Clinical Rotations

Overview

Our program’s clinical rotations emphasize critical care and exposure to a number of different emergency environments, including pediatrics. We also offer unique rotations in neuro-intensive critical care and early exposure to unparalleled ultrasound training and EMS. Throughout these rotations, residents will encounter complex patients with varying acuities in various settings including community rotations, acute care units, emergency departments, intensive care units, and the trauma resuscitation unit. Because of these unique opportunities, our residents graduate as well-rounded physicians who can thrive in academic and many types of community practice.

The hospitals participating in these rotations outside of University Hospital include:

• Main Methodist Hospital
• Metropolitan Methodist Hospital
• Baptist Health System
• Children’s Hospital of San Antonio (CHOSA)

Rotation Highlights:

PGY1

Focus on Foundations

Orientation Block

The goal of the Orientation block is to provide a smooth transition into residency. During this two week block, residents discover how the Emergency Department, hospital and community work together to provide patient care. Through this orientation block, participants get to know fellow residents and faculty through various educational experiences. Activities include a hospital tour, a library tour and visits to community resources. The residents are introduced to programs related to emergency medicine including the medical flight service, the disaster medical assistance team, the center for injury prevention and research. There are also procedure labs, splinting courses, and wellness events.  Residents will work about 15 hours weekly in the ED during this block.

Ultrasound Block

New residents will work closely with Ultrasound Fellowship-Trained faculty and fellows during the first half of their PGY-1 year.  During this block, you will learn all the core ultrasound modalities, ultrasound-guided procedures, basic ultrasound physics, and knobology.  Each week residents will review all the studies performed in the department with faculty and fellows, increasing their exposure to unique pathology, pattern recognition, and discussing current ultrasound literature by participating in weekly journal club.

Anesthesia

In addition to 3 weeks of general adult anesthesia at the VA, our PGY1 residents get to rotate with Tejas anesthesia and do 1 week of dedicated pediatric anesthesia.  With the general rarity of Pediatric airway procedures, this rotation allows residents ample exposure and opportunity to become comfortable with pediatric airways.

Other PGY1 rotations include: MICU, STICU, CCU, Pediatric EM, Longitudinal Trauma, and Orthopedic trauma.

PGY2

Focus on critical care

After your PGY1 year provides a foundation of common emergency presentations, procedures, and developing plans, the PGY2 year has a heavy focus on critical care.  During this year, residents rotate through the Neurocritical Care Unit and the Pediatric Intensive Care Unit.  In these blocks, residents function as senior residents, developing comprehensive care plans, performing advanced procedures, and developing comfort managing multi-organ system problems.

Toxicology/EMS

Residents in their second year are focusing on a broader view of Emergency Medicine, and this rotation allows residents to see the bigger systems that work to mitigate disasters, develop protocols with prehospital providers, and to know what it takes to get patients to the Emergency Department.  Residents work with EMS fellows and faculty, participating in medical direction, on scene calls and participating in didactics.

During this block, residents rotate through the South Texas Poison Control Center, working directly with multiple fellowship-trained toxicologists.  They also participate in calls and formal toxicology didactics, as well as the general approach to the poisoned patient.

Other PGY2 rotations include: OB/GYN, Pediatric EM at CHOSA, and Community ED blocks at Main Methodist and Baptist Health Systems.

PGY3

Focus towards independent practice

Much of the PGY3 year is focused in the Emergency Department.  Senior residents will have a focus on running resuscitations, supporting PGY1 residents, and also working as a Teaching Resident, where they assist 3rd and 4th year medical students with EM specific chalk talks, procedure guides, and mentorship.

Other rotations during PGY3 year are: Admin, Elective, Metropolitan Methodist Hospital, Longitudinal Pediatrics, Longitudinal Trauma, and MICU, functioning as the senior resident, assisting with consults and responding to codes.