CLINICAL ROTATIONS
FIRST YEAR
Orientation/Airway Mgmt
Emergency Medicine
Cardiac Care Unit/Cardiology
(UNC)
Internal Medicine (WakeMed)
P Skills
Ob/Gyn (WakeMed)
General Surgery (WakeMed)
SECOND YEAR
Emergency Medicine
Trauma (UNC)
PICU (UNC)
Surgical ICU (WakeMed)
MICU (WakeMed)/Research
Orthopedics (WakeMed)
THIRD YEAR
Emergency Medicine
Administrative month
Elective
1 month
6
months
1 month
1 month
1 month
1 month
1 month
7 months
1 month
1 month
1 month
1 month
1 month
10 months
1 month
1 month
First year rotations:
Orientation- This is a great introductory month. It is a brief crash course in Emergency
Medicine. This month includes a two day airway course, two day ultrasound course,
simulation time and time in the recess lab. There is a procedural skills section where
residents practice splinting and suturing. It is during this month residents become
certified in ATLS, ACLS, PALS. There are many introductory lectures during this time
as well. This month is a great time for the new class to get to know one another and is
also filled with multiple social events for residents and their families. Residents leave this
orientation ready and prepared to start intern year!
Emergency medicine (first year)- These months are equally split between UNC and Wake
Med. The UNC shifts are 7a-7p, 7p-7a, and an occasional float shift 12a-12p. There is
also a team C shift (minor trauma) from 5p- 2a. The shifts at Wake Med are 7a-5p and
5p-3a. The pediatric shifts are either 7-3, 3-11 or 11-7a. The intern works 18 shifts a
month.
CCU- This month occurs at UNC. The intern is part of a team that takes care of cardiac
patients. The team is composed of an intern, resident, fellow and attending so the learning
opportunities are countless. During this month you follow patients in both the cardiac
intensive care unit and the floor.
Surgery- This month is at WakeMed. During this rotation, you learn to manage basic
surgical patients. While on call, you go to all traumas and perform all consults. You
spend a small amount of time in the operating room where you are always the first assist.
You are assigned to cases that will improve your technical skills.
Ob/Gyn- This month is at WakeMed. It is a very busy month and most residents end the
month with over 40 deliveries! The resident will learn basic ob/gyn skills and are better
prepared to care for pregnant patients at the end of the rotation.
Internal Medicine- This month is at Wake Med. The resident is assigned to a medical
team composed of one attending, one upper level medicine resident and the ER resident.
It is a great rotation with lots of teaching time and medical conferences.
P-Skills- This is a month dedicated to pediatrics, subspecialties, EMS and ultrasound.
The resident will work several pediatric shifts. They will also spend 2 days in
ophthalmology clinic practicing the slit lamp and two days in the ENT clinic learning
how to manage ENT complaints. During this month, the resident will also have a few
EMS ride alongs. There is also some time to practice ultrasound skills. The resident is in
charge of their schedule during this month so it is a very flexible month.
Second year rotations
Emergency medicine- (second year) The second year resident is in charge of the B-side
of the emergency department. They are usually paired with an off service intern and
begin to learn how to run an emergency department. Shifts are 7a-5p, 5p-3a. The shifts at
Wake Med remain the same as intern year.
Ortho- This rotation is at Wake Med. During this month, the ER resident is in charge of
the consult pager. We are not involved in floor management of patients or expected to go
to the operating room. It is a great month for learning emergency orthopedics. We are
able to perform many reductions during this month. We are also able to practice our
splinting.
SICU- This month is at Wake Med. During this month, the resident is paired up with a
surgical intensive care attending. The resident will learn to manage the most severe
trauma and surgical patients. There is no overnight call.
PICU- This month is at UNC. The resident gains more experience managing critically ill
children in an ICU setting. There is a flexible overnight call schedule.
Trauma- This month is at UNC. During this month, the resident attends all traumas. They
are also responsible for helping manage acute surgical consults from the floor and
emergency department. The resident follows patients through their ICU hospital course,
but have no floor responsibilities.
MICU/research- This month is at Wake Med. During this month, the resident will work
one on one with the medicine intensivist. The resident and attending are responsible to
run all codes in the hospital. The resident will also work with the intensivist on all new
admissions and management of patients in the ICU.
Third year rotations:
Emergency medicine- (third year)- The third year is in charge of the A side. The shifts
are either 7a-3, 3p-11 or 11-7a. The shifts at Wake Med remain the same. The third year
resident is in charge of the department.
Administrative/Research month- This time is dedicated to finishing the required
residency project. The resident also has an opportunity to participate in administrative
meetings and projects to improve ED logistics and patient care.
Elective Month: Residents have the opportunity to take one month of elective in the final
year. We offer a number of interesting opportunities to explore areas of interest or
develop clinical or research skills.
1. Scholarly Activity Elective - The research elective is designed to allow the
emergency medicine resident to complete his/her research project. The time can
be used to 1) complete a laboratory experiment, 2) collect data, 3) prepare a
manuscript. The resident is expected to attend conference. In order that progress
on the project can be monitored, the resident will be required to meet weekly with
a faculty mentor.
2. International Elective - The road has been paved by residents and attendings
alike to study foreign language and emergency medicine in other countries.
Recent graduates have spent elective time in Europe, India, Costa Rica, Hawaii,
and northewestern Canada. Current faculty have also participated in medical
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missions to Panama. In addition, the chair of the department, Dr. Tintinalli, has
spent extensive time in Turkey, Poland, and Mexico (just to name of few places)
and can facilitate electives.
Children's Emergency Department at Wake - For residents desiring more
experience with pediatric emergency medicine, a dedicated month of pediatric
emergency medicine is available.
Pediatric Intensive Care - at Wake. For residents desiring more experience with
pediatric intensive care, a second dedicated month of PICU at Wake is available.
Call and other responsibilities will be worked out between the resident and the
pediatric intensivists at Wake.
Administrative Elective - at UNC/WMC. This elective is designed to expose the
resident to the responsibilities of managing both an academic and a non-academic
practice of emergency medicine. Time will be split between UNC and Wake. A
medicolegal review elective has also been arranged by past graduates.
EMS at Wake/UNC - For residents desiring more experience with EMS, a
second dedicated month of EMS at Wake and or UNC is available.
Responsibilities will be worked out between the resident and the EMS Director at
Wake and or UNC.
Toxicology - at Carolina's Medical Center in Charlotte, NC. The toxicology
elective is designed to provide the resident with an advanced knowledge base in
toxicology. This will be accomplished by spending a month on the toxicology
service at Carolina's Medical Center in Charlotte North Carolina. This elective
will expose the resident to the career of an emergency medicine toxicologist to
help the resident make an informed decision about entering a fellowship in
toxicology.
Alternative Electives - Residents desiring a unique educational elective may do
so by accomplishing the following: 1) receiving written approval from the
program directors by June 1, prior to the third year, 2) providing to the program
directors a set of educational objectives for the month, 3) providing your own
housing arrangements, 4) providing written approval from the rotation director,
who must be an Emergency Medicine physician, or must be a person deemed
suitable by the program directors to take responsibility for rotation on behalf of
the resident.