Progressive Responsibility

The University of Illinois Emergency Medicine Residency program is proud of the diverse settings and clinical arenas within which our residents have the privilege of training. However, our program believes that the key to the development of confident and competent Emergency Physicians is the acknowledgment that each resident progresses differently in regards to their knowledge, skills sets, proficiency and efficiency in the emergency department. Care is taken to ensure that roles of the residents during each the three post graduate years are well defined. In addition, every reasonable effort is made to ensure that the rate of individual development is appropriately assessed with regard to the level of each resident’s personal growth in the clinical arena.

PGY1

In general, the first year is the time for the PGY1 resident to become familiar with the diverse environment that makes the emergency department unique. First year residents are expected to competently conduct a complete history and physical exam along with the formulation of a differential diagnosis and plan. The PGY1s work closely with an attending emergency physician and spend the majority of their time learning to manage multiple patients at one time. Not only are plans and dispositions discussed with ER attendings, but the first year resident learns how to communicate with several key professionals in the hospital including nursing staff, consultants and ancillary services that are essential to the function of an emergency department. The first year resident learns to make the distinction between “sick” and “not sick” realizing that becoming comfortable with a stable patient is initial step to approaching the critical one. PGY1s have the advantage of the guidance of the senior residents when it comes to developing treatment and diagnostic plans and dispositions. A mid-year evaluation helps to recognize strengths and identify areas for improvement. Our residents will tell you that by the end of their first year, they feel more comfortable in their decision making and ready to take on the steep learning curve that starts at the beginning of second year.

PGY2

It is this year that the EM resident takes the skills sets obtained in year one and apply them to the critically ill patient. By glancing at our curriculum, you’ll notice that this is the year that our residents spend a great deal of time in the intensive care unit learning how to manage the sickest of patients. This undoubtedly is an integral part of the development of the EM resident. Second year residents see any type of patient that comes into the department and the expectation is that they focus their attention on the management of the seriously ill. The PGY2 is the team leader during resuscitations in the ED. In addition PGY2s are expected to continue their multi-tasking development by managing several patients while keeping an eye on the sickest in the ED. Although the PGY2 enjoys the independence that is encouraged at this point in their training, final plans and dispositions are always discussed with the attending. An exciting part about this year is that the residents are actively involved in the area of teaching of first year residents and medical students. If you ask any of our second year residents, most will agree that by mid-way through their second year they spend a lot of time teaching procedures to younger learners of Emergency Medicine, having “run codes” independently during their ER shifts or in the ICU, allowing them to become confident in their own procedural skills. Another exciting part of the second year is that residents are introduced to emergency ultrasound, finding it to be a useful adjunctive tool in the management of many of their patients

PGY3

By now you see the true progressive nature of the roles of the ED resident at UIC. In keeping with that, our residents are known to thrive during their third year enjoying a higher level of responsibility and capability of managing any and all patient that comes into the ER. Although an ER attending is always supervising, the senior year resident functions almost completely independently in the management and treatment of their patients. Not only is this the time to fine tune speed and efficiency, but it is also the time to learn how to coordinate the flow of the emergency department. The PGY3 becomes cognizant of the challenges of the ED that are not related to a patient’s illness. They learn to focus also on the “behind the scenes” components such as a busy waiting room, the availability of ICU beds and the concept of throughput. As one would expect, the teaching responsibilities are plentiful during the third year, effectively coordinating the functions of medical students as well as junior and off-service residents in the ER. Chief residents have the added responsibility of making the residents and medical student’s schedules, as well as increased responsibility for teaching both in the ED and at our weekly conferences.