The Emergency Medicine Residency at Penn State Health Milton S. Hershey Medical Center is a three-year, ACGME-accredited program that accepts nine residents per year.
Thank you for your interest in Penn State Health’s Emergency Medicine Residency Program. It has many advantages for the emergency physician in training:
- Hershey Medical Center is a large academic teaching hospital — the only combined Level 1 adult and pediatric trauma center in the state.
- We see more than 75,000 visits per year; 19,000 are pediatric patients. With high patient acuity and a wide variety of complaints, our residents are provided with an exceptional and well-rounded exposure to both common and rare pathologies.
- The emergency department includes more than 60 patient treatment areas. There are resuscitation bays, an ED observation unit, an area of patients with less severe illness or injuries, as well as a recently expanded Pediatric Emergency Department.
- Through Life Lion air and ground EMS services, we provide both 911 and critical-care transport for the local community and greater central Pennsylvania region. All residents are trained in providing medical command, and senior residents take medical command calls in the department under faculty supervision. Residents and faculty also provide event coverage at Beaver Stadium in State College, PA, for home Penn State football games.
- We use the latest technology including a completely electronic medical record, electronic patient tracking system, computerized order entry, a digital radiology system, select point-of-care laboratory testing and point-of-care ultrasound. Residents and staff use a wireless telephone system so they are never tied to a phone.
The academic year is broken down into 13 four-week blocks. The 2016-2017 academic year block schedule includes:
- Emergency Department – 7 blocks
- Anesthesia – 1 block
- Cardiology – 1 block
- MICU – 1 block
- Obstetrics and Gynecology – 1 block
- Orthopaedics – 1 block
- Trauma Surgery – 1 block
Seven blocks are spent in the emergency department during the PGY-1 year, including the first block in July, which is dedicated to orientation. Residents become accustomed to patient care as well as their role in the department. ED blocks are balanced with off-service rotations throughout the year.
This rotation focuses on the perioperative airway and anesthetic management of patients undergoing surgery. Residents work under the direct supervision of an anesthesiologist. Responsibilities include performance of pre-operative history and physical examination, induction and maintenance of anesthesia, airway and ventilator management, intra-operative monitoring and post-operative evaluation.
This rotation is shared between both the acute cardiology and the congestive heart failure services. Residents become familiar with the acute and daily management of common and uncommon cardiac issues.
The Medical Intensive Care Unit (MICU) is a busy, high-acuity rotation, where residents stabilize and manage a large variety of pathology, including more common conditions as well as more complex cases infrequently seen outside of an academic teaching facility.
Obstetrics and Gynecology – Harrisburg Hospital
The Obstetrics and Gynecology rotation is completed at Harrisburg Hospital, part of Pinnacle Health System. During this rotation, residents familiarize themselves with the stages of labor and delivery, and participate in both uncomplicated and occasionally complicated deliveries.
The orthopaedics rotation focuses on the evaluation and management of musculoskeletal complaints. Residents work under the supervision of Emergency Department faculty, as well as working in conjunction with the Orthopaedics team. Residents learn the necessary elements to complete a detailed musculoskeletal exam, determine any appropriate testing for the complaint involved, perform or assist in relevant procedures, as well as determine management of that complaint.
Residents will be a member of the Trauma Surgery team and participate in the care of patients meeting trauma criteria, with primary emphasis on evaluation, resuscitation, proficiency in procedural skills, as well as post-operative monitoring and care. The resident is supervised by the team leader (senior surgical resident) and trauma faculty.
- Emergency Department – 8 blocks
- Emergency Department at Pinnacle – 1 and 1/2 blocks
- EMS – 1 block
- Surgical Anesthesia Intensive Care Unit (SAICU) – 1 block
- PICU – 1 block
- Ultrasound – 1/2 block
Eight blocks are spent in the emergency department during the PGY-2 year. Residents focus on honing the skills obtained during their PGY-1 year, as well as providing more efficient delivery of patient care. They balance this with new skills expected of a senior resident, such as taking medical command calls, coverage for trauma airways, and supervision and teaching of medical students and junior residents.
Emergency Department – Harrisburg Hospital
Six weeks are spent in the emergency department of Harrisburg Hospital, part of Pinnacle Health System. This is an inner-city community hospital in Harrisburg, PA. The rotation is designed to expose residents to all types of patients presenting to a non-academic, non-tertiary care emergency department.
This PGY-2 level EMS rotation is geared towards educating the resident about the structure and function of EMS and the role of the emergency physician in interacting with pre-hospital providers. The resident will work under the direct supervision of the attending physician or senior healthcare provider (RN or paramedic) on scene.
Surgical Anesthesia Intensive Care Unit (SAICU)
A rotation at the PGY-2 level in the Surgical Anesthesia Intensive Care Unit (SAICU) is required of all residents. The rotation is designed to expand the resident’s knowledge base regarding the evaluation and management of the critically ill surgical patient. The Emergency Medicine resident will spend two weeks on the Anesthesia Critical Care Service and two weeks on the Surgical Critical Care Service. There is a broad range of pathology seen on either of the two services during the SAICU rotation.
The Pediatric Intensive Care Unit (PICU) rotation is required of all residents. The goal of this rotation is to develop the resident’s knowledge base in the evaluation and management of critically ill pediatric patients. The resident oversees a mix of medical and surgical cases, as well as common and uncommon pathologies, while rotating in the PICU at our nationally ranked Children’s Hospital.
All PGY-2 residents have a dedicated two-week ultrasound rotation under the direct supervision of the department’s Ultrasound Director. The rotation enhances the resident’s ability for real-time decision making based on point-of-care ultrasound findings. Preparation for independent practice occurs by furthering their skills in both ultrasound image acquisition and interpretation.
- Emergency Medicine – 11 blocks
- Elective – 1 block
- MICU/Pinnacle – 1 block
Eleven blocks are spent in the emergency department during the PGY-3 year. This rotation focuses on refining the clinical skills achieved during the first two years of residency and developing the supervisory and administrative abilities required to manage an emergency department. Residents learn the logistics of running a busy department, including the elements of throughput, staffing, and efficiency. They continue to supervise medical students and assist junior residents, in addition to managing their own patients, all in preparation for independent practice.
MICU – Harrisburg Hospital
This rotation occurs in the Medical Intensive Care Unit (MICU) at Harrisburg Hospital, part of Pinnacle Health System. This rotation provides an opportunity for the resident to further their skills in the evaluation and management of multiple critically ill medical and surgical patients, but at a community hospital with a different patient population and varying pathology.
All residents have a four-week elective rotation in their PGY-3 year. Residents may arrange an elective within the Penn State Health system, or may gather information on an outside rotation and apply for approval through the GME office.
Resident Life FAQs
How are the shifts scheduled?
Shifts are nine hours long with the final hour focused on patient disposition and transitions of care. Interns typically work 21 shifts in a four-week block with decreasing numbers of shifts in each subsequent year of residency. There is also a clinical shift reduction for blocks containing vacation weeks.
Do you have electronic medical records in the emergency department?
Yes, Penn State Health is integrated into one EMR. There is an electronic tracking board to assess throughput and optimize patient care in the department. All charting, order entry and result viewing is electronic.
What is conference like?
Every Wednesday from 8 a.m. to 1 p.m., residents have protected time and will attend conference. Didactic material is provided in a variety of formats.
Are there dedicated pediatric shifts or pediatric months?
In order to be exposed to the full breadth that is pediatric emergency medicine, our residents have a longitudinal exposure to pediatric patients throughout all three years of their training. Emergency Medicine residents start seeing children on day one and can expect to see children on nearly every shift. Residents are also scheduled for dedicated shifts with our pediatric emergency medicine faculty.
What fellowships are available?
We currently sponsor an Emergency Medical Services Fellowship.
What research opportunities exist?
Multiple opportunities exist depending on your interest. Dedicated departmental support for resident research is available. Every resident is expected to complete a scholarly activity project during training.
How much vacation do residents get?
Residents get three weeks of vacation each year; during a vacation block, they work a reduced number of clinical shifts. In addition, post-graduate year three (PGY-3) residents are given additional time to attend the national American College of Emergency Physicians (ACEP) scientific assembly.
What type of benefits do I get as a resident?
The Office of Graduate Medical Education Office offers a competitive package of benefits for our residents. Learn more about benefits here.
How is ultrasound incorporated into the residency?
Residents participate in an ultrasound course during their orientation to the department. Afterward, they are encouraged to use ultrasound each and every shift. Our ultrasound director reviews all of the studies, grades them and offers teaching points when appropriate. The residents have a two-week ultrasound rotation during the second year to further hone and develop their skills.
Is there an orientation period for new interns?
Yes, there is a dedicated period of orientation for new interns upon their arrival in July. All new ED interns will work a reduced number of clinical shifts and participate in a variety of labs, simulations and orientation activities to help in the transition from senior medical students to functioning emergency medicine interns. In addition, all new interns will become certified in advanced cardiac life support (ACLS), advanced trauma life support (ATLS) and pediatric advanced life support (PALS).
Where would I go for my community emergency medicine experience?
During the second year of residency, students rotate through Harrisburg Hospital, part of the Pinnacle Health System, approximately 12 miles from Hershey Medical Center. This clinical environment exposes our residents to an urban and community-based patient population, which is distinctly different from that of Hershey Medical Center.
What type of critical-care experience do I get during my training?
Interns rotate through the Medical Intensive Care Unit (MICU) at Hershey Medical Center, and frequently encounter critically ill patients on their Cardiology rotation as well. Our second-year residents rotate through the Surgical Anesthesia Intensive Care Unit (SAICU) and the Pediatric Intensive Care Unit. In PGY-3, residents rotate through the MICU at Harrisburg Hospital, part of Pinnacle Health System.
How often do you use simulation during residency?
We incorporate three or more hours of simulation into almost every month of the conference schedule. Residents also have independent access to the Simulation Center; some areas are open 24/7.
The Emergency Medicine Residency accepts applications through ERAS and participates in the NRMP Match.
The completed ERAS application form should include:
- Dean’s letter/MSPE
- Medical school transcripts
- Letters of recommendation/SLOEs
- Personal statement
- Medical examination score (USMLE Step 1 or COMLEX Step I)
Visiting Medical Students
Visiting medical students interested in completing an away rotation in our department should apply through VSAS.
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