Emergency Medicine Long Statement

Welcome to Garden City Hospital emergency medicine website. We are very pleased that you are interested in learning more about our residency program.

The primary goal of our program is to prepare residents for the clinical practice of either academic or community-based emergency medicine. We train our residents to understand the scientific underpinnings of their practice, to know how to take charge, set priorities, care for the sickest patients, and to multitask in a very busy ED environment and yet never lose their humanity or compassion.

I have lead several emergency medicine residencies, been chairman or in other leadership positions. This residency at Garden City Hospital (the “Garden”) is my favorite. I have supercharged, enthusiastic, highly adept residents in an environment that is conducive to excellence. In many emergency medicine residencies there is a daily grinding, grueling “fight” about admitting patients. Or if you agree on admission, it’s not to that admitting officer’s service. None of that occurs here. We admit when appropriate, and there are no further arguments. None of these irksome, pernicious, exhausting, time-consuming, undermining arguments with other services about admitting patients. It is so renewing and refreshing to be able do the job of emergency medicine without that distraction. This program has been a boutique gem attracting the best residents who develop a phenomenal skill set. One of their best rotations is at the famed Maryland Shock Trauma where they run many trauma resuscitations each day of the rotation under the tutelage of some of the best trauma attendings and fellows in the United States. They have a one of a kind fresh cadaver lab where many less common procedures are practiced such as thoracotomy, cricothyrotomy, and lateral canthotomy. It is a unique feature of our program and no more than ten other emergency medicine residency programs in the United States.

Residency training in emergency medicine is a complex privilege. It is a profession involved in saving life, limb, and reducing suffering, all factored in to a time-dependent model termed a shift. An emergency is a medical condition in which time is of the essence. How much of the big picture can you see? How much of the timely, relevant, important minutiae is available to you intellectually? We teach the residents there is time to look up some things and, for true emergencies, there may not be time to look for certain information – you just have to know. It is a constant dynamic between these overarching concepts and precepts and never-ending details. Mostly emergency medicine is exciting. You must always be prepared for the next “fascinoma”, mundane case, or tragedy. Those in the field have often felt this “at home” moment when they worked in the emergency department. They knew emergency medicine was for them. They have wanted to master the emergency medicine skill sets. We are looking for these applicants. We are committed to train them in these skill sets.

We teach based on fundamentals, basics and precepts yet combine that with all the essential fine points and manual skills involved in emergency medicine. These require much time to acquire and practitioners spend a lifetime honing their skills. We start here in residency for that life-time of learning. One thing you can be sure of. The shifting sands of emergency medicine will lead to change: changes in therapy and skill sets. How will you evolve? We teach best practices for making these life-long changes.

We believe the ED is your home for the best learning. Some skills and assessments are not as frequent in the ED: such as deliveries or multiple trauma. All the same the emergency physician must be highly skilled when these less frequent emergency situations arise. We supplement the emergency medicine experience with specific rotations outside the emergency department. In addition, this program is being remolded with renewed energy. The marks you make on this training program will be like no other. These marks may readily last for decades.

We train our residents to be adept at procedures, yet understand how to adjust for difficulties in execution and complications. To accomplish this we have many opportunities for procedures in the ED itself. We never need to share procedures with other residencies within the ED. The training is by a highly technically adept group of attendings from Dr. Brenner who has written acclaimed books on procedures and techniques in emergency medicine to the Chairma, Dr. Rancont, who has mastered many ultrasound guided nerve blocks, such as scalene block to anesthetize the entire arm. Journal clubs are topic based, consensus format and evidence based. Our residents will receive training in procedure, , formal ultrasound training, morbidity and mortality, interesting cases, “near misses”, “good catches” and mock oral board examinations. The program teaches integration of emergency information with experience, in other words, the development of the clinical judgment and the fact that there are many different ways to approach an emergency. Having plan A and plan B is good, but you often need to be even more prepared by having several backup plans.

Not only do our residents and faculty encourage academic excellence, we also strive to demonstrate compassionate care. Concerning compassion and humanism in emergency medicine, we have a resident-driven symposium on ethics in emergency medicine jointly developed by the emergency medicine residents, thought leaders, and nationally-respected ethicists.

It is one thing to revamp and develop a new didactic curriculum, which we have done. It is another thing to experience or “live” that curriculum. Residency input into their training is a vital part of our constant quality improvement in education. We have a yearly retreat focused on wellness and focused on improving the program. The residents are in charge of the entire review. All aspects of the program are reviewed, evaluated and in all probability implemented promptly. Emergency medicine can be exciting, and likewise we are committed to making it a sustainable exciting experience. Wellness is emphasized as well as how to maintain that wellness and foster resilience. We are looking for residents who love emergency medicine and are committed to emergency medicine. We intend to give you the skill sets to be successful in all practice models (from urban to rural, from academic to corporate) and yet maintain your passion about emergency medicine and patient care. If you love what you do, it is no longer work.

We are looking for kindred spirits, residents who are passionate and highly upbeat about emergency medicine. Detroit is an amazing city, and we will have an excellent group of residents. It will be an honor and pleasure to be their Program Director and have a part in their training as emergency physicians.

We all wish you the best of luck in your future endeavors in the field of Emergency Medicine. There is much more to learn about this great program, and I hope I have piqued your interest to discover more. Please browse around our hospital’s site, drop us an e-mail if you have questions, and we hope to see you on the interview trail, in-person or virtual.

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