The First Year

The first year of training is designed to give residents the strong background in various specialties that he or she will need to practice clinical medicine. At the same time, residents are taught to use these skills in caring for patients in the Emergency Department.

Residents will learn to focus the broad fund of knowledge learned in their undergraduate years and apply it to the practice of Emergency Medicine. The program stresses the importance of good interpersonal and communication skills as well as the importance of professionalism.

Problem solving, logical thinking and assimilation of information are fundamental to the successful practice of emergency medicine, and the faculty continually help the residents to become proficient in using and applying these skills in the clinical setting.

PGY-1 Goals:

  • Residents will focus on developing skills in individual patient evaluation, management and medical decision-making while delivering safe and efficient patient care within the context of their practice environment. They will learn the principles of team-based patient care.
  • Residents will become competent in the identification of the critically ill patient, the performance of a targeted history and physical exam, the appropriate use of laboratory & diagnostic studies, development of a treatment plan, invasive and non-invasive therapeutic interventions, request for appropriate consultation, patient reassessment and appropriate disposition, transition of care and follow-up.
  • Residents will learn the approach to common emergent and critical presentations and become competent in prioritizing, developing appropriate differential diagnoses and management plans while avoiding misdiagnosis or delayed diagnosis of life threatening conditions.
  • Residents are expected to see a reasonable number of patients and will begin to develop multi-tasking skills. Patient load will be determined by the acuity and complexity of cases and the degree to which procedures, diagnostics, etc. are required for each case. While they are responsible for following through with all details of their patients, they will keep the senior resident or attending informed of results or changes in the patient’s status.
  • Residents will learn appropriate medical record keeping and documentation and will become competent in the use of the Electronic Health Record.
  • The resident should understand the basic resources available for patient care, being able to formulate a question and enlist the appropriate resources to find the answers to that question. They should have a basic understanding of research methodology and design. They should understand the essentials of the QI process, root cause analysis, errors and near misses.
  • Residents will attain competence at basic procedural skills including endotracheal intubation, peripheral and central venous access, wound management, incision and drainage, and orthopedic maneuvers and splint application. The resident will begin to gain competence in the use of ultrasound for diagnostic and therapeutic interventions.
  • Residents at this level should be able to communicate effectively and professionally with all members of the health care team as well as patients and their families. They are expected to adhere to the honor code and promulgate individual responsibility, integrity, and professionalism as a reflection of themselves, the Program and Kaiser Permanente.
  • Residents should be able to listen and learn from constructive feedback, identify strengths and weaknesses and strive to improve during the course of the year. Through patient follow-up, they should be able to apply lessons learned to improve the care of future patients. Residents will be expected to construct and maintain an individualized learning/teaching portfolio.