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The learning experience is split over three years. The experience begins with an orientation month with focused lectures, shifts in the emergency department, and a team building retreat. During your training, you will spend most of your time in the emergency department, learning what matters most. Months spent outside of the Emergency Department are heavily focused on critical care. A total of 7 months of exposure to critical care medicine will prepare you to take care of whatever comes through your doors.

Rotation Grid


Emergency Medicine

Learn more about your comprehensive education in Emergency Medicine that will take place in our large, state-of-the-art Emergency Center which opened in 2019. The center is the statewide leader in Emergency Medicine visits and has over 135 patient beds to accommodate increasingly large volumes of sick patients. The Emergency Center is ACEP geriatric accredited, has a dedicated psychiatric treatment area, as well as a dedicated Pediatric Emergency Center which sees over 23,000 patients in a kid-friendly environment. 

Emergency Medicine

You will benefit from working alongside fellowship trained Pediatric Emergency Medicine faculty within our on-site Children's Hospital. Not only will you have several dedicated months of Pediatric EM in your first and second year, along with a PICU experience in your PGY2 year, but you will also have integrated shifts in the Pediatric Emergency Center throughout your training. This will allow you to take advantage of the full depth and breath of pediatric acute care.

The population of older adults is growing rapidly with US adults ≥65 projected to double to 83 million by 2050. The population of the oldest old, aged ≥85, will triple in the same period. At Beaumont Royal Oak, roughly 30% of our volume is made up of geriatric patients, with 70% of these patients being admitted. Older adults often have multiple medical problems, atypical presentation of diseases, and cognitive impairment. They often require additional resources, lab testing, and imaging. 

At Beaumont, we have made caring for older adult patients a priority and are accredited by the American College of Emergency Physicians as a Level 2 Geriatric Emergency Department. On shift, residents work with our intradisciplinary team to create the best care plans for their patients. Their education is supplemented by a longitudinal lecture series focusing on the different domains of Geriatric Emergency Medicine, innovative simulations, and interaction with the Geriatric Emergency Medicine Fellow, whether on shift or during formal teaching sessions. Additionally, residents have the opportunity to be involved in geriatric research projects, initiatives, and committees both at the hospital and national level. This ensures our residents receive a comprehensive education, allowing them to optimally care for older adults upon graduation.   

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Ultrasound

Clinical ultrasound has become an increasingly important tool in the evaluation and Ultrasound treatment of emergency department patients. Our Ultrasound program was developed to train emergency physicians in the utilization of this important diagnostic modality.

Residents are trained in this discipline by expert faculty using fourteen state-of-the-art ultrasound machines. We have two ultrasound fellowship trained faculty on staff along with a robust fellowship program. The majority of our staff are credentialed in a variety of core ultrasound applications and regularly perform studies on clinical shifts.

Residents will have an opportunity to learn this discipline in a variety of ways. The educational curriculum has two blocks of time carved out in the PGY1 and PGY2 year for dedicated ultrasound experiences. The rotations include hands on scanning supervised by expert clinical faculty, image review, journal club, and monthly ultrasound didactic conference. Residents also receive several grand rounds lectures throughout the academic year, participate in procedure labs and attend regional US conferences. This broad exposure translates into seamless use of ultrasound effectively while on clinical shifts. Our residents graduate having completed between 300 and 500 ultrasound studies

Research and scholarly activity are important components of the ultrasound program. Faculty are active at the regional and national level with a number of peer-reviewed publications and grant-funded projects with key areas of interest including: ultrasound-guided vascular access, cardiac ultrasound, and trainee education. Residents have the opportunity to engage in the research process and learn from expert faculty.

Critical Care

As a Level I Trauma Center and a tertiary referral center there is no shortage of critically ill patients. Our residents spend a total of six months on intensive care units acting as junior and senior residents taking care of patients with autonomy. They also get the opportunity to become a critical care specialist within our department during the resuscitation rotation.

The research and resuscitation rotation is built into the PGY-2 curriculum. It is a one month rotation where residents spend time in the high acuity area of the ED assisting with taking care of the sickest patients and performing procedures. The rotation includes weekly meetings to discuss up to date literature and evidence based medicine.

Trauma

Education in trauma care includes both opportunities within our Emergency Center, the Trauma surgical ICU, and the Trauma Service at Sinai Grace. This well-rounded experience allows ample exposure to critically injured patients along with the added dimension of allowing our residents to experience a different hospital system and patient population.

As the only level 1 trauma center in Oakland County, residents will have ample exposure to Trauma. In addition to resident exposure to critically injured patients during EM months, residents will have a well-rounded experience with a downtown rotation at either Sinai Grace or Detroit Receiving. This allows for an urban trauma experience with the added dimension of experience in a different hospital system and patient population. 

Emergency Medicine

How Residents are Evaluated

EM residents at Beaumont are evaluated and provided with feedback in multiple ways. First, residents receive feedback on every EM shift verbally from faculty, and in electronic form using Shift Feedback Cards. Also, a summative evaluation is completed at the end of each rotation in the ED and off-service rotations. Residents also are evaluated once yearly by a nurse and a patient. Finally, residents undergo comprehensive evaluation twice a year by the Clinical Competency Committee, and these findings are discussed with each resident individually at a meeting with the Program Director or Associate Program Director.

How Residents Evaluate the Program

Beaumont EM residents assess and provide feedback to the Beaumont EM Residency on multiple occasions and in multiple formats throughout each year. This includes survey feedback in the form of an ACGME annual survey, and an internal EM Residency survey covering all facets of residency training at Beaumont. Residents also evaluate each faculty member in the residency program to give specific feedback on what they do well and where they can improve as educators. Residents evaluate each rotation at the end of the month as well. Finally, Beaumont EM residents have the opportunity to provide verbal feedback to EM program leadership at monthly Residency Advisory Council meetings, quarterly Program Evaluation Committee meetings, and an annual Program Review meeting.

Teaching

Residents at the Beaumont Emergency Medicine Residency possess a passion for medical education and our residency affords them a variety of opportunities to pass on medical knowledge and to expand their medical education skills. Medical education at Beaumont begins with working with medical students from the Oakland University-William Beaumont School of Medicine. All students from our medical school will rotate through our ED and residents have the opportunity to teach students, both clinically on shift and through a variety of student didactic sessions.

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As a resident in our program, you will be provided with robust educational opportunities to solidify your Emergency Medicine knowledge base. EM core content delivery will be the focus of our weekly EM Grand Rounds, monthly journal clubs, and quarterly simulation and procedural review. Residents will have the opportunity to participate as both learners and educators. We currently utilize a hybrid model for educational content delivery including in-person and virtual meetings. We also emphasize varying models of large versus small group sessions based on topic content and best methods for information delivery. We hope to aid our residents in preparation for their EM written and oral boards while allowing a safe space to discuss various topics that contribute to Emergency Department care. 

Foundations is a national curriculum that uses a flipped classroom approach along with case-based learning to learn the fundamentals of emergency medicine. Our residents have 1-3 sessions of Foundations a month during Grand Rounds. Residents are assigned the topic and directed to the appropriate materials to prep for the week's flipped classroom. During Grand Rounds, the residents are broken into small groups based on PGY level and work directly with a faculty member to go through several cases that help reinforce what they prepped for the session. Afterwards, our residents are assigned Rosh Review questions that really cement their knowledge. 

We have a variety of EM Resident, Faculty, and guest speakers that contribute to the evolving content of Emergency Medicine practice. We also welcome specialty topics that fit the curiosity of our trainees.

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Mentoring is a very important part of our residency. Mentoring helps residents gain practice advice, encouragement and support and helps empower the resident. Our residents choose a faculty member to become their mentors about 6 months into their intern year. This allows the resident time to develop relationships with our many faculty and find one that most aligns with their goals. The relationship is then cultivated over the next 2.5 years. The mentor and mentee meet several times a year to ensure the resident is on track to graduate and to help in any way, be it wellness, scholarly activity or networking. The faculty member is also best positioned to help the resident if there are any clinical or knowledge gaps. These relationships are both mutually beneficial to the resident and faculty member and widely praised throughout the residency.

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Journal Club

One of the activities our residents take a part of on a monthly basis is our Emergency Medicine Journal Club. Once a month, usually a Wednesday night, the residents will get together to discuss new high impact journal articles in the field of Emergency Medicine. These journal clubs are graciously hosted by our faculty, usually either at their houses or at an activity of their choosing (e.g. bowling, kickboxing, laser tag, etc.). The goal is to keep up-to-date on the latest and greatest information in the field of Emergency Medicine, while also giving the residents a consistent opportunity to get back together in a fun setting outside of the hospital. Journal clubs are always a fun outlet for our residents, while providing an opportunity to maintain the latest information in the field of Emergency Medicine.

Teaching

The Wilderness Interest group (WILDS) at Beaumont Royal Oak is dedicated to inspiring residents to engage in the outdoors in an educated and safe manner. The focus is on core topics with training and personal readiness for response to emergencies in the backcountry. Our group promotes and engages in the peripheral disciplines of disaster response, international medicine, sports event medicine. We currently run a longitudinal curriculum of monthly Wilderness topic discussions, culminating in a summer hands-on workshops series. We encourage and work with you to attend national trainings, conferences, and support you in obtaining your Fellowship in the Academy of Wilderness Medicine credentialing.

 

Longitudinal Curriculum

Each resident in-training at our program will participate in longitudinal learning experiences that fall under the umbrellas of Patient Safety and Quality Improvement, EMS and Flight, and Health Equity. These three curriculums were developed with a unique set of learning objectives and patient care goals in mind. We hope to provide every resident with exposure to various resources that allow advancement of medical care in our patient population and our surrounding community. Whether fostering the development of a niche, or simply gaining understanding of the larger picture of emergency care, these curriculums help to broaden the resident training experience.

Healthcare disparities, as defined by the Centers for Disease Control and Prevention (CDC), is the “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” 

Our curriculum includes lectures and SIM sessions centered around our care for marginalized communities. In recent years, these have included focus on

  • Racial & ethnic minority groups
  • LGBTQ population
  • Limited English Proficiency (LEP) population
  • Incarcerated population
  • Homeless population 




Ensuring our residents graduate with the leadership skills necessary to excel as an emergency medicine team leader is a critical component of our residency curriculum.  Our residents have multiple leadership education opportunities across all three years including simulation experiences, resuscitation management, and committee involvement. We have also developed an innovative, longitudinal leadership curriculum which combines high-yield self-directed learning with interactive case-based discussions. The intent is to help our residents develop the skills, resources, connections, and confidence to successfully lead any medical team in the treatment and care of our patients and community.

EMS

Emergency Medical Services (EMS) is a unique discipline in emergency medicine compared to any other specialty. EMS is more than just EMTs, paramedics and ambulances, and is an integrated system of emergency care for patients and communities. EMS transports the majority of critical patients to emergency department. EM providers are looked to by the rest of the health care system to coordinate emergency care for patients with trauma, stroke, STEMI, pediatrics, emergency preparedness and many other specialties. EMS providers are the health care providers that make “house calls” and understand the social determinants of health and the out of hospital circumstances that lead to an individual patients’ emergency visit. They also transport 15-20% of all ED patients to the hospital. For all of those reasons, EM providers must be knowledgeable about EMS, understand how the EMS system works, and how to interact with it in their and other communities.

The residency and its faculty at Beaumont have a long history of EMS engagement at the local, regional, state and national level. Residents become engaged in EMS care, beginning with EMS ride alongs during their first month of their residency. Residents interact with EMS providers on a daily basis when patients are transported to the ED. The educational curriculum provides overview lectures, case review sessions and didactic sessions regarding issues that EMSS plays an important role, such as out of hospital cardiac arrest, and emergency systems of care. EM Residents provide online medical direction beginning in their PGY II year, after completing an online training module regarding medical direction. Residents also have a number of options to provide education to EMS students and practicing providers in the community. They also have the opportunity to participate in other EMS administrative, planning and political activities. For the resident with a particular interest in EMS and wishes a more intensive experience, an EMS elective rotation may be arranged and has been uniformly well received. The department has an active EMS and resuscitation research program in which residents are encouraged to be engaged. 

 

Simulation

Simulation at Beaumont brings forth a wide range of educational opportunities for our Resident Physicians. The highly integrated format is unique at Beaumont through the existence of one of the most advanced medical simulation facilities in North America, the Marcia & Eugene Applebaum Simulation Learning Institute (SLI). Through the resources at SLI, we have access to highly advanced trainers for the betterment of our Residents’ education. High fidelity simulation scenarios begin from intern year and continue throughout residency training. A connection is formed through individual and group-based learning. One of personal reflection with the goal of gaining familiarity to the real clinical world while a group-based understanding of important team related strategies to parallel a successful outcome in a hectic trauma or medical code. The introduction of the Health Disparity Simulation curriculum has further advanced the Resident education. Through important, but less talked about topics, our Health Disparity Simulation curriculum sheds light on vulnerable patient populations or social considerations or focuses on the Art of Medicine or soft signs of Physician-Patient relationship.

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We believe that as physicians our role is not limited to the care we provide in the emergency department. We are community leaders and advocates for our patients inside and outside of the hospital. To provide excellent care for our patients, we need to develop strong relationships with our community and recognize the needs of our specific patients. Our faculty and residents are actively engaged in several programs to serve our community and patients. On a weekly basis, we provide medical care to our homeless population outside of the hospital through our Street Medicine Oakland program in collaboration with OUWB. We have the opportunity to recognize their specific barriers to care, and we are able to bring that knowledge back to the care we are providing in our emergency department. Additionally, we are actively involved in the local schools providing age-based education to both elementary and high school students. Our commitment to service has far-reaching effects both on our community as well as our own personal wellness.

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Emergency Medicine Specialty Track

Learn more about our optional tracks offered for residents interested in creating a niche within our emergency medicine program.

Goals

To provide a two-year immersive experience in the field of geriatric emergency medicine; covering in further depth the eight domains of emergency medicine, the identification and management of geriatric syndromes, and development and coordination of intradisciplinary treatment plans for complex older adult patients.


Opportunities

  • Gain additional Geriatric EM expertise from a nationally recognized, Level 2 Geri ED
  • Network to further develop your career, connecting with national and international leaders in Geriatric Emergency Medicine
  • Work with Beaumont’s Division of Geriatrics
    • Ranked #30 in the U.S.
  • Participate on hospital and national committees
  • Attend SAEM during PGY-2 Year
  • Funding for a research project to present at a national conference in PGY-3

Why GEM?

  • Clinical - Develop a relevant niche within EM. You will only see more geriatric patients throughout your career. Learn how to optimally take care of them. It is not only for academic focused physicians.
  • Education - Geriatric EM education is unique, and we are currently working to revamp:
    • Geriatric ED Guidelines 2.0
    • Medical School clerkship curriculum
    • ABEM EM Board Exam Questions
    • ITE Exam Questions
  • Administration - Geriatric ED Accreditation requires a Geriatric ED Medical Director
  • Research - Plenty of research and funding opportunities in geriatrics

Track Outline PGY-2

  • Develop and start research project
  • Monthly GEDA meeting and AGEM sub-committee meeting (schedule permitting, minimum quarterly)
  • Quarterly National Geri EM Fellowship Journal Club attendance
  • Attend SAEM and AGEM Business Meeting
  • Continuous mentorship with individualized didactics

Track Outline PGY-3

  • Geriatric EM Elective
  • Research project completed, abstract submitted and presentation at national meeting
  • Presentation at Beaumont GME Research Forum
  • Monthly GEDA meeting and AGEM sub-committee meeting (schedule permitting, minimum quarterly)
  • Quarterly National Geri EM Fellowship Journal Club attendance
  • Attend Geriatric Medicine Grand Rounds (minimum annually)
  • Continuous mentorship with individualized didactics
  • Graduate with certificate

AIM

  • Provide residents the opportunity to explore medical education and allow for a more focused approach to different facets of medical education
  • Delve deeper into medical student education; enhance clinical and didactic teaching skills
  • Develop scholarly activity based in medical education
  • Learn about mentoring and effective feedback

Who & Why

The WHO

  • Highly motivated residents interested in an academic career with a focus on medical education
  • Passionate about improving own skills and helping others learn

The WHY

  • Desire to develop as an educator
  • Certification of involvement in a dedicated education program

Perks

  • Quarter 1 – identify scholarly project, enroll in PGY2 Resident as Teacher Certification Course
  • Quarter 2 – continue with Resident as Teachers Certification, attend RAC, scholarly activity
  • Quarter 3 – continue with Resident as Teacher Certification Course, scholarly activity, attend CORD
  • Quarter 4 – finish Resident as Teacher Certification Course, scholarly activity, plan 3rd year elective
  • Quarter 5 – Medical education elective, data analysis for scholarly activity, write sim case, Advanced Medical Education Curriculum
  • Quarter 6 – submission of scholarly activity to National Conference (SAEM, CORD, etc.), participate in the Advanced Medical Education Curriculum
  • Quarter 7/8 – present scholarly activity at National Conference and Beaumont GME research symposium, continue with Advanced Medical Education Curriculum, graduate with a Medical Education Certificate!

Track Requirements

  • Complete Residents as Teachers Certification Course as a PGY2
    • Sessions include:
      • Professionalism
      • Effective Bedside Teaching
      • Feedback
      • Understanding Medical Oppression
      • Challenging Learners
      • Learning Climate
      • Evaluation
      • Promotion of Self-Directed Learning
  • Complete an Advanced Residents as Teachers Program as a PGY3
  • Will work in conjunction OUWB Center of Excellence in Medical Education
  • Six Sessions – meet every other month
    • Educator Portfolio + Working Meeting
    • Education Theory
    • Curriculum Development
    • Medical Education Week
    • Assessment and Evaluation
  • Participate in the Medical Education Elective – July, August or September (PGY3)
  • Creation of a SIM case for interns (PGY 2/3)
  • Scholarly activity with Medical Education focus (PGY 2/3)
  • Attendance at CORD with focus on the Navigating the Academic Waters track (Spring PGY2)
  • Presentation of scholarly activity at a National Conference (Spring PGY3)
  • Presentation of scholarly activity at Beaumont GME Conference (Spring PGY2 or 3)

Goals

  • Intensive research experience in PGY2 and PGY3 years
  • Develop skills to engage in high quality research
  • Instruction to research methodology, statistics, grant and manuscript writing
  • Begin to develop scholarly portfolio
  • Prepare for future as fellow or academic faculty member

Timeline

  • Quarter 1 – Enroll in Emergency Medicine Basic Research Skills Course (EMBRS), select research mentor, outline and begin first research project
  • Quarter 2 – Attend Fall EMBRS course
  • Quarter 3 – Design EMBRS research project and grant application
  • Quarter 4 – Attend Spring EMBRS course and complete first research project, submit abstract to national conference (e.g. ACEP)
  • Quarter 5 – Begin work on EMBRS research project
  • Quarter 6 – Present abstract at Cational Conference
  • Quarter 7/8 – Complete EMBRS research manuscript and submit for publication, submit abstract for ACEP presentation 

Introduction

As an Emergency Medicine resident, you have the opportunity to be a part of a cutting-edge and rapidly growing field within the specialty: Point of Care Ultrasound (POCUS). Our scholarly track in POCUS is designed to provide you with advanced training, career guidance, and mentorship to help you develop a focused area of expertise and prepare you for an academic career.

Participating in our POCUS scholarly track will give you the opportunity to gain proficiency in the use of POCUS as a diagnostic and procedural tool, which is essential for providing optimal patient care in the emergency department and other clinical settings. You will have the opportunity to participate in ongoing research projects and present your findings at local, regional and national conferences, providing you with a platform to contribute to the advancement of the field.

Our program is committed to fostering an innovative and collaborative learning environment, and our experienced POCUS faculty members will provide you with mentorship and guidance to help you achieve your career goals. Participating in this scholarly track will not only enhance your clinical skills and prepare you for an academic career, but it will also make you a leader in the field of POCUS. It's a unique opportunity to be a part of a rapidly growing field and make a significant impact on patient care. We encourage you to consider this opportunity to take your training to the next level and become an expert in POCUS.


Objectives

  • Develop advanced proficiency in Point of Care Ultrasound (POCUS) through a comprehensive curriculum and hands-on training.
  • Offer opportunities for trainees to participate in ongoing POCUS research projects and present findings at local, regional and national conferences.
  • Provide mentorship and guidance for trainees interested in pursuing an academic career in POCUS.
  • Foster an innovative and collaborative learning environment through regular didactic sessions, simulation training and case-based discussions.
  • Develop trainees' ability to use POCUS as a diagnostic and procedural tool to improve patient care and outcomes.
  • Encourage trainees to become leaders in the field of POCUS through opportunities to present grand rounds, publish articles, and participate in national POCUS organizations.

Requirements

  • Successful completion of 800 examinations, a pre-requisite to take a POCUS certification course, such as the RDMS or RDCS (optional)
  • Quarterly scanning with faculty (1/2 day); Semi-annual attendance and participation in US didactics
  • Completion of a research project related to POCUS and presentation of the findings at a local, regional or national conference (2 nights of conference support provided by department)
  • Work in conjunction OUWB Center of Excellence in Medical Education and OUWB medical students
  • Two years commitment to the scholarly track
  • Attendance at one advanced POCUS meeting/conference (up to $2100 funded by department)
  • Deliver one formal POCUS presentation at EM grand rounds (topic TBD)
  • Develop 5 cases to add to educational content at alittlecoldgel.com

Goals

The aim of this track is to provide residents the opportunity to explore academic medicine in the niche of resuscitation and critical care and to develop an enhanced understanding of in-ED clinical resuscitation principles (what to do & what not to do). The residents completing the Resus/CC track will cultivate expertise within multiple realms: cardiac arrest / post-arrest care, pulmonary embolism, cardiac rhythm disturbances, acute MI, sepsis, neurologic emergencies and airway management and hemodynamic stabilization in peri-intubation period.


Objectives

  • Recruitment of up to 1 highly engaged resident for a 2-year Resus/US track
    • Selection of resident will be done through a formal application process and selection by the program and track leadership
    • Applications will be solicited in the Spring of the PGY1 year
    • Applicants must be on track with all milestones and have no administrative or professionalism concerns
  • Participation in a dedicated longitudinal curriculum focused on development of Resus/CC skills that sufficiently prepares the candidate for a career at a high-acuity academic job and an ideal candidate (if desired) to do a Resus/CC fellowship
  • Presentation of quarterly Resus Case in GR
  • Participation in Resus Meeting ≥ 6x per year
  • Participation in Combined Resus/US meeting ≥ 1x per year
  • Participation in the PGY3 Resus elective (in addition to the PGY2 core rotation)
  • Encouraged to participate in Resus/CC-related hospital committee
  • Expectation to create an enhancement/alteration to the Resus Rotation (subject to approval by Dr. Berger)
  • Expectation to Resus/CC research project
    • Presentation of Resus/CC research ABSTRACT at
      • Beaumont GME Research Symposium
      • Society of Critical Care Medicine and/or Resuscitation Science Symposium
    • Expectation of SUBMISSION of a manuscript prior to graduation.


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