Residency Programs  > Emergency Medicine  > FAQs 

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How do I contact the Emergency Medicine residency program?

Please contact:

Sherry Allen, Residency Coordinator
Palmetto Health Richland
Five Medical Park, Suite 350
Columbia, 29203
Phone: (803) 434-3790
Fax: (803) 434-3946
E-mail: sherry.allen@palmettohealth.org

 What is the accreditation status of Palmetto Health Richland's Emergency Medicine program?

The Accreditation Council for Graduate Medical Education granted full accreditation for the maximum of five years to the program in September 2009. Our application for continued accreditation will be reviewed in September 2014.  The program has always received continued accreditation.

When did the Emergency Medicine residency program begin?

The program began in 1974 at the Medical University of South Carolina in Charleston. The program moved to Richland Memorial Hospital (now Palmetto Health Richland) in 1978. The program is affiliated with the University of South Carolina School of Medicine ( http://www.med.sc.edu/).

Does the emergency department have full departmental status?

Yes, the emergency department currently operates as an independent department. The chairman of the Emergency Department, Dr. John Stewart, was the hospital chief of staff for Palmetto Health Richland in 2003.

How many residents are in the Emergency Medicine program?

Currently, there are 30 residents. All three classes have ten residents each.

How can I contact a current Emergency Medicine resident?

Residents can be contacted by class group e-mail. The mailing addresses for the current classes are:

Class of 2011 2011@emergencyresident.com

Class of 2012 2012@emergencyresident.com

Class of 2013 2013@emergencyresident.com 

Application

Does the program give preference to applicants from the southeastern area or the University of South Carolina?

Although the program strives to have diversification in every entering class, applicants with ties to South Carolina are given additional consideration with regard to being invited to interview with the program.  Regardless, each current class has graduates from ten different medical schools except for the class of 2012 (two students from Mercer University). Over the years we have had residents from 30 states. We are always looking for the best candidates for our program.

May applicants observe in the Emergency Department either prior to or after the interview process?

Yes, every interview season applicants are encouraged to schedule observation time in the Emergency Department to provide insight into the program.

Does completing a rotation at Palmetto Health Richland improve my chances of matching at this program?

It may help for certain candidates; however, most of the current residents did not complete a medical student rotation in our department prior to matriculation into the program.

Does the residency program accept physicians with previous training?

Yes, but this is becoming a rare occurrence. The classes of 2003 and 2004 each had one physician that had one previous year of post-graduate training. The classes of 2005 through 2013 do not have any physicians with prior post-graduate training.

Does the residency program accept osteopathic physicians?

Yes, the program traditionally attempts to match one osteopathic physician in each class.

Does the residency program accept international medical graduates (IMG's)?

We do accept applications from international medical graduates (IMG) who are U.S. citizens or have J-1 visas. However, it is very rare that we interview IMG applicants. Only one IMG has graduated from the program (class of 1980).

Are USMLE Step 2 scores required?
Although a part 2 score is desirable for application to the program, it is not required at that time. However, ultimately all residents at Palmetto Health are required to pass part 1 & 2 of the USMLE prior to matriculation into our program.

How many letters of recommendation are required?
Three letters of recommendation, in addition to the dean's letter, are required. One of these letters should be from an emergency medicine physician with whom you have worked in an emergency department setting. We encourage you to submit more than one letter from an emergency physician and also will accept more than three total letters of recommendation if they are available.

Curriculum - Clinical Rotations

How long is the Emergency Medicine residency?

36 months in a PGY 1, 2, 3 format.

What certifications are provided?

PGY-1: ACLS, PALS, FCCS, FEMA and ATLS provider certifications

PGY-2: You may also take ACLS, PALS and/or ATLS instructor training.

What is the curriculum of the Emergency Medicine program?

 PGY1    PGY2    PGY3  

Rotation

Length

Rotation

Length

Rotation

Length

EM

5 months

EM

8 months

EM

9 months

Pediatric EM & Orthopaedics

1 month

MICU

1 month

Electives

2 months

US/EMS

1 month

PICU

1 month

Tourist Medicine (Hawaii)

1 month

MICU

1 month

Trauma

1 month

 

 

Trauma

1 month

Cardiology

1 month

 

 

Internal Medicine

1 month

 

 

 

 

Inpatient Pediatrics

1 month

 

 

 

 

Obstetrics

1 month 

 

 

 

 

How many months do Emergency Medicine residents work in the Emergency Department setting?

Currently, Emergency Medicine residents do 23 months at Palmetto Health Richland in the Emergency Department with one month of these months dedicated to pediatric emergency medicine. During the senior year, one elective month may be spent working in the emergency department of Queen's Medical Center in Honolulu.

How many EM shifts per month do residents work?

PGY-1 and PGY-2 residents work 16–20 shifts per month (average 50 hours per week). PGY-3 residents work 13–16 shifts per month (average of 40 hours per week).

How long are Emergency Department shifts?

Residents work 12 hour shifts, 7 a.m.–7 p.m. or 7 p.m.–7 a.m. When allowable, swing shifts are eight hours lone and are scheduled from 3 PM- 11 PM.

How long after a shift do residents spend wrapping up or signing out?

On average, residents spend an additional 15–30 minutes after a shift to wrap up all loose ends.

How many patients are seen per hour in an Emergency Department shift?

One to two patients are seen per hour, depending on the resident's level of experience.

How many off-service call months do residents have?

PGY 1: MICU, Trauma, Internal Medicine, Pediatrics, OB/GYN,

PGY 2: MICU, PICU, Trauma, Cardiology (home call only for cardiology)

Do residents have call while on emergency medicine rotations?
Yes, resident usually have one to two days of home call while on emergency medicine rotations.  Residents are required to come for colleagues who are sick from 7 AM to 8PM.

How many call nights do residents take on off-service rotations?

The average call schedule for rotations with call is every 4th night. All rotations comply with the new ACGME standards for work duty hours.

How much exposure do residents have to pediatric Emergency Medicine?

Residents will average about one-third of their shifts in the Children's Emergency Center during EACH emergency medicine rotation.  This works out to approximately 100 shifts over the three-year residency.

What is the relationship like between the Emergency Medicine Department and the other departments of the hospital?

We have an excellent reputation in the hospital for providing efficient, quality care to patients. Therefore, residents find the vast majority of consultants eager to provide care to Emergency Department patients.

Is there an ultrasound teaching program?

Yes, ultrasound is an integral part of Emergency Medicine training at Palmetto Health Richland. All residents complete an introductory course in emergency ultrasound before they start working in the emergency department. In addition, two weeks of the intern year are dedicated to emergency ultrasound training with over 20 hours of lectures. Residents are required to log 400 exams during their residency training. Case reviews are routinely conducted by the faculty of the emergency ultrasound fellowship.  

Is there an aeromedical program?

Yes, the hospital's air ambulance service,  LifeNet, provides rapid air transport to the critically ill and injured as well as transport from accident scenes and inter-facility transfers for patients  needing additional medical resources.

Are residents involved in the aeromedical program?

Yes, residents may ride along during any year of their training. An elective also is available for PGY-3 residents.

How are residents evaluated?

Evaluations are completed on a semi-annual basis and are reviewed with the program director and the resident's advisor. Emergency Medicine residents receive composite written evaluations from the Emergency Department faculty. Each resident is evaluated on:

  • Compassionate Health Care
  • Interpersonal and Communication skills
  • Medical Knowledge and Information Management
  • Practice-based Learning
  • Systems-based Practice
  • Professionalism

Residents also receive feedback on

  • dictations
  • procedure logs
  • ultrasound logs
  • monthly testing and in-training exams
  • Simulation Medicine training for emergency procedures and resuscitations
  • Oral board simulation performance
  • Toxicology Training
  • Conference attendance and participation
  • Conference lecture presentations
  • EMS assignments
  • Off-service evaluations 

Residents annually complete an online evaluation form for each faculty member. Residents may also discuss any specific concern at any time with the program director, department chair, or director of graduate medical education.

How are specific rotations evaluated?

Residents complete an evaluation form online for each off-service rotation. These evaluations are compiled and then discussed at the annual curriculum meeting.

Are residents involved in changes to the program?

Yes, each year all residents attend a curriculum meeting to discuss every component of the program and how to improve the training. Several changes to the rotation schedule have been made based on recommendations at this meeting.

Curriculum-Electives

Hyperbaric Medicine

Palmetto Health Richland is the world leader in hyperbaric education. Each resident will have the opportunity to take a week-long course on hyperbarics before spending one to two weeks on the HBO consulting service.

Ultrasound

Since 1997, we have offered a comprehensive emergency ultrasound curriculum for our residents. Seniors may take an elective in ultrasound to learn techniques such as vascular ultrasound, vascular access, and advanced cardiology among others.

Aeromedical EMS

The elective includes additional air time with  LifeNet as well as training on the equipment unique to the air ambulance environment, administration, and aviation physiology.

Wilderness Medicine

Started in 1998, the wilderness medicine rotation is a lecture-based rotation covering a wide range of material from this unique area of emergency medicine. All lectures are provided by faculty experienced in the various components of wilderness medicine. Students also take part in outdoor skill stations and a camping trip in the nearby Appalachian Mountains. The rotation is only presented during the month of September.

Observational Medicine & Echocardiography

This is a one-month rotation focusing on the management of patients admitted to the Chest Pain Unit. In addition, the resident is trained in advanced echocardiography techniques that includes afternoons in the echocardiography laboratory at the Heart Hospital on the Palmetto Health campus.

International Emergency Medicine

This can be a two-to-six week rotation working in another country.  Residents have participated in a number of medical mission trips over the past few years to such locations as Honduras, Kenya, Mexico, Guatamala, Samoa, and Peru.

Tourist and Travel Medicine

PGY-3 residents can participate in a one-month elective in the Emergency Department at Queens Hospital in Honolulu ( http://www.queens.org/ ). Residents work  approximately twelve evening shifts. Each resident on the rotation has the use of a two-bedroom furnished apartment located in a secured building with covered parking that is only one block from the beach. Residents are responsible for providing airfare and may take their family members at their expense (most do).

Academic Emergency Medicine

This one-month rotation allows residents to focus on the development of their teaching skills. They are required to present two hours of lecture and resident conferences, teach medical students, and develop one lecture for upload onto our internet-based education system. Residents on the rotation receive advanced training in using Power Point and how to convert these Power Point files for upload to the internet.

Other electives include Dentistry, Ophthalmology, and Research

Curriculum-Conferences and Labs

Which residents attend the weekly Emergency Medicine conferences?

All residents on Emergency Medicine, Cardiology, Obstetrics, Pediatric Emergency Medicine, , EMS/ultrasound, and on-campus elective rotations are required to attend weekly conference.

Is conference time protected for residents?

Yes, the emergency department faculty covers for conference time so those residents scheduled in the ED may attend conference.

When are conferences?

Conferences are scheduled from 0700 to 1100 on Wednesdays.  One additional hour of conference time each week is done through online educations modules.

Who teaches conferences?

The first 60 minutes of each conference day is for "chief's conference." This time is reserved for residents to present interesting cases or review for the written board exam. The other hours of conference primarily are taught by the emergency department faculty.

Are there any recurring conference topics?

Topics regularly addressed include pediatrics, cardiology/EKGs, evidence-based medicine, journal club, oral boards, M & M, surgical procedure lab, and personal finance. One conference session per month is held at the simulation medicine center.

Are there conferences on business practices in emergency medicine, malpractice, coding and contracts?

Several conferences are provided on a variety of business issues in emergency medicine. In addition, a retreat is held for senior residents and their spouses each year at a mountain resort that is entirely dedicated to the transition from practicing as a resident to life outside the training program.

Does the program provide any procedure/skill labs?

Skill labs are provided for residents to improve techniques in all emergency procedures.  Animal and manikin simulators are utilized.

What resources are available for patient simulation?

The Simulation Medicine Center for Palmetto Health is located across the street from the administrative office of the emergency department.  The center's director is an emergency medicine faculty member, Dr. Eric Brown. The center has over 10,000 square feet of service areas and is capable of simulating nearly any medical emergency or procedure for resident education.  Residents work in the center one time each month when they are on emergency medicine rotations.

Do you have a journal club?

Yes, each month we review 10–15 articles related to emergency medicine as selected by one of our faculty members.

Are there scheduled times that all the residents meet?

There are approximately four to five dinner meetings scheduled during the course of the academic year. Residents' spouses are invited to most of these meetings. This meeting is held at different local restaurants that provide excellent food and atmosphere for the residents and their spouses to enjoy some time together outside the ED. Departmental news and upcoming events also are discussed, along with a presentation on a relevant EM topic.  The last meeting of each year is saved to conduct our annual senior roast.

What forms of teaching are required of residents?

Every PGY-2 and PGY-3 resident gives one lecture per year for the paramedic training course of Richland County EMS. All senior residents are encouraged to present cases during first 30 minutes of each conference day during what is referred to as "chiefs' conference."

Who is responsible for educating medical students?

Most medical students shadow PGY 2 &3  residents in the emergency department and present cases directly to them.

Does the program have an oral board review course?

Yes, a national oral board review course presented by the South Carolina College of Emergency Physicians is provided at a discounted rate to graduates. In addition, residents undergo oral board simulation during each quarter of their training.

Curriculum-Research

What are the research requirements?

The Residency Review Committee for Emergency Medicine requires the completion of a scholarly project by each resident by the end of their training. This requirement may be met by completing original research or by participating in a scholarly project approved by the Residency Director. Examples would include a textbook chapter, developing an on-line education module, or setting up an educational program for the residency. 

Is funding available for research projects?

Grants up to $7500 are awarded each year by the office of Graduate Medical Education at Palmetto Health. Additional funding is provided for travel expenses to residents who are invited to present their research at appropriate conferences.

Facilities

Describe the physical plant for Palmetto Health Richland?

The program is located at a community-based academic hospital with 650 total beds. Palmetto Health Richland is the only Level 1 Trauma Center in the 16-county Midlands region of South Carolina. The hospital is one of the primary teaching facilities for the University of South Carolina School of Medicine.

Describe the physical plant of the Emergency Department at Palmetto Health Richland?

In the Emergency Department, there are a total of 61 individual rooms divided into smaller treatment areas referred to as PODS. Included in these areas are two trauma bays, a children's emergency center, two dental and ophthalmology treatment areas, sexual assault examination suites, and a chest pain observation unit.

How many patient encounters are completed each year?

The annual patient census is more than 83,000 patient visits each year (25,000+ pediatric visits).

What is the admission rate from the Emergency Department?

Currently, our average admission rate is 22 percent with approximately half of those admissions going to the ICU setting. Approximately 8 percent of pediatric patients are admitted.

How long does a patient typically spend waiting for a floor bed once admitted?

Patients wait on average one-to-two hours prior to transfer; however, holds are common during busier months.

How are pediatric Emergency Department patients handled?  

There is a separate pod for pediatric patients with eleven beds as well as a resuscitation room. The current pediatric census is over 25,000 patients per year.

How are trauma patients managed?

All trauma patients with a significant mechanism of injury are managed in tandem with the trauma service. However, in every situation the EM resident manages the airway. Residents on the individual services share all other procedures in the trauma bay.

What are general lab turnaround times?

The Emergency Department has its own separate laboratory within the clinical area of the department. ABGs are finished within minutes. Most other labs are available in 30–45 minutes or less.

What radiologic services are available?

There are three CT scanners available 24 hours a day. ED patients receive first priority on all CT scanners. MRI and invasive procedures are also available 24 hours per day. There is an extensive radiology suite for plain films and two dedicated X-ray machines in the trauma bays.

Who reads radiologic films and when?

All imaging studies through the department of radiology are available for interpretation 24 hours per day. There are two dedicated radiologists who work exclusively night shifts for 24-hour-per-day readings.

Do residents train at other facilities? If so, how much time is spent at each facility?

One month of the residency is spent working in the MICU at the William Jennings Bryan Dorn Veterans Hospital. A one-month elective rotation is spent at Queen's Medical Center in Honolulu, Hawaii. The remaining 34 months are completed at Palmetto Health Richland (including all Emergency Department months) unless an off-campus elective is scheduled during the senior year.

Describe the physical plant for William Jennings Bryan Dorn Veterans Hospital?

The hospital has a total of 216 beds with a total of 32 ICU beds, including eight MICU, six CCU, ten PCU, and eight SICU. During your MICU rotation at the facility you will be providing care to various patients in each type of critical care setting.

Describe the physical plant for Queen's Medical Center?

The Queen's Medical Center, located in downtown Honolulu, Hawaii, is a private, non-profit, acute medical care facility. It is the largest hospital in Hawaii, licensed to operate with 526 acute care beds and 28 sub-acute beds. The medical center has more than 3,000 employees and more than 1,200 physicians on staff. It also is the state's trauma center. During your one-month "tourist and travel medicine" rotation at this facility, you will be providing care to a culturally diverse group of patients that live in and visit one of our most beautiful states.

How far apart are the Palmetto Health Richland and William Jennings Bryan Dorn Veterans Hospital?

The Dorn VA is 7.6 miles (approximately 16 minutes over local roads) from Palmetto Health Richland.

Emergency Department Faculty

How many faculty members are on staff? Are all faculty Emergency Medicine board certified?

There are 19 full-time staff members. Eighteen members of the faculty are certified by the American Board of Emergency Medicine. The other faculty member is a board certified pediatrician with extensive pediatric emergency department experience.

How experienced are the Emergency Department faculty members?

The average experience of all the faculty members is over 15 years. The chairman has practiced more than 25 years and has occupied his position since 1995. The medical director has practiced since 1990 and occupied his current position in 2007. The program director has been practicing since 1990 and has held his position since 2001. There is very little turnover inthe department's faculty.  In the last decade, only three attending physicians have left the program (one retired).

What is faculty coverage like during Emergency Department shifts?

There is extensive attending coverage 24 hours a day. Residents staff all patients directly with attending physicians. There are three attendings available from 7 AM-3 PM, four attendings available from 3 PM –12 AM, and two attendings available from 12 AM–7 pm

Benefits

Does the program pay for any journal subscriptions?

Each resident receives Annals of Emergency Medicine. Emergency Medicine Reports, Pediatric Emergency Medicine Reports, EM Practice, and EMRAP are available through our administrative website for download.

Does the program pay any professional membership dues?

The program pays each resident's dues for American College of Emergency Physicians (ACEP), the South Carolin Medical Association, the American Medical Association, and the Emergency Medicine Residents Association (EMRA).

Does the program provide residents with an educational allowance?

Residents receive $500 during the PGY 2 year and $1000 during the PGY 3 year that can be used for books, computer software, andtravel expenses to conferences or off-campus rotations.

Does the program pay for residents to attend outside conferences?

Residents receive $750 during the PGY 2 year and $1000 during the PGY 3 year that can be used for books, travel expenses to conferences, and software.

Moonlighting

 

When can residents start moonlighting?

Residents are allowed to start during the second half of the PGY-2  year.  Each resident that is moonlighting must be in good standing with the program and have completed all other residency-related assignments.

How many hours are residents allowed to moonlight?

Residents are allowed to moonlight an average of 40 hours per month.

How much do residents typically earn when moonlighting?

 Hourly rates for moonlighting at various emergency departments range from $125-$200 per hour.

Post-Graduation

What is the first time pass rate of graduates on the ABEM examinations?

The first time pass rate in the written test component of the ABEM certification exam is 100 percent from 2006-2010 (45 of 45). 

The first time pass rate in the oral test component of the ABEM certification exam is 92 percent from 2002 to 2007 (41 of 45). 

All graduates who failed on the 1st attempt of the written oral boards passed on their 2nd attempt.

Do residents have difficulty finding jobs?

No. Emergency medicine specialists trained at our facility are in high demand.

Where do graduates practice?

Approximately 10 percent of graduates go into academic emergency medicine. The remainder of our graduates have pursued clinical practice in a mix of urban and rural locations. The majority of graduates go on to practice in the Southeast region of the country, but we have graduates who have relocated to thirty of the fifty states.

In the past five years, six residents have gone on to fellowship training (emergency ultrasound - 2; toxicology - 2, academics- 1, EMS - 2). 

Four of the current PGY 3 residents are applying for fellowship positions (international medicine - 2; pediatric emergency medicine - 1; simulation medicine - 2).

What fellowships are available at Palmetto Health Richland for Emergency Medicine residents?

  • Sports Medicine
  • Emergency Ultrasound

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