Clinical Curriculum

The PGY-2 year (junior year) is a transition to becoming an advanced and effective emergency care provider. You spend a vast majority of the year at your home ground, the busy, high-acuity Harbor-UCLA Emergency Department, to hone your skills and prepare for a supervisory role as a future senior resident. As opposed to your intern year where Adult and Pediatrics come in separate blocks, your second year will consist of a combined schedule of both Adult and Pediatric shifts, with pediatrics accounting for approximately 15 to 20% of your shifts. As a junior resident, you are responsible for leading all adult and pediatric lower-level (ED) and mid-acuity (level 2) traumas in the department.

This is a year of high acuity and procedures, including your first introduction to community-based Emergency Medicine at St. Mary Medical Center (a STEMI Receiving Center and Level II Trauma Center in Long Beach, CA). We will introduce you to educational opportunities outside of clinical care as well. Our R2s participate in a rotation through LA County Emergency Medical Services (EMS) so you can learn more about the care of our patients prior to hospital arrival. You’ll also have dedicated elective and academic/research time. This will also be your first year participating in “Jeopardy” – our on-call rotation system for residents’ sick calls.

Additional Perks

Your second year begins with a two-week dedicated time period to optimize your effectiveness as a new junior resident. Your R2 orientation involves looking at simulation, didactics, and skills labs, with time devoted to ATLS and PALS certification. Class bonding is a bonus. In addition to the Department Retreat every Fall, you will have a “Class Weekend” to help your class stay united during this busy year. R2s also spend a day of dedicated time as a class learning to become base hospital physicians, where you’ll learn to coordinate appropriate prehospital care for patients throughout LA County.

• ED Orientation: 2 weeks
• Harbor-UCLA Adult & Pediatrics ED: 35 weeks
• Mary’s Medical Center: 3 weeks
• EMS: 2 weeks
• Academic Discovery/Jeopardy: 2 weeks
• Social EM/Jeopardy: 2 weeks
• Elective/Jeopardy: 2 weeks
• Vacation: 4 weeks

The PGY-3 year is a year of refining your clinical skills and learning to run an entire emergency department in addition to providing patient care. Key goals for the PGY-3 year include improving efficiency, patient flow, and further honing clinical skills, supervisory and educational roles, as well as exploring the community Emergency Departments to get a feel for future career goals. Once more, your Harbor-UCLA Emergency Department block will include adult and pediatric shifts, with pediatrics accounting for 25% of your shifts.

As a senior resident, you are now responsible for running rounds at the beginning of each shift, running all adult and pediatric level 1 traumas and traumatic full arrests, all trauma airways, and mid-week airway call for inpatients. You will be doing on-shift teaching with medical students and interns and generally running the department.

Our third-year curriculum not only allows you to hone your skills in our department, but also broadens your knowledge of community-based Emergency Medicine at another community site. Long Beach Memorial Medical Center is a STEMI Receiving Center, Comprehensive Stroke Center, and adult and pediatric Level II Trauma Center, with approximately 100,000 ED visits per year.

You will also continue to hone your critical care skills through a rotation at the Cedars-Sinai MICU. In addition, you have six weeks of combined elective and selective time to continue finding your niche in Emergency Medicine and explore your interests.

Additional Perks

In addition to the Department Retreat each Fall, you will also have a “Class Weekend” to help your class stay united during the busy year, as well as a day dedicated for your entire class to receive certification through the Neonatal Resuscitation Program (NRP).

• Harbor-UCLA Adult &Pediatrics ED: 34 weeks
• Cedars-Sinai MICU: 4 weeks
• Long Beach Memorial ED: 4 weeks
• Elective/Jeopardy: 2 weeks
• Selective (with Jeopardy): 4 weeks
• Vacation: 4 weeks

The PGY-4 year allows residents to transition to independent practitioners who can see patients efficiently, perform all procedures seamlessly, and supervise and educate junior residents, nurse practitioners, and medical students. With your senior role duties unchanged from your third year, you’ll spend your time at Harbor-UCLA rotating between adult and pediatrics, with pediatrics accounting for 30% of your shifts. In addition, you’ll be seeing patients on Fast Track while supervising a junior resident and nurse practitioners, and independently discharging your own patients.

During the year, you will gain critical care skills in caring for our littlest and most fragile patients at White Memorial Neonatal ICU. The time you spend in the NICU will require you to focus on neonatal intubations, resuscitations, and umbilical line placement.

A rotation in administration will help you learn the “behind the scenes” aspects of running the Emergency Department and allow you some time to work on quality improvement projects. You will also spend time leading and continuing development in our many social EM projects. Lastly, there are six weeks of Jeopardy call-free selective time to explore different facets of emergency medicine that you find interesting or want additional exposure to.

Additional Perks

In addition to the Department Retreat each Fall, the entire class will attend the ACEP Fall Conference together while the second and third years cover the department. It’s a great time for learning, networking, bonding, and socializing.

• Harbor-UCLA Adult &Pediatrics ED: 35 weeks
• ACEP: 1 week
• Miller Children’s PICU: 3 weeks
• Administration/Jeopardy: 3 weeks
• Selective (no Jeopardy): 6 weeks
• Vacation: 4 weeks