Emergency Medicine

Training Sites

One of the greatest strengths of this residency program is the variety of clinical settings in which the residents train.  Affiliations with three major medical centers in the Bay Area provide the chance to practice in diverse academic, community, and county environments, preparing residents for emergency medicine careers in any setting. Each of our training sites offers distinct learning opportunities.  In addition to providing outstanding emergency medicine experience, Stanford offers world-class tertiary care exposure, while Kaiser offers award-winning community-based care, and Santa Clara Valley provides a exceptional county experience serving one of the most populous cities in the country.

Stanford University Medical Center

Stanford UniversityIntubationThe Stanford University Medical Center is comprised of the Stanford Hospital and Clinics, the Stanford University School of Medicine and the Lucile Packard Children’s Hospital at Stanford. The Emergency Department serves as the joint emergency care facility for both the Stanford Hospital and the Lucile Packard Children's Hospital, and is a Level I Trauma Center for both adults and pediatrics. The Stanford ED currently treats greater than 50,000 patients annually, including 2,400 traumas (many of which are brought by aeromedical transport from around the Bay Area and northern and central California).

Recognized by US News and World Report as one of America’s Best Hospitals, Stanford Hospital is a 611 bed tertiary care center to which patients requiring advanced specialists in cardiology, neurology, oncology, transplant medicine, and a host of surgical subspecialties are referred from all over the world.  Most of these patients pass through the emergency department resulting in a patient population with very complex pathology.  The emergency department also serves the communities of the Peninsula, Santa Clara Valley, and Santa Cruz mountains and is a safety net for underserved cities of East Palo Alto, East Menlo Park, and Redwood City.  It is a Pediatric STEMI and stroke receiveing center.  A high acuity patient population is likewise seen at the 240 bed Lucile Salter Packard Children's Hospital, which was named one of the top ten pediatric hospitals in the country by US News and World Report.

StanfordThere are currently 57 patient beds in the ED; of which 10 are critcal care, 3 are trauma resusitation bays, 10 are in the Pediatric ED and 11 are in the 23 hour observation unit.  The patient population is of exceptionally high acuity, reflected by the fact that approximately 21% of the patients are admitted to the hospital. The state of the art pediatric emergency department (one of only two in the bay area) opened in 2005.  There are approximately 13,000 pediatric visits annually and these patients are routinely seen by Emergency Medicine residents while in the Pediatric Emergency Department.

While rotating in the ED, residents work in either the Middle Hall (fast track) area seeing 2-3 patients/hour or in the high acuity Front Hall where the admission rate is close to 40% and includes all the critical care beds and trauma beds.  There is graduated responsibility in the department as R2’s are expected to see the bulk of the patients and do most of the procedures and R3’s are expected to know everyone in the Front Hall (18 beds) and supervise interns and medical students. 


Kaiser Permanente Medical Center

Kaiser PermanenteKaiser Permanente Medical Center is located in Santa Clara, approximately a 20 minute drive from Stanford Hospital. It boasts a new state-of-the-art hospital building which opened it’s doors in 2007. The brand new 46 bed Emergency Department sees approximately 70,000 high acuity patients a year.  Pediatrics accounts for more than 15% of the population.  The ED consists of a 26 main treatment beds, a 10 bed Minor Injury Area, and a 14 bed Clinical Decision Unit.  Kaiser Santa Clara is a busy receiving site for Santa Clara paramedic units and is a designated STEMI receiving center, acute stroke center, and referral center for pediatrics.  Of note, Kaiser Santa Clara has garnered national recognition from U.S News and World Report for excellence in acute stroke and STEMI care.  

Kaiser ED
Gus M. Garmel, MD & Kaiser Co-Program Director James Lin, MD
At Kaiser Permanente, unique learning opportunities exist for the EM resident; these include a 1:1 faculty to resident teaching ratio in the Kaiser ED.  As such, interns gain the unique experience of running codes alongside their attendings.  There is graduated responsibility as R3’s are expected to act almost independently as attendings and lead daily 4 PM teaching rounds with the other residents in the department.

The hospital has 327 beds and serves over 250,000 Kaiser Foundation Health Plan (KFHP) members in Santa Clara County and is a major affiliated hospital of the Stanford University School of Medicine. Kaiser Permanente Medical Center has independent residency programs in Internal Medicine, Obstetrics and Gynecology, and Podiatry. These are complemented by residents in other specialties from Stanford University including pediatric and general surgery residents.

KaiserHealth Management Organizations are an integral part of health care delivery in California. Approximately one out of every three Northern Californians is a member of the Kaiser system; this number continues to grow.  Kaiser’s intregrated delivery system has been a model for national health care reform and quality improvement.  Numerous opportunties exist for research and quality improvement projects within the organization. 

 

 

Santa Clara Valley Medical Center

Santa Clara ValleySanta Clara Valley Medical Center is a full-service, 461 bed county hospital located in the heart of San Jose, about 25 minutes by car from Stanford Hospital. Serving a population of 1.4 million, the hospital provides high quality, cost-effective health care to all persons in Santa Clara County, regardless of ability to pay. The Emergency Department, newly built in 1989, is a 29 bed Level 1 Trauma Center and a Burn Center seeing greater than 130,000 patients per year, with about 10-15% being pediatrics. There are approximately 3,000 trauma activations each year with a high proportion of pediatric traumas.  Santa Clara Valley Medical Center is the second busiest county Emergency Department in the state of California. The urban patient population is extremely diverse and is comprised of many recent immigrants. 

Santa Clara Valley Currently ED residents manage all trauma airways and are primarily responsible for a 11 bed area called “The Wall” which includes the trauma bay and medical resucation bays. There are ample opportunities to perform procedures in this high acuity environment, where both advanced medical pathology and large amounts of blunt and penetrating trauma are seen.  Housed within the Emergency Department is one of Santa Clara County 's major paramedic bases. Handling over 7,000 paramedic calls per year, the Emergency Medicine residents get invaluable first-hand experience in the management of pre-hospital care.

Education is of primary importance at Santa Clara Valley Medical Center. The hospital has a full affiliation with the Stanford University School of Medicine, and as a major county teaching hospital, playing a significant role in residency education. The departments of internal medicine, obstetrics/gynecology, radiology, and pathology maintain their own, independent residency programs.

In addition to the high level of medical services at Santa Clara Valley Medical Center, the hospital provides many regional specialty-care programs with a top ranked comprehensive spinal cord and head injury unit, an 8 bed regional burn center, a Level III neonatal intensive care unit, a chronic dialysis unit, and a high-risk pregnancy program.


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