+ The Mission Statement of UC EM

The mission of the Department of Emergency Medicine is to provide compassionate, equitable and timely care in service to our community through innovation, collaboration and research, and to train the future of the specialty, as we have done since the birth of Emergency Medicine. Our vision is to be international leaders in emergency clinical care, education and research.

+ The History of the Residency Program

Postgraduate training in Emergency Medicine began in 1970 with the establishment of the nation’s first residency in Emergency Medicine at the University of Cincinnati Medical Center. The residency started with one resident in 1970 and has flourished to its present level of 56 residents over four years of training with 14 residency positions per year. The residency has the full accreditation of the Accreditation Council for Graduate Medical Education (ACGME). Many leaders throughout the world in both academic and clinical Emergency Medicine received their training at the University of Cincinnati. In July 1982, the Department of Emergency Medicine expanded its residency program from a three-year format to a four-year format. The benefits of a four-year training program are many, but they boil down to becoming a more experienced clinician, educator, and leader poised to embark on a fulfilling career in Emergency Medicine, rather than isolating the focus upon competence in the care for the acutely ill.

+ Career Satisfaction

The goal of your residency training is not only to train you to take care of patients well, and not just to get you a job, but to get you THE JOB. The ideal job that will fulfill your life goals. This journey is extraordinarily difficult to navigate in a mere few years out of medical school. Our training program, through the use of focused mentorship and increased elective time, allows you to explore all aspects of Emergency Medicine, including Critical Care, EMS, International, Tactical, Ultrasound, Research… if you can dream of incorporating it into your career, we can design electives that will allow you to explore it. Community Practice, Clinician-Educator, Academic Researcher, Operations Director – any of it is possible with the right training.The educational mission of our Department is to train residents to be able to function at the highest level in any Emergency Department. We strive to produce emergency physicians with the ability to become leaders in Emergency Medicine. Their clinical experiences, both as the primary caregiver and in a supervisory role, coupled with their involvement in academic pursuits, give them the opportunity to obtain faculty positions at teaching institutions upon completion of their training. We are very proud that a significant number of our alumni from our four-year program have pursued academic careers. 

+ Academic Excellence

One point of focus of the four-year curriculum is developing teaching strategies in the ED. Effective bedside and didactic teaching is not innate. It is taught and learned over time. Many of our residents enjoy educating medical students and residents and we focus our curriculum on developing those skills for future careers. Much of our PGY-4 year is spent not only on patient care, but also in supervision of junior residents in preparation for a potential teaching role in the ED in the future.  

+ Clinical Excellence

Four years of varied and longitudinal training in Emergency Medicine allows more mentored patient encounters, more critical care experience both in the ED and in the ICU, and more time in both Academic and Community settings to understand the differences in practice. The result is an emergency physician that can excel in any practice setting upon graduation, rather than after gaining a few more years of experience.·

Curriculum

• Four years allows for adjustments in curriculum to meet the ever-changing demands of Emergency Medicine in the real world. It allows for the flexibility to move and add rotations that the residents feel are important. We have modified rotations most years based on resident feedback and the changing landscape of Emergency Medicine. This would have been impossible in a three-year program. Four years also allows the time to master the vast educational curriculum in Emergency Medicine to provide superior patient care.

Electives

• Four years also allows for a substantial 6.5 months of elective time for career exploration and professional development. Elective time is available in the second, third, and fourth years of our curriculum and provides opportunity for residents to explore areas of interest and form a niche within EM. This distinguishes our residents when they apply for jobs or fellowships, as they are uniquely skilled and qualified to compete for the best academic and community positions as well as the top fellowships in the country. This is evidenced by the number of graduates of our program who hold leadership positions in our specialty all over the country. Many of our residents are offered leadership positions straight out of residency.

Clinical Maturity

• Expertise in Emergency Medicine requires a high volume of patient encounters supplemented by continual teaching from dedicated attending physicians. Our four-year curriculum is built on a model of graduated responsibility that provides the resident with the clinical experience and confidence to be immediately successful after residency training in any clinical environment, whether they enter an academic or community setting.

Fellowships and Academic Careers

• Many three-year programs tell applicants that they can always do a fellowship after three years of residency training and that the fellowship is a better use of their time if they wish to enter academics. Fellowships offer focused clinical and educational exposure in a subspecialty, but lack a broad scope of patient encounters and education in Emergency Medicine. Fellowships will not provide what a fourth year of residency training can provide as fellows generally work considerably less clinical time in the ED in order to pursue the focused goals of fellowship. Interestingly, graduates of four-year programs tend to enter fellowships and take jobs within an academic or teaching setting at a much higher rate than those of three-year programs. In addition, a four-year program graduate is often more competitive for fellowship positions with productive use of elective time during residency.

Supervisory Role

• Our fourth-year residents act as junior attendings and supervise medical students, residents from other specialties, and our own EM first-year residents. This increases their clinical exposure to an even wider variety of patient encounters than they could experience in seeing patients primarily, and it prepares them to better move into the attending/supervisory role when they complete residency, overseeing both residents and APPs. Many medical students and residents are interested in teaching. Rather than struggling to develop this skill on the fly in a three-year program, the fourth-year supervisory role allows the resident to focus on honing skills as an educator of patients, medical students and residents, while still in an environment to receive feedback.

Determining the Training Length for Emergency Medicine

• When medical educators and policy makers met to decide on optimal Emergency Medicine training length, estimates were suggested as high as 13 years! The country needed EM physicians, it needed them quickly, and with minimal expense. Out of necessity, Medicare went with the bare bones approach and advocated for three years as that is the “minimal” training length. Institutions that are able to fund four-year programs are committing to and investing in an educational mission. In the last 10 years, there have been multiple three-year programs which have converted to a four-year model. It is more rare for a program to downsize from a four-year to a three-year model and that decision is typically driven by the need to quickly increase the number of trained Emergency Physicians in the local, under-served region.

Options - Opening ALL Doors

• Graduating from a four-year program assures that you can apply for any position in Emergency Medicine. Three-year program graduates often have to bring more experience to the table before they are considered for many positions, while graduates of four-year programs are much more likely to enter academic positions or become clinician educators when they finish residency. Our graduates advance to a true leadership role in the fourth year and mature to a level they would not otherwise reach. This critical time period allows us to train not only excellent clinicians, but outstanding physician leaders.