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UCSF's Newest Academic Department Emergency Medicine Residency Opens Its Doors By Susan Davis 07.01.08 
Photo: Majed Hemal Kanzaria, MD, decided he wanted to go into emergency medicine in his third year of medical school at UCSF. The East Coast native had enjoyed all of his rotations at UCSF, but the emergency department offered a chance to work with what he calls "a diversity of pathologies and patients." "In the emergency department, I get to see what's interesting about every specialty," he says. "Plus I get to see everyone from CEOs to homeless gentlemen, as well as explore my interests in public health." And because the School of Medicine officially opens its new Emergency Medicine residency this month, Kanzaria – and 11 other residents – can now pursue their professional passions right here in San Francisco at the UCSF Medical Center and at San Francisco General Hospital. "Having gone to medical school at UCSF, I feel very lucky to be a resident in the new Department of Emergency Medicine," Kanzaria says. "I truly believe the faculty here are among the best in the country, both as teachers and as individuals. They have long been the leaders in emergency medicine education – even before they got their own academic department, they were having a major impact on the medical students here." A New Specialty The creation of the new academic Department of Emergency Medicine was spurred by several developments:
Indeed, until the new department and its corresponding residency program was created, UCSF was the only major teaching hospital in California without one, although UCSF Fresno has been successfully training emergency medicine residents since 1974. "It just became more and more logical for us to develop our own emergency medicine residency," Callaham says. Treating Patients, Attracting Students The new academic department's creation is expected to unify faculty and trainees working in the emergency departments at UCSF Medical Center and at SFGH. Together, these EDs treat 93,000 patients per year, which provides fertile ground for medical students to learn about treating undifferentiated patients of all types. (Fully 65 percent of SFGH's patients are admitted through the ED.) The department's opening is also expected to facilitate collaboration with both UCSF Fresno and the future pediatric emergency department at the new UCSF Women's and Children's Hospital at Mission Bay. "Since emergency medicine is one of the few areas in medicine where almost all specialties intersect and interact, the new department will benefit all patients, students, and residents, not just those in emergency medicine," Callaham points out. "Creating an academic department reinforces the idea that emergency medicine is a specialty that is growing in size and importance." In the past, adds Chris Barton, MD, the vice chair of the department and chief of SFGH's emergency services, new doctors rotated through the ED, "so they were exposed to emergency medicine, but not always invested in it. Now that there's a formal department, we'll have the pleasure of working with doctors who are invested both in the specialty and in learning, on a deeper level, to deliver emergency care. That sense of ownership and partnership is very exciting for all of us." Department faculty also expect to provide improved training in emergency medicine to other residents at UCSF, as well as serve as an educational resource for local healthcare professionals and the community. This includes teaching such courses as basic and advanced cardiac life support, pediatric life support, and basic and advanced trauma life support.  The Emergency Medicine Residency Program The four-year program will train 48 residents at a time (12 residents in each class), who will be split between SFGH and the UCSF Medical Center. Each resident will graduate with a specific area of distinction (e.g., research, emergency medical services [EMS], medical education, ultrasound, pediatric EM, and public or global health). During their residency, the doctors also will have a chance to earn dual degrees (e.g., MPH, MBA or MPA) and/or pursue fellowship opportunities in wilderness medicine, public health, toxicology, international medicine, ultrasound, EMS, medical education, and other subspecialty areas within emergency medicine. One feature of the residency program that is attractive to students is the opportunity to work at SFGH, which is a Level 1 Trauma Center the only one in the North Bay. "This is an ideal environment for training doctors in emergency medicine," Barton says. " Our residents will be exposed to heightened acuity on a daily basis. We also care for the underserved in the City, so the doctors will be seeing a very wide variety of patients." Another attraction is UCSF Medical Center's state-of-the-art emergency department, which was renovated in recent years to make patient flow more efficient, integrate modern IT, and improve patient privacy. EM residents, for instance, will learn to use portable bedside ultrasound equipment, work with the ED's electronic medical record system (which instantly integrates lab and radiology results into the patient's chart), and benefit from the presence of teaching aids, such as the Glide Scope (which allows a teacher to monitor a student's intubation progress from a real time video image on a computer screen). The Entering Class The first class of the new residency officially began study on June 21, 2008. They include students from UCSF, Tulane University, UC Irvine, University of Washington, Stanford University and Georgetown University, with areas of expertise ranging from ophthalmology to music, rock climbing, epidemiology, dermatology, global health, and direct-to-consumer pharmaceutical advertising. "I feel super proud to be a part of this class," Kanzaria says. "Besides having stellar academic credentials, they're all really friendly, really down to earth, and really nice." (Read about the new class.) "I want to go into emergency medicine because it is a hands-on, practical field that also has tremendous potential for improving community health," says Jenny Wilson, MD, another new resident who did her medical school training at UCSF. "As the interface between the hospital and the world beyond, the ED is where you can see and hopefully improve on how our health care system works, especially for people with little other access to health care." "I was particularly attracted to this residency," she adds, "because most of the residents rotate through both SFGH and UCSF and can appreciate and address any disparities that may exist between the different hospitals. I think this makes for a higher standard-of-care at our county hospital, which is something I really care about." The Faculty The more than three dozen faculty who will be involved in the department already have been active in emergency medicine on both the clinical and research fronts for a long time. Recent articles by the faculty, for instance, include 93 peer-reviewed research journal articles and 43 textbook chapters; the department's faculty also have edited seven textbooks in the last five years. Various EM researchers at UCSF have long collaborated with researchers in other disciplines, including cardiology, infectious disease, neurology, trauma surgery, pulmonary medicine, radiology, and health policy, both at UCSF and nationally. Current areas of expertise include cardiac arrest, pre-hospital EMS care (including stroke diagnosis and management), portable ultrasound diagnostic techniques, health policy (including ED crowding and ambulance diversion and ED use by the uninsured), procedural sedation, disaster preparation and response, and infectious disease management. |
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