Stanford EM Residency Curriculum

First Year

The first year starts with a 4-week orientation to familiarize interns with the emergency department, refresh emergency medicine topics, provide hands-on skills labs, and foster connections with classmates. Rotations during the intern year cover the essential areas of emergency medicine, as well as Medical ICU and EMS. Interns also begin to explore ACCEL.

Blocks are 3-4 weeks.

Orientation: 1 block
Emergency Medicine: 5.25 blocks
EMS: 0.5 block
Trauma: 1.5 blocks
MICU: 1 block
Anes/QI: 0.75 block
Orthopedics: 0.5 block
Ob/Gyn: 0.5 block
Procedures: 0.5 block
ED Ultrasound: 0.5 block dedicated (also integrated into other areas)
Careers in Academic Medicine (CAM) Elective: 0.5 block
Vacation: 1 block

Second Year

Residents spend the majority of this year in the emergency department and ICU's, honing critical care skills and efficiency. Residents are given ACCEL time for further experience in their niche of focus or clinical elective.

Emergency Medicine: 8 blocks
MICU: 1 block
SICU: 1 block
PICU: 1 block
Elective: 1 block
Vacation: 1 block

Third Year

Residents refine clinical skills through increased graduated responsibility. This is developed by supervising junior residents and medical students, and continuing to learn how to manage multiple critical patients. Residents have ACCEL time to develop expertise in a sub-specialty.

Emergency Medicine: 9 blocks
CVICU: 0.5 block
Fast Track: 0.5 block
Elective: 2 blocks
Vacation: 1 block

Fourth Year

Our goal is for residents to be able to run an emergency department. As a fourth year working in the Stanford ED, you are responsible for departmental flow in our busiest zone while supervising all residents. While working at the Kaiser ED, you will have an opportunity to run a functional pod.

Emergency Medicine: 9.5 blocks
Elective: 2.5 blocks
Vacation: 1 block

Residency Training Sites

Stanford Health Care

Stanford Medicine offers world-class tertiary care exposure, as a Level I Trauma Center for adults and pediatrics. Because Stanford Hospital is the winner of multiple patient care awards, patients come from all over the world for specialized care, resulting in a patient population with complex pathology.

Our local patient population is extremely diverse and the majority of our patients receive federally-subsidized care.

Rotation highights include: emergency medicine, pediatric emergency medicine, critical care, and other quality off-service rotations that build a strong foundation. Multiple elective opportunities are also available through our ACCEL program.

The 824,000-square-foot Stanford Hospital opened in 2019. The Marc and Laura Andreessen Adult Emergency Department features state-of-art technology and an emergency department the size of a football field.

The Marc and Laura Andreessen Pediatric Emergency Department opened in 2022 and is a Level I Pediatric Trauma Center with world-ranked pediatric specialists.

Stanford is the main site of clinical training. We also have rotations at community and county sites to provide exposure to different practice settings, resulting in a well-rounded clinical education.

Kaiser Santa Clara

Kaiser Permanente Medical Center offers award-winning community-based care, and a precedent-setting efficiency model, as well as advanced care in pediatrics, neurocritical care, interventional cardiology, obstetrics, and several other fields.

In addition to excellent patient care, Kaiser provides residents with a 1:1 faculty-to-resident teaching ratio. First- through Third-year residents run codes alongside attendings, while Fourth-year residents run their own independent pod in preparation for independent practice.

Kaiser also offers daily “GI rounds” for residents on swing shifts; departmental leadership or senior residents provide teaching from 4-4:30 while residents grab something to eat. Teaching sessions often involve interesting cases and workflow updates, and provide residents an opportunity to connect in an otherwise busy environment.

Valley Medical Center

Santa Clara Valley Medical Center provides a robust county experience in a busy county emergency department. This is a high-acuity environment serving an extremely diverse urban population with advanced medical pathology and a high number of trauma cases.

Core Conference

Our Wednesday morning conference time is a valuable opportunity for our residents to not only review basic EM principles and get hands-on practice in our state-of-the-art simulation center but also to learn about cutting edge research and technology that are changing how we practice medicine. Our graduated four-year curriculum is designed with unique lecture series and small-group discussion sessions for each level of training.

In order to ensure our residents are able to fully engage in conference, they are excused from most clinical duties Tuesday evening 6pm through Wednesday afternoon.

The renowned Stanford EM faculty work with our residents to lead M&M, critical care conferences, social EM lecture series, health equity rounds, and pediatric EM core content. We also invite a nationally-recognized Grand Rounds speaker each month.

In addition to lectures, core conference includes:

Team Challenge Days

Residents have hands-on skills sessions integrated into their yearly conference didactic curriculum and participate in multi-disciplinary learning that includes immersive simulation training, advanced ultrasound skill training, and dedicated procedural skill training.

Simulation
In our state-of-art simulation center, residents work in teams to manage progressively complex pediatric and adult simulation cases targeted for their year of training.

Ultrasound
Hands-on labs teach basic (FAST, aorta, cardiac, gallbladder, renal) and advanced ultrasound techniques (venous access, orbital, procedural, etc); as well as rapid ultrasound in shock.

Procedural Skill Training
During Team Challenge Days residents have dedicated procedural training with our faculty to hone standard procedural skills of intubation, central venous, paracentesis, and lumbar punctures as well as for high acuity low occurrence procedures including lateral canthotomy, pericardiocentesis, transvenous pacing, cricothyrotomy, and needle-jet ventilation

Foundations

We have incorporated the Foundations curriculum into our Wednesday conferences. This year-long flipped classroom curriculum provides level specific content that builds a comprehensive framework for understanding cardinal presentations, “can’t miss” diagnoses and essential management strategies within the EM Model of Clinical Practice. Our 4th year residents assist in teach these sessions for our 1st and 2nd year residents as part of our resident as teacher curriculum.

4th Year Grand Rounds

Each 4th year gives Grand Rounds during their final year. This is a subject of their choice, usually focused on their ACCEL niche. It serves to give them greater exposure to presenting, help in building their CV and showcasing their efforts throughout their residency.

Career Development Curriculum

Throughout the 4 year program we have a “Year Directed Curriculum” which is a series of didactics which is specific for each year of residency.

Included in the R4 residents curriculum are topics such as job searches, financial planning, billing and practice management

Cadaver Labs

Residents practice advanced procedures, including chest tubes, thorocotomies, cricothyrotomies, lateral canthotomies, DPL, central lines, and more.

Quality Improvement/Patient Safety Curriculum

Residents will participate in a longitudinal curriculum to explore principles in Quality Improvement/Patient Safety (QIPS). As juniors, residents complete asynchronous modules to solidify foundational concepts. As R3s, each resident declares a self-designed QI project to execute during the remainder of residency. Senior residents also participate in a reflective case-based didactic series among peers as a component of the Year Directed Curriculum. All residents participate in M&M sessions on a monthly basis as a part of the Core Conference Curriculum.

Journal Club

Journal Club, held one evening a month, allows residents and faculty to connect in an informal setting. Emphasis is on learning to critically read medical literature, foster discussion, and evolve residents’ medical practice. Journal Clubs also include joint meetings with other programs (e.g. pediatrics, internal medicine, surgery).

Check out one of our recent journal club discussion guides if you're interested in a particular topic: critical care, neurology, or operations

Clinical Teaching Scholars Seminars Series

Residents interested in medical education may apply to the interdisciplinary Stanford Health Professions Education and Scholarship, endorsed by the Stanford University School of Medicine Teaching and Mentoring Academy.

Stanford Health Professions Education and Scholarship offers nine succinct monthly seminars on key medical education concepts, including designing assessments, giving feedback, and bedside teaching. Participants apply what they have learned to their own projects, receiving near-peer and faculty mentoring in small break-out sessions, and have the opportunity to present at a major end-of-year conference.

Stanford Health Professions Education and Scholarship also offers an Honors Certificate in Medical Education to scholars who complete specific requirements.

The Advanced Clinical and Career Enrichment Line (ACCEL) Program consists of resident selected, longitudinal scholarly tracks that are integrated throughout your 4 years focusing on career development. As early as intern year, residents are given elective time to choose from a variety of subspecialties to explore. As residents hone in on their desired niche in Emergency Medicine, they receive mentorship from their track’s faculty. Ultimately each resident produces a scholarly project in their track and graduates with an additional certificate of ACCEL track completion.

The ACCEL program offers the opportunity to do over 75 electives with the option of creating your own electives if you are passionate about a field not offered.

Timeline

During Intern year, residents explore three Lines:

Emergency Medicine Without Walls
Medical Education
Advanced Clinical

At the end of Intern year, residents select a Line to pursue further.

In PGY2 year, residents identify and develop collaborators through exploration of tracks within their chosen line. They begin to develop a scholarly focus and take part in different projects. By the additional exposure to the different tracks by the end of their second year, residents select the track they are most passionate about to pursue as their selected scholarly track. Track options include:

Emergency Medicine Without Walls (EM WOW) tracks:

Global/International Emergency Medicine
Social Emergency Medicine and Population Health
Emergency Medical Services (EMS)
Wilderness Medicine

Medical Education tracks:

Medical Education Scholarship
Simulation
Graduate Medical Education (GME)
Medical Humanities

Advanced In-Hospital Medical Care and Clinical Operations tracks:

Pediatric Emergency Medicine
Critical Care
Emergency Ultrasound
Clinical Operations/Administrative
Sports Medicine

In PGY3 and PGY4 years, residents work closely with track faculty, becoming an integral member of the track. They use their elective time to work toward completing their project(s), doing research and gaining exposure to important facets of the track. Ultimately each resident graduates with a completed scholarly project and certification of ACCEL track completion.

Stanford also offers fellowships in 13 sub-specialties. Learn more.

Examples of Track Opportunities

Recognized as a leader in global health and international emergency medicine, Stanford has previous led projects in India, Papua New Guinea, Vietnam, Nepal, and Guatemala. Stanford is always looking to build new bridges internationally and welcomes ideas for new opportunities and partnerships.
Our competitive wilderness medicine program is a leader in the field. The program offers many electives to explore wilderness medicine including obtaining your certification in Advanced Wilderness Life Support (AWLS), as well as the opportunity to become a Lead Instructor. Other electives have included staffing a ski clinic in NorCal, a clinic at high altitude in the himalayas, and more!
The EMS program works closely with Santa Clara County EMS, which covers one of the most populous metropolitan areas in the country. A Stanford Life Flight elective is available for those interested in aeromedical medicine.
Our sports medicine faculty serve as physicians and doctors for San Francisco 49ers, the Golden State Warriors, and of course Stanford, a top Division I athletic program in the country.

One of the highlights of our residency program is the opportunity to get involved with research projects that match your interests and ultimate career goals. We aim to prepare our graduates to continue advancing the field of emergency medicine by providing a foundation in research practice. We foster expertise in research by:

Pairing residents with a mentor in their chosen track to develop the niche
Offering a robust didactic series exclusive to residents that is dedicated to research skills development (a total of 12 hours over 4 years)
Partnering with research faculty to regularly engage trainees in departmental research
Providing access to countless resources, including the PEARL (Precision Education and Assessment Research Lab) dedicated exclusively to medical education research in Stanford’s Department of Emergency Medicine, the Lane Medical Library, the Health Sciences Department at Stanford, a variety of university seminars, and projects through the Kaiser Permanente system

Each resident will produce at least one scholarly work by graduation, however most of our graduates contribute several works to the emergency medicine literature. For those interested in Quality Improvement/Patient Safety (QIPS), there is a graduated curriculum in place to ensure each resident gains an understanding of foundational concepts and has experience implementing a QI initiative. The curriculum includes modules from the Institute for Healthcare Improvement, regular participation in case review during conference, attendance at clinical operations meetings, formal didactic content for senior (R3/R4) residents, and execution of a formal QIPS project during residency using the PDCA cycle.

Research Resources

Residents can utilize Lane Medical Library, the renowned Health Services Department at Stanford, and the vast array of public and community health projects through the Kaiser Permanente system. Residents have access to the Kaiser research unit where statisticians help crunch research numbers. And residents can take the monthly seminar, “Health Care Policy, Economics, and Finance for Resident Physicians,” featuring Bay Area health care leaders.

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Stanford EM Residency Curriculum

First Year

Second Year

Third Year

Fourth Year

Residency Training Sites

Stanford Health Care

Kaiser Santa Clara

Valley Medical Center

Core Conference

Journal Club

Clinical Teaching Scholars Seminars Series

Examples of Track Opportunities

Research Resources