» Family Medicine Residency

For Prospective Residents

PGYI - Emergency Medicine
Santa Monica-UCLA Medical Center

Goals:

The goals of the rotation in Emergency Medicine are to teach the Family Medicine residents principles of recognition and management of acute life-threatening conditions, rapid assessment and coordination in crisis-oriented settings, and clinical experience in the performance of basic and advanced cardiac life support.

Objectives:

Residents will:

Patient Care and Medical Knowledge

  1. Achieve competence in the triage of emergency patients, both under ordinary and disaster circumstances.
  2. Achieve competence at the family practice level in evaluating and managing critical emergencies, including ACLS skills.
  3. Achieve competence in the diagnosis and management of acute trauma, including lacerations, head and neck injuries and sprains and fractures.
  4. Achieve competence in the diagnosis and treatment of acute medical illnesses, including cardiac diseases, pulmonary disorders, and the acute abdomen.
  5. Achieve competence in the diagnosis and treatment of acute OB/GYN disorders.

Practiced Based Learning and Improvement

  1. Be able to use the internet to access current literature about Emergency Medicine topics.
  2. Be able to access the internet and other resources to provide patient education materials.
  3. Be able to work well in the context of the team of providers in the Emergency Room.
  4. Be able to implement changes in patient care based on new information obtained from clinical experience, faculty teaching, and independent reading.

Interpersonal Communication Skills

  1. Communicate effectively with patients
    1. Able to communicate in a manner in which the patient and the family of a patient in the Emergency Room setting are able to successfully understand their disease, treatment and prognosis.
    2. Able to listen to and address the concerns of patients and their families in the Emergency Room setting.
  2. Communicate effectively with colleagues
    1. Able to work efficiently in the context of the Emergency Room in a community hospital.
    2. Able to clearly communicate the patient visit to the Emergency Room attending, including history, physical, assessment and plan.
    3. Able to work efficiently with the support staff in the care of the patient in the Emergency Room setting.

Professionalism

  1. Demonstrate cultural competency.
  2. Demonstrate the ability to act in the best interests of the patients
    1. Respect for confidentiality.
    2. Respect for patient autonomy.
  3. Be professional in all aspects of patient care
    1. Accepts personal responsibility for patients.
    2. Accepts feedback in all aspects of care, including the six core competencies.
    3. Timeliness.
    4. Appropriate attire.

Systems-Based Practice

  1. Demonstrate understanding of the care of the patient in the Emergency Room and how this care is different than in a continuity clinic setting.
  2. Coordinate care with ancillary services to improve the healthcare of the patient.
  3. Assist patients in dealing with their medical issues.
  4. Assist the patient in the navigation of the health care system
    1. Appropriate use of resources (clinic vs. ER).
    2. Appropriate follow-up
      1. Medical studies
      2. Laboratory studies
      3. Patient follow-up

Logistics

Contact Location
Wally Ghurabi, MD
Rotation Director
(310) 785-7291 (pager)		 Santa Monica-UCLA Medical Center
1250 16th Street
Santa Monica, CA 90404
Emergency Medicine Center
Front Desk
(310) 319-4765

Schedule (4 weeks)

  Monday Tuesday Wednesday Thursday Friday Saturday Sunday
AM       Clinic 8a-12p AM Off Off Off
PM       ER 2-10 ER 12p-12a Off Off
               
  Monday Tuesday Wednesday Thursday Friday Saturday Sunday
AM AM Off AM Off Ed Day FHC Off AM Off Off
PM ER 12p-12a Clinic 12p-5p FHC ER 2-10 Off ER 12p-12a Off
PM   ER 6-12          
               
  Monday Tuesday Wednesday        
AM AM Off AM Off Ed Day        
PM ER 12p-12a Clinic 12p-5p FHC        
PM   ER 6-12          

Continuity Clinic - You will have 3 continuity clinics per week during this rotation, Tue PM, Wed. PM, and Thur. AM.

Educational Half Day - Attendance is required.

Day Off - Two days off per week: The 1st and 3rd week of the rotation you'll have Sat. and Sun. off. The 2nd and 4th week of the rotation, you'll have Fri. and Sun. off.

Duties and Responsibilities

  • Patient care is supervised by the attending physicians in the Emergency Room
  • Code Blue - the ER resident is part of the Code Blue team of the hospital (see below for detailed Code Blue assignments)
    • Part of the team with the IPS junior and senior residents
    • Must carry the code pager when on shift in the Emergency Room
      • Pick up the pager prior to your shift from the R1 call room
      • Drop off the pager after your shift in the R1 call room
    • Primary responsibility is for the procedures that are needed during a code
  • Urgent cross cover of patients in the hospital that are not on the IPS team
    • Only patients in Santa Monica Hospital that this does not include are those that have UCLA residents in house:
      • Patients on IPS
      • Patients on the General Surgery or Vascular Surgery service
    • Including, but not limited to patients with acute medical issues chest pain, shortness of breath, fall out of bed, etc.
    • Consult the senior on IPS as needed
    • Responsible for the documentation of the cross cover in SOAP note format
    • Responsible for notifying the Primary Physician of actions taken
      • The Primary Physician is responsible for following up on the patient and any labs or studies ordered
    • Non-urgent cross cover
      • Assist on Cesarean sections
        • If requested by the IPS team
        • If available for release from the Emergency Room
          • If you scrub in on the Cesarean section, plan on staying until the completion of the surgery except for code blues.
      • Death pronouncements
        • If requested by the IPS team
        • Resident that pronounces the patient is to write a brief death note in the chart and to notify the Primary Physician
      • Push IV medications at night if requested by the IPS team
      • Patient Transport if requested by the IPS team

Code Blue

The Code Blue team consists of either two or three Family Medicine Residents (the third resident is the resident in the Emergency Room). The Code Blue team is responsible for all codes in the hospital, including other teaching services (i.e. - Geriatrics, Surgery). If you arrive and a resident from another service is running the code, please make yourself available to help, and do not take away the code from that resident unless requested to do so.

  • If 2 residents in house
    • On-call senior runs the code
    • On-call junior resident does the procedures
  • If 3 residents in house
    • On-call senior supervises the code
    • On-call junior runs the code
    • Emergency room resident does the procedures

Note - Always hand the code pager to another resident. Do not leave it anywhere; it must be handed off in person.