As a PGY-III resident, residents continue to have a high degree of responsibility in the Emergency Department, continuing to respond to traumas and care for critically ill patients. Additionally, PGY-III’s take on more teaching and supervisory responsibilities. They often supervise and teach medical students, and assist junior residents with patient care and procedures.
For the senior resident (PGY-II & III) in Emergency Medicine, there continues to be graduated responsibility. The PGY-III resident is expected to be able to handle many patients at once with variable levels of acuity as well as jointly working with the faculty in managing the flow of the department and learning to “run” the department. This resident should be peripherally aware of what is going on throughout the department and be ready to lend a hand wherever it is needed. He or she also is expected to provide supervision to medical students and interns, as well as guidance for PGY-II’s. While on all Emergency Medicine rotations, PGY-III residents are given the option of joining the University of Iowa AirCare as flight physicians where they will perform inter-facility and scene transports of critically ill neonates, pediatric and adult patients.
Community Emergency Medicine
Rotating at St. Luke's Hospital in Cedar Rapids is an excellent opportunity to experience emergency medicine in a community setting. Your role at St. Luke's is to see patients under the supervision of your staff physician, just as you would during other emergency medicine rotations. The educational highlights of this rotation include a high volume of pediatric and high acuity patients, large amount of orthopedic emergencies, mentorship relationships with community emergency medicine physicians,and independence practicing medicine without the presence of other sub-specialty residents.The rotation at St. Luke's is certainly a favorite among residents, and offers a great deal of educational and practical experience.
Surgical and Neuroscience Intensive Care Unit
While rotating in the SNICU, residents manage critically ill patients from the Trauma Service, General Surgery, Neurosurgery, Cardiothoracic Surgery, Transplant Surgery, and other surgical patients. Common diagnoses include poly-trauma, intracranial bleeding, stroke, septic shock, hypovolemic shock, cardiogenic shock, respiratory distress, and hypertensive emergency. The opportunities to perform an abundance of procedures/critical skills relevant to Emergency Medicine are performed on a regular basis including: intubation (direct, glidescope, fiberoptic), central lines, arterial lines, ventilator management, tube thoracostomy, vasopressor management, and volume resuscitation. The daily schedule generally involves arriving at 6am, rounding with staff at 7am, procedures and daily work after rounds until sign out at 2pm.
Emergency Medical Services / Emergency Medicine Administration
In this month you will have the opportunity to ride, fly, and learn about becoming an EMS medical director. The rotation is comprised of 4 flight shifts, 4 ambulance rides, and 4 shifts in the department with special attention focused on interaction with EMS crews. In addition you will have the opportunity to visit the 911 call center, fire station, and learn about disaster management and EMS research opportunities. You will have the opportunity to be on the front lines and see people in their homes and gain a better understanding of the limitations of ambulance crews. This is a great month with a lot of different experiences that will help to round out your training.