The Second Year

The second year resident (EM-2) focuses on stabilization of the critically ill patient and assuming a leadership role in the ED. Time spent in the trauma critical care and pediatric intensive care units ensures that the resident is comfortable with treating and caring for the critical patients for prolonged periods and is aware of the progression of pathology in these individuals. They will also become proficient at invasive procedures required for the care of critically ill and injured patients.

PGY-2 Goals:

  • The second year Emergency Medicine Resident will concentrate on expanding and refining patient care skills begun during the first year. Under the supervision of the senior resident and attending, the PGY-2 resident begins to focus on developing an efficient approach to patient care and becomes proficient with the skills needed to recognize stabilize and manage complex and critically ill patients. They will become proficient at multitasking and be able to manage several patients simultaneously.
  • 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. They are expected to see a larger number of patients to broaden the base of expertise. Participation in major medical and trauma resuscitations is increased during the second year of training. The PGY-2 resident is responsible for airway management at resuscitations and may act as team leader for select encounters.
  • Residents will expand their knowledge of the efficient use of the EHR and will be competent in advanced uses of the HealthConnect EHR (CareEverywhere, “TeachingTips and “EBM Smartphrases”, filters, graphs,etc). They will be able to clearly document their own medical decision making and understand the evidence that supports that reasoning. They will understand coding and billing of the EHR. Residents at this level should also understand the limitations and potential pitfalls of the EHR.
  • The resident will participate in department and hospital QA/QI initiatives, become fluent in the QI process/root cause analysis and will begin working on their own QI project to be completed by their PGY-3 year. They will learn the essentials of risk management and understand the medico-legal review process. The resident should become proficient at research methodology and be able to formulate a question and work towards completion of a Scholarly Project. At this level the resident will be proficient at critically appraising different types of research of and will participate and present at regular journal clubs. Residents will understand the role of regulatory bodies and understand the role and mission of national Emergency Medicine organizations.
  • The second year resident should be competent with advanced procedural skills including advanced airway management, cardioversion/defibrillation, central venous access, and IO placement, tube thoracostomy/thoravent placement, pericardiocentesis, diagnostic and therapeutic uses of ultrasound.
  • 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 and the QI process, they will continue to apply lessons learned to improve their own practice. They will learn to become skilled educators, being able to effectively teach, mentor and give constructive and appropriate feedback to medical students and junior residents. They will continue to build their portfolios and participate in CV and job readiness workshops. Through mentoring and self assessment, they will learn the importance of work-life balance, long term wellness and prepare for a sustainable career in emergency medicine.