Emergency Medicine

Residency: Curriculum


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Our clinical and didactic curriculum is one of our biggest strengths as a program. Our curriculum ideally balances our ‘tried-and-true’ methods with a dynamic and evolving approach to training quality EM physicians. Shaped by regular feedback from our current and former residents, we are proud to highlight our block schedule and some key curricular features.

PGY-1 PGY-2 PGY-3
Orientation/EM – 1 block EM – 9.0 blocks (each month includes 1-2 CMH shifts & EMS) EM – 10.5 blocks (each month includes 1-2 CMH shifts & EMS)
EM – 4 blocks (including EMS) Elective – 0.5 block Community EM at TMC LW- 0.5 block
Internal Medicine – 0.5 block Critical Care Medicine at TMC (as Supervisor) – 1 block Elective – 1 block
Ultrasound – 0.5 block Community EM at SLH – 0.5 block Pediatric EM at CMH – 1 block
Critical Care Medicine at TMC– 1 block Pediatric ICU at CMH – 1 block
Pulmonary Critical Care at SLH -1 block Pediatric EM at CMH – 1 block
Neurosurgical ICU at SLH – 0.5 block
Cardiology at SLH – 0.5 block
OB at TMC- 0.5 block
NICU at TMC– 0.5 block
Trauma Surgery at TMC– 1 block
Anesthesiology at SLH – 0.5 block
ED/MSK at TMC – 0.5 block
Pediatric EM at CMH – 1 block

1 Block = 4 weeks

Highlights:
Dr. Carney, KFCD Medical Director (3rd from Left), and UMKC EM residents (starting 4th from left: Phi Dinh, Matt Twillman, and Jarret Gardner) enjoying a break at the KC Air Show while providing medical direction.
Dr. Carney, KFCD Medical Director (3rd from Left), and UMKC EM residents (starting 4th from left: Phi Dinh, Matt Twillman, and Jarret Gardner) enjoying a break at the KC Air Show while providing medical direction.

EMS: Our EMS rotation is a longitudinal experience over the course of the three-year training program with varying responsibilities per PG year. Our faculty members are the medical directors for both the Kansas City, Missouri Fire Department and Johnson County, Kansas EMS systems, giving our residents unique opportunities to see EMS in action on both sides of the state line. Experiences include: Ambulance and supervisor ride-alongs, QI/protocol reviews, administrative meetings, and paramedic teaching/mentoring. All our residents become certified as base-station physicians and provide pre-hospital direction for a large urban paramedic system. Our residents also have unique opportunities to participate as healthcare providers at mass gatherings and citywide disaster events. Aeromedical experience is not available. 

Pediatrics: Our primary site for pediatric training is at Children’s Mercy Hospital, which is continually recognized as one of the top Children’s hospitals in the country. Our pediatric experience is both focused and longitudinal. The curriculum includes dedicated rotations in the PICU, NICU, and CMH Main ED (1 full block/year). Our PGY2 and PGY3 residents continue to work 1-2 CMH ED shifts/block while rotating in the TMC ED. This provides continual pediatrics exposure. CMH has one of the busiest EDs in Kansas City and was one of the first established Pediatric Emergency Medicine fellowships in the country. Our residents consistently say they feel comfortable caring for ill children by the end of their training.

Ultrasound: Please see our dedicated Ultrasound section for more details.

Wellness and Community Engagement: We have a robust wellness program that includes didactics and special conferences, social events, and book clubs. Didactic topics include career planning, financial wellness, and resilience. Our annual Wellness day incorporates both fun and learning (always with food!). We also participate in community service events benefitting programs and partners that serve our patients. A biannual wellness survey for faculty and residents is done. Please see our dedicated Wellness page for more details.

Pictured from L to R (Dr. Jim O’Brien, Deven Bhatia, MS6, Dr. Jesal Amin, and Dr. Inboriboon). A few of our EM residents and EM bound medical student in Thailand on elective. They were able to learn about emergency medicine education abroad while Dr. Inboriboon was in Thailand on a Fulbright.
Pictured from L to R (Dr. Jim O’Brien, Deven Bhatia, MS6, Dr. Jesal Amin, and Dr. Inboriboon). A few of our EM residents and EM bound medical student in Thailand on elective. They were able to learn about emergency medicine education abroad while Dr. Inboriboon was in Thailand on a Fulbright.

Elective program features: Residents are encouraged to individualize their elective time based on educational experience needs/interests. The program works with residents to optimize elective time for research or other educational experiences. Recent electives include hyperbaric medicine, Sedation/procedures, oral surgery, radiology (pediatric and adult), ultrasound, research, education/simulation, and administration. 

Global Health: The UMKC Emergency Medicine Residency Program is pleased to offer a Global Emergency Medicine and Community Health Track. This track serves as an introduction to the field of global health with a focus on emergency medical care. It will also serve to prepare residents for a global health elective. The curriculum consists of self-paced learning modules and in-person didactic sessions that consist of small group discussion, journal club, workshops, simulation, and project/elective preparation. In addition to these didactics, the residents will have the option to complete a scholarly activity that would fulfill their RRC Scholarly Activity Requirement.

Finish line

Mentorship and feedback: We provide robust mentorship, advising, and opportunities for bidirectional and multisource feedback. Each resident is assigned a PGY2 and faculty advisor at the start of the residency program to assist and guide the resident throughout training. The residents meet with their advisor biannually. The residency leadership team also meets with each resident biannually to discuss wellness, evaluations, and the resident’s progress towards graduation. Residents receive regular performance feedback including face-face shift evaluations, procedure evaluations, monthly faculty consensus evaluations, biannual Milestones assessments, and yearly peer-peer evaluations. Residents are also given the opportunity to confidentially evaluate the program and faculty on an annual basis.

Residents Quality Management Meeting: This bi-monthly meeting facilitates communication about residency program activities. Residents are provided an updated dashboard that includes performance review information, status on procedure logging, and meeting residency requirements. We discuss opportunities for improvement within the residency and between EM residents, faculty, nursing, off-service rotations and support staff. Resident feedback to improve processes and their educational experiences in the ED and on other clinical rotations is solicited and discussed.

 

“The program has a strong and established presence at the hospital. The attendings are supportive, the residents are friendly, and it’s a great learning environment.”

Eric Canaday, DO
Class of 2014


Emergency Medicine Conferences

SimulationWe strive to make our didactic conferences interactive, interesting, and clinically relevant. To that end, we continue to incorporate adult learning techniques such as simulation, small group learning, case-based discussions, and the “flipped classroom” approach in addition to traditional didactics. We have developed a comprehensive Google Education website for our residency, which houses our curriculum, resident dashboards, calendars, forms, and multiple other learning resources. Below is a brief description of our regularly held educational sessions.

Case Conference: Weekly conference that reviews an interesting clinical case highlighting issues pertinent to emergency medicine. Real-life cases from the ED are presented in an interactive manner with the audience, with a focus on problem solving and Oral Boards format.

Theme of the month reviews:  Designed to cover the content of the Model of Clinical Practice of Emergency Medicine over a 2-year period. Topics are presented by the residents with faculty input and oversight. Presentations are a mix of core content, review questions, and multi-media resources. Residents have a suggested reading schedule using Tintinalli’s Emergency Medicine as their core text.

Faculty Lecture Series: Given by our emergency medicine faculty. Faculty discuss Core Content of EM, including areas of their expertise. Interactive discussion, Board-style review questions, current literature review, case-based discussions, and simulation experiences are some of the adult learning strategies used. The faculty may use an audience-response system to get “real-time” feedback to ensure that residents understand key concepts.

Resident Education Cases: 30 minute clinically based sessions given by faculty. The focus is on practical topics such as procedures, imaging, ultrasound, or ECG interpretation that tie into our “theme of the month”.

EM Journal Club: Monthly conference that discusses recent journal articles from the EM literature, with a focus on critically interpreting the literature and developing an understanding of evidence-based medicine. A team approach is used with a PGY-1, 2 and 3 resident presenting different aspects of the article and key concepts with the guidance and input of our departmental Research Director and a faculty mentor.

Annual Cadaver Lab: Over the course of several weeks, residents practice infrequently done but life-saving, procedures with direct EM faculty supervision. Direct feedback on procedural skills is given. This experience includes an annual introduction to the procedures, a procedural knowledge test, and skills evaluation. Procedures done include but are not limited to:  chest tubes, pericardiocentesis, thoracotomy, retrograde intubation, DPL, and lateral canthotomy. Each session is also paired with procedural simulations in our simulation center and mock oral board practice. This allows us to keep group sizes small, all while covering a lot of ground!

Simulation and “Hands on” experiences: We have implemented adult, active learning through our “hands on” days. These simulation-heavy experiences are held monthly and include a combination of case-based learning, critical care simulations, and procedural training. We typically incorporate inter-professional education with the assistance of our ED pharmacy team. These sessions in our state-of-the-art simulation center occur monthly and are based on the “theme of the month”. We even have access to our own ambulance and have used it to simulate trauma transfer care between facilities and to incorporate inter-professional education with paramedic students. Other recent sessions have included: management of difficult airways, vascular access, US workshops, Transvenous pacing/defibrillation, foreign body removal, epistaxis management, and pediatric airways and sedation. Our residents regularly teach using simulation and serve as instructors for ACLS, medical student clerkship education, and the GME Central line course.

Emergency Medicine Foundations:  We are avid users of the online EM Foundations curriculum. This flipped-classroom model is designed to provide small group case-based learning on essential topics in emergency medicine. We provide EM foundations sessions at least bimonthly. We also host special EM Foundations “Lunch and Learns” for PGY-1 residents. We cater lunch and select cases that are “must know” for PGY-1 EM residents.

Wellness Series: In 2019-2020, we have over 20 hours of conference time dedicated to our wellness program, led by our wellness committee. Please see above under ‘curriculum highlights’ for more details.

Emergency Medicine Morbidity and Mortality conference: Monthly conferences that focus on better methods for handling EM cases with a focus on quality improvement and system changes. A Chief Resident moderates and collaborates with a PGY-2 resident for discussion points.

Emergency Medicine/Internal Medicine Morbidity and Mortality conference: Interdisciplinary quarterly conference that emphasizes a team approach to patient care, including quality improvement practices and patient safety. 

Multidisciplinary Trauma conference: Monthly conference that emphasizes the i

nstitutional teamwork necessary to care for a trauma patient from the pre-hospital setting to the Emergency Department to Surgery to Intensive Care to Rehab to discharge.

Emergency Medicine/Trauma Services Morbidity and Mortality conference: Monthly conference that emphasizes a team approach to patient care, including quality improvement practices and patient safety. 

Pediatric conferences: Pediatric emergency medicine faculty from Children’s Mercy Hospital gives regular monthly didactic conferences over core content. Pediatric simulation and sedation workshops are also provided annually. In addition, we incorporate pediatric activities into most of our simulation activities. 

Additional experiences: We also try to “break up the routine” on occasion. Recent examples of more innovative opportunities include: a Wilderness event with sessions on mass casualty management and field procedures and a procedural “boot camp” for our PGY1 class focusing on frequently performed procedures such as splinting, lumbar punctures, and slit-lamp usage.

Asynchronous learning: For board style practice questions, we use the ROSH Review question bank. We also utilize Academic Life in Emergency Medicine (ALiEM U) site; an on-line open-access, peer-reviewed site for EM faculty, residents, and practitioners. We are also developing an online curriculum that can be used as an online study aid and to “flip the classroom” during conference theme of the month didactics. Residents also have opportunity for asynchronous credit through Journal Club assignments, on-line teaching modules, and EM Foundations sessions at https://foundationsem.com/.