After successful completion of the PGY-1 year, the second year resident should be comfortable evaluating any patient who presents to the Emergency Department. During this year, the residents will be expected to develop their clinical acumen, sharpen their physical exam techniques and hone their procedural skills. Their organizational abilities should improve to the point that at least three to four patients can be managed simultaneously. Emphasis will also be placed on the importance of patient follow-up. The PGY-2’s demeanor should be calm and professional, reflecting their increasing competence and confidence in their abilities and in those of the staff around them. They will be expected to develop their teaching abilities at this stage as well. They will supervise PGY-1’s during procedures for which they have been credentialed; they will teach medical students, Physician Assistant students, and EMT students in the clinical setting.
PGY-2 residents will take active part in the presentation of cases in the weekly clinical case conferences, journal club, and M&M conferences. Research projects will begin during this academic year.
PGY-2 residents will be directly supervised by PGY-4 residents and faculty members, and will require their superior’s authorization for the admission, transfer or discharge of patients. A faculty member must sign all patient charts.
At the completion of this training year, the residents will demonstrate competence in and be able to :
refine their history and physical exam skills
document the medical record accurately and concisely
In the third postgraduate year the residents will grow in confidence while working independently. They will have an increased role in Junior Resident supervision, will refine their teaching skills, and carry out administrative tasks assigned by faculty members. In addition, PGY-3 residents will demonstrate increased competence in management of multiple critically ill or injured patients simultaneously. Research projects will continue this academic year. The third year resident will have the ability to make admission, transfer and discharge decisions, after discussing the case with a faculty attending physician. All charts must be co-signed by a faculty member. By the completion of this year of training they should be comfortable managing the full range of pathology that can present to an Emergency Department.
At the completion of this training year, the resident will demonstrate competence in and be able to:
perform rapid, accurate histories and physical diagnoses on all patients presenting to the Emergency Department
create comprehensive differential diagnoses for their patients
create and carry out treatment and disposition plans for all patients presenting to the Emergency Department
supervise the activity of more junior residents in their area
conduct teaching/management rounds in all patient care areas, including the direct supervision of care provided by PGY-1 and 2 residents
be an effective member of the Continuous Quality Improvement system
be comfortable directing all patient resuscitation situations, and managing the critically ill and injured
improve their lecturing and teaching skills
Description of clinical experiences:
Third year residents should have experience and demonstrate competence in the following procedures:
all procedures previously delineated for PGY-1 and 2
pulmonary artery catheter placement
extensor tendon repairs
supra-pubic bladder aspiration (pediatric)
abdominal and pelvic sonography
utilization of rapid-sequence and neuro-intubation techniques
utilization of conscious sedation techniques
Core Competencies Patient care
Procedural practice and teaching of these procedures
Demonstration of physical exam skills
Supervision of junior practitioners
Independent formulation of treatment and disposition plans