Philosophy
The University of Chicago Emergency Medicine Residency is a fully accredited three year PGY 1-3 training program. The mission of the Residency is to produce emergency medicine specialists who are excellent clinicians and who will lead the next generation of emergency physicians.

History
The University of Chicago began training residents in the specialty of emergency medicine in 1972, thus the Program is one of the oldest in the country. Peter Rosen, the first chair, was the guiding spirit in the development of the department, the residency, and the specialty of emergency medicine. His continued insistence upon excellence set the tone; it is our mission to be leaders in emergency medicine education.

As testimony to the success of the residency over 30 percent of the graduates have become directors of emergency departments. Over 40 percent of our alumni have pursued academic careers in emergency medicine and we are proud that numerous emergency medicine residency programs across the country are currently chaired or directed by a graduate of our Program.

Clinical Experience
The 36 month clinical experience is designed to give the resident a broad exposure to all aspects of emergency medicine. This is accomplished through rotations in critical care areas, including trauma, pediatric, neonatal, cardiac and medical intensive care units, exposure to emergency medical services (EMS) and aeromedical transport, and working in the University of Chicago Medical Center Mitchell Adult and Comer Children's Hospital Emergency Departments and the Lutheran General Hospital and Mt. Sinai Hospital Emergency Departments.

The major emergency medicine training sites are City of Chicago/regional-designated trauma centers and combined have over 200,000 total patient visits per year. Each institution is located in a distinctly different demographic part of the metropolitan Chicago area. This provides the resident with a broad mix of clinical experiences with patients from a variety of socio-economic and cultural backgrounds.

The patients who come for care are unselected, from the newborn to the aged, and present with a high acuity of illness. This diverse experience will prepare the resident to work in any emergency medicine setting. All training sites have 24-hour bedside supervision provided by residency-trained, board certified faculty.

The First Year
The first year is dedicated to the acquisition of the core emergency medicine knowledge base, development of skills in the management of the emergent patient, and the attainment of major emergency manipulative skills.

Of note, half of the first year is spent in the emergency departments at the University of Chicago Medical Center (Adult and Pediatric ED) and Advocate Lutheran General Hospital (LGH) seeing patients under the direct guidance of a more senior emergency medicine resident and the attending physician. Particular attention is given to understanding the emergent nature of disease processes and how to prioritize care.

The remainder of the first year emphasizes critical care rotations vital to the development of an emergency medicine specialist. This includes clinical experiences in the intensive care units of the cardiology, critical care (medical), pediatric and neonatal care services, the labor and delivery obstetrical unit, the anesthesia service, and two distinctive trauma units. We are proud to emphasize our unique clinical curriculum which precludes general floor rotations in favor of exclusive exposure to the high intensity critical care settings that our three hospitals offer.

This is a transitional year in which progressive development of teaching and managerial skills occurs in the emergency department. This includes supervision of more junior emergency medicine residents under the direct guidance of attending faculty. A busy community hospital emergency department provides the resident with exposure to private practice emergency medicine under the supervision of a board certified emergency physician.

Other experiences include managment of acutely traumatized patients in the emergency department at Mount Sinai Hospital, a large, inner city, level I trauma center, a month in the Comerr Pediatric Emergency Department and a month of cardiology in the CICU at LGH. The second year resident is the designated flight physician during his/her MER clinical rotations. The resident is responsible for all helicopter and selected ground transports.

A specially developed one month "Selective" allows the resident to gain additional experience in echocardiography, general ultrasonography, occupational medicine, CT radiology, ophthalmology, ENT care, sports medicine, and toxicology. We also host a "Critical Appraisal of the Literature Course".

"As a flight physician, there is nothing more exciting than landing on an expressway to provide patient care..."

Tobin Efferen, MD.

The Third Year
During the final year, time spent in the major emergency medicine training sites incorporates patient care, teaching, supervision and administration. Third year residents are "in charge" of the emergency department during shifts and are responsible for directing junior emergency medicine/rotating residents and students and managing a busy emergency department.

The third year resident is the team leader in the resuscitation setting. All experiences are guided by attending physicians who will support the resident in the development of leadership and administrative skills.

Other clinical experiences include pediatric emergency medicine, ED-based trauma experience at Mt. Sinai, an international health care experience in a post conflict setting (the African country of Liberia) and a one month elective experience.

The administrative chief rotation allows the senior resident to function in a junior faculty role. The resident works with the Program Directors to organize the Residency educational conferences, medical student and paramedic lectures, and also attends scheduled departmental meetings. The administrative chiefs also serve as the "Teaching Resident" in the MER, a role which allows extended time periods of supervision and teaching of procedures and the cognitive aspects of emergency medicine in the ED setting to more junior residents and medical students.

The administrative chief has defined responsibilities related to continuous quality improvement and clinical operations programs. S/he is also given an opportunity to network with area UC alumni department directors in order to attain a broad experience in practice management.

In summary, the clinical experience will prepare the resident to be an excellent clinician who is comfortable practicing in any emergency medicine setting. As important, the tradition of our residency is to emphasize at each stage of resident development those professional behaviors and personal qualities that are requisite to leadership.

Residency Review
The Residency educational process is fluid and must respond to a changing work environment, clinical problems encountered by residents or perceived gaps in the clinical experience of the residents. In order to meet this need, the faculty and residents meet quarterly at a Residency Breakfast where clinical and didactic experiences are discussed in an informal setting. More formal review of the Program is the function of the Residency Education Committee. The members include the program directors and residency administrative leadership of each of the emergency departments that comprise the Program (UCMC, LGH, MTS), the Chief Resident(s) and Administrative Residents; it is chaired by the Residency Program Director. This committee meets quarterly and is responsible for ongoing review of the Program and formulation of policy to be implemented by the Program Directors.