Clinical Rotations

PGY-1

Immersion Month


This one month block is designated for all incoming interns each July. It is designed as an introduction month to help transition and integrate new interns into the department, and into residency as a whole. The block includes clinical shifts, didactics, hands on skills sessions and protected time to get to know your new co residents.




Emergency Medicine (7 total blocks)


First year residents will spend the majority of their time working clinical shifts at our Level 1 trauma center which offers quaternary care as a premier cardiac, stroke, and transplant center. We have a busy, high acuity ED with a wide breadth of diversity and pathology. Interns work with seniors residents and attending, managing patients with appropriate oversight. You will also spend one month at Milford Hospital, our community site.




Cardiac ICU


Rotating in the Cardiac Intensive Care Unit, you will care for patients with severe hart failure, cardiogenic shock and post cardiac arrest care. On this rotation you will have additional procedural opportunities for central and arterial lines on critically ill patients.




Anesthesia/Ultrasound


This block is designed to allow residents to spend time in the operating suites on multiple campuses to gain adequate experience with controlled intubations in both adults and pediatrics. Typically residents spend the mornings in the OR intubating, and afternoons with our ultrasound faculty learning hands on point of care ultrasound skills with our fellows and attendings. Our residents are ultrasound leaders in the hospital typically graduating with over 900 individually performed ultrasounds.




Labor and Delivery


Interns will spend 4 weeks at our Memorial Campus working closely with our OB/GYN colleagues to care for both low risk and highrisk pregnancies in our tertiary Labor and Delivery division. This important block allows residents to feel comfortable with not only standard vaginal deliveries, but also emergent presentations such as preeclampsia, abruption, and post partum hemorrhages.




Medical ICU


Interns will spend time in 6ICU, a 16 bed ICU, to expand knowledge on continued management of critically ill patients after they leave the ED. Residents work closely with their team and attending with primary ownership of their patients. Management of ventilators, vasopressors and multiorgan dysfunction are key skills learned on this rotation, along with procedural skills such as central lines, arterial lines, paracentesis and airway management.




Pediatric ED


Pediatric EM trained physicians will guide residents through the intricacies and nuances of managing the pediatric population in our 13 bed pediatric ED here at our primary University campus. To ensure exposure to a diverse range of seasonal presentation, residents are swapped into the Pedi ED intermittently throughout the year in addition to the month long block to care for summer injuries, and respiratory emergencies such as asthma, RSV and flu in winter months.





PGY-2

Emergency Medicine (5 total blocks)


Second year senior residents spend 5 months at University and one at Milford and progress to a more senior role including increased responsibility in the department, the chance to work with shadowing and rotating medical students, as well as increasing patient care autonomy and pod ownership. During these blocks residents will continue to grow in medical knowledge and patient management through experiential education and teaching responsibilities.




Medical ICU


Second year residents rotate through 7ICU, a 16 bed Medical ICU. Residents this year take on a senior role on a medicine service with exceptional sick patients, include ill hepatic and pre transplant patients. This involves teaching interns and mid-levels, and taking on more critically ill patients. This resident also responds to rapid responses throughout the hospital.




Surgical ICU/Neuro ICU


This month, residents spend half the month rotating through the surgical ICU, and half rotating through our Neuro ICU. While in SICU, you will manage critically ill trauma and post op patients. You will gain experience managing chest tubes, and be exposed to advanced wound care. Our Neuro ICU provides experience managing hemorrhagic strokes, herniation, severe traumatic brain injuries, TPA and critical spine injuries.




Trauma


As the EM resident on the trauma service, you will be in charge of the airway during level 1 and 2 trauma activations as well as management of trauma patients that are in the emergency department including level 3 transfers and trauma consults. You will increase your proficiency with traumatic airways, chest tubes, emergent venous access and overall evaluation of the trauma patient.




Toxicology/EMS/Ultrasound


This multi-faceted block is designed to expose residents to our robust toxicology service which cares for diverse presentations, and is at the forefront of the opioid public health crisis. Residents take primary tox call with our faculty and fellows, as well as attend weekly conferences at UMass and in Boston. Additionally, residents take part in EMS and life flight quality review, and continue to hone emergency point of care ultrasound skills.




NEXT Pod


The NEXT pod is the newest addition to our training program and serves as the high acuity pod in the ED. Here you will work one on one with an attending and become experts in management of respiratory distress, sepsis, arrhythmias, traumas, strokes, cardiac arrests and all the procedures associated with these conditions. This rotation is an intense immersion into critical care and has been a favorite among current residents for its hands on experience and one on one teaching with attendings.




Pediatric ED


As a second year resident in the Pediatric ED, you will have increased independence working with our PEM attendings in the management of the pediatric population and increased ownership of patient care.





PGY-3

Emergency Medicine (6 total blocks)


The highlight for most residents, you will spend two months in the community setting at both our Memorial campus as well as Kaiser Permanente on the island of Oahu, Hawaii. While at University, you will be encouraged to ‘own’ the pod and ensure the adequate care of all patients as well as making sure the interns and off service residents are comfortable with their patient load. Residents become comfortable with flow and overall management of our busy pods.




Supervising Month


This month is an excellent indicator of what it’s like to be an attending. The Super acts as the ‘Pre-tending’ and take report from interns and off service residents while working with them to care for their patients. While challenging, it is a very rewarding experience and teaches you how to teach juniors.




Elective


Flexibility is the name of the game here. Some options include a volunteer global health elective in Uganda, spend 3 weeks as the ship’s doctor for the Mass Maritime Academy at sea, ultrasound elective, medical education elective, administrative elective or make your own!




Pediatric ED


Third year residents are the true seniors in the Pedi ED this year. They encouraged to keep an eye on all patients in the department and solidify your clinical skills allowing you to feel comfortable managing pedi patients on your own once you graduate, including pediatric traumas, codes and critically ill infants.




Neonatal ICU/Pediatric ED


This combo block includes 2 additional weeks in the pedi ED and also gives you time in the NICU allowing you to evaluate and treat high risk newborns. Residents attend high risk deliveries and participate in the resuscitation of neonates including intubations, and central lines.




NEXT Pod


Residents have an additional month in the NEXT pod to solidfy critical care experience in the ED. As a busy high acuity center, this pod can be extremely busy with primary patients suffering from undifferentiated shock, agitated delirum or trauma while responding to code strokes, cardiac arrests and STEMIs and traumas. This pod truly develops competent and capable physicians that are able to feel comfortable working in any academic or community center after graduation.





 
Contact

55 Lake Avenue North

Worcester, MA 01655

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Tel: (508) 421-1400

Questions or Comments?

nancy.boisvert@umassmemorial.org

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