Emergency Medicine Residency Handbook 2009 Edition table of contents chapter page
Possible Conclusions from Journal Club
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- EVIDENCE BASED MEDICINE CONFERENCE
3. Possible Conclusions from Journal Club
The schedule for Journal Club and resident presenters will be posted and distributed by the education chief resident. Please contact the resident coordinators at least 1 month in advance for topic and article assignments EVIDENCE BASED MEDICINE CONFERENCECoordinators: Michael Lanigan, MD/Lorenzo Paladino, MD Purpose: *To address a focused clinical question that pertains to the everyday practice of emergency medicine *To present the background, evidence and conclusions in a concise and conclusive talk
*2 separate EBM topics will be presented during the one hour lecture block. The conference coordinator may also include some didactic material on EBM during the session *Residents may design their own clinical question or select one from the list provided. Topics must be approved by the conference supervising attending prior to beginning work *The speaker should first address why the clinical question was chosen and how it affects our clinical practice *The discussion should include a brief (no more than 5 minutes) review of the issue including background of the topic *The talk should be no more than 20 minutes duration, and contain no more than 15-20 slides *Review the presentation with the conference supervising attending at least 1 week prior to presentation
All 3rd and 4th year residents will give lectures. The topics and material will be geared to junior residents or all academic years. The topics should be selected at the beginning of the Academic Year with the assistance of the Education Chief Resident. It is expected that preparation will be far in advance. In order to present a high quality lecture, the residents will be expected to utilize current literature as well as textbooks and position papers. The residents must contact a faculty member, their advisor or any of the residency directors at least 1 week prior to the scheduled presentation time in order to go over the lecture slides. If the resident fails to contact a faculty member additional lecture or clinical duties will be assigned. Practice is important, and it is therefore expected that the resident has had several practice sessions in order that the material is presented in a smooth and well-rehearsed fashion. Handouts will also be appreciated. In addition, the residents should arrive early to set up the AV equipment, so that the lecture may start on time. The schedule for Senior Resident Lectures and resident presenters will be posted and distributed by the education chief resident MISCELLANEOUS POLICIES AND PROCEDURES RESIDENT RESPONSIBILITIES AND DUTIES In accordance with the recommendations of the Accreditation Council for Graduate Medical Education (ACGME), and the SUNY-Downstate Graduate Medical Education Committee, the resident will be provided with an opportunity to: 1) Develop a personal program of self study and professional growth with guidance from the teaching staff. 2) Participate in safe, effective, and compassionate patient care, under supervision, commensurate with their level of advancement and responsibility. 3) Participate fully in the educational scholarly activities of their program and, as required, assume responsibility for teaching and supervision of other residents and students. 4) Participate in institutional programs and activities involving the medical staff and adhere to established practices, procedures, and policies of the institution. 5) Participate in institutional committees and councils, especially those that relate to patient care review activities. 6) Participate in evaluation of the quality of education provided by the program. 7) Develop an understanding of ethical, socioeconomic, and medical/legal issues that affect graduate medical education and of how to apply cost containment measures in the provision of patient care. 8) Residents shall perform their duties and at all times conduct themselves in compliance with all applicable departmental rules and regulations, as well as applicable Hospital policies and procedures, both personnel and operational, and such specific rules and regulations. It is therefore expected that the resident always acts in a professional manner. Dishonesty, disinterest, and unkindness are serious offenses and may be grounds for dismissal from the program. Policy on Eligibility and Selection of Residents Candidates for residency will have graduated an LCME-accredited medical school or a medical school approved by the program director. Candidates will have passed the USMLE step 2 or the Complex Step 2 prior to entry into the training program. Residents will hold a medical degree from an allopathic or osteopathic medical school or an equivalent degree if from a foreign medical school. All applications for PGY1 positions are accepted through the ERAS program. The Residency Director and the Assistant Directors screen completed applications for specific criteria. Interviews are offered to approximately 185 applicants based on their personal statement, letters of recommendation, board scores, transcripts and dean’s letter. Interviews are held twice a week, with 10 applicants per session. Applicants are given an introductory slide presentation, which describes the key aspects of the program including the length of the program. Usually, the residency director, and the assistant residency directors, and a resident interview candidates. The interviews are one on one or two on one and run approximately 20 minutes each. During the interview day, applicants are offered an opportunity to meet with residents for a question/answer session and tour of the facilities. Recruitment for the combined program was done similarly in concert with the Internal Medicine Program Director. The Interviewers rank the applicants based on their prior academic performance and future growth potential, their interview presence and interpersonal skills, their commitment to Emergency Medicine, ethnic and cultural diversity, and the desire to work and learn in an inner city hospital environment. PROMOTION/GRADUATION CRITERIA Education in emergency medicine is a lifelong journey, not a destination. We, as a program, will teach you the fundamental skills, knowledge and humanistic qualities that constitute the foundations of emergency medicine practice. Under the guidance and supervision of qualified faculty, residents need to develop a satisfactory level of clinical maturity, judgment and technical skill. On completion of this program, residents should be capable of practicing emergency medicine, able to incorporate new skills and knowledge during their careers, and able to monitor their own physical and mental well being and that of others. This program has established specific educational and administrative criteria for promotion to the next program level and graduation from this program. Educational requirements are outlined for each program year in the “Educational Objectives” section in this handbook. Furthermore, ACGME core competencies criteria by which residents’ performance will be judged, is outlined in the “Evaluations” section in this handbook. Please read these over carefully. Other promotion/graduation criteria include, but are not limited to:
PLEASE BE AWARE: Compliance with the fulfillment of these regulations has been a problem in the past, especially during the last months of the final year. Please follow these rules carefully - it is ultimately the Program Director’s decision on whether to promote or graduate you. Supervision of Residents Residents working in the ED will be supervised by ABEM board-eligible or board certified attending physicians who are licensed in the state of their practice. When residents rotate on non-EM services, they will be supervised in accordance with the ACGME/RRC faculty supervision guidelines for that specialty. Residents rotating in the Pediatric Emergency Department may be supervised by faculty boarded in Pediatric Emergency Medicine. Residents rotating in the Pediatric Emergency Department may also be immediately supervised by fellows enrolled in an ACGME-accredited Pediatric Emergency Medicine fellowship. However, these residents will also have immediate access to a faculty member who is board-certified/board-eligible in EM or Peds EM. All EM residents are ultimately under the supervision of the Program Director of Emergency Medicine regardless of what specialty they are working on. Each patient encounter MUST be presented to an faculty member prior to disposition. All charts MUST countersigned by an attending in a timely manner. Junior residents can be supervised by senior residents in the specialty under which they are rotating, but must ultimately be under a supervising faculty meeting the above criteria. Residents must be under direct supervision during all procedures until they are credentialed in that procedure. After that time, they will perform all procedures under general supervision. In the ED, there is always an attending in the clinical area to supervise all procedures. Faculty will not provide coverage from outside of the clinical area. As the residents progress in their level of training, they are given more autonomy in regards to patient management plans, procedures, and disposition. Senior residents will be responsible for supervising the junior residents working in their assigned clinical area. Residents are also responsible for supervising and monitoring medical students. As residents progress, they may precept medical students. However, all patient encounters must ultimately be presented to the faculty in the clinical area. Residents will also work in conjunction with the nurse and clerical staff to assure that optimum patient care is given. Further delineation of supervisory policies can be found in the resident handbook under that rotation summary. Policy on Resident Duty Hours and Work Environment The EM Residency adheres religiously to the duty hours restrictions. Residents will adhere strictly the ACGME and New York State Health Code duty hour rules. Any potential violation of these rules shall be reported to the Program Director immediately. If the Program Director does not correct the issue, then the resident should address the issue with the DIO of SUNY Downstate. Residents will work in an environment that is safe from physical harm and free discrimination based on the residents’ sexual orientation, race, ethnicity, identified gender, or socioeconomic background. Residents will be required to dress and act professionally while on duty. Work Hours Rules: Duty hours are defined as all clinical and academic activities related to the program; i.e., patient care (both inpatient and outpatient), administrative duties relative to patient care, the provision for transfer of patient care, time spent in-house during call activities, and scheduled activities, such as conferences. Duty hours do not include reading and preparation time spent away from the duty site. As a minimum, residents shall be allowed an average of one full day in seven days away from the institution and free of any clinical or academic responsibilities, including planned educational experiences;
On-call Activities 1. In-house call must occur no more frequently than every third night, averaged over a four-week period.
resident has not previously provided care. CLINICAL PROCEDURES The purposes of procedure documentation are multiple. First, our program is required by the Resident Review Committee (RRC) section of the ACGME to ensure residents complete a certain number of procedures prior to completing their Emergency Medicine residency training. The RRC language is vague on the number of procedures required in most cases but is very strict about programs providing documentation of residents’ performing certain procedures. You will be supplied with a list of procedures that MUST be documented throughout your residency. The other major reason for requiring documentation of residents’ procedures is that after completion of residency training, hiring institutions will require documentation of competence in certain procedures before Attending Physician privileges are granted. Over the last several years, many hospitals have become more rigorous with respect to verification of procedural competence during the credentialing process. Thus, it is important for the resident to receive credit for all procedures performed or supervised during training. The SUNY-Downstate system has gone exclusively to web-based tracking of procedures and resuscitations. During your orientation you will be given information about how to log onto the New Innovations system to record your procedures. Please realize that there are two different “requirements” for the number of procedures you will need to document. You will be given a purple procedure book that lists all of the major procedures we do in the ED and how many you must log before you are considered “credentialed” to do that procedure by yourself in the hospital. Once you are “officially credentialed by our hospital” to do that procedure, you will be able to perform that procedure without supervision at and of the hospitals you rotate through. However, at that time, you still need to log more of that procedure in order to meet the RRC’s expectations of how many procedures you must do in order to graduate from any EM residency program. Both of these sets of numbers will be provided to you. Keeping an accurate record is not only important for your future employment credentialing process, but is also imperative to maintain our program’s RRC accreditation. Furthermore, keeping an updated procedure log is also part of your promotion/graduation requirements. If you have any problems or questions about the tracking program, please do not hesitate to contact Dr. Silverberg. POLICY ON SUPERVISION OF FELLOWS AND FELLOW SUPERVISION Fellows working in the Pediatric Emergency Department will be supervised by faculty that are board-eligible or board certified in Pediatric Emergency Medicine or Emergency Medicine. Fellows working in the Adult ED will be supervised by ABEM board-eligible or board certified attending physicians. When fellows rotate on non-EM services, they will be supervised by appropriately qualified and certified teaching faculty in that specialty. All PEM fellows are ultimately under the supervision of the Program Director of Pediatric Emergency Medicine regardless of what specialty they are working on. Fellows may be supervised by senior residents in the specialty under which they are rotating, but will ultimately be under a supervising faculty meeting the above criteria. Fellows will be under direct supervision during all procedures until they are privileged in that procedure. After that time, they will perform all procedures under general supervision. In the PED, there is always an attending in the clinical area to supervise all procedures. Faculty do not provide coverage from outside of the clinical area. As the fellows progress in their level of training, they are given more autonomy in regards to patient management plans, procedures, and disposition. Fellows may supervise pediatric and emergency medicine residents working in the Pediatric ED, but all patients are ultimately to be presented to the faculty member assigned to the Pediatric ED. The chain of supervisory responsibility from medical student to Chief Medical Officer is as follows: student- resident- fellow- supervising attending- section director- program director- chairman of the department- Chief Medical Officer. EVALUATIONS and FEEDBACK Residents will be evaluated on each clinical and non-clinical rotation using the following evaluation & feedback mechanisms. The six (6) core competencies will be addressed in these evaluations as they apply to the individual rotation. Evaluation process: A. Resident Evaluation Multiple tools are used in the evaluation of the residents. They include oral feedback, written monthly evaluations, the EVALBOT computerized system, 6-month reviews with the Residency Directors, faculty advisor meetings, self-evaluation forms and a computerized SDOT (Standardized Direct Observational Tool), which is located on-line called COMPOTENCYBOT.
B. Feedback mechanisms:
C. Faculty Evaluation:
D. Rotation Evaluation
E. Program Evaluation
PLEASE BE AWARE: Compliance with the fulfillment of these requirements has been a problem in the past. We will therefore treat non-compliance very strictly. Residents in non-compliance will have to meet with one of the residency directors in person. They may be given extra assignments, have their clinical areas moved to undesirable locations or may even be prevented from advancing to the next year of their residency training (even graduating) if these goals have not been fulfilled. Patient Encounter Follow up (part of the competency-bot program) Objectives: The resident will be able to:
A career in medicine means being a student of our patients. Our clinical work constantly generates questions as we manage our patients’ medical problems. An important component of being a physician is asking ourselves how to handle those questions and finding the answers in the most current literature as a way to continuously improve our own practice. This is the Practice-based-learning competency is its pure form. We find ourselves challenged when a particular patient’s diagnosis is unclear or when management options were in questions. What clues were in the patient’s initial presentation that could have ultimately led us to the diagnosis in more direct fashion? Why did we choose one particular test or treatment regimen over another? Were there other options we should have considered? What is the standard of care and what evidence supports it? How did our decisions affect the patient’s outcome? Specific examples of questions (and sources for answers):
Select four patients per year to do a follow-up on. This is only 1 follow-up every 3 months on average. This should be a patient that raises a question you feel you could learn something from. Examples would be where the diagnosis was unclear or the work up or management options were in question or new to you. Follow up on the patient’s course after the ED. This can be obtained through hospital records (admission chart, discharge summary, outpatient clinic notes), discussion with consultants who managed the patient after you and/or follow up phone calls to the patient. Use this information to launch your investigation, and fill in the follow-up form on the competency-bot website. This is a requirement of your residency and failure to do this will result in failure to progress to the next PGY level or failure to graduate. RESIDENT PORTFOLIO The resident portfolio is a useful tool to document all of your educational activities, assist you in the development of expertise and promotion and will give you a sense of satisfaction and accomplishment. In addition, the portfolio will help you evaluate your own performance in a self-reflective manner. This is the first step on your lifelong journey as a teacher and educator, and setting up your personal portfolio will help you gather and document all the educational activities throughout your career. At some point in your career you will have to present the same or similar information to your chairman when negotiating promotion and tenure as a faculty member. The Portfolio should contain enough detail to allow evaluation of teaching and scholarly activity and yet be concise and selective as outlined. It should consist of two parts: Part I: Summary - This is a summary of the teaching/scholarly activity documentation and should contain the following:
This statement could be as short as one paragraph but shouldn’t exceed two single-spaced pages. It should include your clear goals, how you prepared to be an educator, what methods you used, what significant results you achieved, effective presentation of teaching materials, and reflective self-critique that allows you to improve. It is not supposed to be an existential statement on your progress or your life; It intended to be based on the contents of your portfolio. It should indicate what you believe is important about teaching/scholarly activity and how you put these believes into practice with specific regard to the five dimensions:
This information may be presented in a summary format (sample provided as attachment). Teaching/scholarly activities may include :
Other scholarly activities may include:
Whenever possible, you should include proof of quality of teaching/scholarly activity including awards and evaluations or letters by faculty, peers, and medical students. Part II: Appendices – Supporting documents for the Portfolio should be kept in a binder or folder documenting the activity, material produced and evaluation of the activity and material. There are a few items you should include in your portfolio (some are in addition to the ones mentioned above):
PLEASE NOTE: The portfolio should be given to the residency coordinator and must be updated after every educational activity. It should be available and will be reviewed during the 6-months evaluation by the Residency Directors. If you have any questions or need help, please contact Dr. Doty. PORTFOLIO – SCHOLARLY ACTIVITIES WORKSHEET
14. National Activities CME Each resident is encouraged to attend a national EM conference. Unfortunately, the department has only limited funds. The policy set forth is that each junior resident may receive an SAEM and EMRA membership and an EM textbook on joining the residency. The program will also contribute $500 for attendance of a national conference or course within one of the senior years. An additional $600 is offered by CIR if he/she attends a conference in the fourth year. Not going to a conference does not entitle the resident to $600 cash in the senior years. In other words, if you don’t go- you lose it. Any additional conference attendance reimbursement, particularly for poster, abstract, and/or lecture presentation, and/or representation of the department has to be cleared before hand with the Chairman or the Residency Directors. OTHER CIR BENEFITS INCLUDE: PEP (Professional Educational Plan): $600 per year per resident. Used balance rolls over each year, accumulative, up to PGY 8 as long as you are on HHC payroll.
Educational Conferences: An additional $600 to use in your next to last or last year of residency, and again as Chief Resident, and each year of your fellowship - as long as you are on HHC payroll. TRAVEL PLANS & REIMBURSEMENT PROCEDURES
b. This is for any type of travel that you anticipate getting reimbursed for. When in doubt, ask Ms. Patella prior to the event..
3. After you receive the approval notice, you can register and pay for conferences and hotel reservations. After the conference bring your original receipts to Ms. Patella and complete a travel voucher form. SUNY will reimburse directly to your home. They will also reimburse for cab fare, breakfast and dinner (no lunch) only with original receipts. If you intend to rent a car, a letter justifying the expense will be required. DUE PROCESS AND GRIEVANCE PROCEDURES A. Departmental Resident Due Process and Grievance Policy Residents who do not meet departmental academic or professional requirements as set forth in this handbook, and accordingly are judged by the Residency Directors to have failed to maintain satisfactory performance resulting in disciplinary action and/or dismissal or termination of contract prior to completion date, may challenge this decision by appealing to the Departmental Resident Grievance Committee. This committee is chaired by the chairperson of the department and includes the resident’s faculty advisor, a member of the departmental steering committee, one of the Chief residents, and a resident representative. A request for review of any disciplinary action by this committee has to be done in writing to the Chairperson of the department. The committee then convenes and will review the case in a timely fashion. Results of this review will be forwarded to the Residency Director and the institutional GME committee for further action. If the unfavorable issue is upheld or not resolved by this committee, the institutional GME Committee may be contacted for review of the action. In the case of a violation of departmental academic and/or professional standards and/or serious patient care issues by a resident, the program director will issue a written warning. This warning will also outline expected corrections, suggestions how to achieve them, and in which time frame. The resident will be given a copy of the warning, the signed original will stay in the resident’s file, and another copy will be forwarded to the GME office. In the unlikely event of a repeated negative action, the resident will be placed on probation. If a performance review after the specified time or a third negative action occurs, and if the resident has been given proper due process, the resident will be dismissed from the program. However, certain serious patient care issues as judged by the departmental leadership, may lead to immediate dismissal. B. Institutional Due Process The resident agrees that the continuation of his residency depends upon the satisfactory performance of assigned duties, and that failure to maintain a satisfactory performance, in the judgment of his Program Director, may result in termination of this Agreement and dismissal of the Resident from the Residency Program prior to the completion date. In the event of resident grievance, academic discipline or dismissal from the Residency Program, the Resident shall be entitled to due process in accordance with the policies and procedures adopted by the Graduate Medical Education Committee (GMEC) and the HSCB standard. Due Process in all SUNY-HSCB programs will be based on department specific educational requirements and expectations for resident performance. Departmental guidelines and procedures for resident review and evaluation must be explicit and in written form, consistent with RRC requirements, and must meet the HSCB standard set below: A. The GMEC must be notified by the Department Chair or Program Director of any action leading to the suspension, probation or dismissal of a resident. In all instances documentation of evaluations and attempted intervention must be in place prior to any action. B. Residents who challenge an evaluation of their academic performance in a required educational activity, or who challenge an unfavorable academic standing or status assigned to them because of inadequate evaluations of their performance may request a review of the evaluation or of the academic status, or both. Each residency program has established procedures for considering such requests. Residents who wish to request a review of an academic grievance should submit such a request in writing to the program Director. If the issue is not resolved through completion of the program’s grievance procedure, residents may then address a petition to the GMEC for a review of their case and of the program’s decisions on it. The GMEC may appoint and refer such petitions to an Ad Hoc Resident Grievance Sub-committee. In reviewing a resident’s petition of redress of an academic grievance, the Ad Hoc Resident Grievance Sub-committee may utilize a variety of procedures. The procedures adopted are those which the committee believes will provide the parties involved with an opportunity to present their sides of the issues to the committee and for the committee to gather information and evidence as it deems necessary to make its decision. Action taken on resident grievances by an Ad Hoc Resident Grievance Sub-committee is reported to the GMEC. Action accepted by the GMEC is final and is not subject to further formal review within the University. C. Departmental due process procedures must be consistent with SUNY HSCB Resident Evaluation Policies and Procedures. D. SUNY-HSCB Due Process and Grievance Policies and Procedures are independent (and complementary) to those set forth by HHC-Collective Bargaining Agreement, the Brooklyn VA and other affiliated hospital procedures. FACULTY ADVISORS Each resident will be assigned a faculty advisor. The role of the advisor is to facilitate the resident’s progress through the residency. The resident is encouraged to utilize his or her faculty advisor with all aspects of resident life. Faculty advisors should be a source of feedback and inspiration for the residents. The faculty advisor may be particularly helpful in assisting the resident to achieve set academic goals. It is required that the faculty member and the advisee meet at least every three months to review the resident’s progress. The faculty advisor is also required to review the monthly patient follow-ups. Residents may ask their advisors to be present during their bi-annual evaluation with the residency director and during any remediation discussions with the residency directors. It is the resident’s responsibility to approach his/her advisor. If there are problems scheduling a meeting with your advisor or you would like to change your advisor for any reason, please let the Residency Directors know. However, the role of the advisor shall not be limited to mandatory meetings but shall be proactive and visible in the resident’s academic development. This can be accomplished in a variety of ways and should consist of, but not be limited to, some of the following:
NOTE: A Resident Evaluation Form (located outside Ms. Lane’s office) may be used as a guideline for resident-advisor meetings to address certain issues and to document regular meetings. This form must be given to the residency coordinator to be placed in the resident’s file. Please inform the Residency Directors (specifically, Dr. Quinn) if there are any problems with meeting with your advisor or if you wish to be assigned to a different advisor for any reason. SICK CALL POLICY The Department of Emergency Medicine has set up a sick call beeper system to cover the ED when residents are ill or unable to work scheduled shifts. During the PGY-2 and PGY-3 years residents will be assigned two separate two-week blocks of sick call. Historically, these rotations have been during non-ICU and non-ED rotations, such as ENT, Ultrasound, and Research/Airway. While on sick call, the resident will generally cover any sick EM resident scheduled for the UHB & KCH adult or pediatrics EDs. Typically, PGY-2 residents cover junior residents and PGY-3 residents cover senior residents. However, at the discretion of the EM Chief or residency directors, any sick call resident may be activated for any sick resident irrespective of year or parent department. The sick call resident will carry the sick call beeper for the entire time on sick call and is expected to be available and free from the influence of any mind altering substance at all times during their call period, including weekends and nights. The resident must also stay within beeper range of the hospital. If you need to leave the NYC area then arrange coverage from a peer. The resident who is receiving the pager at the time of turn over is responsible for obtaining the pager. Not having been given the pager is not an excuse to miss a call. Any resident who is unavailable during their sick call will be held accountable for the missed clinical time. The sick call beepers are usually used when another EM resident calls in sick, the ED is busy, and extra help is required to ensure adequate patient care. Do not abuse the Sick Call System. It is not to be used for recreational or personal needs. The only people who are authorized to activate the sick call resident are the Chief-on-call or one of the Residency Directors. If the sick call resident is called in by another person, the called resident is to immediately refer the matter to the Chief Resident on call or one of the residency directors. The following is the procedure for an ill resident to activate the sick call system: PLEASE NOTE: NOT ADHERING TO THESE PROCEDURES HAS CAUSED MAJOR PROBLEMS IN THE PAST. THEREFORE, STRICT ADHERENCE IS MANDATORY AND WILL BE ENFORCED. Sick Call Procedure: KCH ED
1-917-760-2005) and the chief on call (1-917-761-1405.) If you cannot reach Dr. Doty, leave a message on his cell phone voicemail. NOT CALLING IS UNACCEPTABLE UNDER ANY CIRCUMSTANCE UNLESS YOU ARE INTUBATED.
Sick Call Procedure: Off-service and Affiliate EDs Same as above, in addition:
Sick Call Procedure Conference Days
ED CONFERENCE ATTENDANCE POLICY In an effort to give the residents more autonomy, we are instituting a new attendance policy for conference. It is a national benchmark that every EM resident must be present for 70% of the Wednesday conferences that we sponsor. (35% for EM/IM residents) With that thought in mind, we would like to leave it up to you, the residents, to make sure that you are making this RRC requirement. Therefore, the directors will not be worried about your reasons for missing conference. It is your responsibility to be there. The attendance statistics will be posted on the conference room door on or around the first of every month. You must be there for the full 5 hours to get credit for the day if you are not scheduled to work that day or the night before. If you leave early or come late outside of the current handbook policy on Wednesday conference attendance, you will not get credit for that conference day. Realize that this 70% of conferences includes everything. (Sick day, I worked overnight, my car got towed, my Granny was in town, I was on vacation, my dog ate my metrocard..EVERYTHING.) If you come more than 5 minutes late, it will be recorded. If you are late 3 times, it will count as one full missed day of conference. It is your responsibility to keep track of your conference attendance and know how close you are to that 70% level. This number can be reviewed with a residency director at your 6 month evaluation meeting or you can make an appointment with a director to discuss this at any time. If by some terrible chance of luck, graduating residents are below your required 70% (35%), they will have to attend conference during their elective or during July to make the minimum requirement in order to graduate the program. The 70% ( or 35% for EM/IMs) RRC conference attendance requirement is not negotiable and you can not graduate from ANY EM residency with out fulfilling it. WORK ATTIRE POLICY We all realize that the hospital is not the cleanest place in the world. Therefore, wearing fancy clothes can become taxing on the wallet when dry cleaning bills and replacements for destroyed garments start to stack up. However, as dirty as the ED may be, we still need to look professional. While we do not want to enforce a strict dress code, we would like to set a standard. When working clinically at Kings County, scrubs are acceptable although we encourage professional casual dress when working in the non-procedure oriented areas such as Pod A. Jeans are never acceptable and neither is any shirt that does not cover the entire abdomen. When working in UHB, men should try to wear khaki pants or slacks and a button down shirt while women can wear a similar ensemble or something equally as professional. Additionally, we should also think about what we wear to our academic Wednesday conferences. This is especially true when an outside speaker is going to be present. When giving a lecture, looking the part is very important. If you are giving a lecture, you should have professional attire or business casual. This means:
1. No scrubs when giving a lecture. If you are working at 12 noon or worked the overnight, you can change into your scrubs before or after your lecture 2. No jeans, t-shirts or sweatshirts when giving a lecture 3. The lecturer should wear business casual which means an ironed shirt, pants, blouse, dress etc. If you have questions, you can check out the link below for some additional examples.
You put a great deal of effort into your presentations. Look the part and complete the package. If you have any questions, please feel free to contact your faculty advisor or any one of the residency directors with additional questions. "The difference between greatness and mediocrity is in the detail." Yüklə 1,16 Mb. Dostları ilə paylaş:
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