Temple
Emergency Medicine
Clinical Curriculum
Each year consists of 13 separate four-week rotations. Central to the curriculum is the expectation to provide comprehensive training in the areas fundamental to the specialty of emergency medicine. Furthermore, emergency medicine residents will develop an understanding and awareness of the major disciplines with which the emergency medicine specialist must interface. The components of the experiential curriculum are listed below.
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Included in the resident vacation time of three weeks, is a one-week "holiday block". Residents chose between Christmas (typically 12/21-12/27) or New Years (12/28-1/4).
01
Fundamentals
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Emergency Medicine - TUH 26 weeks
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Pediatric Emergency Medicine - CHOP 4 weeks
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Pediatric ICU - St.Chris 4 weeks
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Trauma - 4 weeks
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Medical ICU - 4 weeks
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Anesthesia - 4 weeks
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Ultrasound - 4 weeks
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Obstetrics/EMS - 4 weeks
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Vacation - 3 weeks
02
Efficiency
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Emergency Medicine - TUH 14 weeks
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Emergency Medicine - Episcopal 4 weeks
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Emergency Medicine - Jeanes 8 weeks
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Pediatric Emergency Medicine - CHOP 4 weeks
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Surgical ICU - 4 weeks
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Toxicology/Addiction Medicine - 4 weeks
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Trauma 4 weeks
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Burn ICU 4 weeks
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Elective - 3 weeks
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Vacation - 4 weeks
03
Leadership
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Emergency Medicine - TUH 21 weeks
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Emergency Medicine - Episcopal 8 weeks
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Emergency Medicine - Jeanes 4 weeks
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Pediatric Emergency Medicine - CHOP 4 weeks
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Medical ICU 4 weeks
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Administration - 4 weeks
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Elective - 3 weeks
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Vacation - 4 weeks
Didactics
The core content of Emergency Medicine as outlined by the American Board of Emergency Medicine (18 topics) will be covered twice over the residents’ 3 years of training. Most didactic presentations will take place during the Emergency Medicine Conference Series held Thursday mornings from 8:00am to 12:00 pm. Each month has a designated system theme, and corresponding suggested reading.
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Each month, senior resident and faculty leaders take turns leading 2 hour Active Learning Sessions (ALS). Under this “flipped classroom” model, EM residents prepare by listening to podcasts, watching archived multimedia presentations from major meetings, or brand new material recorded by their faculty and peers. Then they come to the session and participate in case discussions, role-play, debates and other hands-on activities. Residents receive credit for the dedicated time they spend on the preparation, which we call asynchronous learning.
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Other components of the monthly schedule are designed to cover core content, as well as new areas of interest, emerging research or controversies. Temple EM faculty and visiting speakers provide 40 minute lectures, with part of the time spent covering high yield facts of diagnosis and mangement, and the rest on an area of expertise. Senior residents lead the ALS and also the Morbidity & Mortality series.
Orientation
Each academic year starts with a multi-station airway day, focused on basics of airway management and intubation for the interns, to advanced techniques and austere airway management for upper years. These days set the stage for continued learning in the interns' anesthesia rotations, and the management of medical and trauma airways by our PGY2s and PGY3s, respectively.
Procedural Education
The Temple Emergency Residency program emphasizes hands-on procedural learning.
While there is no shortage of procedures for our residents during their clinical experience, we of course provide dedicated time to teach procedures. In addition to the Orientation block, procedure stations and didactics run in parallel in the Sim Center when residents are not in a sim case, to avoid downtime and maximally utilize time.
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Short lecture-based and simulated procedure days are integrated longitudinally into the conference curriculum. There are opportunities for residents to design and lead their own procedure learning, as well, including some as part of their Content Expert Program projects.
Core Lectures
The core content of emergency medicine outlined by the American Board of Emergency Medicine is covered twice during every resident’s three years of training. Most didactic presentations take place during the conference held Thursday mornings from 8:00 am to 12:00 pm. Each month has a designated system theme and corresponding suggested reading. Core curricular lectures are given by faculty from our department, but we also invite in guests from other departments, as well as the Children’s Hospital of Philadelphia.
Some content is spaced over the year in recurring lecture series. These include Toxicology, Addiction Medicine, EMS and Wilderness Medicine, EKGs, Narrative Medicine, and Palliative Care.
Active Learning Sessions
We have seven Active Learning Sessions (ALS) throughout the year run by two PGY3 residents and a faculty leader. Under a “flipped classroom” model, residents prepare by listening to podcasts, watching archived multimedia presentations from major meetings, or reading from a variety of sources. Then they come to the session and participate in case discussions, games, debates, and other hands-on activities led by the PGY3 facilitators and faculty in small group sessions.
Class Specific Seminars
Roughly once per month residents split up by class for content that is tailored to their specific PGY level. The PGY1 seminar series imparts fundamental skills and knowledge in high-yield topic areas, allowing our interns to become more competent and confident emergency physicians from early in their residency training.
The PGY2 seminar series focuses on the resuscitation of critically ill patients. The content is mostly based on physiology, recent literature, and historical perspective, and it is tailored each year to the interests of the class.
The PGY3 seminar series focuses on non-clinical competencies that prepare residents for life after graduation in both the community and academic settings.
Structural Competency Series
We have a bi-monthly lecture series which focuses on the history and complexities of the social environment that shape our patient’s lived experiences. This is a series dedicated to giving a foundational education on the forces at play that have resulted in health inequity and social dilemmas that we as emergency medicine physicians are forced to face daily. The lectures focus on housing, mass incarceration and prison health, LGTBQ+ issues, violence and climate among other interconnected topics that relate to our patients and our community. Lectures are followed by a directed discussion to allow our physicians to understand these social issues at a deeper level as well as work towards solutions for health equity by focusing on programs in Philadelphia and next steps we can take individually and as a group. In addition to this series, every core lecture now has incorporated talking points focused on integrating community context, including social and structural determinants of health, to help learners better care for our patients.
Morbidity and Mortality Conference
M&M is held once per month with all residents and faculty, where a PGY3 and a faculty member review recent prescient cases with significant learning opportunities. The atmosphere is not adversarial and provides a great experience for all to learn medicine through difficult cases.
Ultrasound
The Ultrasound Division, affectionately known as the Ultrasquad, is actively involved in resident didactics. We offer an intern ultrasound rotation, advanced elective, and scholarly track. We partner with the Simulation Crew to provide hands-on US training sessions throughout the year. One of our faculty members is active in the Global Health community as well providing an opportunity for those interested in international health. Check out our webiste to learn more!
Simulation
Our simulation curriculum involves simulation cases both at our state of the art simulation center as well as in situ simulation cases in the ED itself. We run simulation cases approximately 1-2 times a month during conference. Our curriculum is a three year longitudinal course, and is divided by learner level (i.e. PGY-I, II, and III) so that we can better cater the cases and the learning objectives to the residents level of training. In addition, our in situ cases allow residents to practice sim with higher environmental fidelity in the same areas of the ED they actually practice in!
ITE Review
We have a very special Inservice Training Exam (ITE) Review annually to help prepare our residents to take their ITE. While we expect residents to longitudinally study for this exam, which spans all core content of Emergency Medicine, the ITE Review day is a way to help refresh our residents on a large breadth of topics. The conference day itself is uniquely themed every year, as residents are divided into groups to partake in multiple games and small group learning stations.
Journal Club
Journal Club is held once a month, usually on a Tuesday night. Four articles are presented and discussed by the group, with the purpose of keeping up with the current EM literature and learning how to critically read medical publications.
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Journal Club is “protected time,” meaning that attending physicians cover the emergency department and all of the residents are free to participate. We take advantage of this time to get out of the hospital, and hold this event at a different location each month–prior locations have included restaurants, bars, outdoor picnics, bonfires and the homes of faculty and residents.
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Journal Club is followed by “Residents’ Night Out,” which is protected time for the residents to get together and do something fun outside of the clinical setting. Residents’ Night Out has included going to a haunted prison, dragon-boating on the Schuylkill River, karaoke, among many other activities.
Content Expert Program
In 2015, Temple's Dept of EM introduced the Content Expert Program (CEP). Through the program, each resident is paired with a faculty advisor to develop expertise in a content area within emergency medicine, including core clinical topics, educational advancements, operational improvements, and research. The CEP spans the three-year residency, in which time each resident will appraise the literature as it relates to their content area, develop an intervention to improve or enhance departmental performance in that area, and study their intervention. CEP projects, which are often multidisciplinary, teach each resident the skills needed to practice performance improvement.