Emergency Medicine Residency Program

The Emergency Medicine (EM) residency training program at LAC+USC began in 1971 and is one of the oldest- and longest-running EM residency programs in the country. We continue to be leaders in the specialty through educational innovation, research and leadership, as well as the training of clinically and procedurally competent emergency medicine physicians.

The program is dedicated to the mission of our safety-net hospital to provide emergency access to the citizens of Los Angeles County regardless of their ability to pay. We pride ourselves on delivering a high-level of culturally competent care to our patient population.

Over 600 physicians have graduated from our program – the largest alumni body of emergency medicine specialists both in the United States and internationally. Our family of graduates has excelled in every aspect of the field, and is well represented in academic medicine, research, subspecialty practice, community leadership, and public service.

Program Overview Video

Immerse yourself in hands-on training at Keck School of Medicine’s Emergency Medicine Residency. With over 650 trained physicians, our program excels in graduating residents who are compassionate, skilled, and ready to take on the challenges of emergency medicine. From trauma care to patient advocacy, discover your potential within our close-knit Trojan family, and prepare to excel in the next phase of your medical career.

Educational Environment

As both a County Hospital and a large Level I Trauma Center, our residents train in a clinical learning environment that is rich in pathology, acuity, procedural experience and cultural diversity. The clinical experience is complimented by an equally rich educational experience.

Our training philosophy embraces the concept of graduated responsibility to empower junior residents to grow comfortably into the role of confident, autonomous senior residents who possess the leadership skills necessary to handle any clinical scenario.

Resident Wellness

Critical to our mission is the promotion of wellness and resilience among our residents, faculty and supporting staff. Throughout their four years, our residents participate in small group peer-facilitated debriefing sessions to discuss the various work and life challenges associated with residency training.

Need Help Applying?

Residency Program Administrator

Becky O’Neal, C-TAGME

Admission

  • We participate in the National Residency Matching Program and abide by all of their rules and regulations. We only accept applications through the NRMP.

    We will consider all applicants who meet the minimum requirement for application as outlined by the Office of Graduate Medical Education at USC.

    We review applications on a rolling basis throughout the interview season but encourage all applicants to apply as early as possible. After your application has been reviewed, you will either be invited, placed on the wait list, or you will receive a notice that we will not be inviting you for an interview.

    We do not discriminate with regard to sex, race, age, religion, color, national origin, disability, or veteran status. Your application will be reviewed on the basis of the preparedness, ability, aptitude, academic credentials, communication skills, and personal qualities such as motivation and integrity.

    Our first set of interview invitations will be going out on October 12th, 2019 at approximately 12PM PST and will continue on a rolling basis. All interview invitations will be sent out electronically. Interview invitations will be scheduled through www.interviewbroker.com. The timing of your invitation has no bearing on your final rank nor is it a reflection of your competitiveness.

  • Applicants with one of the following qualifications are eligible:

    • Graduates of medical schools in the United States and Canada accredited by the Liaison Committee on Medical Education (LCME).
    • Graduates of colleges of osteopathic medicine in the United States accredited by the American Osteopathic Association (AOA).
    • Graduates of medical schools outside the United Sates and Canada who meet the requirements of the Medical Board of California for residency training and meet one of the following qualifications:
      • ƒ Have received a currently valid certificate from the Education Commission for Foreign Medical Graduates (ECFMG)
      • Have a full and unrestricted license to practice medicine in a U.S. jurisdiction.
    • Graduates of medical schools outside the United States who have completed a Fifth Pathway program provided by an LCME-accredited medical school.

    We do not have a specific cutoff for minimum Step 1 scores nor do we require you to rotate with us to apply.

  • The following documentation is required for all applicants for each program selected.

    • Completed ERAS Application
    • Dean’s Letter
    • 3 Letters of Recommendation
    • A minimum of one Emergency Medicine Standard Letter of Evaluation (SLOE)
    • Medical School Transcript
    • For M.D. applicants: A copy of your USMLE Step 1 score (and USMLE Step 2 CK/CS, if available)
    • For D.O. applicants: A copy of your NBOME/COMLEX level I score (and NBOME/COMLEX level II, if available)
    • Personal Statement
    • Curriculum Vitae
    • Visa Status (if applicable)
    • In addition to the above-required materials, International Medical School Graduate applicants are required to also submit the following documentation with their application before it will be considered for review:
    • A copy of your diploma with translation
    • A copy of your current valid ECFMG Certificate
    • A copy of your USMLE Step 1 and Step 2 scores
    • An unconditional “Applicant Evaluation Status Letter” from the Medical Board of California in which they have determined that your undergraduate medical education is acceptable to satisfy licensure requirements as a physician and surgeon. This letter must be dated no earlier than one year prior to the date your training will begin. Otherwise, you must contact the Medical Board of California for an updated approval letter before your application will be reviewed. Or a valid California Medical License.
    • International Medical Graduate applicants should contact the ECFMG for application materials and eligibility requirements with regard to registering with NRMP and ERAS.
    • Applicants must complete and pass USMLE Step 1, Step 2 CS, and Step 2 CK prior to starting the GY-1 year

Rotation Schedule Overview

*PGY – Post Graduate Year

  • The PGY1 year is an exciting one with a focus on the approach to both emergency medicine and critical care. The goal of the intern year is to provide a solid foundation in the management of both medical and surgical emergencies. Interns spend roughly equal amounts of clinical time in the Emergency Department and on off-service rotations.

    Prior to starting their clinical rotations, the intern class participates in a two week orientation. This orientation period offers interns an opportunity to get to know one another, while simultaneously attending several clinical courses. In addition to obtaining both BLS and ACLS certifications, interns receive an introduction to ED ultrasound, procedure workshops, an overview of wellness resources, and various other introductory lectures.

    ED-Based Rotations:
    In addition to spending 27 weeks in the Adult and Pediatric Emergency Department, interns complete a 2 week ED ultrasound rotation. During this time, they have the opportunity to practice their scanning skills under the direct supervision of ultrasound division faculty members and participate in ultrasound division didactics.

    Off-Service Rotations:
    Interns spend 2.5 months in the ICU setting, rotating through the CCU, MICU and SICU. Additionally, interns spend time in the orthopedics evaluation area, participating in urgent and emergent ED orthopedics consultations. On the anesthesiology rotation, interns have the opportunity to become familiarized with airway management in a controlled setting. An additional 2 weeks are spent in the Psychiatric Emergency Department, as well as on internal medicine’s general service.

    2 weeks – Orientation to the DEPARTMENT OF EMERGENCY MEDICINE
    27 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
    2 weeks – EM Ultrasound – LAC+USC
    4 weeks – Surgical Intensive Care Unit – LAC+USC
    2 weeks – Cardiac Care Unit – LAC+USC
    4 weeks – Medical Intensive Care Unit – LAC+USC
    2 weeks – Internal Medicine Wards – LAC+USC
    1 week – Psychiatric ED – LAC+USC
    2 weeks – Anesthesia / Orthopedic Evaluation Area – LAC+USC
    2 weeks –Selective – LAC+USC
    4 weeks – Vacation

    Wellness:
    We understand the importance of self-care and reflection during training and provide ample opportunities throughout the year for residents to debrief on work-life challenges during residency. As a group, the PGY1 class will write a reflection piece during their orientation week, outlining their purpose, individual mission, and goals for residency training. Interns can also participate in our “opt-out” mental health counseling program (see below) and are introduced to other institutional and departmental wellness programs during their residency orientation:

    Opt-out program: Our interns are all scheduled for an “opt-out” on-site mental health therapy session with an on-site mental health counselor to establish connections and care early on in their training.

    Helping Healers Heal: Our institutional H3 team (Helping Healers Heal) is comprised of trained crisis response facilitators that are available to meet with residents after difficult cases or any challenging situation encountered during training.
    Our institutional Wellness Director, Tobi Fishel PhD: all residents have free access to discuss any issues (mental health and non mental health related) with our phenomenal Director of Residency Wellness.

    Our departmental Peer Family program: all residents join a family that consists of a PGY1, PGY2, PGY3, and PGY4 resident. These families meet regularly and longitudinally during protected time to discuss various projects and work/life challenges associated with training.

  • The PGY2 year is designed to provide supervised experience in the management of commonly encountered critical and non-critical illnesses. There is particular focus on developing procedural competence, resuscitation, multi-tasking, and increasing the sophistication of patient management.

    The PGY2 year includes certifications in the ATLS, PALS, and ACLS-Instructor courses. In addition, all PGY2s travel to Catalina Island to participate in a course in hyperbaric medicine at the hyperbaric chamber run by the Department of Emergency Medicine.

    ED-Based Rotations:
    During their PGY2 year, residents begin working in both the Resuscitation area and the Jail Emergency Department. The addition of Resuscitation shifts pushes residents to hone their procedural and resuscitation skills. The Jail ED experience drives residents to begin expanding their independence in clinical decision-making. PGY2 residents also complete a second 1-week ED Ultrasound rotation. This rotation builds upon the foundation established during the PGY-1 year.

    Off-Service rotations:
    To round out their year-long focus on resuscitation and critical care, PGY2 residents spend 1 month in the Medical Intensive Care Unit (MICU) acting as an integral part of the MICU team. They also spend 3 weeks rotating in a community hospital emergency room at the Verdugo Hills Hospital of USC. Finally, residents complete a 3-week OB rotation at the Good Samaritan Hospital gaining experience in vaginal deliveries and the management of peri-partum and post-partum patients.

    34 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
    3 weeks – Obstetrics – Good Samaritan Hospital
    1 weeks – EM Ultrasound – LAC+USC
    1 week – EMS
    4 weeks – Medical Intensive Care Unit
    3 weeks – Community Emergency Department – USC Verdugo Hills Hospital
    2 weeks – Elective – LAC+USC
    4 weeks – Vacation

    Wellness:
    As a group, the PGY2 class embarks on two separate 3-day retreats in both winter and summer to engage in career mentorship and class bonding.

  • The PGY3 year provides supervised experience in the recognition and management of higher-acuity clinical emergencies and promotes an even higher level of competence and confidence in non-critical patient management.

    This training year provides residents with increasing responsibilities both in the emergency department and throughout the hospital.

    In addition to individual patient care responsibilities, the PGY3 resident is in charge of overseeing the ER West pod, while acting as “2 Star”. As 2 Stars, residents must supervise the flow of patients through their assigned area from triage to final disposition, make decisions regarding resource utilization within the area, and enhance clinical teaching of junior residents, physician assistants, and students.

    Beyond their responsibilities in the ED, PGY3 residents begin to carry the “code bag”, responding to hospital-wide cardiac arrest and airway codes activations, where they are charged with leading the resuscitation team and efforts. During their PG3 year, residents also spend one month in the Pediatric Intensive Care Unit (PICU) at Long Beach Memorial Medical Center / Miller Children’s Hospital

    33 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
    2 weeks – Toxicology
    4 weeks – Pediatric Intensive Care Unit – LBMMC/Miller Children’s Hospital
    4 weeks – Elective – LAC+USC
    4 weeks – Vacation

    Wellness:
    With increased responsibility, there is also greater emphasis on self-care and reflection. Residents utilize their Elective rotations to focus on projects that hold personal and professional purpose as they become more aware of their identities as physicians. The PGY3 class also has two protected 3-day retreats in the winter and summer months that provide an opportunity for bonding, reflection and career mentoring. In addition, all PGY3 residents are protected to attend the annual ACEP Scientific Assembly in the fall.

  • The PGY4 year allows the continued refinement of independent clinical judgment, honing the sophisticated management of both critical and non-critical patients. It also encourages the development of academic, teaching, research, managerial, and administrative skills and provides residents with opportunities to train in areas of highest interest. Its purpose is to produce emergency physicians who can practice at the highest level of clinical Emergency Medicine and who can integrate all aspects of the specialty into a balanced professional career.

    Overall, the PGY4 year is designed to augment clinical knowledge and skills with a specific emphasis on the development of leadership capabilities.

    While in the Emergency Department at LAC+USC, PGY4 residents serve as the 2 Star in the Resuscitation pod. They are responsible not only for highest acuity medical and trauma resuscitations, but also for overseeing the flow of patients throughout the entire department, including the Jail, West, and North clinical areas.

    The 2 Star has the authority to make decisions that have far-reaching implications, both within the department and throughout the Medical Center. Specifically, they oversee the utilization of resources and personnel, the movement of patients from triage into the various clinical areas, CT scanner prioritization, and the influx of patients being transferred into LAC+USC from surrounding hospitals. This intensive clinical experience is meant to produce specialists with the highest level of proficiency in Emergency Medicine.

    36 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
    4 weeks – Community Emergency Department – Verdugo Hills Hospital
    4 weeks – Community Pediatric Emergency Department – Miller Children’s Hospital/Long Beach Memorial Medical Center
    4 weeks – Elective – LAC+USC
    4 weeks -Selective
    4 weeks – Vacation

    Wellness:
    PGY4 residents have ample time for electives and career planning with dedicated residency office mentorship and guidance.

Rotation Facilities

LA General Medical Center provides a full spectrum of emergency, inpatient and outpatient services. These include medical, surgical and emergency/trauma services. LA General is the largest single provider of health care in L.A. County, and treats more than 28 percent of trauma victims in the region. In addition, LA General operates one of only three burn centers in the County and one of the few Level III Neonatal Intensive Care Units in Southern California.

USC Verdugo Hills Hospital (VHH) is a 158-bed acute care hospital serving patients in the cities of Glendale and La Cañada Flintridge, as well as the surrounding Foothill communities of Southern California. PGY3 and PGY4 residents rotate through the ED at (VHH) to gain valuable community ED exposure.

Good Samaritan Hospital is a world-class academic medical center affiliated with USC School of Medicine. PGY2 residents spend 3 weeks on the Obstetrics service where they perform vaginal deliveries under the supervision of OB attendings.

Long Beach Memorial Medical Center (LBMMC) operates a Level Two Trauma Center, emergency chest pain center and stroke center. The ED has 56 beds and sees an annual volume of 47,000 patients, 40 percent of whom are children seen in the Miller Children’s Hospital Long Beach (MCHLB) emergency department. All residents will spend one month in the LBMMC Pediatric ICU as PGY2 residents. In addition, PGY4 residents spend a month in the pediatric ED at MCHLB.

Frequently Asked Questions

  • The work hours for our PGY1-3 residents are at or below average weekly work hours for other 4-year programs. The work hours for our PGY4 residents are below the average for many other programs.

  • No. Our residents do work 12-hour shifts but we also have 8-, 9-, and 10hour shifts on our resident schedules. Additionally, shifts after our Thursday morning conference are often 6-hour shifts.

  • EM residents perform all procedures, including all intubations, cricothyrotomies, central lines, and chest tubes in all trauma cases. The only procedure that goes to trauma is the left-sided thoracotomy but only if the trauma service is present at the time of patient arrival. Due to the large number of traumatic arrests that we see in our ED, our trauma residents/fellows/attendings are more than happy to perform the thoracotomy either WITH our ED residents or, if they have already performed many of them, let our ED residents perform the procedure. Additionally, the right-sided thoracotomy is routinely performed by the ED resident.

  • Our graduates are well positioned to choose careers in all potential practice settings. While many of our graduates have chosen to pursue private practice, many of our residents have chosen advanced training as well as directly entered academic practice.

    In recent years have seen graduates pursue fellowship training in Peds EM, EMS, Medical Education, Ultrasound, International, Wilderness Medicine and Research.

    Our residency program has over 600 graduates and they work all over the United States and the world providing a huge alumni network. While the majority of our graduates choose to stay in California we have graduates working in other states such as Alaska, Hawaii, Colorado, New York, Oregon, Arizona, Texas, Indiana, Michigan, Pennsylvania, Maryland, Washington DC, Connecticut, Massachusetts, New Hampshire, and Illinois, as well as internationally in Canada, Guyana, Burundi, New Zealand, Bermuda, UK, and Italy. Just because you train in California doesn’t mean you have to stay here! Your training, your reputation as a graduate, and our alumni network can help you to make your career what you want.

  • Our 4-year curriculum offers comprehensive and broad training in Emergency Medicine. The combination of our commitment to graduated responsibility and the addition of the 4th year allows our residents to develop not only their clinical skills but also the intangible aspects of leadership in both the the clinical areas as well as within their areas of interest. Our residents receive exceptional training in the care of critically ill and injured adults and children including robust numbers of emergency procedures. We also offer 3 months of experience in community hospital settings.

    Additionally, our didactics are second to none. Our protected resident conference time is on Thursdays from 7:30am-12:30pm. The first 90 minutes (7:30-9:00) is spent in small groups with class-specific learning taking place. We call these “modules”. The majority of our core curriculum is delivered during the modules where we have designed a longitudinal curriculum that spans the 4 years of training and in delivered in a learner-specific fashion. For example, on a Thursday from 7:30am-9am, the PGY1’s might be learning about “Approach to the red eye” with a basic review of anatomy, differential diagnosis, and physical examination findings with a focus on pertinent positive and negative findings and a discussion of the various common diagnoses and management. The PGY2’s might be doing a module on “GU emergencies” where they discuss common GU emergencies and management. The PGY3’s might be reviewing “Aspects of neonatal resuscitation” with one of our Pediatric EM specialists. The PGY4’s might be discussing “Evidence-based approach to the evaluation of subarachnoid hemorrhage” and engaging in a critical appraisal of literature pertinent to the controversies surrounding the work-up of this important diagnosis. The core curriculum will be delivered to you in a way where topics are pertinent to your level of training and small-group discussions will facilitate better interaction and review.

    From 9:00am-12:30pm, the entire department gathers together for state-of-the art educational rounds. Some content is resident delivered and some is faculty led. We have multidisciplinary combined conferences with other departments, challenging case conference, guest speakers and more. You’ll find that our rounds are fun, interactive and very high quality. Also, breakfast is served every week!

  • Recruiting residents from diverse backgrounds is a priority for our residency program. Our hospital serves an incredibly diverse patient population and we seek to train residents who are interested in working with underserved and diverse patient populations. We believe that we offer an excellent training environment for applicants from diverse backgrounds. We offer 2 scholarships per year for medical students from underserved minority backgrounds who would like to come and rotate in our department. We also have a diversity night during recruitment season to welcome and speak with applicants from underrepresented backgrounds.

  • Yes. We do accept applications from DO students. We ask that DO applicants take the USMLE exam in addition to the COMLEX.

  • You can still be considered for our residency program if you have previous training.

  • We do not have a specific USMLE “cutoff” for applicants. Our system for application review is designed to take in the entirety of the application and not a single score in isolation.

  • Rotating at our program is not required for consideration for our program. Although we do extend interviews to all students completing a 4-week rotation, a significant portion of our interview slots go to non-rotators. In fact, for our residency class of 2021, 9 of the 17 positions went to applicants who had not rotated with us.

  • Of course! We think applicants who have worked in a “county-style” environment will have the best idea of what training at a County hospital will be like, however, those applicants who haven’t are not at any disadvantage.

  • Because we have a 4-year program, we have the ability to offer extra experiences that will benefit you. We would love to talk about these in person on your interview day but to highlight a few:

    1. 3 months of elective time in the PGY3 and PGY4 years to spend exploring other areas of emergency medicine. Some of those areas include extra exposure to things like research, advanced ultrasound, health administration, clinical operations, advanced toxicology, educational projects and many others. These experiences and exposures will help residents explore career paths outside of clinical emergency medicine that they might be interested in.
    2. Leadership and teaching experiences. PGY4 residents work with the attending physicians to manage our enormous clinical department. Our department sees over 500 patients a day and our PGY4 residents are instrumental in leading the clinical teams, overseeing flow and triage of ambulance runs and teaching junior learners.
    3. Track program. PGY3 and 4 residents get involved in the clinical divisions of our department as “junior” members. They are included in division meetings, research projects and other activities to expose them to these areas and promote faculty-resident and resident-resident collaboration. Many of these tracks offer a “certification” of extra training and expertise that will benefit them in their career decisions and job searches.