Frequently Asked Questions
What sets your program apart from the others?
Our people. Yes, our facilities are some of the best in the country but the people make the program. Our residency moto is "character, competence, and compassion". We strive to recruit faculty and residents with these same personal attributes. Our faculty and residents all have the same goal in mind; to be the best emergency physicians we can be.
We have figured out the optimal way to train emergency physicians and make it fun. The atmosphere is very resident friendly with abundant clinical and academic opportunities fully supported by a diverse faculty. Our residents become part of our emergency medicine “family’ during their three years of training here where lifelong friendships are developed.
What do your graduates choose to do?
The door is wide open following graduation. We currently have graduates practicing in all areas of Emergency Medicine (academics and community practice) while several residents each year choose to pursue fellowship opportunities in a variety of emergency medicine sub specialties. Our graduates are currently chairs of departments, residency directors, research directors, and medical directors. We have graduates practicing as flight physicians, medical missionaries, and presidents of corporations. We are proud of our alumni and what they have done for the specialty of Emergency Medicine.
What does your orientation consist of?
Our new interns are all assigned to the emergency department as their first clinical rotation in July. In addition to their clinical shifts they attend intern specific didactic lectures (e.g., chest pain stratification, approach to seizures, etc.) and clinical labs (e.g., airway, suturing, splinting, slit lamp, etc.) given by the faculty during the month.
Is conference time truly protected for residents?
Yes. We offer scheduled conferences each week. Faculty cover the E.D. while the residents attend. While the attendance on some off service rotations may be difficult at times, our residents usually have no problem attending and maintaining the required 70% cumulative attendance rate.
Do your resident's really experience "progressive clinical responsibility"?
Absolutely. This is one of the major strengths of our training program. Each level of training receives more clinical responsibility throughout the years, which culminates during the senior year. Our senior residents have the opportunity to manage patients primarily, supervise medical students and interns, interact with referring physicians about incoming patient transfers, and perform aero medical triage and medical command, as well as many other department functions. They are also involved with department administration, quality assurance and bedside teaching.
The primary weakness in many programs is the pediatric training. How about yours?
Pediatrics is actually one of our strengths. We have a brand new children's hospital on campus. EM faculty and residents staff the pediatric ED. Our pediatric curriculum includes clinical rotations in the Pediatric Intensive Care Unit and our the Pediatric ED. Shifts are scheduled in our Pediatric ED throughout each year, thus ensuring that our residents do not miss out on any seasonal pediatric illnesses. If you total the number of shifts worked over the three years it is equivalent to at least six months of time spent in our Peds ED. This is amazing for a three year training program. We also have structured didactics focused on pediatrics during our conferences each month.
What is the ED patient population and acuity at WFUBMC?
WFUBMC is a high volume, high acuity academic tertiary care medical center. The entire spectrum of patients is well represented at WFUBMC. WFUBMC is both a level one adult and pediatric trauma center and continues to be one of the busiest trauma centers in NC. WFUBMC is also a nationally certified stroke and chest pain center. All specialties are well represented. The current ED volume is in excess of 90,000 annual patient visits with 26.5% being pediatric patients. Thirty percent of all ED patients are admitted to the hospital with 76% of patients admitted to monitored beds (ICU, CCU, IMC, acute care, telemetry). Fifty percent of all hospital admissions come through the ED. The ED at WFUBMC is considered the “front door” to the hospital, not the “back door” as is the case in some medical centers.
How are the inter-departmental relationships within the hospital?
We are very fortunate to have strong inter-departmental relationships throughout the medical center. Our faculty and residents are well respected by the other departments. All of the specialties get along well with each other which make for a very supportive environment to teach our residents and to deliver the best health care we can to our patients.
How are trauma patients managed at Wake Forest?
We believe in the "team" approach here at Wake Forest, not “us versus them”. Our trauma team is made up of emergency physicians and trauma surgeons. Our trauma center is certified as both a level one adult and pediatric trauma center and continues to be one of the busiest trauma centers in NC. Our residents have a different role on the trauma team in each year of their training.
During the internship, our residents rotate on the trauma service for an entire month. During this time, they have the same roles and responsibilities of any surgical intern. They care for patients on the floor, Trauma ICU, and Burn Unit. They function as an integral member of the team during trauma resuscitations in the E.D. often responsible for securing central venous access and insertion of chest tubes, while learning the ABC’s of trauma management.
Our second year ED resident is responsible for managing the trauma airways, not Anesthesia. Our residents receive extensive training on “difficult” airway management including the use of RSI and alternative airway devices. The second year EM resident also spends a month in the Trauma ICU serving as the primary care physician for severely injured multi-trauma patients. They also respond to "trauma codes" and consults in our ED where they serve as a team leader. Our residents get to hone their critical care and procedural skills while being supervised by the Trauma ICU staff.
Our senior residents perform the FAST exam on all appropriate trauma patients and assist in the overall management of the "trauma code" patient in the ED.
Is emergency ultrasound taught?
Yes. Our residents are individually taught the use of emergency bedside ultrasound during their formal Anesthesia/Ultrasound rotation supervised by our ultrasound director, Manoj Pariyadath, M.D. We have two portable ultrasound machines in the E.D. Our residents receive both didactic and clinical training in emergency ultrasound. Our residents are expected to become proficient in the following applications: FAST exam, detection of AAA, basic cardiac echocardiography, detection of IUP (includes endovaginal), and vascular access, as well as many of the other expanding applications of emergency ultrasound. Residents may also pursue further advanced ultrasound training during an elective rotation available to them.
How are residents evaluated?
Residents are evaluated in a variety of ways. First of all, faculty are encouraged to give immediate feedback to the residents while on clinical duty in the ED. Residents also receive written faculty evaluations after each completed rotation which can be viewed online. Faculty also perform real time direct observations of clinical care in the ED, procedural competency, and resuscitation competency. Residents meet with the program director twice a year for a semi-annual evaluation and evaluate the program and faculty annually. Overall, our residents receive the optimal feedback possible by keeping communication lines open between faculty and residents. Our faculty is very friendly and approachable and all have an “open door” office policy for all residents.
What is your pass rate on the boards?
Our residency consistently scores in the top quartile of all US training programs on the annual American Board of Emergency Medicine (ABEM) In-service Training Exam. In fact, our most recent scores place us in the top 20% of all EM residency programs for overall mean score on the exam. After residency, our pass right on both the written and oral ABEM exam exceeds the national average with our written pass rate being 100% for the past five years.
Tell me about technology at WFUBMC?
Our institution and department believes in integrating technology in medicine. The medical center has been a leader nationally with utilizing computer based medical records, radiography and wireless applications. The ED utilizes an electronic medical record (T-system EV). The residency uses an online residency management website (eResidency) to track procedures, attendance; perform evaluations and access important documents such as journal club articles online. We also have access and utilize the medical center's highly sophisticated "patient simulator" to teach resuscitation skills.
Is resident input sought when making changes to the residency?
Absolutely. We hold regularly scheduled Residency Education Committee meetings that are open to all residents and faculty. We discuss and make decisions in an open forum about clinical rotations, didactics, policies, etc. Most of our recent curriculum changes are because of initial input from residents concerns or comments.
Do you allow moonlighting?
Yes. Residents have opportunities to start moonlighting in their second year.
What do residents do for fun?
A variety of things are available depending on your interest. Our residents schedule regular social events such as attending sporting events, movie nights, skiing trips, etc. NC has multiple start parks close to Winston-Salem where residents go hiking, rock climbing, and camping. Many of our residents are involved in either city or Wake Forest intramural athletic leagues. The city is very runner and biking friendly. There are some outstanding health clubs in the city including several YMCA's as well as work out facilities in the medical center.
What does Winston-Salem have to offer me?
A lot! Winston-Salem is a medium sized city (city population 220,000, county population 340,000) located in the piedmont triad area of North Carolina. It is located about 2 hrs from snow skiing resorts and 4 hrs from the beach. Winston-Salem has most of the amenities of a "big city" without all the hassles such as traffic, crime, etc. Cost of living is ~20% below the national average. This means that most residents can purchase homes and even walk to work. The public schools are outstanding. The city parks are amazing. Winston-Salem is a great city to live in whether you are single or married. Most residents do not want to leave the area after they graduate. Check out our Winston-Salem page for further information.