Program Pages 1   2   3   4   5   6   7   8   9   10   11   12

Progressive Responsibility:
All HO1s in the Emergency Department are treated equally in terms of schedule, responsibilities and authority. HO1 house officers see patients primarily (not consult with medical students) and present all patients to an attending. HO1 residents should see one patient at a time, present to the attending immediately, and develop a plan of care. HO1 residents should respond to the critical care areas with their team and participate in the patient care to help develop the skills needed for the transition to the HO2 year. The HO1 ED residents are usually scheduled to work with an HO3 residents to maximize learning opportunities in critical care areas.

HO2 Emergency Medicine residents primarily care for the most ill or injured patients who arrive at the Emergency Department and are informed whenever such patients arrive.  They also assist in maintaining patient flow by seeing patients not seen by students or interns.  HO2 residents may consult other specialty residents. HO 2 residents should see several patients and then present them to the attending for guidance after the initial steps have been initiated.

HO3 residents in Emergency Medicine should begin to take more of a role in managing the ED while still having primary responsibility for a wide variety of patients in the ED.  HO2s and HO3s manage all Level I traumas with the trauma team and supervise or manage all cases needing the resuscitation room. They are responsible for answering Medical Control Emergency Physician (MCEP). HO3 residents should see multiple patients and present them when they are ready for disposition, need help with the plan or have any questions or concerns. The HO3’s still present to attendings in the ED. However, as described above, they have much more freedom to manage their patients before presenting. In addition, the HO3’s help the patients to monitored beds, facilitate flow of patients in the ED and supervise procedures being done by more junior residents. HO3 residents are also expected to help to integrate EM interns into patient care in the trauma/resus areas. This is an opportunity to develop critical bedside teaching skills. To further facilitate HO3s supervising and teaching skills each resident does periodic teaching/supervisory shifts during which time they do not see their own patients but focus instead on teaching the students and interns. HO3 residents should be familiar with all the patients on their side and take a very active role during rounds including teaching and filling in gaps on patient plans/conditions.

Students:
Students see patients primarily and present all of them to Emergency Department faculty for review.  If this is not possible a student may present a case to an HO3 Emergency Medicine resident who must then examine, take responsibility for the patient, and present to the attending.  If a teaching/supervising HO3 is present students present cases to teaching HO3.

Faculty:
Faculty are present and available in the Emergency Department at all times during their shift.  The amount of primary care involvement will vary depending on the level and skills of resident(s) present on their team. All faculty are expected to see patients primarily when their team is busy.  Faculty deal with administrative and public relations problems.  When HO3 Emergency Medicine residents are present, faculty share responsibilities for patient care, teaching and responsibilities in the Emergency Department.  Faculty personally see all patients

Top of page

continue next page>>