Curriculum

At ARMC, the combination of a hands-on approach, strong didactic curriculum, research, and committed faculty make for a well-rounded resident training program. Learning is obtained on a case-by-case basis with bedside teaching viewed as a crucial instrument for education.

CURRICULUM BY YEAR:

PGY I
EM 5.5 months
Ultrasound 1 week
Anesthesia 0.5 months
Ophthalmology 1 week
Pediatrics 1 month
OB/Gyn 0.5 months
Surgery 1 month
Medicine 2 months
MICU 1 month

PGY II
EM 8.5 months
MICU 1 month
Trauma/SICU 1 month
Orthopedics 1 month
EMS 0.5 months

PGY III
EM 9.5 months
Peds EM 1 month
Research 1 month
EMS 0.5 months

PGY IV
EM 9 months
Elective 2 months
Sub-Surgical Speciality 1 month

There are five hours of scheduled weekly didactics, which include morbidity and mortality conference, resident lecture series, the Academic Life in Emergency Medicine’s Approved Instructional Resource modules and trauma grand rounds with the surgery department. Medical research is encouraged at ARMC, with multiple on-going research projects throughout the year. Residents have presented at regional conferences and are published in peer-reviewed journals. Attending physicians give procedure workshops, as well as oral and written board review. Additionally, outside guest speakers periodically provide lectures on various topics.


The curriculum is set up as a PGY 1-4 program. The ED resident will do 16 12-hour shifts per month, usually divided evenly between day and night shifts. Most shifts are 7-7. When off service, residents adhere to the schedule for that service.

PGY-1’s will obtain a diverse foundation of knowledge that will be crucial for their development in the following years. On the medicine service each resident will admit, manage, and discharge their own patients. They will also attend a daily morning report where case presentations are discussed among residents and attending physicians. On the surgery service each resident will split their time between the general surgery team and the trauma surgery team. They will learn to do chest tubes, central lines, and gain surgical experience. Residents participate in trauma alerts and activations, providing crucial initial evaluation and resuscitation of the injured patient.

PGY-2’s begin to experience community Emergency medicine by rotating at St. Bernardine’s Medical Center and St. Mary’s Medical Center. They also serve as senior residents on MICU and SICU services. On the MICU service each resident manages an entire team, supervising two interns and two medical students. Residents manage critically ill patients with multiple medical problems and perform procedures such as intubations, central lines, arterial lines, and pulmonary artery catheterizations. Residents also become familiarized with “drips,” “pressors,” and mechanical ventilation. On the SICU/Trauma service, residents will directly manage severely injured trauma patients as well as the resuscitation of burn victims.

PGY-3’s are given more autonomy and are expected to develop their leadership skills as they begin overseeing and supervising the junior residents. They also rotate at Loma Linda University Medical Center to gain pediatric EM exposure, as well as at St. Bernardine Medical Center to continue their exposure to community medicine.

The PGY-4 year is designed to allow the residents to hone their skills prior to graduating. There are also two elective blocks built into the schedule for further experience in areas of special interest.

The ARMC ED is divided into sections called “pods,” each of which have between eight and eleven beds. The more senior residents are given autonomy to run each pod with direct supervision from an attending physician. The more junior residents are paired up with a senior resident or attending. Residents have ample opportunity to do student teaching and mentoring during shifts.

Bedside ultrasound is now an integral component of our ED. It is used for a variety of purposes; examples include diagnosing traumatic intra-abdominal injuries, ruling out cholecystitis/cholelithasis/choledocolithasis, appendicitis, pericardial effusions, pneumothoraces, retinal detachments and central lines. Recently the ED was voted the best rotation in the hospital by students and residents.