| Emergency Medicine
| St. Luke's Hospital
|| 3-4 Weeks
| Pediatric Emergency Medicine
|| Boston Children's Hospital
|| 4 Weeks
| Pediatric Intensive Care Unit
||Boston Children's Hospital
|| 4 Weeks
| Medical Intensive Care
|| 4 Weeks
| Emergency Medical Services & Administration
|| 3 Weeks
| 6 Weeks
| 4 Weeks
The third year rotation in Emergency Medicine stresses the development of emergency physician leadership. PGY3 residents assume the role of clinical leader in the emergency department with close emergency faculty supervision. They direct patient care in critical medical, surgical, trauma, psychiatric, and obstetric/gynecologic care situations. The PGY3 resident is responsible for supervising junior residents and medical students in the emergency department.
St. Luke's Hospital: As the only emergency medicine residents at this busy community hospital, the PGY3 residents are responsible for seeing the sickest medical and surgical patients and performing all the procedures. The residents gain firsthand experience of practicing in a high volume, high acuity, community hospital.
Pediatric Emergency Medicine
Boston Children's Hospital: The PGY3 residents are responsible for all facets of the patient’s clinical management while rotating in the Emergency Department at Children’s Hospital Boston. They have the opportunity to direct pediatric medical and trauma resuscitations and perform advanced procedures.
Pediatric Intensive Care Unit (PICU)
Boston Children's Hospital: The PGY3 residents spend four weeks as members of the pediatric intensive care team at Boston Children's Hospital. This team is composed of both Emergency Medicine and Pediatrics and team members are responsible for all facets of clinical management. As the primary physician for his/her patients, the EM resident is responsible for ordering all therapies and diagnostic studies. The educational curriculum includes mock codes, simulation, and daily didactic sessions.
Intensive Care Unit (ICU)
Brockton Hospital: Residents rotate in the Brockton medical/surgical ICU during their EM3 year, a 253-bed community hospital south of Boston serving a diverse patient population that provides residents the opportunity to care for high acuity patients in a busy ICU setting. As the only resident in the ICU overnight, they have first attempt at any and all procedures as well as experience considerable independence in patient care. The residency provides residents with a Zip car to use for this rotation that is fully paid for by the program.
Emergency Medical Services & Administration
PGY3 residents spend 3 weeks involved with a full range of EMS activities within the City of Boston, several suburban EMS systems and Boston MedFlight. They attend local, regional, and statewide meetings related to various aspects of EMS. Residents are exposed to mass gathering emergency care by working as physicians for Fenway Park during Boston Red Sox home games and special events. Time is also spent working with the chairman of Emergency Medicine acquiring a practical understanding of administrative issues (i.e. leadership, continuous quality improvement, risk management, managed care, marketing, computer systems, ethics) necessary to become an effective manager in Emergency Medicine. A quality assurance project is also completed during this rotation. Residents spend time at the Harvard Risk Management Foundation. Here they learn the basics of risk management and review closed malpractice cases.
Residents have 6 weeks of elective time in their PGY3 year. Residents can choose from a large number of previously arranged electives or can design their own educational elective. Electives have included pediatric anesthesia at a high-volume community hospital, medical direction and oversight of a local EMS service, clinical research in a specific area of interest and the evaluation and management of patients presenting to the ED in shock. Harvard’s Humanitarian Studies Initiative for Residents (HSIR) offers a six-week elective that combines intensive class work with an international field placement.