Clinical Curriculum
CURRICULUM: AT A GLANCE
PGY-1 Curriculum
Year 1 is focused on building your foundation as a physician, and to expose you to the many different facets of emergency medicine starting with a 1-week introduction to life as a HUP Emergency Medicine Intern.
Orientation
This relaxed period contains instructional sessions to review common chief complaints and procedural skills. Short clinical shifts are also integrated to allow new interns to meet the ED staff and get comfortable in their new “home”. Fun activities throughout the week allow for socialization with fellow residents and faculty.
Anesthesia
Become comfortable with our most valuable procedure – airway management. At Penn Presbyterian Medical Center, the focus is on getting you as much experience as possible managing adult airways. You will also use various devices including the Glidescope, laryngeal mask airway, and bougie.
CHOP Emergency Department
The Children’s Hospital of Philadelphia (CHOP) is a world-renowned children’s hospital with 90,000 annual ED visits. You will see everything from bread-and-butter pediatrics to major traumas and “only-at-CHOP” syndromes and genetic diseases.
Internal Medicine Wards
This two-week internal medicine rotation at the Hospital of the University of Pennsylvania (HUP) will show you how to better facilitate care in the ED for patients being admitted to the floor, and teach you longitudinal management of common medical admissions. In addition, it is a great opportunity to meet and work with HUP medicine residents who you will work with throughout residency.
Heart and Vascular ICU
This four-week rotation at Penn Presbyterian Medical Center will provide you with a solid foundation in bread-and-butter cardiology and advanced hemodynamics. You will interpret tons of EKGs and deepen your knowledge in cardiac pharmacology and critical care. You will also learn to manage balloon pumps and inotropic infusions, in addition to furthering your expertise at placing central and arterial lines.
HUP Emergency Department
Your home! The Pavilion ED is your home base, where you will gain clinical experience in the evaluation and management of patients with undifferentiated complaints. As an intern, you will be working directly with senior residents and attendings in managing acutely ill patients at our flagship tertiary care hospital. PGY-1s focus on improving foundational clinical skills, get first access to all procedures, and as the years progress, so do the responsibilities. All shifts are 8 hours.
Medical ICU
This four-week rotation at the Hospital of the University of Pennsylvania (HUP) focuses on the care of the most critically ill patients anywhere in the region. You will have tremendous exposure to ventilator management, pressors, antibiotics and managing complex patients while improving your data organization skills in this high-acuity ICU environment. In addition to bread-and-butter ICU patients with sepsis, diabetic ketoacidosis, and GI bleeds, you will care for transplant and oncology patients with multi-system organ failure. In addition, you will gain experience with placing central lines, arterial lines, paracentesis and a variety of other procedures. Finally, you will also experience and participate in difficult conversations regarding goals of care. The importance of developing this skillset cannot be overstated as you continue your career in acute care medicine in the ED.
Obstetrics
As an integral part of the labor floor team, we participate in the management of labor and delivery and complications such as pre-eclampsia, eclampsia and postpartum hemorrhage. The L&D service is mainly managed by residents, which offers excellent hands-on experience in deliveries. Your primary function will be to deliver as many babies as possible, while learning about the intricacies of peri-partum care. You will also spend some time in the Perinatal Evaluation Center, where patients with acute complaints in their second and third trimesters are triaged and evaluated.
HUP Surgical ICU
During this four-week rotation in the SICU at the Hospital of the University of Pennsylvania, you will take care of extremely sick surgical patients. Great teaching by the Anesthesia and Trauma/Surgical Critical Care faculty will make you comfortable with all forms of resuscitation and vent management. An incredible number of procedures including central lines, arterial lines, chest tubes, and dialysis catheters round out this experience.
Ultrasound
EM residents undergo four weeks of basic training in bedside ultrasonography. In addition to proctored scanning practice in the ED, rotators spend one day of dedicated video review per week in which all the scans with significant pathology or particular educational value are reviewed with all members of the Ultrasound Division which includes trainees and faculty from other departments. Residents with a special interest in ultrasound have gone on to publish numerous papers published by the Division. Because our residents receive dedicated training in bedside ultrasonography during their intern year, they are also frequently involved in teaching initiatives with medical students at the Perelman School of Medicine.
Vacation
Residents get 4 weeks of vacation, one of which will be spent during either Christmas or New Years.
Interncation
At the end of your intern year, you and your entire class will have about 10 days off together! This special perk is in addition to your 4 weeks of vacation during the year. Traditionally, classes have spent the time travelling together to places like Costa Rica, Puerto Rico, Jamaica, the Dominican Republic, and Cuba for time to decompress together and reunite with each other after a busy year.
PGY-2 Curriculum
Year 2 focuses on building your efficiency and independence as an Emergency Medicine Physician, while continuing to refine your clinical knowledge and skills. You will gain foundational skills in managing injured trauma patients at Penn Presbyterian Medical Center and perform many procedures. Lastly, you will be able to engage in opportunities to explore your interests within or outside Emergency Medicine through elective time.
CHOP Emergency Department
As a PGY-2 you will spend one month at the Children’s Hospital of Philadelphia (CHOP) Emergency Department, continuing to refine your efficiency and independence as an emergency physician, and have added responsibilities during pediatric resuscitations and traumas.
CHOP Pediatric ICU
You will spend one month working in CHOP’s Pediatric ICU, a 55-bed-unit with the region’s most critically ill pediatric patients. This is a mixed unit, which is great for exposure in surgical critical care and medical critical care.
Elective
As a junior, you will have two weeks to explore your interests in, and outside of, emergency medicine with incredible opportunities available to you throughout the University of Pennsylvania system.
Emergency Psychiatry
Two weeks will be spent at the Philadelphia’s Crisis Response Center, a psychiatric emergency department made specifically for patients in psychiatric crises. You will gain experience in interviewing a wild variety of patients from those who are depressed to those who are acutely psychotic. You will also learn how to admit patients who are at risk of harming themselves or others and the Pennsylvania laws surrounding this process.
HUP Emergency Department
As a PGY-2 working in the Hospital of the University of Pennsylvania emergency department, you will be working directly with attendings and independently managing patients under their supervision. During this year the focus is on building your efficiency and independence as an emergency physician, and start to build your personal practice patterns. You will have an active role in running resuscitations and continue to perform critical procedures, such as central and arterial lines, difficult intubations, and chest tubes. During weekly didactics, you will be expected to lead a number of teaching sessions over the course of the year with the guidance of senior residents and attendings. In addition, you will begin to be paired with clerkship and sub-internship medical students for on-shift teaching and supervision. All shifts are 8 hours.
Pediatric Anesthesiology
You will spend one week at CHOPs operating rooms practicing intubations on pediatric patients, ranging from neonates to young adults
HUP Cedar Emergency Department
Penn's newest addition, HUP Cedar, is a true community rotation. The hospital has an admitting medicine and psychiatric service but essentially everything else requires transfer. It is a great experience to learn how to manage sick patients without an in-house ICU. The EM team responds to all rapid responses in the hospital and is the sole airway provider.
Trauma Junior
This foundational and busy four-week rotation in the Penn Presbyterian Medical Center (PPMC) Trauma Bay will be spent evaluating and treating injured patients. PPMC is Penn Medicine’s Level 1 Trauma Center, seeing a large volume of over 13,000+ injured patients every year. You will do primary and secondary surveys, perform life-saving procedures including chest tubes, emergent thoracotomies and crash lines while perfecting your FAST exam. As part of your responsibilities, you will also be managing some of the admitted trauma floor patients. All trauma airways are managed by ED PGY3-4s alongside the EM attending.
Toxicology
You will spend two weeks learning the basics of toxicology from Penn and CHOP faculty. You will also get the chance to attend Consultant’s Conference at NYU Bellevue, the birthplace of toxicology.
Vacation
Residents get 4 weeks of vacation, one of which will be spent during either Christmas or New Years.
PGY-3 Curriculum
Year 3 focuses on becoming a leader. As a PGY-3 you will be stepping into the role of senior resident in the Emergency Department, who works side-by-side with the attending to oversee half the Emergency Department while supervising junior residents. You will have graduated responsibilities in teaching during weekly didactics and procedure labs, and teaching and supervising students on-shift. This early start to pre-attending experience allows our residents to demonstrate immense ability and confidence upon graduation while starting an independent career in emergency medicine.
Emergency Department
As a PGY-3 you will be stepping in to the role of senior resident in the Emergency Department at the Hospital of the University of Pennsylvania (HUP), who works side-by-side with the attending to oversee half the department while supervising and teaching junior residents. Your expanded role also includes triaging and managing emergent trauma and stroke activations, and managing transfers, all while responding to calls and follow-up from discharged patients. While on an EM block, your shift schedule incorporates longitudinal experience at the Children’s Hospital of Philadelphia ED where you will serve as the EM Senior and be in charge of pediatric resuscitations and procedures. You will also have senior resident shifts at the Penn Presbyterian Medical Center ED, where you will be one of the sole residents and see patients on your own. As a PGY-3 you will have graduated responsibilities in teaching during didactics and procedure labs, and in teaching and supervising students. You will continue to have opportunities to build your independence and improve your efficiency as you also see patients primarily in other areas of the department to master your practice style.
Emergency Medical Services
You will spend two weeks with the Philadelphia EMS, going on runs with the medics and getting a chance take part in pre-hospital care.
Pennsylvania Hospital Emergency Department
You will spend one month at the nation’s first hospital, which serves as one of Penn Medicine’s community hospitals. This is one of our “community rotations” (in addition to HUP Cedar) where you will treat a patient population that is typically less sick compard to the HUP and PPMC populations. You will work with a high degree of autonomy with fewer resources and consultants.
CHOP Transport
You will part of the Children’s Hospital of Philadelphia EMS and PennStar Flight team, transporting critically ill pediatric patients from other hospitals throughout the region to CHOP. You will be the only doctor on these runs and have significant autonomy in managing these patients.
Elective
You will have 8 weeks of elective as a PGY3, giving you the opportunity to refine your niche or pursue any other areas of interest.
Vacation
Residents get 4 weeks of vacation, one of which will be spent during either Christmas or New Years.
PGY-4 Curriculum
Year 4 focuses on perfecting your expertise and skills as an Emergency Physician. You are a leader in the department. During your shifts you will be critical to running the department, overseeing residents and students, while also leading resuscitations and triaging potentially critically ill patients in the waiting room. You will have additional teaching responsibilities and have a meaningful voice in department operations. Elective time will allow you to round out research or project in the area of your interest. Strong demand for Penn EM graduates around the nation as well as robust alumni connections will allow you to enter the workforce in an area and practice type of your choosing. Alternatively, past residents have seen success in matching to fellowship as extremely competitive EM applicants
Administration
You spend two weeks participating in executive department meetings as the resident voice and seeing the inner workings of how to run a busy department.
Elective
You have 8 weeks of elective as a PGY4, giving you the opportunity to refine your niche or pursue any other areas of interest.
Emergency Departments
As a fourth year, you will continue to rotate through the Children’s Hospital of Philadelphia (CHOP), Hospital of the University of Pennsylvania (HUP), and Penn Presbyterian Medical Center (PPMC) as a senior resident. At HUP, you will act as a pre-attending and help in running the department. At PPMC, you will be one of the sole residents and independently see patients on your own. At CHOP, you will serve as the EM Senior and are in charge in pediatric resuscitations and procedures. All shifts are 8 hours.
Trauma Senior
As a PGY-4 you will return to the Penn Presbyterian Medical Center Trauma Service as a senior, leading trauma resuscitations along with junior residents and managing critically ill patients in the Trauma and Surgical Intensive Care Unit.
Teaching
The PGY-4 teaching rotation is meant to help master your skills as a clinician-educator through dedicated time to teach medical students and residents the foundations of emergency medicine.
Vacation
Residents get 4 weeks of vacation, one of which will be spent during either Christmas or New Years.