Menu
Curriculum

Clinical Curriculum

Our clinical year is comprised of thirteen four-week blocks. Over the course of the four years, the majority of your clinical time is spent in one of our four affiliated EDs. Rotations outside the ED have been carefully selected to maximize the educational experience of the residents and benefit from the experiences available in our institutions. Additionally, residents spend six weeks during the second year as the procedure resident in the ED at MGH performing a high volume of procedures in the department. The include inpatient rotations in critical care, obstetrics and cardiology as well as other experiences in anesthesia, administration, teaching, emergency ultrasound and toxicology.

  • First Year
  • Second Year
  • Third Year
  • Fourth Year

The First Year

The year begins with a month long bootcamp where interns enjoy a lightened clinical schedule as they gain experience and comfort in both the MGH and BWH EDs. We balance this clinical time with a variety of core didactics, including lectures, procedure labs, an ultrasound day and multiple interactive activities. Several protected evenings allow time for the the class to spend time together outside of work, bonds, get to know the other residents and explore Boston. Once back into the regular block schedule, interns spend time in the adult and pediatric EDs along with several other key rotations helping to form fundamental skills for the practice of EM.

Rotation

ED (BWH/MGH)

Pediatric ED (BCH)

Medical ICU

Pediatric ICU

Cardiology Inpatient

Mixed Medical/Surgical ICU (MGH)

OB (Labor and Delivery)

Ultrasound

Anesthesiology

Intern Bootcamp

Vacation

Duration

4.5 blocks

1 block

0.5 block

1 block

1 block

0.5 block

1 block

1 block

0.5 block

1 block

1 block

The Second Year

In the second year (PGY-2), residents focus on mastering individual patient care, spending five and a half blocks in the adult emergency departments of the affiliated hospitals as well as one block of pediatric emergency medicine. Elective time is introduced in the PGY-2 year to allow residents focused time for independent research and study.  The remainder of the year is spent on off-service rotations, such as orthopedics, surgical intensive care, trauma intensive care, cardiac step down unit and ultrasound.

Rotation

ED & Pedi ED (BWH/MGH)

Mixed Medical/Surgical ICU (MGH)

Surgical ICU (BWH/MGH)

Procedure

Toxicology

EMS

Elective

Vacation

Duration

7 blocks

1 block

1 block

1.5 blocks

0.5 block

0.5 block

0.5 block

1 block

The Third Year

During the third year (PGY-3), residents begin to assume a supervisory role in each of the emergency departments, advising junior house-staff and senior medical students, and directing paramedics. The primary goal of the third year is to acquire the skills necessary to manage multiple critical emergencies. Pediatrics remains a focus and elective time is increased to two blocks. Third year residents gain experience with systems-based practice as well as quality and safety by leading Trauma conferences during didactics.

Rotation

ED (BWH/MGH)

Community ED (Newton-Wellesley)

Pediatric ED (BCH)

Elective

Vacation

Duration

8 blocks

1 block

1 block

2 blocks

1 block

The Fourth Year

The PGY-4 resident functions as the supervisory emergency physician for the base institutions. Under the guidance of emergency medicine attendings, the senior resident directs major resuscitations and directs patient care and flow in each ED. Senior residents learn the skills needed to administer emergency departments, teach medical students and paramedics. There are two four-week blocks of elective time that may be used for research or added clinical activities related to emergency medicine. The fourth year also contains rotations in ED administration and teaching.

Fourth year residents gain experience with systems-based practice as well as quality and safety by leading Morbidity & Mortality conferences. Throughout the fourth year curriculum, our graduates develop the clinical and administrative skills necessary to assume leadership roles in emergency medicine.

Rotation

ED (BWH/MGH/Newton-Wellesley)

Administration

Teaching

Elective

Vacation

Duration

8 blocks

1 block

1 block

2 blocks

1 block

Educational Curriculum

Didactics

Our educational curriculum follows the Model of the Clinical Practice of Emergency Medicine (EM Model) and repeats this every two years so that residents are exposed to the full content of EM twice during training. Our weekly didactics conference, held on Tuesday morning from 8am to 1pm, alternates between MGH and BWH and residents are free from clinical responsibilities in order to attend. Each week begins with an hour of core content using EM Fundamentals for interns and and Foundations of EM for the rest of our residents. We recognize that learning is achieved through many modalities and have incorporated various methodologies into our curriculum including short lectures, simulation, small groups, journal club, procedure labs, trauma conference, M&M and individualized interactive instruction. Our faculty across our sites are experts in many aspects of EM which enhances the educational experience of our conference through their participation and teaching. Residents build their academic portfolio and teaching experience by delivering lectures each year. Recent innovations and additions to conferences developed by our residents include successes and saves, Rapid Fire Clinical Cases and a longitudinal Health Equity Curriculum. 

Simulation

HAEMR has designed its curriculum to heavily incorporate the use of simulation throughout conference. Simulation offers a rich, risk-free environment for residents to learn clinical emergency medicine under the direct supervision of expert attending faculty. Rather than passively hearing new knowledge, residents are able to use newly acquired knowledge in simulation exercises which allows them to integrate it into their growing clinical knowledgebase. Medical simulation facilitates the learning of certain types of tasks, integrating medical knowledge, and demonstrating capability or competency across the spectrum from individual procedures to complex resuscitative management. Each site has a comprehensive simulation center used regularly in conference. At BWH, STRATUS, is an internationally known state of the art simulation center housed within the Department of Emergency Medicine. We benefit from this facility where faculty and fellows are innovating and advancing simulation-based medical education. At MGH, the Learning Laboratory also facilitates hands-on learning for “EM on Demand” where our residents can practice core EM procedures any time in a deliberate practice approach. Between these two simulation centers, residents have the opportunity to practice a wide array of procedural and non-technical skills. 

Professional Development

At HAEMR, we are committed to preparing you for a successful career in emergency medicine. Our mentorship program begins shortly after arrival during intern year. Based on areas of interest and career goals, the residency leadership team pairs our new residents with a faculty mentor in their first month. This longitudinal mentorship relationship helps guide academic development over the course of training. The experience is mapped across the four years guiding the development in order to ensure residents are achieving the paramount milestones that will make them highly competitive in the academic and community job market. 

Throughout their training, residents meet individually with program directors semi-annually to review clinical, academic and career growth. This is an opportunity for feedback and assessment of progression along the EM milestones. The last year focuses on guidance through the job or fellowship application process not only with the program leadership and mentors, but also individual meetings with our chairs. We also recognize that not all residents progress at the same rate and some residents will require additional support. We have a group of dedicated and talented faculty members with expertise in coaching to assist our residents who may need more individualized instruction. We believe this multifaceted approach helps us to achieve our ultimate goal of graduating outstanding emergency physicians able to practice in any future setting.  

Research

At HAEMR, residents have access to significant mentorship to successfully complete research. Our research divisions are well-funded and supported providing the infrastructure to assist residents in the development and execution of multiple projects. We recognize that not all residents arrive at residency with the same experience and are committed to providing the mentorship to those interested in pursuing research while at HAEMR. As scholarship is a key component of our mission, the residency provides up to $1500 of financial support for the presentation of work at national or regional meetings. As many diverse opportunities are available for residents in clinical medicine, basic science and public health, numerous resident-authored manuscripts are published annually. The program awards two internal grants each year to trainees to support projects which may not be possible without some seed funding. 

A highlight of the program is our senior project day when our graduates present their completed scholarly project to the residency which also provides an opportunity for us to celebrate their varied accomplishments.  

Elective

The specialty of emergency medicine continues to expand and career includes many opportunities for your career (clinical expertise, policy, research, education, quality and subspecialty certification). In order to allow residents to make informed decisions about their future, we are committed to providing adequate time to investigate areas of interest. We believe that one of the many benefits of a four year training model is the ability to provide residents with time in their schedule to explore subspecialty experiences, different clinical experiences not offered in the standard curriculum and to pursue further academic development for those destined to a career in academics. We provide 4.5 months of dedicated elective time, with the first block in the second year of training. This allows time for meaningful exploration beginning in the second year of training

Academic Support

We provide funding to each resident to attend an academic emergency medicine conference during their final year of residency training as well as support residents to present their research at national emergency medicine conferences.