Educational Curriculum
The educational curriculum for Loma Linda University Medical Center (LLUMC) emergency medicine residents has been developed to provide an environment where learners have optimal exposure to the core content of emergency medicine training. Under the direction of experienced emergency medicine staff, residents will develop their skills in a graded fashion over the three year period with progressively greater responsibility and autonomy. By the close of their training residents are equipped to work in academic, county, or community settings. The monthly block rotations and didactic sessions have been designed to optimize the educational experience in all aspects of emergency medicine.
TRAUMA
Trauma training is essential for mastering the specialty of emergency medicine. LLUMC serves as a level 1 trauma center for the region and RUHS-MC (Riverside University Health System Medical Center, formerly Riverside County) serves as a level 2 trauma center. Both are high-volume trauma centers with significant numbers of both blunt and penetrating trauma. At both institutions trauma teams are activated by the ED for the most critical trauma patients. Emergency medicine residents play essential roles in both the ED and serving on the trauma team. In all trauma activations emergency medicine residents are responsible for securing the airway. The department of anesthesia is not a member of the trauma activation team and they do not respond to trauma activations. The trauma captain role alternates between the surgery senior resident and emergency medicine senior resident in a prearranged schedule (every other day). Due to the high volume and acuity of trauma at both institutions, residents have ample opportunities to perform a variety of procedures such as thoracostomy tubes, emergency department thoracotomies, cutdowns, central lines, and the occasional cricothyrotomy.
PEDIATRIC EMERGENCY MEDICINE
Recognizing and caring for the critically ill child is an important part of the practice of emergency medicine and therefore is a principle part of the training at Loma Linda. A significant number of patients seen in the program's two emergency departments are children. RUHS-MC is the local county hospital and has become the entrance point to the health-care system for many children without financial resources. Loma Linda University Children's Hospital is a large referral center for the surrounding community and is also the region's only pediatric trauma center. Residents thus receive exceptional training in both trauma and the resuscitation of critically ill children.
During all three years of training resident physicians have dedicated pediatric emergency medicine rotations in which all of their shifts are in the Pediatric Emergency Department. In addition, every month residents spend a minimum of 20 percent of their total Loma Linda emergency department shifts in the pediatric ED. This format ensures residents are consistently learning pediatric emergency medicine throughout the year instead of just during their dedicated pediatric emergency department rotations. Residents are taught only by board certified pediatric emergency medicine attendings or board certified emergency medicine attendings. Loma Linda also offers a fellowship of pediatric emergency medicine that has consistently attracted bright and energetic residents interested in subspecializing in the emergency care of children.
EMERGENCY MEDICAL SERVICES (EMS)
Resident participation in pre-hospital care and education takes several different forms. Residents participate in "ride-along" experiences on paramedic ground ambulances during their PGY-2 EMS rotation. Ride-along experiences on helicopters are also available, but not required. Residents play an active role in the training of local paramedics and emergency medical technicians, as well as disaster planning and drills. Residents with additional interest in this area of emergency medicine have ample additional opportunities to get involved.
ULTRASOUND (US)
Ultrasound teaching is incorporated into all aspects of residency education, from didactic sessions to bedside instruction. With the high volume and acuity of patients seen, residents rapidly become adept in using ultrasound for the breadth of emergency medicine applications. Residents graduate with superior ultrasound knowledge and expertise--skills that are increasingly sought in all practice environments.
DIDACTICS
Five hours of formal emergency medicine conferences take place each week and are designed to complement the residency's strong clinical ED experience. Utilizing the most up to date educational advances, our training program facilitates resident participation in simulation sessions, flipped classrooms, utilization of FOAMed resources, US labs, journal clubs, as well as interactive sessions with the some of the educators in the field.
The educational curriculum for Loma Linda University Medical Center (LLUMC) emergency medicine residents has been developed to provide an environment where learners have optimal exposure to the core content of emergency medicine training. Under the direction of experienced emergency medicine staff, residents will develop their skills in a graded fashion over the three year period with progressively greater responsibility and autonomy. By the close of their training residents are equipped to work in academic, county, or community settings. The monthly block rotations and didactic sessions have been designed to optimize the educational experience in all aspects of emergency medicine.
TRAUMA
Trauma training is essential for mastering the specialty of emergency medicine. LLUMC serves as a level 1 trauma center for the region and RUHS-MC (Riverside University Health System Medical Center, formerly Riverside County) serves as a level 2 trauma center. Both are high-volume trauma centers with significant numbers of both blunt and penetrating trauma. At both institutions trauma teams are activated by the ED for the most critical trauma patients. Emergency medicine residents play essential roles in both the ED and serving on the trauma team. In all trauma activations emergency medicine residents are responsible for securing the airway. The department of anesthesia is not a member of the trauma activation team and they do not respond to trauma activations. The trauma captain role alternates between the surgery senior resident and emergency medicine senior resident in a prearranged schedule (every other day). Due to the high volume and acuity of trauma at both institutions, residents have ample opportunities to perform a variety of procedures such as thoracostomy tubes, emergency department thoracotomies, cutdowns, central lines, and the occasional cricothyrotomy.
PEDIATRIC EMERGENCY MEDICINE
Recognizing and caring for the critically ill child is an important part of the practice of emergency medicine and therefore is a principle part of the training at Loma Linda. A significant number of patients seen in the program's two emergency departments are children. RUHS-MC is the local county hospital and has become the entrance point to the health-care system for many children without financial resources. Loma Linda University Children's Hospital is a large referral center for the surrounding community and is also the region's only pediatric trauma center. Residents thus receive exceptional training in both trauma and the resuscitation of critically ill children.
During all three years of training resident physicians have dedicated pediatric emergency medicine rotations in which all of their shifts are in the Pediatric Emergency Department. In addition, every month residents spend a minimum of 20 percent of their total Loma Linda emergency department shifts in the pediatric ED. This format ensures residents are consistently learning pediatric emergency medicine throughout the year instead of just during their dedicated pediatric emergency department rotations. Residents are taught only by board certified pediatric emergency medicine attendings or board certified emergency medicine attendings. Loma Linda also offers a fellowship of pediatric emergency medicine that has consistently attracted bright and energetic residents interested in subspecializing in the emergency care of children.
EMERGENCY MEDICAL SERVICES (EMS)
Resident participation in pre-hospital care and education takes several different forms. Residents participate in "ride-along" experiences on paramedic ground ambulances during their PGY-2 EMS rotation. Ride-along experiences on helicopters are also available, but not required. Residents play an active role in the training of local paramedics and emergency medical technicians, as well as disaster planning and drills. Residents with additional interest in this area of emergency medicine have ample additional opportunities to get involved.
ULTRASOUND (US)
Ultrasound teaching is incorporated into all aspects of residency education, from didactic sessions to bedside instruction. With the high volume and acuity of patients seen, residents rapidly become adept in using ultrasound for the breadth of emergency medicine applications. Residents graduate with superior ultrasound knowledge and expertise--skills that are increasingly sought in all practice environments.
DIDACTICS
Five hours of formal emergency medicine conferences take place each week and are designed to complement the residency's strong clinical ED experience. Utilizing the most up to date educational advances, our training program facilitates resident participation in simulation sessions, flipped classrooms, utilization of FOAMed resources, US labs, journal clubs, as well as interactive sessions with the some of the educators in the field.
POSTGRADUATE YEAR (PGY)-1
Rotation |
Number of Months |
Location |
LLUMC Emergency Department Orientation |
1 |
RUHS |
LLUMC Emergency Department |
1 - 1.5 |
LLU |
RUHS Emergency Department |
1 |
RUHS |
LLU MICU |
1 |
LLU |
Cardiac care unit |
1 |
LLU |
General Surgery |
1 |
RUHS |
Acute Care Surgery/Trauma surgery |
1 |
LLU |
Anesthesia |
1 |
VA |
Orthopedic procedures |
1 |
LLU |
OB/GYN |
0.5 - 1 |
LLU |
LLU Pediatric Emergency Department |
1 |
LLU |
LLU Ultrasound |
0.5 |
LLU |
PGY-2
During the PGY-2 year emergency medicine residents rotate through the busy MICU/CCU and PICU. Our residents rotate senior call with internal medicine and pediatric residents, respectively, and while on call are the most senior in-house physicians for these ICUs. This experience provides extensive opportunities for leading resuscitations and performing critical care procedures. The Medical Center's pediatric ICU is among the busiest in the nation. On average, emergency medicine residents take call on inpatient rotations every fourth night during both the PGY-1 and PGY-2 years.
During the PGY-2 year emergency medicine residents rotate through the busy MICU/CCU and PICU. Our residents rotate senior call with internal medicine and pediatric residents, respectively, and while on call are the most senior in-house physicians for these ICUs. This experience provides extensive opportunities for leading resuscitations and performing critical care procedures. The Medical Center's pediatric ICU is among the busiest in the nation. On average, emergency medicine residents take call on inpatient rotations every fourth night during both the PGY-1 and PGY-2 years.
Rotation |
Number of Months |
Location |
LLU Emergency Department |
4.5 |
LLU |
RUHS Emergency Department |
3 |
RUHS |
LLU pediatric intensive care unit |
1 |
LLU |
LLU Neuro ICU |
0.5 |
LLU |
VA intensive care unit |
1 |
VA |
LLU Pediatric Emergency Department |
1 |
LLU |
Elective |
1 |
LLU/RUHS |
PGY-3
LLU Emergency Department |
5.5 - 6.5 |
LLU |
RUHS Emergency Department |
3 - 4.5 |
RUHS |
LLU Pediatric Emergency Department |
0.5 |
LLU |
Elective |
1.5 |
LLU/RUHS |
