (adult and peds EM)

As an R3 the majority of shifts will be as a supervisory resident in charge of running the front hall, the high acuity critical care and trauma area with up to 18 total beds.  In the R3 role the resident takes presentations from med students, interns and R2s, and is in charge of overall patient flow in the department.  The R3 is also in charge of running major traumas and supervising procedures performed by med students and junior residents.  When the department is especially busy, the R3 is expected to also see patients primarily as well. 

14-18 weeks

Kaiser Santa Clara Medical Center ED (adult and peds EM)

At Kaiser, the R3 is expected to act as a community ED attending seeing all patients primarily and making all disposition decisions.  The R3 is also supposed to act as the EPIC doctor making decisions on patient flow, ambulance diversion, and resource distribution.  The faculty are there as mentors in this final phase of training.  Additionally, the R3 is in charge of running 4:00 PM teaching rounds in which all residents in the department gather and go over interesting patients in the ED, review interesting EKG’s and x-rays, or present a lecture or an interactive case. 

10-14 weeks

Santa Clara Valley Medical Center ED (adult and peds EM)

As an R3, the resident is expected to act as a junior attending and independently manage the 11 beds of “The Wall.”  The R3 also continues to be in charge of trauma airways and assists with EMS base calls. 

8-12 weeks

Pediatric Emergency Medicine

The R3 is in charge of the department on nights and weekends when the volume is highest and supervises pediatric and emergency medicine interns.  The R3 is in charge of running codes and all pediatric procedures.  There are no fellows in the department.

3 weeks

Emergency Medical Services

This rotation is intended to provide a background in EMS with ambulance ride alongs and the opportunity to be a flight doctor on the aeromedical transport helicopter, LifeFlight.  The helicopter experience is optional.  Elective time can be used to further extend exposure to EMS and LifeFlight.

1 week

Elective

Residents get 2 four-week elective blocks to pursue areas of interest.  International rotations are extremely popular and well supported by our program.  Recent international elective include: teaching paramedic instructors in India, relief work in Zambia and Eritrea, working a rural hospital in Guatemala, doing a trauma and peds rotation in South Africa, being an expedition doctor in Mongolia, working in a clinic in Honduras, and many more.  Popular local electives include sports medicine, peds anesthesia, EMS, toxicology at San Francisco Poison Control, ultrasound, and extended research. 

8 weeks

Research

Residents use the last week of their research block to work on a manuscript suitable for publication or to finish their administrative project.  Research abstracts are presented at an annual research day during weekly conference.  Funding is available to allow residents to present their abstracts at national meetings.

1 week

Vacation

3 weeks