Electives

Administrative Electives

Administration

Experiences are variable depending on the interest of the learner and in discussion with the operations leaders, but should include attending departmental and hospital administrative meetings and working on a directed administrative project.

Patient Safety

Experiences are variable depending on the interest of the learner and in discussion with faculty, but should include attending departmental and hospital administrative, quality, process and improvement, and safety meetings, directed readings and video-based teaching, and working on a directed safety project. At the end, the resident should have a better understanding of challenges in protecting patients from accidental injury during the process of care and the principles of patient safety, and be able to identify high yield interventions that can improve patient outcomes.

Quality and Process Improvement

Experiences are variable depending on the interest of the learner and in discussion with the EDQI leaders, but should include attending departmental and hospital administrative, quality, process and improvement meetings, and working on a directed process and improvement project.

Clinical Electives

Anesthesia, Children’s Hospital of Los Angeles

Gain procedural skills in pediatric airway management, endotracheal intubation and laryngeal mask airway placement, sedation, analgesia and anesthesia administration, and perioperative care.  

Anesthesia, Martin Luther King Jr. Community Hospital

Gain procedural skills in direct and video laryngoscopy with endotracheal tube intubation, supraglottic airway placement, effective bag valve mask ventilation, and procedural sedation.  

Burn Center/Burn Intensive Care Unit, LAC/USC Medical Center

Improve the understanding of burn management, wound care, burn center criteria, and the short- and long-term complications and prevention of inhalation injury and concomitant intoxication (CN, CO, etc.).

Gain additional critical care experience in ventilator management, fluid replacement, pain management and procedural sedation, antibiotic and medication stewardship and preventative care (DVT, GI, decubiti, etc.), and understand the importance of temperature control in burn patients.

Cardiac Care Unit, Harbor-UCLA

Develop the ability to rapidly evaluate, diagnose, stabilize, and treat critically ill patients with primary cardiac complaints. Gain additional critical care experience in ventilator management, fluid replacement, and use of vasoactive medications. There will be procedural experience when available in intubation and central and arterial line insertion and management.

Cardiology (CORE) Unit, Harbor-UCLA  

Participate in the care of patients in the Cardiovascular Open Access Rapid Evaluation (CORE) unit, including but not limited to, optimizing medical management of CAD and CHF patients, cardioversion, rate control, etc. Develop an efficient, thorough approach to EKG interpretation. Learn the basics of echocardiogram interpretation and risk stratification utilization. Complete a small project based on resident’s area of interest.

Dermatology, Harbor-UCLA

Become familiar with general dermatology language and principles and gain exposure to general clinical dermatology, while also engaging in independent study of this complex specialty.

EMS/Aeromedical and EMS/Disaster, LA County EMS

Gain a broad overview of disaster medicine, including the management of mass-casualty events involving biological, radiological, chemical, and explosive injuries. Also covered will be decontamination and donning and doffing of personal protective equipment. Learn the basics of aeromedicine, including the range, patient characteristics, and capability of providers of helicopter transport. Be able to describe patient situations which may be adversely affected by air transport. Participate with EMS Agency system in protocol development and revision, disaster preparedness activities, and mass gathering planning. If possible, tours will be arranged of the Disaster Staging Facility in Santa Fe Springs to better understand how the Los Angeles County Emergency Medical Services Agency has integrated our region towards better disaster preparedness.

Event Medicine

Ever wondered about practicing emergency medicine at a large concert, sporting event, or mass gathering? Learn about considerations for delivering emergency medical care outside of the traditional hospital setting. Topics covered include temporary medical facility set up and supplies, mass casualty incident management, and the clinical management of drug toxidromes and environmental disease. Event staffing may include music festivals, local marathons, or other mass gathering events in the Los Angeles area. Participants will learn to deliver emergency medical care in a mass gathering event setting.

GYN Urgent Care, Harbor-UCLA

Develop the ability to rapidly and appropriately care for patients presenting with gynecological or early obstetrical complaints in an urgent care setting, including common medical or gynecological complaints such as abnormal bleeding, infertility, contraception, abdominal or pelvic pain, breast concerns, and domestic violence.

Medical Intensive Care Unit, Cedars Sinai Medical Center or Harbor-UCLA

Develop the ability to rapidly evaluate, diagnose, stabilize, and treat critically ill patients with primary medical complaints. Gain additional critical care experience in ventilator management, fluid replacement, antibiotic and medication stewardship and preventative care (DVT, GI, decubiti, etc.), and use of vasoactive medications. There will be procedural experience when available in intubation and central and arterial line insertion and management.

Observation Medicine, Harbor-UCLA

Gain experience caring for patients with common conditions such as asthma, COPD, cellulitis, chest pain, congestive heart failure, dehydration, electrolyte disturbances, pneumonia, pyelonephritis, and syncope in an Observation Unit setting using goal-based protocols and temporal landmarks.

Ophthalmology, Harbor-UCLA

Gain advanced knowledge of common ophthalmologic diseases, improve skills in ophthalmologic history and examination, understand the relation of pathology of the eye to systemic diseases, and master the slit lamp exam.

Oral Maxillofacial Surgery, Harbor-UCLA

Gain practical exposure to clinical oral maxillofacial surgery outpatient care with the development of diagnostic skills and management of dental problems. Gain experience with dental blocks and participate with OMFS residents in consultations.

Orthopedic Surgery Cast Room, Harbor-UCLA

Gain exposure to diagnosis and management of patients with common orthopedic traumatic and non-traumatic conditions. Learn to apply splints and casts properly.

Otolaryngology/ENT, Harbor-UCLA

Gain practical exposure to clinical otolaryngology with the development of diagnostic skills and management of routine otolaryngologic problems and with improved understanding of the roles of audiology and speech pathology in the management of head and neck related problems.

Palliative Care, Harbor-UCLA

Gain exposure/experience in the practice of Palliative Care in adults and pediatrics (the pediatric component outside of Harbor-UCLA Medical Center). Improve knowledge of palliative care and symptom management, appreciation for the spiritual needs of patients with terminal cancer, cultural sensitivity, and the role of culture in influencing a patient’s experience of dying. Enhance appreciation for a team approach to patient care, especially for the terminal patient. Appreciate the contribution of all health care professionals to the care of the terminal patient.

Pediatric Clinics, Harbor-UCLA

Gain clinical pediatric subspecialty expertise by rotating through any of the following clinics: Adolescent, Allergy and Immunology, Cardiology, Child Abuse, Development and Behavioral, Endocrinology, Gastroenterology, Genetics, Hematology/Oncology, Infectious Disease, Nephrology, Neurology, and/or Rheumatology.

Pediatric Delivery Team, Harbor-UCLA

As a member of the delivery team attend all in-hospital deliveries and attend to the resuscitative needs of the infant. Care for patients in the nursery following delivery and gain expertise in the newborn examination, high risk screening, and perinatal care.

Pediatric Emergency Medicine Elective, Children’s Hospital of Orange County (CHOC) or Harbor-UCLA

Refine and gain additional fundamental skills of the practice of pediatric emergency medicine, including but not limited to: performing an age appropriate and complaint-focused history and physical exam, demonstrating an age appropriate differential diagnosis for each complaint, recognizing and managing critically ill medical or trauma patients, developing and carrying out treatment plans and procedures through admission or discharge, and honing resuscitation and stabilization skills. Develop proficiency in multi-tasking, documentation, time efficiency, and cost efficiency in a private practice community ED setting (CHOC site). Gain administrative skills by participating in a PED quality improvement project (Harbor-UCLA site).

Pediatric NICU, White Memorial Hospital or Harbor-UCLA

Develop the ability to rapidly evaluate, diagnose, stabilize and treat critically ill neonatal patients. Gain additional critical care experience in resuscitation, ventilator management, fluid and nutrition management, and vascular access of neonates. There will be procedural experience when available in intubation, chest tube, and central/umbilical and arterial line insertion and management.

Pediatric Intensive Care Unit, Harbor-UCLA

Develop the ability to rapidly evaluate, diagnose, stabilize, and treat critically ill pediatric patients. Gain additional critical care experience in ventilator management, fluid replacement, antibiotic and medication stewardship and preventative care (DVT, GI, decubiti, etc.), and use of vasoactive medications in the care of pediatric conditions. There will be procedural experience when available in intubation, chest tube, and central and arterial line insertion and management.

Pharmacy, Harbor-UCLA

Round with the pharmacy team and antibiotic stewardship team in the ICUs daily to gain expertise in medication reconciliation, antibiotic choice, adverse events, and medication reactions and interactions.

Psychiatry Adult, Harbor-UCLA

Gain experience with acute psychiatric illness along with a better understanding of the medical and legal aspects of involuntary holds (5150) and the pharmacology of common psychiatric medications.

Psychiatry Adolescent, Harbor-UCLA

Gain experience with acute child and adolescent psychiatric illness along with a better understanding of the medical and legal aspects of involuntary holds (5585) and the the pharmacology of common psychiatric medications. Harbor-UCLA has a Child and Adolescent Psychiatry fellowship and a separate adolescent psychiatry emergency unit.

Radiology, Harbor-UCLA

Develop an efficient, thorough approach to plain film interpretation and improve interpretation of head CTs. One may also gain experience in areas of interest, including pediatric radiology and body CT.

Sports Medicine, Harbor-UCLA

Learn how to manage musculoskeletal/sports-related issues with up-to-date treatments in a community practice setting within the pediatric/adolescent age group. Become familiar with various musculoskeletal and sports medicine disorders in the pediatric population, including return to sports play criteria, athletic physical exams, and sports injuries. Gain comfort with triaging various sports injuries and demonstrate knowledge in relevant anatomy and physiology. Learn about psychosocial aspects of pediatric sports/musculoskeletal medicine issues and be familiar with current literature and management of common conditions.

Surgical Intensive Care Unit, Harbor-UCLA

Develop the ability to rapidly evaluate, diagnose, stabilize, and treat critically ill patients with primary surgical complaints. Gain additional critical care experience in ventilator management, fluid replacement, wound management, and antibiotic and medication stewardship and preventative care (DVT, GI, decubiti, etc.) for the surgical patient. There will be procedural experience when available in intubation, chest tube insertion and management, and central and arterial line insertion and management.

Toxicology, UCLA Reagan

Gain experience in the initial management for the most common poisonings and envenomations and understand the use of the most commonly employed antidotes in the management of poisonings.

Ultrasound, Harbor-UCLA

Learn the basics of ultrasound theory, technique, and machine maintenance/troubleshooting. Prepare a teaching file interesting case to help teach future residents about the utility of ultrasound in emergency medicine. Achieve level II certification in as many applications as possible in the following order: FAST (pericardial effusion & abdominal free fluid), IUPs, AAA, gallbladder, hydronephrosis, ultrasound-guided procedures (femoral vein catheterization, internal jugular vein, catheterization, paracentesis, abscess drainage).

Urology, Harbor-UCLA

Gain practical exposure to clinical Urology with the development of diagnostic skills and management of urologic problems, and gain experience with urologic procedures. Participate with Urology residents in consultations and in the OR if interested.

Wilderness Medicine, Harbor-UCLA

The wilderness medicine elective is structured to provide an overview of medical practice in an austere, outdoor environment. Didactic curriculum includes an overview of wilderness travel planning, altitude disorders, survival techniques, water and food procurement, patient movement in a wilderness environment, and wilderness medical kit preparation. Participants are expected to plan a wilderness expedition with complete medical plan during the rotation.

Education Electives

Advocacy/Social Medicine, Harbor-UCLA

The Social EM/Advocacy elective provides residents an opportunity to develop a good foundation of knowledge for opportunities in health advocacy, social determinants of health, structural vulnerability, health equity, and health and human rights. Residents will help in the development and administration of one of our many programs. Areas of concentration include but aren’t limited to substance use disorder/MAT, homelessness, food justice, trauma recovery/hospital-based violence intervention programs, social needs screening, immigration advocacy, and medical-legal partnership for vulnerable patients.

emDocs

Expand knowledge in one or more topic areas in consultation with the emDocs editorial team, prepare a post, and publish online.

EMS Education and Teaching, LA County EMS

Experience gained depends on the resident’s areas of interest and focus and may include teaching and curriculum development for paramedic trainees at the Paramedic Training Institute and Harbor-UCLA Department of Emergency Medicine or the Aeromedical Squad. May also include contributions to the EMS system continuing education update, presentation at Harbor-UCLA grand rounds, and development and preparation of EMS tape review or teaching for the Base Physicians Course. 

Medical Education, Harbor-UCLA

Identify primary sources to learn about bedside teaching methods (specific to constraints unique to working in the emergency department), and develop and practice learned bedside teaching skills, the principles of effective feedback, and skills in delivering feedback while addressing the individual resident/medical student’s educational needs and interests. On this elective, residents spend at least 3-4 “teaching ED shifts” per elective week (adult and pediatrics) and focus time on individual resident/medical student teaching needs (journal club, didactics, simulation, etc) and participate in sub-intern activities when scheduling permits.

Medical Spanish

Gain better understanding of medical terms and phrases in Spanish through completion of modules on the Google Chromebook asynchronous learning program, which may be checked-out from the program coordinator.

Narrative Medicine

Have the opportunity to express the challenges faced during medical school and residency and develop a creative outlet for the stresses that we face as emergency physicians. This is an important skill that can improve career satisfaction and diminish burnout. Complete a total of 4 narrative medicine written pieces or audio podcast episodes which will be published on the Physician Grind. The written pieces will be submitted for publication to Emergency Medicine News and Tincture. Podcast episodes will be published on the Physician Grind Podcast and will be submitted for publication to Emergency Medicine News. The Physician Grind and nuMose were co-founded by two Harbor-UCLA DEM alumni.

Public Health, Los Angeles County Dept. of Health Services

Get actively involved in at least one ongoing project within the department of public health, attend public health talks going on during the rotation period, and complete the reading and reference guide for public health rotators. By the end of the rotation residents should be able to: explain the relationship and interaction between clinical and public health practice, describe what a public health department does, understand what happens when a disease is reported to the Health Department, know who to call for disease control, describe various community activities in Los Angeles aimed at health promotion, understand the role of the Public Health nurse and how they can help the clinician, and explain how the Environmental Health unit protects health.

Simulation, Harbor-UCLA

Simulation is an exciting teaching tool that can, when used appropriately and effectively, enhance active learning in curricula. In the simulation elective, participants will be able to design simulation cases that are appropriate for a range of learners, be able to functionally operate the simulation equipment, and implement best practices in debriefing techniques. Participants will design a case with one-on-one guidance from experts in simulation, implement that case, debrief with the learners, and get direct feedback on each of these steps.  

WikEM

Expand the knowledge in one or more topic areas of Emergency Medicine by publishing an update to the online medical reference WikEM.

Research Electives

EMS Research, LA County EMS and/or Harbor-UCLA

The experience and schedule for this rotation will depend on the resident’s areas of interest and should focus on taking part in a novel or ongoing EMS research project.

Clinical Research, Harbor-UCLA

The experience and schedule for this rotation will depend on the resident’s areas of interest and should focus on taking part in a novel or ongoing clinical research project.