Vanderbilt Emergency Medicine

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.