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Post Graduate Year 1

Rotation Schedule

Orientation   2 Weeks
Emergency Medicine BIDMC: 19 Weeks
 

Needham:

Cambridge:

4 Weeks

2 Weeks

Pediatric Emergency Medicine Boston Children's Hospital: 4 Weeks
Medical Intensive Care Unit (MICU) BIDMC: 4 Weeks
Plastic Surgery BIDMC: 3 Weeks
Anesthesia (and Ultrasound) BIDMC:    4 Weeks
Obstetrics BIDMC: 2 Weeks
Acute Care Surgery/ Trauma BIDMC: 2 Weeks
Red Zone BIDMC: 1 Week
Vacation  

4 Weeks

Orientation                                                                                                                            

Incoming interns spend their first two weeks in an intensive orientation program designed to prepare them to function effectively as Emergency Medicine residents. The orientation includes didactic sessions as well as multiple procedural labs. Procedural skills are taught in an animal lab, splinting and suturing workshops, and slit lamp lab. All interns receive Advanced Cardiac Life Support, Advanced Trauma Life Support, and Pediatric Advanced Life Support training and certification. A difficult airway management lab and a basic ultrasound course are also offered during the orientation.

Emergency Medicine                                                                                                     

BIDMC: PGY1 interns manage all types of patients in the BIDMC emergency department under the supervision of senior Emergency Medicine residents and faculty. Interns perform all procedures for their patients. A significant proportion of special teaching shifts are designated for PGY1s, where residents work one-on-one with an attending with an emphasis on teaching.

Beth Israel Deaconess Needham & Cambridge Hospital: During the PGY1 year, interns also rotate at two community sites, Beth Israel Deaconess-Needham and Cambridge Hospital. Both sites have busy emergency departments that serve a suburban population. Rotating at these community hospitals, interns will learn how to evaluate patients without the constant availability of other services, when to appropriately transfer patients to tertiary care centers, and typically have even more opportunities to perform procedures and care for critically ill patients.

Pediatric Emergency Medicine

Boston Children’s Hospital: PGY1 interns spend 4 weeks in the emergency department at Children's Hospital Boston under the supervision of pediatric emergency attendings, fellows, and residents. They develop skills in pediatric resuscitation as well as diagnosis and treatment of common pediatric emergencies. The interns learn to manage pediatric airways, obtain intravenous access, perform lumbar punctures, perform conscious sedation, and how to administer appropriate doses of emergency medications. They assist in the evaluation and stabilization of pediatric trauma patients.

Medical Intensive Care Unit (MICU)

BIDMC: PGY1 interns spend 4 weeks caring for critically ill patients as part of the MICU team. They are also responsible for responding to cardiac arrests in the hospital. A significant amount of procedural skills are learned and reinforced in the MICU. Emergency Medicine interns are supervised and taught by medical attendings and fellows as well as senior medical residents.

Plastic Surgery

PGY1 interns spend 3 weeks on the plastic surgery service under the supervision of the plastic surgery fellows and attendings. They acquire in-depth knowledge of the anatomy of the hand and face, as well as principles of wound healing and wound care. They develop skills in various wound closure techniques and regional anesthetic blocks

Anesthesia/Ultrasound                                                              

PGY1 interns spend 3 weeks on the anesthesia service under the supervision of anesthesiology attendings and residents. They develop skills in emergency airway management, the use of paralytic agents and general anesthetic agents. The interns receive instruction on rapid sequence induction, oral awake intubation, nasotracheal intubation, fiberoptic intubation, use of the intubating laryngeal mask airway, central line placement, and arterial line placement. They also assist in the performance of complex procedures such as transesophageal echocardiography and regional nerve blocks. They spend an additional dedicated week for ultrasound.

Obstetrics

PGY1 interns spend 2 weeks caring for obstetrical patients and performing vaginal deliveries under the supervision of obstetrics and gynecology residents and attendings. As the junior resident on the service, interns have ample access to normal vaginal deliveries and episiotomy repairs. Residents also first-assist on c-sections and participate in high-risk deliveries. In addition, they gain experience in performing first trimester ultrasounds.

Acute Care Service

PGY1 interns spend 2 weeks as surgical interns on the surgical service. As such, they participate in trauma and surgical resuscitations in the emergency department, assist on surgical cases in the operating room, and attend surgery clinic. Emergency Medicine interns are supervised and taught by surgical attendings and fellows as well as senior surgical residents.

Red Zone                                                                                                         

This one week rotation is designed to give interns a dedicated exposure to critically ill medical and trauma patients in the emergency department. Working alongside the EM2 and EM3 residents, interns see all patients in the highest acuity zone in the BIDMC emergency room. During this rotation, they have the opportunity to observe and perform various procedures, which could potentially include intubation, central line placement, lumbar puncture, arterial puncture and line placement, conscious sedation, fracture reduction, and others. Some dedicated time is also spent working with nursing and tech staff in the red zone, learning more about the role of these providers in caring for critically ill patients in the emergency department.

Ultrasound

PGY1 residents spend three weeks on the ultrasound rotation. Designed to complement the residency ultrasound curriculum, the resident further refines his or her skills in ED bedside ultrasound. Abdominal, OB-GYN, trauma, echo, and procedural ultrasound are emphasized. Hands-on experience is supplemented by computer simulations and readings.

Contact Information

Carlo Rosen, M.D.
Emergency Medicine Residency Program Director
Beth Israel Deaconess Medical Center
West Clinical Center - 2nd Floor
1 Deaconess Road
Boston, MA 02115
617-754-2339
617-754-2350
crosen2@bidmc.harvard.edu