St. Barnabas Hospital Health System
Mission statement
The St. Barnabas Hospital Emergency Medicine Residency Program is designed to provide the emergency medicine resident with the skills, knowledge, and experience required to become an outstanding and complete emergency physician. Accredited in 1990, and beginning with one resident, the emergency medicine residency program now trains over 65 residents in its various programs. The residency program, based at St. Barnabas Hospital, is now a 97,000 visit full service emergency department, accounting for some 70% of the admissions to the 460 hospital beds. Several expansions since 1990 have more than tripled the size of the emergency department, added faculty and resident office space and a resident classroom. A pediatric emergency department opened in 1999, and a Level I trauma designation was acquired in July of 2000, with another expansion in 2004, which included a trauma bay and expanded radiological services. St. Barnabas Hospital is also now a stroke center, the first in the Bronx, and a hypothermia center. In 1990, the faculty was composed of two residency trained, board prepared/certified emergency physicians; today, the faculty consists of 22 residency trained, board prepared/certified emergency physicians, all of whom are provided at least 20% “protected time” in order to better train the emergency medicine residents.
Curriculum
Clinical Curriculum
The clinical curriculum is designed to allow a progressive increase in case load and case complexities, as well as administrative and managerial aspects of emergency medicine. Other clinical, administrative, and research rotations are integrated into the emergency medicine experience as well. The emergency medicine internship (OGME-1) at St. Barnabas Hospital in fact begins residency training. During this year, residents spend 4 months in “ED-2,” caring for the “bread and butter” patients of emergency medicine. Additionally, they spend one month in “ED-1” caring for more acutely ill patients, an additional month is spent in the pediatric emergency medicine department at St. Barnabas Hospital. In the OGME-II year, residents move to “the back side” of “ED-1,” where they care for the moderately ill and injured patients. By the OGME-III year, residents progress to the “front side” of “ED-1,” caring for the most acutely ill and injured patients. In the OGME-IV year, residents act as “critical specialists,” participating in all resuscitations as well as assisting in the management of the overall department and the teaching of the junior residents. At all times, an attending faculty member directly supervises emergency medicine residents caring for emergency department patients. While rotating in the ICU, the emergency medicine residents are at all times supervised by an attending level intensivist. While rotating on the medical or surgical floors, the residents are supervised by either an attending level physician or a senior resident on service.
Academic Curriculum
Recognizing that a clinical experience, no matter how broad and varied, cannot supply all the knowledge necessary to become complete emergency physicians, a strong complementing academic curriculum has been developed. The academic curriculum is instructive and at the same time interactive, composed of daily teaching rounds, daily didactic sessions – including a full morning of didactics every Wednesday, required weekly readings (Rosen in the OGME-2 and 3 years, Tintinalli in the OGME-4 year) with concomitant required quizzes, as well as required monthly graded exercises in ECG and radiographic interpretation. In order to assure accountability, all residents are required to maintain a 70 average in all quizzes and exercises. Wednesday conference is required of all residents except those on specific rotations (including trauma, ICU, and out of town rotations), or when in conflict with Bell Commission rules. Plaques and prizes are awarded to those residents scoring the highest in Rosen, Radiology, and ECG quizzes.
Emergency Medicine (DO)
Emergency Medicine Emphasis Tract Internship
The Emergency Medicine Emphasis Tract Internship is comprised of thirteen four week rotations. This allows for twelve rotations and four weeks of vacation. While this tract gives extra Emergency Medicine experience, it does not guarantee acceptance to or give credit toward an Emergency Medicine Residency. The internship is comprised of the following rotations:
4 Months Of Emergency Medicine
While on the Emergency Medicine Service, the Intern will work under the supervision of Emergency Medicine Attendings and Residents. Both St. Barnabas and New York United Medical Center Emergency Departments are training sites. This provides a large broad based patient population with a wide variety of pathology.
3 Months Of Medicine
While on the Medicine service, the intern will work side by side with PGY1 Internal Medicine Residents under the supervision of Attending Internists and Senior Residents. Time on the Medicine Service is broken down as follows:
2 Months of In-Patient Medicine
1 Month of Intensive Care Medicine
2 Months Of Surgery
While on the Surgical service, Interns will work under the supervision of Attending Surgeons and Surgical Residents. This is primarily an In-patient service, but time will be assigned in the Out-Patient Surgical Clinic.
1 Month Of Obstetrics And Gynecology
While on the Ob/Gyn service, Interns work under the supervision of Attending Physicians. Out-Patient Ob/Gyn, labor and delivery, and In-Patient Ob/Gyn services are all provided at St. Barnabas Hospital. Some Out-Patient services are also provided at other training sites.
1 Month Of Pediatrics
Emergency Medicine Tract Interns satisfy their Pediatrics requirement by rotating in the Jacobi Hospital Pediatric Department. Interns are supervised by Attendings and Residents from the Departments of Pediatrics and Emergency Medicine.
1 Month Of Anesthesia/Ambulatory Care
Emergency Medicine Tract Interns spend one month obtaining intubation and anesthesia skills and participating in the emergency medicine follow-up service.
1 Month Of Vacation To be scheduled through the Tract Director.