|Policy on Supervision of Residents|
1. Residents will be supervised by Emergency Medicine (EM) faculty at all times in the ED.
2. These faculty are qualified by the requisite section of the Program Requirements as follows:
A. The physician faculty must possess current medical licensure
and appropriate medical staff appointment.
B. The faculty must establish and maintain an environment of
inquiry and scholarship with an active research component.
1) The faculty must regularly participate in organized
clinical discussions, rounds, journal clubs, and conferences.
2) Faculty should encourage and support residents in scholarly activities.
3. Supervision will never be from outside the ED area.
4. Supervision will be commensurate to the individual needs of the resident and
level of training.
5. Residents from other services will also receive supervision from EM faculty
When rotating in the ED.
6. The presence of other residents/students should not interfere with the supervision
of EM residents.
7. EM residents on off-service rotations will be provided supervision equivalent to
that provided in ACGME-approved residencies in those specialties.
8. Residents will in general be afforded increasing responsibility and autonomy as
they progress through residency. There should be a progression from data
gatherer through patient-centered planning to systems knowledge. This involves
increasing knowledge base, efficiency, multi-tasking, teaching, the ability to
work in parallel rather than just linearly with multiple patients and the learning of
techniques to enhance communication and interpersonal skills in order to enhance
outcomes. PGY-1 residents are expected to see approximately 1 patient per hour
in the ED and will present early in the course of a patient stay (before or soon
after writing orders). They may have responsibilities to teach medical students
and peers from off-service occasionally (predominantly in procedures). PGY-2
residents are expected to see up to 1.5 patients per hour and their presentations
should occur after orders are entered but before a decision on disposition is made.
They will have greater teaching obligations to PGY-1 residents from both EM and
off-service as well as students and they will begin to guide care. PGY-3 residents
are expected to see 2 patients per hour and their presentations should occur before
disposition occurs. They will assume a greater teaching role to begin the workups
with students who are assigned to them and guide care. They will assign
responsibilities to and teach interns from EM and off-service. They will teach off-
service peers in areas such as procedures.
9. The Department of Emergency Medicine will abide by the general guidelines in the House Staff Manual.