About the Program

Emergency Room Training

We are convinced our people, our approach, our facilities, the ease of living in Iowa City, and our quality of training can all make a difference in your career.

We invite you to consider the advantages of choosing Iowa for your Emergency Medicine training.

Quick facts

  • 9 residents are accepted each year.
  • 27 total residents are ACGME approved for our training program.
  • The University of Iowa Hospitals and Clinics Emergency Department (main training site) sees greater than 60,000 patients per year with a 30% percent admission rate with 4% admitted to an Intensive Care setting.
  • St. Luke’s Medical Center Emergency Department (community training site) sees approximately 53,000 patients per year with a 20% admission rate with 2% admitted to an Intensive Care setting.

Rotations

  • All required Emergency Medicine and other required rotations are scheduled at the University of Iowa Hospitals and Clinics or at St. Luke’s Medical Center in Cedar Rapids, Iowa. St. Luke’s is an approximate 30 minute drive from the University of Iowa (25 miles).
  • Elective rotations can be scheduled at the University of Iowa Hospitals and Clinics, or in a number of other locations including internationally.
  • Our third year emergency medicine residents have the opportunity to serve as flight physicians in Iowa's 25-year-old Air and Mobile Critical Care Services Program. They response to the scene of motor vehicle accidents and other major traumas. They also participate in the interfacility transfer of patients with conditions such as intracranial hemorrhage, stroke, myocardial infarction, and sepsis. Flight physicians have the ability to perform procedures on flights as well as assist the flight crew with management of these critically ill patients.
  • Thanks to the dedicated work of Iowa Emergency Medicine faculty who have been working in Haiti for over a decade, our residents have the opportunity to participate in medical mission trips working with a well-established organization that has strong ties to the rural communities it serves.

Benefits

Program accreditation

The Emergency Medicine residency at UI Hospitals & Clinics is accredited by the Accreditation Council for Graduate Medical Education. Information specific to program requirements for an emergency medicine training program may be found at the ACGME’s Emergency Medicine Residency Review Committee (RRC).


Kaila Pomeranz portrait “What drew me to Iowa was the true team-based atmosphere and level of support from faculty to residents to staff to everyone in the ED. Our faculty have diverse interests, and I knew that I would be able to develop my own niche in emergency medicine with their support and guidance. Iowa is a great place to train and live!”
Kaila Pomeranz, DO, second-year Emergency Medicine resident

 

Program Differentiators

Emergency Room Training

Advantages of our program

  • The University of Iowa Emergency Department is number one among academic centers for the shortest waiting times for patients and has strong customer service scores. We will teach you to provide rapid, efficient care to patients while maintaining kind and compassionate service.
  • Abundant clinical experience comes from our burgeoning patient census, and more than a fifth of our patients are pediatric.
  • University of Iowa is one of the top research institutions in the nation providing unparalleled resources. Our department has many ongoing clinical, basic science, and translational research projects.
  • Outstanding, nationally-recognized clinical faculty who have trained all over the country. Teachers who have recognized that University of Iowa is a very special place and have come here to help create a world-class teaching institution.
  • We have two dual-boarded emergency medicine and critical care faculty who divide their time evenly between the emergency department and the MICU and SNICU respectively. This allows us to offer our residents unparalleled critical care education, both in the department and during their ICU rotations.
  • We have a diverse faculty with diverse interests including critical care, ultrasound, simulation, sports medicine, international medicine, emergency medicine services, and others.
  • Our Emergency Department supports a full time clinical pharmacist who assists with patient care and is highly involved in our research programs. 
  • We have 24-hours a day of full social work support dedicated to the Emergency Department.
  • The use of ultrasound in the practice of Emergency Medicine is expanding exponentially. The University of Iowa Emergency Department recently purchased new, state of the art ultrasound equipment to assist our residents in learning this fundamental skill. The residency program also supports a full time director of the ultrasound curriculum. 

Facilities

  • State-of-the-art, 60,000 square foot Emergency Department that contains 45 beds.
  • Only Level 1 trauma center and burn center in Iowa.
  • University of Iowa Hospitals & Clinics is a 711-bed hospital.  

Clinical experiences

  • The Emergency Medicine residents get a longitudinal EMS experience starting with RAGBRAI medical coverage as interns, followed by event medicine coverage at Iowa Hawkeyes football games, basketball games, and wrestling matches culminating in a month-long EMS month during the third year.
  • Our residents learn cutting-edge critical care through dedicated rotations in the Surgical and Neurosciences ICU, the Medical ICU, the Pediatric ICU, the Neonatal ICU, and the Burn Unit at a tertiary academic medical center. 
  • The opportunity to participate in an ACSME accredited Sports Medicine EMS fellowship at a Big 10 university.
  • Fellowships in EMS, Critical Care, Sports Medicine, Academics, Globa Health, Injury Prevention, Research, and Palliative Care.
  • Optional Wilderness Medicine course taught mainly in the mountains of Colorado by Iowa faculty.
  • Moonlighting available in surrounding community to eligible PGY-3 residents.
  • Medical simulation is used extensively within the residency training program. The residency has a full time simulation director who coordinates this area of the residency curriculum. Residents receive training using high-fidelity simulators to augment their clinical experience. 
  • The residency program has a close relationship with our partner community hospital in Cedar Rapids, with residents spending several months learning there. This allows residents to experience patient care not only in a large academic center, but also at a large community hospital.

Iowa City

  • Iowa City is a highly intellectual community with premier arts events that are accessible to residents in terms of cost and location. 
  • We have an outstanding school system for children in grades K-12. 
  • A great training program and a high quality of life at an affordable price.

Curriculum

The University of Iowa Emergency Medicine Program encourages residents to tailor their own course of study, in order to best prepare themselves for their chosen career focus. Residents have the opportunity to choose electives and their academic project in areas that they have particular interest in. Some opportunities are listed below; we are always interested in developing more!

Emergency Medical Services (EMS)

The Emergency Medicine residents get a longitudinal EMS experience starting with RAGBRAI medical coverage as interns, followed by event medicine coverage at Iowa Hawkeyes football games, basketball games, and wrestling matches culminating in a month-long EMS month during the third year. The Emergency Medicine residents also enjoy the opportunity to teach EMS students in the Emergency Medical Services Learning Resources Center (EMSLRC), which conducts EMT and paramedic classes as well as all of the merit badge courses. Finally, as part of a voluntary program, third-year Emergency Medicine residents in good standing can join UI Hospitals & Clinics AirCare as flight physicians where they will perform inter-facility and scene transports of critically ill neonates as well as pediatric and adult patients.

Wilderness Medicine

Several of the Emergency Medicine residents participate in a Wilderness Medicine course that is held every year. The course contains a didactic portion that covers the basics of wilderness medicine including patient evacuation and other pertinent topics. There are also skill labs sessions and a variety of class outings in the area. The course is culminated by a “class-trip” to experience the wilderness environment, in the past this has often been to Colorado.

Ultrasound

The uses of ultrasound for diagnosis and management of patients in the Emergency Department is rapidly expanding. Department faculty are highly skilled at using ultrasound for a wide variety of indications in the Emergency Department. The department recently purchased state-of-the-art ultrasound machines. Additionally, a dedicated FAST machine is used to evaluate all trauma patients. Furthermore, a new ultrasound curriculum for all residents has recently been implemented. Several residents have dedicated elective time to further hone their ultrasonography skills.

Sports Medicine

Emergency departments care for a large number of patients with sports related injuries. Our department is no different. For residents who have a special interest in sports medicine, elective rotations are available. A formal sports medicine fellowship is also available to program graduates.

Critical Care Medicine

One of the goals of the residency program is to train residents to be capable of taking care of any patient with minimal or no back-up. Because of this goal the residency program places a particular focus on critical care medicine. The residents spend several months rotating through a variety of intensive care units at UI Hospitals & Clinics. A specific critical care curriculum has been designed and implemented into the weekly conference schedule. A critical care fellowship is currently in the planning stages.

International Medicine

Many of the program’s residents choose to spend time working internationally during their residency. Many of the program’s faculty members are also involved in medicine overseas. The program has a close relationship with the “Community Health Initiative” in Haiti, and residents and faculty make regular trips there. Residents have traveled to other locations including Israel, India, Tanzania, Nicaragua, Abu Dhabi, and others. Residents can work overseas for up to one month while still maintaining their full pay and benefits.

Rural Medicine

Iowa is predominantly a rural state, with much of the state lacking sufficient emergency medical care. Residents interested in providing care in rural communities have the opportunity to complete electives in medically underserved areas. Residents may also spend a portion of their EMS rotation with rural providers.

Advocacy

Residents have the opportunity to become involved by serving as the residency representative on the ACEP State Board of Directors and may attend ACEP’s leadership and advocacy conference. Residents also may attend the Iowa Medical Society House of Delegates. Other opportunities include serving as the Emergency Medicine Resident’s Association representative and/or House Staff Council representative.

PGY-I

As a PGY-I emergency medicine resident, you spend time both in the Emergency Department learning the basics of emergency medicine, and additionally spend time on a variety of other services to learn skills essential to the practice of emergency medicine.

Introduction to Emergency Medicine / Advanced Life Support

For every new resident, the first month of residency at University of Iowa Hospitals & Clinics is spent together on an introduction to emergency medicine rotation called Advanced Life Support. During this month, interns spend most mornings in informative and interactive didactics, both in the lecture hall and in the simulation lab. They are also assigned to eight shifts in the Emergency Department to allow them to get to know the department, the faculty and nurses, and the way around the hospital.

This rotation is a great balance between getting accustomed to the hospital and life as a resident at UI Hospitals & Clinics, while still allowing for some free time to get settled into a new town and to get to know your co-interns. The best part: students and interns participate in a wilderness medicine race. At the end of the Advanced Life Saving month, first-year residents participate as medical support in the Register’s Annual Great Bike Ride Across Iowa (RAGBRAI) by riding along with the four ambulance crews. RAGBRAI is an annual event with 15,000-20,000 riders traveling from the Missouri River to the Mississippi River across the state over one week. It is a great time for learning field medicine, making independent treatment decisions, and getting to know our EMS colleagues.

Emergency Medicine

In the months in the department, interns work with a senior resident and faculty member with close supervision, gaining independence in practice at their own pace. Senior residents are assigned to go to any incoming trauma, but otherwise interns are encouraged to see any cases they want. Patient load in the department can be daunting at times, but it is stressed that the job of the interns is to learn, not to move patients through the department. Typically, if the senior residents are comfortable performing procedures and have reached their goal, the interns are then sought out to perform the procedures.

Pediatric Emergency Medicine

Residents spend one dedicated month seeing only pediatric patients in the Emergency Department. Residents work most often one-on-one with an attending, making this a great learning experience. Residents are exposed to many typical pediatric patients, but also complex ones being a tertiary referral center.

Residents can perform a number of different pediatric procedures, including:

  • Procedural sedation
  • Foreign body removal
  • Laceration repair
  • Lumbar punctures

During these months residents participate in pediatric traumas. There are also dedicated pediatric didactic sessions throughout this month.

Trauma Surgery

This rotation gives interns the experience of trauma from the point of view of the surgeons rather than the emergency medicine practitioners.

There are four interns on the service, and we they alternate responsibility for long and short call, as well as trauma evalustions/resuscitations. Interns can go to the OR if they want, or they can handle floor calls for polytrauma patients on the service. These calls include medication checks to wound care to pulling chest tubes and.or other bedside procedures. 

The patient population is typically split about equally between the SNICU and the floor, exposing the interns to a broad range of patient morbidity. They are also paged to the ED whenever a trauma is set to arrive. The emergency medicine interns participate in the trauma resuscitation along with surgery residents working in the emergency department. The hours are typical of a surgical service, running from 5:30 a.m. to 6:00 p.m. on weekdays with shorter hours rounding on the weekends, but interns do get two full weekends off during the month-long rotation with no patient care responsibilities.

The weekly trauma conference is an excellent learning experience, and the topics presented frequently overlap with emergency medicine issues and practice. Interns also attend surgery grand rounds and M&Ms, which are also great for learning.

Orthopedic Surgery

Emergency medicine residents work as an integral part of the orthopedic trauma team. The block is split into two halves, giving the residents a well-rounded exposure to orthopedic emergencies.

During one half of the rotation, residents are members of the orthopedic trauma service. Residents are expected to attend daily morning conferences, which can be very educational. You carry the orthopedic pager and take calls on inpatients and Emergency Department consults during the day. When not busy with consults, you will work in the clinic. There are some operating room opportunities if you so desire.

During the other half of the rotation, residents work on the orthopedics night float team. This team is responsible for seeing all the orthopedics consultations, both in the Emergency Department, as well as inpatient units. Residents gain a broad exposure to not only traumatic orthopedic emergencies, but also infection, pediatric, joints, and spine cases. The most valuable experiences of the rotation include gaining experience casting, splinting, fracture and dislocation reductions, as well as fine tuning exam skills.

Anesthesiology

During the month on anesthesiology, interns are assigned to one operating room for the day. Usually they will be working with a certified registered nurse anesthetist, but at times they may be with an anesthesiology resident. Most often, emergency medicine interns can manage the airway while starting a case. First case starts at 7:15 a.m. or 8 a.m. and arriving 20-30 minutes before case start to get to know the patient is advised. There are no weekend duties on this rotation. This month is a great time to perform as many intubations as possible and to get to be an expert at bag-valve-masking patients.

Burn Surgery

During the two weeks on burn surgery, emergency medicine interns are in the role of an intern on any surgical team. The team consists of a junior resident, emergency medicine intern, and possibly another co-intern from another service. Rounding is dependent on staff and patient load and usually starts around 6:15 a.m. with first operating room cases starting at 7:15 a.m.

Interns are allowed and encouraged, if they choose, to split time with the other residents scrubbing in to surgery, and typically can do as much of the surgery as they desire. On the floors, time is spent managing patients and writing notes. No worries about not knowing all of burn management right off the bat: nursing staff is very knowledgeable and helpful and will direct you as needed. The exact day-to-day task performed is dependent on the junior surgery resident. This is a great month to help manage very sick patients and to get some time operating!

Cardiothoracic Surgery

Residents spend two weeks working with our cardiothoracic surgeons. The primary goal of this rotation is to give the emergency medicine residents an opportunity to place many chest tubes under the supervision of the cardiothoracic surgery staff. Residents also can learn a great deal about the management of thoracic disease including pneumothoraces, hemothoraces, aortic dissections, and others.

Quality Improvement and Patient Safety

During this two-week rotation, our residents train in a variety of quality areas, including

  • Patient safety
  • Administration
  • Research
  • Education

Residents will obtain the Institute for Health Improvement (IHI) Basic Certificate in Quality and Safety. A billing and coding teaching session will take place with our lead coder to improve charting. Residents complete their human subjects training as required by the IRB to be better researchers. Residents will take the lead on one of the recommendations from the resident improvement committees to improve the overall education in our department. Seventy-two-hour patient returns to the emergency department will be analyzed for quality improvement.

PGY-II

During your PGY-II year, you not only spend more time in the Emergency Department, but you also take on a much higher degree of responsibility. You will act as the senior resident on your team, be responsible for responding to traumas, and care for multiple critically ill patients simultaneously.

PGY-II residents spend several months working in a variety of intensive care unit settings to hone their critical care skills. Additionally, residents have their first opportunity to rotate at our community hospital partner.

Emergency Medicine

For the senior resident (PGY-II and III) in emergency medicine, there continues to be graduated responsibility. The PGY-II resident learns the role of the senior by beginning to supervise medical students and interns while still maintaining excellent patient care. You are expected to see more patients than as an intern and learn to handle multiple complex patients simultaneously. Senior residents also respond to the level 1 trauma patients and care for these patients in conjunction with the trauma surgery team. The EM resident's primary role is the airway, but often helps with the primary and secondary survey and resuscitative efforts, including procedures outside of airway management.

Community Emergency Medicine

Rotating at St. Luke’s Hospital in Cedar Rapids is an excellent opportunity to experience emergency medicine in a community setting. Your role at St. Luke’s is to see patients under the supervision of your staff physician, just as you would during other emergency medicine rotations.

The Educational Highlights of This Rotation Include:

  • Large volume of pediatric and high acuity patients
  • High exposure to orthopedic emergencies
  • Mentorship relationships with community emergency medicine physicians
  • Independence practicing medicine without the presence of other sub-specialty residents

The rotation at St. Luke’s is certainly a favorite among residents and offers a great deal of educational and practical experience.

Medical Intensive Care Unit (MICU)

The team usually consists of an emergency medicine resident, internal medicine residents, and a critical care/pulmonary fellow. Call is every fifth day, where you are on with an Internal Medicine resident and the fellow. Expect to work from 7 a.m. to 5 p.m. on non-call days. You split taking admissions on non-call days with the other residents until 3 p.m., when the call team starts taking admissions.

There are teaching sessions on three weekday mornings. These teaching sessions cover most of the essentials of critical care and are invaluable.

Teaching Sessions Include:

  • Ventilator management
  • Vasoactive drugs
  • Medical resuscitations

Procedures/Critical Skills on This Rotation Include:

  • Intubations
  • Central lines
  • Arterial lines
  • Thoracenteses
  • Paracenteses
  • Ventilator management
  • Vasopressor management
  • Volume resuscitation

Surgical and Neuroscience Intensive Care Unit (SNICU)

While rotating in the SNICU, residents manage critically ill patients from the trauma service, general surgery, neurosurgery, neurology, cardiothoracic surgery, transplant surgery, and other surgical services.

Common Diagnoses Include:

  • Poly-trauma
  • Intracranial bleeding
  • Stroke
  • Septic shock
  • Hypovolemic shock
  • Cardiogenic shock
  • Respiratory distress
  • Hypertensive emergency

Procedures/Critical Skills Learned and Performed Include:

  • Intubation 
  • Central lines
  • Arterial lines
  • Ventilator management
  • Tube thoracostomy
  • Vasopressor management
  • Volume resuscitation

The daily schedule generally involves arriving at 6 a.m., rounding with staff at 7 a.m., then procedures and daily work after rounds until sign out at 2 p.m.

Obstetrics

While on the obstetrics rotation, emergency medicine residents work directly with an obstetrics and gynecology faculty managing patients in active labor and those past 20 weeks of gestation. This rotation is done at St. Luke’s Medical Center in Cedar Rapids.

Procedures/Critical Skills Learned and Performed:

  • Deliveries
  • Fetal heart monitoring
  • Rule-out active labor work-ups
  • Ob-gyn ultrasounds
  • Participating in neonatal resuscitations

The rotation utilizes a day float/night float system, so there are no call days. You also get weekends off.

PGY-III

As a PGY-III, residents have a high degree of responsibility and assume a real leadership role in the Emergency Department. They continue to respond to traumas and care for critically ill patients while taking on an increased teaching role. PGY-III residents often supervise and teach medical students, while at the same time assisting junior residents with patient care and procedures.

Emergency Medicine

For the senior resident (PGY-II & III) in emergency medicine, there continues to be graduated responsibility. The PGY-III resident is expected to be able to handle many patients at once with variable levels of acuity as well as jointly working with the faculty in managing the flow of the emergency department and learning to “run” the department.

This resident should be peripherally aware of what is going on throughout the department and be ready to lend a hand wherever it is needed. He or she also is expected to provide supervision to medical students and interns, as well as guidance for PGY-IIs.  While on all Emergency Medicine rotations, PGY-III residents are given the option of joining the UI Hospitals & Clinics AirCare as flight physicians, where they will perform inter-facility and scene transports of critically ill of all ages.

Community Emergency Medicine

Your role at St. Luke’s is to see patients under the supervision of your staff physician, just as you would during other emergency medicine rotations.

Educational Highlights of This Rotation Include:

  • High volume of pediatric and high acuity patients
  • Large amount of orthopedic emergencies
  • Mentorship relationships with community emergency medicine physicians
  • Independence practicing medicine without the presence of other sub-specialty residents

The rotation at St. Luke’s is certainly a favorite among residents and offers a great deal of educational and practical experience.

Surgical and Neuroscience Intensive Care Unit (SNICU)

While rotating in the SNICU, residents manage critically ill patients from the trauma service, general surgery, neurosurgery, cardiothoracic surgery, transplant surgery, and other surgical services.

Common Diagnoses Include:

  • Poly-trauma
  • Intracranial bleeding
  • Stroke
  • Septic shock
  • Hypovolemic shock
  • Cardiogenic shock
  • Respiratory distress
  • Hypertensive emergency

Procedures/Critical Skills Learned and Performed Include:

  • Intubation (direct, glidescope, fiberoptic)
  • Central lines
  • Arterial lines
  • Ventilator management
  • Tube thoracostomy
  • Vasopressor management
  • Volume resuscitation

The daily schedule generally involves arriving at 6 a.m., rounding with staff at 7 a.m., procedures and daily work after rounds until sign out at 2 p.m.

Emergency Medical Services/Emergency Medicine Administration

In this month you will have the opportunity to ride, fly, and learn about becoming an EMS medical director. The rotation is comprised of flight shifts, ambulance rides, and Emergency Medical Services Learning Resources Center (EMSLRC) teaching shifts in the department with special attention focused on interaction with EMS crews. Individuals who don't wish to fly with AirCare will do more ambulance shifts.

In addition, you will have the opportunity to visit the 911 call center, fire station, and learn about disaster management and EMS research opportunities. You will have the opportunity to be on the front lines and see people in their homes and gain a better understanding of the limitations of ambulance crews. This is a great month with a lot of different experiences that will help to round out your training.

Elective

During the third, year residents have two months of elective/selective time to explore subspecialties of emergency medicine or other areas of interest. This allows residents to enhance knowledge within emergency medicine or focus on a particular skill set.

Options Include But Are Not Limited To:

  • Emergency department nursing
  • Dentistry
  • Ophthalmology
  • Palliative care
  • Sports medicine
  • International medicine
  • Social medicine
  • Advanced EMS
  • Teaching
  • Community medicine
  • Toxicology
  • Pharmacy
  • New born baby
  • Advanced ultrasound

Residents are allowed the flexibility to help create an elective with the assistance of faculty mentors. 

Training at a Glance

Emergency Room Training

The emergency medicine (EM) training program at University of Iowa Hospitals & Clinics is a three-year program and provides each resident physician with a diverse experience.

To view a synopsis of the training program, please download our block schedule.

Year 1 Block Schedule
  UI Hospitals & Clinics
Rotation 1 Intro to EM (3)
EM (1)
Rotation 2 EM
Rotation 3 EM
Rotation 4 EM
Rotation 5 Pediatric EM
Rotation 6 Ultrasound
Rotation 7 Anesthesia
Rotation 8 Sports Medicine (2)
EM Orthopedics (2)
Rotation 9 Trauma
Rotation 10 Pediatric Intensive Care Unit (PICU) (2)
EM (2)
Rotation 11 Burns (2)
EM (2)
Rotation 12 EM (2)
Cardiovascular and Thoracic Surgery (2)
Rotation 13 EM (2)
Quality Improvement (2)
  EM Weeks: 27
Year 2 Block Schedule
  UI Hospitals & Clinics St. Luke's
Rotation 1 EM  
Rotation 2 EM  
Rotation 3 EM  
Rotation 4 EM  
Rotation 5 EM  
Rotation 6   EM
Rotation 7   EM
Rotation 8   Obstetrics
Rotation 9 Medical Intensive Care Unit (MICU)  
Rotation 10

Surgical and Neuroscience Intensive Care Unit (SNICU)

 
Rotation 11 EM (2)
Neonatal Intensive Care Unit (NICU) (2)
 
Rotation 12 Elective  
Rotation 13 Selective  
  EM Weeks: 30  
Year 3 Block Schedule
  UI Hospitals & Clinics St. Luke's
Rotation 1 EM  
Rotation 2 EM  
Rotation 3 EM  
Rotation 4 EM  
Rotation 5 EM  
Rotation 6 EM  
Rotation 7 EM  
Rotation 8 EM  
Rotation 9   EM
Rotation 10 EMS (3)
EM (1)
 
Rotation 11 SNICU  
Rotation 12 Elective  
Rotation 13 Elective  
  EM Weeks: 37  

Unless otherwise noted, each rotation is 4 weeks.

UI Hospitals & Clinics EM in second and third year will be comprised of both adult and pediatric EM shifts.

Total Number of EM Weeks: 94 Weeks of EM

Total Number of Weeks: 156

Percent Time in EM: 60.2%

PDF iconCompare our rotations with the national average.

Training Locations

University of Iowa Hospitals & Clinics

  • Patient Volume: >60,000
  • Pediatrics represent 18% of total volume
  • Trauma represents 22% of total volume
  • 30% admission rate with 4% being admitted to an intensive care setting
  • Recently constructed, state of the art, 45 bed, 60,000 square foot Emergency Department
  • Newly constructed pediatric area
  • Level 1 Trauma Center
  • Comprehensive Stroke Center
  • Specialized trauma, ophthalmologic, dental, and psychiatric rooms
  • Three ED ultrasounds, in addition to a trauma dedicated FAST machine
  • Advanced imaging modalities located within the department
  • Full time dedicated ED based emergency pharmacist support
  • Twenty-four hours per day dedicated ED social work support

 

St. Luke’s Medical Center, Cedar Rapids, Iowa

  • Patient Volume: 52,598
  • Pediatrics represents 27% of total volume
  • Trauma patients represent 15% of total volume
  • 20% admission rate with 2% being admitted to an intensive care setting
  • ED renovation completed in 2008
  • Specialized critical care, ENT, and behavioral health rooms
  • Level III Trauma Center
  • Society of Chest Pain Center Accreditation 2010
  • Primary Stroke Center 2010

 

 

 

Education/Conferences

Emergency Medicine conferenceThe residency supports five hours of weekly educational conference. This time is protected from clinical duty and all residents are expected to attend. An 18-month curriculum is in place that covers the “Model of the Clinical Practice of Emergency Medicine.”

In addition to lectures, the residency incorporates case presentations, small group discussions, and oral board practice. Many conferences include simulations, either techniques such as ultrasound, procedures such as cardiac pacing, or important cases in the simulation lab. Additionally, once a month during "Big Thursdays" we focus on rare procedures and core curriculum, which is always an exciting, hands-on morning for all residents.

Topic: Psych/Team Thursday/Mock Oral Boards/Vulnerable Patients/MSK
Topic Coordinator: Sangil Lee, MD/Mike Takacs, MD/Brooks Obr, MD, MME/Dan Miller, MD, Nathaniel Shekem, PA-C/Matt Spragg, DO/Shannon Findlay, MD/Chris Hogrefe, MD
Location: EM Auditorium, 0070 RCP (Elevator F to LL, left off elevator, left at first doorway, through double doors, left at first hallway)

Journal Club

Journal Club is held monthly at a faculty member’s home. The articles are selected by faculty members as well as residents. The objective of journal club is two-fold: to keep up to date on medical literature pertinent to the practice of emergency medicine and to learn the essentials of evidence-based medicine. Food is provided by the faculty host!

Frequently Asked Questions

What are the fellowship opportunities available?

Currently, Sports Medicine, Critical Care Medicine, Emergency Medical Services, and Palliative Care are available. Associate Scholar Fellowships are available in Education, International Medicine, Social Emergency Medicine, Injury Prevention, and Research.

Where is Iowa City?

Iowa City is 220 miles directly west of Chicago on Interstate 80. It’s also within a 4-5 hour drive to Milwaukee, Madison, Minneapolis, Omaha, Kansas City and St. Louis. It has the cultural, educational, social, and political opportunities of a bigger city with the values and ambiance of a Midwestern town. It’s clean, safe, nothing is farther than a 15 minute car ride, it has a great city bus system (with bike racks!), wonderful parks, sports, schools, and even sailing. Those who have lived here and left frequently return because what they were looking for was in their own back yard. But we’re not the only ones who think Iowa City is great: 

What’s the weather like in Iowa City?

It depends on what you like. For about two weeks every winter it’s very cold and windy and for two weeks every summer it’s really hot and humid. The rest of the time it’s pretty nice. We have a lot of sunny days even in the winter – 166 per year. Our average snowfall is 28”, average rainfall is 35”, average temperature in the summer is 72.6 and in the winter, 23.7. We consider our weather character building.

What is there to do in Iowa City when you’re not working?

There are 15 different festivals and art fairs, plus concerts and race events. There are many music venues, sports events and neighborhood street fairs and garden walks. We also have a really big mall and several smaller ones, 41 parks, nine golf courses, six public tennis courts, six public pools, some lakes and a reservoir with trails, camping, and boating. There are bike trails, some famous bookstores, a ton of galleries and excellent museums. There are half a dozen or more performing arts venues including Hancher Auditorium. There's always something going on. Find more information from the Iowa City/Coralville Convention and Visitors Bureau.

What’s Iowa City like for kids and families?

There’s ice skating, bowling, organized sports, 50 public parks, miniature golf, a great public library, a toy library, fun centers, swimming pools and three beaches, nine museums including a children's museum, dance companies and public recreation centers that feature many activities for kids and families at little or no cost. We also have 20 movie screens and 50-licensed daycare providers. The Iowa City schools are perennially ranked among the top schools in the nation. Iowa City is unique in the facilities and services available for individuals with disabilities. Many families who have a family member with a disability are reluctant to leave Iowa City because they cannot duplicate those services in another location.

Are there any job opportunities for my spouse/significant other?

Iowa City has a high rate of employment. Check out The University of Iowa's Dual Career Network. 

Is it possible to do an international elective in your program?

Yes! Our residents have traveled to Haiti, Indonesia, Vietnam, India, and Tanzania to name a few.

Is this a family friendly program?

Yes! We love children and support residents in their efforts to balance work with family life. We have several dual physician resident and faculty families and understand the stresses. Women residents receive up to 6 weeks of paid maternity leave after delivery. Men get 5 working days off for paternity leave. The house staff health insurance policy provides full coverage for spouses and children. There are several childcare facilities near the hospital and one on-site. The training program also has activities during the year where all family members are invited. 

Is there sufficient patient volume so that I can have multiple exposures to a variety of diseases?

Currently, the University of Iowa Hospitals & Clinics Emergency Department (ED) sees > 60,000 patients per year. Of these, approximately 82% are adults, and 18% pediatrics. Trauma patients represented approximately 22% of our patients, surgical non-trauma 8%, medical 58%, obstetric 5%, and psychiatric 8%. Of the patients seen in the ED, 30% are admitted to the hospital with approximately 4% being admitted to an intensive care unit.

Do you have a research project requirement for graduation?

Yes. Our program requires residents to complete a scholarly activity prior to graduation. We support this through a generous travel allowance to national meetings, a research curriculum, and an experienced research staff.  The scholarly activity requirements include: 

  • A thorough review of the scientific literature relevant to their topic
  • Generating a hypothesis research question
  • Data collection and analysis
  • Development of a publication-quality abstract or manuscript 
  • Presentation of findings at national, state, regional, or local meeting

If you have additional questions please contact our program coordinator at nicole-hansen@uiowa.edu

Learning Resources

Emergency Room TrainingSimulation and Procedure Labs

Simulation is a rapidly growing and evolving area of medical education. Management of critically ill patients, treatment algorithms, and team leadership skills are only a few of the essential proficiencies that are taught and practiced using medical simulation.

Iowa has dedicated faculty with special expertise and focus on simulation education. The program utilizes high fidelity simulators including both the Laerdal SimMan® and SimBaby®.

During the introduction month for PGY-I, a large amount of time is dedicated to medical, trauma, critical care, and procedural simulation to prepare residents to begin caring for patients in the Emergency Department. Throughout residency, simulation is used to reinforce concepts in patient care and teamwork.

In addition, Simulation Faculty are continually working to expand the role of simulation for education, including in-situ scenarios that take place in the Emergency Department during clinical shifts.

Procedure labs are incorporated throughout the residency to augment the procedural skills that residents attain during clinical practice. The residency uses several “task-trainers” including “The Central Line Man System,” “The Trauma Man System,” and various airway trainers to practice procedures such as central line placement, chest tube placement, cricothyrotomies, and emergency airway management. The residents also participate in slit-lamp labs, splinting workshops, and ENT procedure labs on a regular basis. In addition, residents are given the opportunity to participate in a cadaver lab to further hone procedural skills.

Library Services

Hardin Library for the Health Sciences is part of the University of Iowa Libraries with many resources for students and trainees in the health sciences. All house staff have access to the UI Hardin Medical Library through the library’s world-wide-web page or through the Graduate Medical Education’s intranet. The library features e-resources that include on-line journals, periodicals, databases, special medical guides and a variety of search and retrieval systems including PubMed. 

VisualDx is also available through the Hardin Library and gives general practitioners the ability to build a differential diagnosis that provides specialist information for more than 900 diseases and offers more than 16,000 related images. 

The library includes the John Martin Rare Book Room, a 5,000-volume collection of original works representing classic contributions to the history of the health sciences from the 15th through 20th Centuries. Also included are selected books, reprints, and journals dealing with the history of medicine at the University and in the State of Iowa. 

UI Hardin Library has specially trained librarians who assist with location of materials and train house staff on effective methods of information searches (e.g., effective methods of searching PubMed). 

• Emergency Medicine Electronic Resource Center 

Organizational Web Sites, Blogs and Podcasts

Web Sites

The American Academy of Emergency Medicine (AAEM) is the speciality society of board certified emergency medicine physicians, a democratic organization with over 6,500 members. AAEM believes every individual should have unencumbered access to quality emergency care provided by a specialist in emergency medicine. The Academy supports fair and equitable practice environments necessary to allow the specialist in emergency medicine to deliver the highest quality of patient care. Such an environment includes provisions for due process and the absence of restrictive covenants. 

The American Board of Emergency Medicine (ABEM) is one of 24 medical specialty certification boards recognized by the American Board of Medical Specialties. ABEM certifies emergency physicians who meet its educational, professional standing, and examination standards. ABEM certification is sought and earned by emergency physicians on a voluntary basis; ABEM is not a membership association. 

Founded in 1968, the American College of Emergency Physicians (ACEP) represents more than 28,000 emergency physicians, residents and medical students. Promoting the highest quality emergency care, ACEP is the leading advocate for emergency physicians and their patients, as well as provide CME resources, news, and leadership opportuniites. 

Emergency Medicine Residents' Association (EMRA) promotes excellence in patient care through the education and development of emerency medicine residency trained physicians. EMRA is the largest and oldest independent resident organization in the world. EMRA was founded in 1974 and today has a membership of more than 10,000 residents, medical students and alumni. 

The Society for Academic Emergency Medicine (SAEM) is dedicated to the improvement of care of the acutely ill and injured patient by improving research and education. To achieve this mission, SAEM influences health policy through forums, publications, inter-organizational collaboration, policy development, and consultation services for physicians, teachers, researchers, and students. SAEM represents excellence and leadership in academic emergency medicine and its values include idealism and quality in all endeavors, nurturing and camaraderie and diversity among members, as well as creative and symbiotic interactions with other organizations.

Blogs/Podcasts

• www.emcrit.org – Great podcast on Emergency Medicine and Critical Care topics 
• www.lifeinthefastlane.com – fun and entertaining site dedicated to all things EM 
• www.academiclifeinem.blogspot.com – the Paucis Verbis cards are great short summaries of frequently encountered clinical scenarios 
• www.hqmeded-ecg.blogspot.com – review of challenging EKG’s 
• www.emlitofnote.com – reviews of some of the latest and greatest medical literature related to emergency medicine, critical care, and trauma 
• www.emlyceum.com – poses monthly “questions” to the collective cyber-audience, then reviews the answers 
• www.pemed.org – very good;pediatric EM podcasts 
• www.emrap.org – the gold standard or emergency medicine podcasts! Free use for our residents 
• www.resus.me – fun and entertaining site dedicated to all things EM 
• www.thepoisonreview.com – all things toxicology 
• www.thennt.com - distills the literature to give providers an idea of how helpful or harmful a treatment may be for a patient 
• www.practicalevidence.org – a review of important clinical policies and guidelines

Supervision and Duty Hours

The University of Iowa Hospitals & Clinics Emergency Medicine Residency Program

Provides appropriate supervision for all residents, as well as a duty hour schedule and a work environment that optimizes quality patient care

Fortifies the educational trajectory of house staff members

Addresses all applicable program requirements 

On-call duties are necessary components of UI Hospitals & Clinics clinical care systems and educational programs; these duties are managed to ensure adequate periods of rest with appropriate levels of supervision to deliver safe, effective patient care. (The terms “resident” or “house staff member” used in this policy shall refer to resident and fellow physicians and dentists at all house staff levels.)

Supervision

The clinical activities of all residents are supervised by teaching staff and/or a more advanced house staff members in such a way as to ensure that residents assume progressively increasing responsibility according to each resident’s level of education, ability, and experience. The teaching staff determines the level of responsibility accorded to each resident. On-call schedules for teaching staff and more advanced house staff members are structured to ensure supervision is readily available to those on duty.

The Emergency Medicine Residency Program demonstrates that the appropriate level of supervision is in place for all patients cared for by all residents. Residents are directly supervised at all times in the Emergency Department. Supervision for other clinical areas is as per the individual department and may include a regulated, intermittent period of indirect supervision. These levels of supervision include:

  • Direct Supervision – The supervising physician or dentist is physically present with the resident and patient.
  • Indirect Supervision

i) with direct supervision immediately available – The supervising physician or dentist is physically present within the hospital or other site of patient care, and is immediately available to provide direct supervision.
ii) with direct supervision available – The supervising physician or dentist is not physically present within the hospital or other site of patient care, but is immediately available by means of telephonic and/or electronic modalities, and is available to provide direct supervision.

PGY- I residents are supervised either directly or indirectly with direct supervision immediately available while they acquire basic knowledge and skills specific to the specialty. Activities of PGY- II residents and above are supervised by any level of supervision, as appropriate to the patient situation and resident capability. Supervision does not equate merely to the presence of more senior physicians or dentists nor with the absence of independent decision making on the part of residents. These supervision standards encompass the concepts of graded authority, responsibility and conditional independence that are the foundation of delegation of authority to more senior house staff members.

Resident Work Hours

Resident work hours are monitored by the program director, associate program director, and program coordinator by means of a work hour record on MedHub, the on-line resident management system, that residents are expected to complete weekly. All residents adhere to work hour requirements and any educational experience found to be interfering with this requirements will be modified or eliminated.

All residents will report any concerns about resident work hours directly to the program director or associate program director or via rotational evaluations solicited at the end of every rotation.

Specific resident work hour requirements are as follows:

Maximum Hours of Work Per Week:

The work hours of any resident must be limited to 80 hours per week, when averaged over a four-week period, inclusive of all in-house clinical and educational activities, clinical work done from home and all moonlighting activities. Any time spent at UI Hospitals & Clinics or at another institution for clinical and academic purposes, related to the residency or fellowship program, both inpatient and outpatient, shall count toward the weekly maximum. Additionally, the weekly maximum shall include time spent for administrative duties related to patient care, the transfer of patient care, scheduled academic activities such as conferences, research related to the program, and any time the resident spends on-site after being called in to the hospital. Not included in the weekly maximum is time spent outside of UI Hospitals & Clinics (or outside another institution related to the program’s academic purposes) for academic preparation, reading, and studying.

Maximum Work Period Length:

  • Residents should have eight hours off between scheduled clinical work and education periods.
  • Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call.
  • Residents must be scheduled for a minimum of one day in seven free of clinical work and required education (when averaged over 4 weeks). At-home call cannot be assigned on these free days.
  • Clinical and educational work periods for residents must not exceed 24 hours of continuous scheduled clinical assignments.
  • In unusual circumstances, residents, on their own initiative, may remain beyond their scheduled period of duty to continue to provide care to a single patient. Justifications for such extensions of duty are limited to reasons of required continuity for a severely ill or unstable patient, academic importance of the events transpiring or humanistic attention to the needs of a patient or family. Residents must appropriately hand over the care of all other patients to the team responsible for their continuing care.
  • Any resident exceeding maximum duty period lengths will document their justification in the institution’s resident management system (i.e. MedHub).
  • All clinical staff, including residents and faculty, personally sign out their active patients in the ED to their relief. In addition, they will document the time and details of this handoff in the ED clinical note.

Maximum Frequency of In-house On-call Duties:

In-house call must not be scheduled more frequently than every third night when averaged over a four-week period.

Maximum Frequency of In-House Night Float:

Residents must not be scheduled for more than six consecutive nights of night float or as specified further by the program’s RRC, as applicable.

Minimum Time Off between Scheduled Duty Periods:

  • Residents should have eight hours off between scheduled clinical work and education periods.
  • Residents must have at least 14 hours free of clinical work and education after 24 hours of in-house call.

 

Home Call:

Residents returning to the hospital from home call must count their time spent in the hospital towards the 80-hour maximum weekly hour limit. The frequency of home call is not subject to the every-third-night limitation but must satisfy the requirement for one day in seven free of duty, when averaged over four weeks.

  • Home call activities must not be so frequent as to preclude rest and reasonable personal time for each resident.
  • Residents are permitted to return to the hospital while on home call to care for new or established patients. Each episode of this type of care, while it must be included in the 80-hour weekly maximum, will not initiate a new “off-duty period.”

Moonlighting:

Moonlighting is governed by the Moonlighting Policy and Procedures for House Staff Physicians and Dentists. All requirements of that policy must also be followed, including visa and license requirements. Moonlighting is allowed with prior approval of the Program Director. It should be noted:

  • Moonlighting is never required and must not interfere with the ability of the resident to achieve the goals and objectives of the educational program.
  • The resident must obtain permission of his/her Program Director prior to the beginning of such activities. All approved requests must be filed with the GME Office.
  • Time spent by residents in internal and external moonlighting must be counted toward the 80-hour maximum weekly hour limit. Failure to completely document all time in moonlighting activities will result in suspension of the moonlighting privilege.
  • PGY-I residents are not permitted to moonlight.

The Emergency Medicine Residency Program meets the requirements of this policy as well as any applicable standard set by the ACGME, the appropriate RRC, or other accrediting or certifying body. This policy is distributed by the GME Office with the GME employment contract as well as included in the residency manual that is distributed during Program Orientation. Emergency Medicine monitors resident duty hours with a frequency sufficient to ensure compliance with this policy and the ACGME/RRC/other accrediting or certifying body’s rules.

Fellowships

Learn more about our related fellowships.

View all fellowships available at the University of Iowa. 

Physician Scientist Training Pathway (PSTP)

The University of Iowa Department of Emergency Medicine Physician Scientist Training Pathway (PSTP) integrates postgraduate clinical and research training to develop physician-scientists who will be future leaders in academic emergency medicine. The PSTP is a pathway within the Emergency Medicine Residency Program and combines graduate medical education with the rich collaborative research community at University of Iowa.

Learn more about this program.