Vol. 12 No. 9 - April, 2010

Emergency Medicine Residency

LF highway
photo provided by Emergency Medicine
Life Flight responds to the scene of a traffic accident

Contributed by Jeffrey Cukor, MD

From ambulances and helicopters to earthquakes and hurricanes, emergency medicine specialists (EM) are there, treating all types of injuries and illnesses regardless of the hour or the circumstance. Emergency Medicine is about caring, preparing and responding; it’s about being there when needed and today at UMass Medical School (UMMS), it’s thriving.
The program’s 36 residents work with 60 EM faculty members, five NP/PAs and multiple fellows to help care for the more than 145,000 patients who come to the UMass Memorial Medical Center Emergency Departments each year.

GME Programs in Emergency Medicine

Residency

Core Emergency Medicine – 3 years

ACGME-Accredited Fellowship

Medical Toxicology – 2 years

Non-ACGME Accredited Fellowships

Emergency Ultrasonagraphy – 1 year
Disaster Medicine and Emergency Management – 2 years (including a master’s degree)
Pre-Hospital and Emergency Medical Services – 2 years (including a master’s degree)

Possible future fellowships

International Emergency Medicine and Global Health

EM training includes extensive exposure to the emergency departments at UMass Memorial University and Memorial campuses as well as the Pediatric Emergency Department in the UMass Memorial Children’s Medical Center and the Milford Regional Emergency Department. Each resident is precepted by EM faculty who are present around the clock and place emphasis on teaching, critical decision-making and procedural competence. Residents also rotate through anesthesia, obstetrics, orthopedics, radiology, trauma and the cardiac, medical, surgical and neonatal intensive care units.

UMMS EM residents study with six toxicologists to learn about poisonings and overdoses and provide consultation support to clinicians throughout Central Massachusetts. In preparation for safer and more expert clinical care, residents and fellows also train in emergency ultrasound through didactics, tape review, small group teaching and bed-side instruction. Each resident performs an average of 400 to 500 scans, with each study recorded and reviewed by one of five fellowship-trained ultrasound faculty members. EM senior residents also serve as flight physicians for UMass Memorial Life Flight, a challenging but very rewarding role that provides essential services for some of the most acutely ill and critically injured patients in the region.

Advanced didactics to help EM residents prepare for independent practice include audience participation devices, small group training, cadaver and skills labs and a national grand rounds program. We also utilize on-line training and question banks and both adult and pediatric simulation sessions. EM residents and fellows also teach medical students in many areas, including physical diagnoses, wilderness medicine, clinical rounds in the ED and procedures/patient management skills in the UMMS Simulation Center.

sim center
photo provided by Emergency Medicine
UMMS Simulation Center

All EM residents also participate in research and scholarly activity, with many producing abstracts and manuscripts presented at national meetings. The department provides an individual, longitudinal faculty mentor for each resident. In addition, research advisors bring to the residents the same expertise and guidance that has made the UMass Memorial Emergency Medicine Department one of the top NIH-funded departments of emergency medicine in the country.

Community service is a core value of the EM residency program. For the past eight years, EM residents have partnered with the Worcester Police Gang Unit to provide medical support for youth and charitable boxing events to benefit the Boys and Girls Club of Worcester. Other EM residents have served as ship’s physicians during the “semester-at-sea” aboard the Massachusetts Maritime Academy’s training ship, the USTS Kennedy, an opportunity that came about as a result of a wonderful partnership with the school. Still others have volunteered at clinics, taught classes in the public schools, staffed the Boston Marathon and provided medical care after natural disasters in Haiti, Louisiana, Florida and Texas.

EM training teaches residents to care for all different age groups across a wide spectrum of illnesses, with a special emphasis on acute care and teamwork. This is a terrific foundation for service in international and global health care efforts.

dmat
photo provided by Emergency Medicine
The DMAT MA-2 team responding to victims of Hurricane Katrina

In the past five years, residents have provided care and taught EM and disaster preparedness in Honduras, Guatemala, the Dominican Republic, Liberia, Uganda, Nepal, Ireland and Hungary. We are currently planning a program in Nicaragua and developing an alliance with the University of Puerto Rico to collaborate on research and to provide cultural exchange.

Established in 1986, the emergency medicine residency program has over 240 graduates now serving in 37 states. Fifty-five percent remain in Massachusetts, so there is a good chance a graduate of the UMMS EM residency is staffing your local emergency department. More than half our graduates continue on to fellowship or work in teaching hospitals, and some stay right here at UMass Memorial. After close to 25 wonderful years of emergency medicine training at UMass Memorial and UMMS, we are eager and excited about starting the next 25.

teaching
photo provided by Emergency Medicine
Group training

Emergency Medicine Training Directors

Residency Director: Jeffrey Cukor, MD
Associate Residency Director: James Sullivan, MD
Memorial Site Director: Paul Zgurzynski, MD
Milford Site Director: Mary O’Neill, MD
Medical Toxicology Fellowship Director: Ed Boyer, MD, PhD
Emergency Ultrasound Fellowship Director: David Blehar, MD
Pre-Hospital and EMS Fellowship Director: Marc Restuccia, MD
Disaster and Emergency Management Fellowship Director: Andrew Milstein, MD