Emergency Medicine
Emergency Medicine
The Emergency Medicine undergraduate experience introduces medical students to the role of the department in the delivery of health care. The Emergency Department is in essence the “show room” for the hospital center. It is a barometer of the well-being of the community, as well as the entire health care system. In Emergency Medicine, students will notice a wide diversity of undifferentiated illness, from the simple laceration to the complexity of a myocardial infarction leading to cardiac arrest. The student will learn how the triage system coordinates how these diseases will be addressed.
First and Second Year Medicine
Our staff are the faculty for various clinical programs in the Med I year, including “Professional Competencies” (Skilled Clinician), Integrated Clinical Experience (ICE), Student Led Clinical Case Review (SLCCR), as well as Host Defence. Many students enter a lottery for the Med II experience of an elective in the Emergency Department. This is a unique opportunity to have an unparalleled “one-on-one” tutorial by the EM faculty.
Clinical Clerkship (Med III and IV)
PIER (Positioning, Integration, Evaluation, Review) I, II and III are combined in a longitudinal unit that occurs in stages throughout the Med III Clerkship year. Emergency Medicine faculty take a leadership role in the administration and running of these multidisciplinary units. All PIER units consist of a combination of lectures, small group sessions, simulated patient encounters, skills and procedures sessions, and simulated resuscitation scenarios. The objectives for the PIER I unit are to familiarize students with hospital and clinical processes, refresh students’ basic clinical and communication skills, and set a framework for clinical problem solving. PIER II occurs after the first 12-week unit of clerkship and features more advanced procedural skills, as well as an opportunity for student-led teaching about clinical cases they have encountered. PIER III occurs in September of the fourth year. The unit is meant to consolidate skills learned in clerkship and to expose students to more advanced simulation scenarios and skills including an airway workshop using clinical grade cadavers, prior to commencing their Med IV electives.
All students complete a three-week rotation during clerkship. As the delivery of Emergency Medicine is unique to each hospital, clinical clerks may rotate at either tertiary care centres or community hospitals. Each experience offers the students different rewards and challenges while fulfilling the learning objectives by the Office of Undergraduate Medical Education and maintaining the standards of the specialty of Emergency Medicine.
Electives
Electives are available for Med II (Dalhousie summer students), as well as for Med IV students. Please contact UGME or Andrew Steele (andrew.steelemoore@cdha.nshealth.ca) for details.
Residency Training
The College of Family Physicians Residency in Emergency Medicine is a one-year program after completing the CFPC Program. The program consists of clinical work, weekly academic days, extensive simulation workshops, and both written and oral mock examinations. Residents participate in grand rounds, journal club and a year-long research component. The Residency is divided over several sites, including Halifax, NS, Saint John and Moncton, NB.
Rotations include Adult Emergency, Pediatric Emergency, CCU, Orthopedic Surgery, Plastic Surgery, ICU and an elective. The program prepares residents to challenge the annual CFPC-EM certification examination.
The Royal College of Physicians and Surgeons Residency in Emergency Medicine is a five-year program offering extensive exposure to the clinical aspects of Emergency Medicine and related specialties. In addition, the resident receives specific training in relevant aspects of medical education, pre-hospital care and administration. Active participation in original research is a core component of this program. Residents have the option to pursue subspecialty training (Pre-hospital Care, Toxicology, Critical Care, Pediatric EM, etc.) during the fourth year, and ample elective time to pursue a masters degree. (Examples include Medical Education, Clinical Epidemiology, Public Health.)
The five-year rotation schedule is as resident-centric as possible. An example schedule follows:
Year One
Twelve weeks of Emergency Medicine. Eight weeks each of: Internal Medicine, Anaesthesia, Pediatric EM, and Surgery. Four weeks each of: Psychiatry, Plastics, Pediatric Anesthesia and Adult Anesthesia.
Year Two
Sixteen weeks each of: Emergency Medicine and ICU. Eight weeks each of: Neurosciences, Pediatric Emergency Medicine and Orthopedics. Four weeks of CCU.
Year Three
Sixteen weeks of Emergency Medicine. Four weeks each of: Pre-hospital, Research, Medical Education, Plastics, Trauma, Elective, Pediatric Emergency Medicine, Pediatric ICU, Community Emergency Medicine.
Year Four
Twelve weeks of Emergency Medicine. Twenty-four weeks Elective. Four weeks each of: Administration, Research, Toxicology and Anesthesia (Difficult Airway).
Year Five
Twenty weeks of Emergency Medicine. Twelve weeks Elective. Eight weeks each of: Research, Pediatric Emergency Medicine and Senior Trauma.
Suggested Resources
Emergency Medicine: Concepts and Clinical Practice, Rosen, Barkin et al
Emergency Medicine: A Comprehensive Study Guide, JE Tintinalli, E Ruiz, RL Krome
Continuing Professional Development
The Department of Emergency Medicine is very active in the provision of high-quality Continuing Professional Development (CPD) at local, regional, national and international levels, including many invited workshops and keynote lectures, in addition to submitted workshops and abstracts. Dalhousie relies heavily on this department for the biannual Dalhousie CPD Emergency Medicine Refresher conference, in addition to the Mini Medical School, webinar series and the faculty development series for the Faculty of Medicine.
This department is home to the Canadian Association of Emergency Physicians (CAEP) roadshows, including the Airway Interventions and Management in Emergencies (AIME) roadshow, the Emergency Department Strategies for Teaching Any Time (ED-STAT) roadshow, the Risky Business and the Emergency roadshow, and the Emergency Medicine Review Course (EMR-I and EMR-II).
Last year, the Department of Emergency Medicine collaborated with Dalhousie CPD’s faculty development to establish a program in critical thinking and an online professional development course, “Teaching and Assessing Critical Thinking” (TACT-I), and this year they have extended this program to include TACT-II. The “Teaching is Where It’s AT” series, including RAT, CAT and iCAT, are also dependent on this department. A new Simulation Training Course in 2014 and 2015 and the new Halifax Resuscitation Course in 2015 complete the new CPD offerings from the Department of Emergency Medicine.
Research
The Department of Emergency Medicine is committed to building research capacity and advancing knowledge in Emergency Medicine. Our investigators have a broad range of research interests that reflect the diverse nature of clinical practice in emergency departments and in pre-hospital care. Our particular strengths are in the areas of EMS, advanced airway management, resuscitation, patient safety and clinical decision-making as well as medical education and knowledge transfer. There are active multidisciplinary research programs in Emergency Medicine at Horizon Health, Capital Health and the IWK Health Centre. Our residents have successfully secured grant funding and won numerous awards for their excellent research projects.
We have a highly-skilled research support team that works with trainees and investigators to facilitate, support and promote the research activities in our department. They contribute their expertise in database management, research administration, grant applications and Research Ethics Board submissions. The Dalhousie Department of Emergency Medicine Research Committee, which includes representatives from our sites in Nova Scotia, New Brunswick and Prince Edward Island, meets regularly to support regional collaboration.