Stanford Residency Curriculum
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: 4.75 blocks
- EMS: 0.5 block
- Trauma: 1.5 blocks
- MICU: 1 block
- Anes/QI: 0.75 block
- Orthopedics: 0.5 block
- CCU: 0.5 block
- Ob/Gyn: 0.5 block
- Procedures: 0.5 block
- ED Ultrasound: 0.5 block dedicated (also integrated into other areas)
- Elective: 0.5 block
- Vacation: 1 block
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
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
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 and features state-of-art technology and an emergency department the length of a football field.
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 an 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.
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 welcome our colleagues in trauma and radiology for monthly case review and 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.
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.
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 for high acuity low occurrence procedures including lateral canthotomy, pericardiocentesis, transvenous pacing, cricothyrotomy, and needle-jet ventilation
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.
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
Residents practice advanced procedures, including chest tubes, thorocotomies, cricothyrotomies, lateral canthotomies, DPL, central lines, and more.
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 a sample discussion guide from our recent trauma journal club.
Clinical Teaching Scholars Seminars Series
Residents interested in medical education may apply to the interdisciplinary Clinical Teaching Scholars Seminars Series (CTSS), endorsed by the Stanford University School of Medicine Teaching and Mentoring Academy.
CTSS 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.
CTSS 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.
During Intern year, residents explore three Lines:
- Emergency Medicine Without Walls
- Medical Education
- Advanced Clinical
- Medical Humanities
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
- 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 projects in India, Papua New Guinea, Vietnam, Nepal, and Guatemala. While the foundation is present for a variety of global opportunities, Stanford is always looking to build new bridges internationally so welcome ideas for new endeavors.
Our competitive wilderness medicine program is a leader in their field. They offer 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 include staffing anywhere from a ski clinic in NorCal to a clinic at high altitude in the himalayas.
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.
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.