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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.