WHAT SETS YOUR PROGRAM APART FROM THE OTHERS?
The greatest strength of this program is our people. Yes, our facilities are some of the best in the country but the people make the program. Our residency motto is "Training to a higher standard." We strive to recruit faculty and residents of remarkable character. Our faculty and residents all have the same goal in mind: to be the best emergency physicians.
The atmosphere at Wake Forest is very resident friendly with abundant clinical and academic opportunities fully supported by a diverse faculty. Our residents become part of our emergency medicine family during their three years of training here where lifelong friendships are developed.
WHAT DO YOUR GRADUATES CHOOSE TO DO?
The door is wide open following graduation. We currently have graduates practicing in all areas of Emergency Medicine (academics and community practice) while several residents each year choose to pursue fellowship opportunities in a variety of emergency medicine sub specialties. Our graduates are currently chairs of departments, residency directors, research directors, and medical directors. We have graduates practicing as flight physicians, medical missionaries, and presidents of corporations. We are proud of our alumni and what they have done for the specialty of Emergency Medicine.
I WANT TO BECOME A FUTURE LEADER IN EMERGENCY MEDICINE; CAN I DEVELOP THESE SKILLS AT YOUR RESIDENCY PROGRAM?
Absolutely. We are very interested in recruiting and training the next group of EM leaders. Our mentoring process is catered to the individual resident's career ambitions. We proactively prepare our residents for a variety of leadership interests including academic careers or community hospital opportunities. Many of our alumni are actively serving in leadership roles across the country including ED medical directors, presidents of EM practice groups, EM residency directors, EMS directors and political leaders. In fact, one of our alumni has served as President of the Massachusetts Medical Society which publishes the prestigious New England Journal of Medicine.
Our faculty consists of many state, national, and international EM leaders. Our faculty leaders include the past president of AAEM, past president of SAEM, founding chairman of CDEM, major EM textbook editor, NC state EMS medical director, education and research experts, and WFU Assistant Dean of Global Health just to name a few. If you are interested in becoming a leader, Wake Forest is the place for you.
WHAT DOES YOUR ORIENTATION CONSIST OF?
Each intern goes through hospital and department orientation during their first week on duty. Our new interns are assigned to the emergency department as either their first or second clinical rotation. In addition to their clinical shifts they attend intern specific didactic lectures (e.g., chest pain stratification, approach to seizures, etc.) and clinical labs (e.g., airway, ultrasound, suturing, splinting, slit lamp, etc.) given by the faculty during the first few months after arrival.
IS CONFERENCE TIME TRULY PROTECTED FOR RESIDENTS?
Yes. We offer scheduled conferences each week. Faculty cover the ED while the residents attend. While the attendance on some off service rotations may be difficult at times, our residents have no problem attending and maintaining the required 70% cumulative attendance rate.
DO YOUR RESIDENTS REALLY EXPERIENCE PROGRESSIVE CLINICAL RESPONSIBILITY?
Absolutely. This is one of the major strengths of our training program. Each level of training receives more clinical responsibility throughout the years, which culminates during the senior year. Our senior residents have the opportunity to manage patients primarily, supervise medical students and interns, interact with referring physicians about incoming patient transfers, and perform aero medical triage and medical command, as well as many other department functions. Residents undergo formal and intensive procedure training that helps them achieve procedural competence. This process also includes a certification opportunity whereby residents can achieve authorization to perform certain procedures without direct supervision when the need arises within the medical center. Residents are also involved with department administration, quality assurance and bedside teaching.
THE PRIMARY WEAKNESS IN MANY PROGRAMS IS THE PEDIATRIC TRAINING. HOW ABOUT YOURS?
Pediatrics is actually one of our strengths. We have a children's hospital on campus with a new pediatric ED which opened in 2011. EM faculty and residents staff the pediatric ED along with residents from the departments of Pediatrics and Family Medicine. EM housestaff are scheduled for shifts in our Pediatric ED on every ED rotation, thus ensuring that our residents do not miss out on any seasonal pediatric illnesses. If you total the number of shifts worked over the three years it is equivalent to at least six months of time spent in our Peds ED. This is amazing for a three year training program. We also have structured didactics focused on pediatrics during our conferences each month.
Our pediatric curriculum also includes a clinical rotation in the Pediatric Intensive Care Unit at our institution. We also offer a Pediatric Emergency Medicine fellowship for graduates of both EM and pediatric residency programs.
WHAT IS THE ED PATIENT POPULATION AND ACUITY AT WFBMC?
WFBMC is a high volume, high acuity academic tertiary care medical center. The entire spectrum of patients is well represented at WFBMC. WFBMC is both a Level I adult and pediatric trauma center and continues to be one of the busiest trauma centers in NC. WFBMC is also a nationally certified stroke and chest pain center. All specialties are well represented. The current ED volume is in excess of 100,000 annual patient visits with 26.5% being pediatric patients. Thirty percent of all ED patients are admitted to the hospital with 76% of patients admitted to monitored beds (ICU, CCU, IMC, acute care, telemetry). Fifty percent of all hospital admissions come through the ED. The ED at WFBMC is considered the “front door” to the hospital, not the “back door” as is the case in some medical centers.
HOW ARE THE INTER-DEPARTMENTAL RELATIONSHIPS WITHIN THE HOSPITAL?
We are very fortunate to have strong inter-departmental relationships throughout the medical center. Our faculty and residents are well respected by the other departments. All of the specialties get along well with each other which make for a very supportive environment to teach our residents and to deliver the best health care we can to our patients. We participate in a number of joint learning activities with our colleagues in the medical center. Our department and the institution are committed to a multidisciplinary approach to patient care and medical education. Residents experience this most directly through a number of joint QI/QA activities, protocol development, and integrated care pathways.
HOW ARE TRAUMA PATIENTS MANAGED AT WAKE FOREST?
We believe in the "team" approach here at Wake Forest, not “us versus them”. Our trauma team is made up of emergency physicians and trauma surgeons. Our trauma center is certified as both a level one adult and pediatric trauma center and continues to be one of the busiest trauma centers in NC. Our residents have a different role on the trauma team in each year of their training.
HOW DO YOU TEACH EMERGENCY ULTRASOUND?
Our residents are individually taught the use of emergency bedside ultrasound during their formal Anesthesia/EMS/Ultrasound rotation supervised by our ultrasound director, Joshua Zavitz, DO. Our interns kick start their ultrasound training with a half day boot camp during their first month at Wake Forest. We have several portable ultrasound machines in the ED. Our residents receive both didactic and clinical training in emergency ultrasound. Our residents are expected to become proficient in the core US applications: FAST exam, detection of AAA, basic cardiac echocardiography, detection of IUP (includes endovaginal), and vascular access applications, as well as many of the other expanding applications of emergency ultrasound. Residents may also pursue further advanced ultrasound training during an elective rotation available to them. Residents also have teaching opportunities in Point of Care Ultrasound through our involvement with other GME, CME, and medical school ultrasound training programs.
DO YOU ALLOW GLOBAL HEALTH CARE ROTATIONS?
Yes. We have several faculty members on staff that are actively involved in global health care. We have longstanding relationships with medical institutions in several countries with regular participation on site. Recently, residents have spent time in Itlay, Peru, and Tanzania gaining valuable perspectives on global healthcare needs. Since we offer several elective rotations in our clinical curriculum, our residents have ample time to plan and take advantage of international medicine opportunities.
HOW DO THE RESIDENTS RECEIVE FEEDBACK AND EVALUATIONS?
Residents receive feedback through a variety of means. Feedback occurs immediately in the clinical setting and evaluations are completed at the end of each ED shift. Residents also receive written faculty evaluations after each completed rotation which can be viewed online. Faculty also perform real time direct observations of clinical care in the ED, procedural competency, and resuscitation competency. Residents meet with the residency leadership twice a year for a semi-annual evaluation and they also evaluate the program and faculty annually. Overall, our residents receive the optimal feedback possible by keeping communication lines open between faculty and residents. Our faculty is very friendly and approachable and all have an open door office policy for all residents.
WHAT IS YOUR PASS RATE ON THE BOARDS?
Our residency consistently scores in the top quartile of all US training programs on the annual American Board of Emergency Medicine (ABEM) In-service Training Exam. In fact, our most recent scores place us in the top 25% of all EM residency programs for overall mean score on the exam. After residency, our pass rate on both the written and oral ABEM exam exceeds the national average.
WHAT FELLOWSHIP OPPORTUNITIES ARE OFFERED AT WAKE FOREST BAPTIST MEDICAL CENTER FOR EM GRADUATES?
Fellowship programs in critical care, EMS, palliative care, pediatric emergency medicine, research, and sports medicine are available through our department or others in the institution. Our graduating residents have been very successful matching in competitive fellowship programs across the country.
TELL ME ABOUT TECHNOLOGY AT WFBMC?
Our institution and department believes in integrating technology in medicine. The medical center has been a leader nationally with utilizing computer based medical records, radiography and wireless applications. The hospital is considered one of the "most wired" hospitals in the nation. The medical center has electronic medical records (EPIC), EKGs, and X-rays that can be accessed at the bedside. The ED utilizes electronic documentation and order entry. The residency uses an online residency management system to track procedures, attendance, perform evaluations, and access important documents such as journal club articles online. We also have access and utilize the medical center's highly sophisticated "patient simulator" to teach resuscitation skills. Our IT department supports the use of personal devices on the network when used within our institutional guidelines.
DO YOU SEEK RESIDENT INPUT WHEN MAKING CHANGES TO THE RESIDENCY?
Absolutely. We hold regularly scheduled residency meetings that are open to all residents. We have an residency education committee made up of resident and faculty who meet on on regular basis as well. We discuss and make decisions in an open forum about clinical rotations, didactics, policies, etc. Most of our recent curriculum changes are because of initial input from residents concerns or comments.
DO YOU ALLOW MOONLIGHTING?
Yes. Residents have opportunities to start moonlighting in their second year.
WHAT DO RESIDENTS DO FOR FUN?
A variety of opportunities are available depending on your interest. Our residents schedule regular social events such as attending sporting events, movie nights, skiing trips, etc. NC has multiple state parks close to Winston-Salem where residents go hiking, rock climbing, and camping. Many of our residents are involved in either city or Wake Forest intramural athletic leagues. The city is very runner and biking friendly. There are some outstanding health clubs in the city including several YMCA's as well as work out facilities in the medical center.
