Rotation Schedule Overview 2017-07-06T11:23:23+00:00

Rotation Schedule Overview

The PGY1 year is an exciting one – with a focus on emergency medicine and critical care. The goal of the internship year is to provide a solid foundation in the management of both medical and surgical patients. Interns spend roughly equal amounts of time within the Emergency Department and on outside rotations.

Intern year begins with a two-week orientation. This orientation allows the class to get to know one another while going through several special courses. These courses include: BLS, ACLS, and introduction to ED ultrasound, concepts relating to wellness during residency as well as various other introductory lectures.

ED-Based Rotations:
In addition to 24 weeks in the Adult and Pediatric Emergency Department, Interns complete a 2 weeks dedicated ED ultrasound rotation. Interns have the opportunity to practice their scanning skills under the direct supervision of ultrasound division faculty members as well as participate in US division didactics.

Off-Service Rotations:
Three months are dedicated to ICU training in the CCU, MICU and SICU. Additionally, interns rotate through the ED orthopedics evaluation area participating in urgent and emergent ED orthopedics consultations. On the anesthesiology rotation, interns become familiarized with airway management under more controlled and expected conditions than those in the ED. Two weeks are spent in the Psychiatric Emergency Department participating in emergent psychiatric consultations.

2 weeks – Orientation to the DEPARTMENT OF EMERGENCY MEDICINE
22 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
2 weeks – EM Ultrasound – LAC+USC

4 weeks – Surgical Intensive Care Unit – LAC+USC
4 weeks – Cardiac Care Unit – LAC+USC
4 weeks – Medical Intensive Care Unit – LAC+USC
4 weeks – Internal Medicine Wards – LAC+USC
2 weeks – Psychiatric ED – LAC+USC
2 weeks – Anesthesia – LAC+USC
2 weeks – Orthopedic Evaluation Area – LAC+USC

4 weeks – Vacation

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

The PGY2 year also includes special courses and certification in ATLS, PALS, and ACLS-Instructor Course. All of these course occur during protected time. In addition all PGY2s go 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 the PGY2 year, residents expand their clinical responsibilities to both the Resuscitation area and the Jail Emergency Department. The addition of Resuscitation pushes the residents to hone their procedural and resuscitation skills. The addition of the Jail ED pushes the residents to expand their independence. In addition to the clinical rotations, PGY2s complete a second two-week ED Ultrasound rotation. This rotation builds upon the foundation learned in the PGY-1 year.

Off-Service rotations:
To round out their yearlong focus on resuscitation and critical care, PGY2s spend one month in the Medical Intensive Care Unit (MICU) acting as an integral part of the MICU team. Additionally PGY2s spend one month in the Pediatric Intensive Care Unit (PICU) at Long Beach Memorial Medical Center / Miller Children’s Hospital. Additionally, residents complete a 3 week OB rotation in order to gain experience in vaginal deliveries as well as the management of the peri-partum and post-partum patient.

In addition to the clinical rotations, the PGY2 class has 3 days of protected time in January year for a class retreat. The purpose of the retreat is to provide a venue for class bonding as well as an opportunity to provide career mentoring. This retreat is off-site and paid for by the department.

33 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC

3 weeks – Obstetrics – Good Samaritan Hospital
2 weeks – EM Ultrasound – LAC+USC
2 weeks – EMS
4 weeks – Medical Intensive Care Unit
4 weeks – Pediatric Intensive Care Unit – LBMMC/Miller Children’s Hospital

4 weeks – Vacation

The PGY3 year provides supervised experience in the recognition and management of the major critical clinical entities, which present to an Emergency Department and promotes an even higher level of competence and confidence in non-critical patient management. Training also continues in other pertinent medical specialties.

The PGY3 year in Emergency Medicine is a year of increasing responsibility both in the emergency department and throughout the hospital. While in the Emergency Department, PGY3 residents continue their clinical work in all of the areas of the Emergency Department.

In addition to individual patient care responsibilities, the PGY3 has responsibility as the Resident-in-Charge (aka 2 Star) in West. As the 2 Star, the resident must oversee the flow of patients through the area from triage to final disposition, make decisions regarding resource utilization within the area, and supervise junior residents, physician assistants and students. The Resident-in-Charge is in direct communication with the Resident-in-Charge in the Major Resuscitation Area, a position always held by a PGY4 resident.

In addition to the responsibilities in the ED, PGY3 Resident in Emergency Medicine is the leader of the hospital-wide cardiac arrest (Code Blue) team. As the leader of the Code Blue team, residents respond to all emergency resuscitation codes throughout the entire hospital, including the Intensive Care Units and Outpatient Clinics.

36 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
5 weeks – Elective – LAC+USC
3 weeks – Toxicology

4 weeks – Community Emergency Department – Long Beach Memorial Medical Center

4 weeks – Vacation

The PGY4 year is designed to provide for the continued refinement of independent clinical judgment and the development of sophistication in both critical and non-critical patient management; to promote the development of academic, teaching, research, managerial and administrative skills; and to provide opportunities for training 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.

The PGY4 year in Emergency Medicine is designed to raise the knowledge and skills developed with a specific emphasis on the development of leadership skills.

While in the Emergency Department at LAC+USC, the PGY4 residents serve as the Senior Resident-in-Charge (aka 2 Star) in the Resuscitation Area. They are responsible not only for the major resuscitations, but also for overseeing the flow of patients throughout the entire department, including the Jail, West and North areas.

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

32 weeks – Emergency Department (Pediatrics and Adults) – LAC+USC
5 weeks – Elective – LAC+USC

3 weeks – Community Emergency Department – Verdugo Hills Hospital
4 weeks – Pediatric Intensive Care Unit – Miller Children’s Hospital/Long Beach Memorial Medical Center
4 weeks – Community Pediatric Emergency Department – Miller Children’s Hospital/Long Beach Memorial Medical Center

4 weeks – Vacation

*PGY – Post-Graduate Year