Occurs on Thursday mornings, 7 AM to 12 Noon. Didactics are designed to provide multiple means of engagement. Readings, podcasts, and videos are assigned as asynchronous learning during the first 30 to 60 minutes of didactics during the academic year. This allows learning to occur at the convenience of the resident and makes use of multimedia sources to embrace different learning styles of adult learners. Conference presentations include medical topics from the core curriculum, ethics, social/medical equity and other social issues, business and practice of emergency medicine topics, morbidity and mortality conference.  Once per 4-week block the residents and medical students engage in simulation-based education which involves small group discussion of patient cases, team-based simulation scenarios, procedure task trainers, and ultrasound skills stations. Several times a year, we engage in interprofessional conferences with the trauma/surgery service and internal medicine. A majority of presentations are performed by faculty but residents are also involved in presentations. So that residents can fully be involved in their education, all emergency medicine residents are scheduled so that they have no clinical duties after 6 PM to 10 PM on Wednesday evening prior to conference.

Resident Presentations (Residents will be guided by the faculty concerning the details and presentation material for each of the assigned conferences):

Journal Club, held one evening a month, hosted by a faculty member for 9 months per year. Journal club is during conference during interview season to respect other time commitments of the residents. The residents and faculty engage in informal discussions of chosen medical literature. Through these discussions the residents learn to critically read medical literature and assess its value and applicability to changes in medical practice.

The residents are involved in all aspects of quality improvement and patient safety at SRMC. Introduction into the fundamentals of patient safety and quality improvement begins with completion of the Institute for Healthcare Improvement (IHI) modules. Every resident then joins a hospital committee as an active member. The residents will champion the mission of the committee, developing projects as teams to improve patient safety within the institution. The residents will also attend focused – reviews and root-cause analysis as they occur in the quality department.

The well-being of the residents is important as well as their ability to learn the factors that affect well-being and available resources to improve well-being and provide the resident with a sustainable and satisfying career in emergency medicine upon graduation. The residency provides a wellness curriculum which includes team-building activities such as a yearly residency retreat and attendance at specific regional or national conferences as post-graduate year activity. Each class of residents are also awarded three other wellness days per year. The residents received protected time to attend to needed appointments in the morning, a lunch with their peers, an informal discussion with a faculty member concerning a topic from the wellness wheel, followed by a social activity of the resident group’s choice.

Sutter Health has 6 research institutes. Sutter Institute for Medical Research (SIMR) supports research in the Sacramento Valley. An assigned support staff from SIMR will assist interested residents and faculty with research projects that match their interests and goals. The SIMR staff also assist the resident and faculty in understanding and performing the fundamental steps in the research process.

The first-year resident chooses a patient case from the emergency department. The resident presents the patient’s chief complaint, history of present illness, past medical and social history, allergies, and medications. The vital signs and physical examination are presented in sufficient detail with typical diagnostic data provided. A faculty member then formulates the differential diagnosis, logically narrowing the list to a few selected probable diagnoses and offers a final diagnosis as well as the diagnostic test that determined the diagnosis. The resident reveals the final diagnosis, discusses how the diagnosis was confirmed, provides details regarding the case outcome, the applicability to Emergency Medicine practice, and the medical management. The best case is chosen to submit to the Council of Residency Directors in Emergency Medicine CPC Competition.

The second-year resident chooses a pediatric case in which they have provided care either in the Sutter Medical Center Sacramento Pediatric emergency department or the Pediatric Intensive Care Unit to present to their peers.  The resident presents the pediatric presentation, diagnosis, medical/surgical management and key learning points about diagnosis and management of the medical care for the patient. Through these presentations the residents obtain pediatric knowledge longitudinally that they apply to their shifts in the emergency department carrying for our youngest patients.

The third-year resident chooses a clinical subject that is illustrated by a treated emergency department patient. The resident presents the patient’s case followed by well-researched information about pathogenesis, diagnosis and/or management.

The third-year resident presents an assigned case deemed to have a possible quality issue. The resident researches the case, identifying safety lapses, performance improvement, cognitive errors, ethical issues, etc. The presentation is presented in an objective manner allowing for open discussion by all members of the audience. Performance Improvement and quality issue recommendations are identified.