Frequenty Asked Questions

Application

Does the program give preference to applicants from the southeastern area or the University of South Carolina?

Although the program strives to have diversification in every entering class, applicants with ties to South Carolina are given additional consideration with regard to being invited to interview with the program. Regardless, each of the current classes has graduates from at least nine different medical schools. Over the years we have had residents from more than 30 states. We are always looking for the best candidates for our program.

May applicants observe in the Emergency Department either prior to or after the interview process?

Yes, every interview season applicants are encouraged to schedule observation time in the Emergency Department to provide insight into the program.

Does completing a rotation at Palmetto Health Richland improve my chances of matching at this program?

Approximately 40 percent of each class is composed of residents who rotated in our emergency department as medical students.

Does the residency program accept physicians with previous training?

Yes, but this is becoming a rare occurrence.

Does the residency program accept osteopathic physicians?

Yes, the program traditionally attempts to match one to two osteopathic physicians in each class.

Does the residency program accept international medical graduates (IMG's)?

We do accept applications from international medical graduates (IMG) who are US citizens or have J-1 visas. However, it is very rare that we interview IMG applicants.

Are USMLE Step 2 scores required?

Although a part two score is desirable for application to the program, it is not required. However, ultimately all residents at Palmetto Health are required to pass parts one & two of the USMLE prior to matriculation into our program.

How many letters of recommendation are required?

Three letters of recommendation, in addition to the dean's letter, are required. One of these letters should be from an emergency medicine physician with whom you have worked in an emergency department setting. We encourage you to submit more than one letter from an emergency physician and also will accept more than three total letters of recommendation if they are available.


Curriculum – Clinical Rotations

How long is the Emergency Medicine residency?

36 months in a PGY 1, 2, 3 format.

What certifications are provided?

PGY 1: ACLS, PALS, FCCS, FEMA and ATLS provider certifications

PGY 2: You may also take ACLS, PALS and/or ATLS instructor training.

What is the curriculum of the Emergency Medicine program?

PGY1

1

PGY2

1

PGY3

1

Rotation

Length

Rotation

Length

Rotation

Length

EM

36 weeks

EM

32 weeks

EM

37 weeks

US/EMS

4 weeks

MICU

4 weeks

Electives

4 weeks

MICU

4 weeks

PICU

4 weeks

Tourist Medicine (Hawaii)

4 weeks

Inpatient Pediatrics

4 weeks

STICU

8 weeks

Hyperbaric Medicine

1 week

Obstetrics

4 weeks

Cardiology

4 weeks

Community EM

6 weeks

How many months do Emergency Medicine residents work in the Emergency Department setting?

Currently, Emergency Medicine residents rotate for 99 weeks (25 months) at Palmetto Health Richland in the Emergency department. During the PGY-2 year, two weeks are spent working at Palmetto Health Baptist in downtown Columbia. During the PGY-3 years, four weeks are spent working at Palmetto Health Baptist. These shifts are integrated into the regular EM shift schedule.

How many EM shifts per month do residents work?

PGY 1 and PGY 2 residents work 19 to 21 shifts per four-week block (average 50 hours per week). PGY 3 residents work 15 to 17 shifts per four-week block (average of 40 hours per week).

How long are Emergency Department shifts?

Residents work a combination of nine and 12 hour shifts. Approximately 60 percent of shifts are nine hours in length.

How many patients are seen per hour in an Emergency Department shift?

By the end of their training, residents will see two to two-and-one-half patients per hour. During shifts with lower acuity patients, residents may see up to three patients per hour.

How many off-service call months do residents have?

PGY 1: MICU, Pediatrics, OB/GYN.

PGY 2: MICU, PICU, STICU

Do residents have call while on emergency medicine rotations?

Yes, resident usually have one to two days of home call while on emergency medicine rotations. Residents are required to come in for colleagues who are sick from 7 a.m.-10 p.m. (however, this is a very rare occurrence).

How many call nights do residents take on off-service rotations?

The average call schedule for rotations with call is every fourth night. All rotations comply with the new ACGME standards for work duty hours.

How much exposure do residents have to pediatric Emergency Medicine?

Residents will average about one-third of their shifts in the Children's Emergency Center during each emergency medicine rotation. This works out to approximately 100 shifts over the three-year residency.

What is the relationship like between the Emergency Medicine Department and the other departments of the hospital?

We have an excellent reputation in the hospital for providing efficient, quality care to patients. Therefore, residents find the vast majority of consultants eager to provide care to Emergency Department patients.

Is there an ultrasound teaching program?

Yes, ultrasound is an integral part of Emergency Medicine training at Palmetto Health Richland. All residents complete an introductory course in emergency ultrasound before they start working in the emergency department. In addition, two weeks of the intern year are dedicated to emergency ultrasound training with more than 20 hours of lectures. Residents are required to log at least 300 cases during their residency training. Case reviews are routinely conducted by the faculty of the emergency ultrasound fellowship.

Is there an aeromedical program?

Yes, the hospital's air ambulance service, LifeNet, provides rapid air transport to the critically ill and injured as well as transport from accident scenes and inter-facility transfers for patients needing additional medical resources.

Are residents involved in the aeromedical program?

Yes, residents may ride along during any year of their training. An elective also is available for PGY 3 residents.

How are residents evaluated?

Evaluations are completed on a semi-annual basis and are reviewed with the program director and the resident's advisor. Emergency Medicine residents receive composite written evaluations from the Emergency Department faculty. Each resident is evaluated on:

  • Compassionate Health Care
  • Interpersonal and Communication skills
  • Medical Knowledge and Information Management
  • Practice-based Learning
  • Systems-based Practice
  • Professionalism
  • Procedure logs
  • Ultrasound logs
  • Monthly testing and in-training exams
  • Simulation Medicine training for emergency procedures and resuscitations
  • Oral boards training
  • Conference attendance and participation
  • EMS assignments
  • Off-service evaluations

Residents annually complete an online evaluation form for each faculty member. Residents may also discuss any specific concern at any time with the program director, department chair or director of graduate medical education.

How are specific rotations evaluated by residents?

Residents complete an evaluation form online for each off-service rotation. These evaluations are compiled and then discussed at the annual curriculum meeting.

Are residents involved in changes to the program?

Yes, each year all residents attend a curriculum meeting to discuss every component of the program and how to improve the training. Several changes to the rotation schedule have been made based on recommendations from this meeting.


Curriculum-Electives

What types of elective rotations are available?

Hyperbaric Medicine

Palmetto Health Richland is the world leader in hyperbaric education. All PGY 3 residents in the program take a week-long course on hyperbarics and have the option to spending one to two weeks on the HBO consulting service as an elective rotation.

Ultrasound

Since 1997, we have offered a comprehensive emergency ultrasound curriculum for our residents. Seniors may take an elective in ultrasound to learn techniques such as echocardiography.

Aeromedical EMS

The elective includes additional air time with LifeNet as well as training on the equipment unique to the air ambulance environment, administration and aviation physiology.

Wilderness Medicine

Started in 1998, the wilderness medicine rotation is a lecture-based rotation covering a wide range of material from this unique area of emergency medicine. All lectures are provided by faculty experienced in the various components of wilderness medicine. Students also take part in outdoor skill stations and a camping trip in the nearby Appalachian Mountains. The rotation is only presented during rotation block in the spring of each year.

International Emergency Medicine

This can be a two-to-six-week rotation working in another country. Residents have participated in a number of medical mission trips over the past few years to such locations as China, Ghana, Guatamala, Nicaragua, Haiti, Honduras, India, Kenya, Nepal, Nicaragua, Peru, Samoa, Sudan, South Korea, Uganda, Tanzania, Tonga, and India.

Tourist and Travel Medicine

PGY 3 residents can participate in a one-month elective in the Emergency Department at Queens Hospital in Honolulu ( http://www.queens.org/ ). Residents work approximately 12 evening shifts. Each resident on the rotation has the use of a two-bedroom furnished apartment located in a secured building with covered parking that is one block from the beach. Residents are responsible for providing airfare and may take their family members at their expense (most do).

Other electives include Dentistry, Ophthalmology, Pediatric Sedation, Simulation Medicine and Research.

Which residents attend the weekly Emergency Medicine conferences?

All residents on Emergency Medicine, EMS/ultrasound, and on-campus elective rotations are required to attend weekly conference.

When are conferences?

Conferences are scheduled from 7-11 a.m. on Wednesdays. One additional hour of conference time each week is done through online educations modules.

Who teaches conferences?

Approximately 70 percent of conferences are presented by emergency medicine faculty members. The other 30 percent are presented by faculty from other departments.

Are there any recurring conference topics?

Cardiology, Infectious Disease, Journal Club, M & M, Oral Boards, Orthopedics, Pediatrics, Personal Finance, Quality Improvement, Simulation Medicine, Surgical Skills Lab, Toxicology, Trauma Conference, and Ultrasound.

Are there conferences on business practices in emergency medicine, malpractice, coding and contracts?

Several conferences are provided on personal finance. In addition, retreats are conducted for each class and include topics on personal finance and the business of medicine.

Does the program provide any procedural skills training?

Skill labs are provided for residents to improve techniques in all emergency procedures.

What resources are available for patient simulation?

The Simulation Medicine Center on the Palmetto Health Richland campus. The center's director is an emergency medicine faculty member, Dr. Eric Brown. The center has more than 10,000 square feet of service areas and is capable of simulating nearly any medical emergency or procedure for resident education. Residents work in the center one time each month when they are on emergency medicine rotations.

What forms of teaching are required of residents?

Every PGY 2 and PGY 3 resident gives one lecture per year for the paramedic training course of Richland County EMS. All residents are encouraged to present interesting cases on three to four occasions each during conference “flea circus." All PGY 3 residents present the results of their quality improvement project during conference.

Who is responsible for educating medical students?

Most medical students shadow PGY 2 and PGY 3 residents in the emergency department and present cases directly to them. Two to three of the PGY 3 residents are appointed as assistant directors of medical student education and are responsible for coordinating the majority of medical student activities in the department for each academic year.

What are the research requirements?

The Residency Review Committee for Emergency Medicine requires the completion of a scholarly project by each resident. This requirement may be met by completing original research or by participating in a scholarly project approved by the program’s director of research and scholarly activity. Examples would include a textbook chapter, developing an on-line education module, or setting up an educational program for the residency.

Is funding available for research projects?

Grants up to $7500 are awarded each year by the office of Graduate Medical Education at Palmetto Health. Additional funding is provided for travel expenses to residents who are invited to present their research at appropriate conferences.

What are the facilities like at Palmetto Health Richland?

The program is located at a community-based academic hospital with 650 total beds. Palmetto Health Richland is the only Level 1 Trauma Center in the 16-county Midlands region of South Carolina. The hospital is the primary teaching facility for the University of South Carolina School of Medicine.

What are the facilities like in the Emergency Department at Palmetto Health Richland?

In the Emergency Department, there are a total of 61 individual rooms divided into smaller treatment areas referred to as PODS. Included in these areas are two trauma bays, a children's emergency center, a psychiatric care facility, and a chest pain observation unit.

How many patients visit the Emergency Department each year?

The annual patient census is more than 90,000 patient visits each year (more than 30,000 of these patients are children).

What is the admission rate from the Emergency Department?

Currently, our admission rate is 22 percent.

How are pediatric Emergency Department patients handled?

There is a separate pod for pediatric patients with 12 beds, as well as a resuscitation room. The current pediatric census is more than 30,000 patients per year.

How are trauma patients managed?

All trauma patients with a significant mechanism of injury are managed in tandem with the trauma service. However, in every situation the EM resident manages the airway. Residents on the individual services share all other procedures in the trauma bay.

What are the lab turnaround times?

ABGs are finished within minutes. Most other labs are available in 30–45 minutes or less.

What radiologic services are available?

There are three CT scanners available 24 hours a day. ED patients receive first priority on all CT scanners. MRI and invasive procedures are also available 24 hours per day. There is an extensive radiology suite for plain films and two dedicated X-ray machines in the trauma bays.

Do residents train at health care facilities other than Palmetto Health Richland?

During their PGY-2 year, residents work four to five shifts at Palmetto Health Baptist medical center in downtown Columbia. During their PGY-3 year, residents work 15 to 20 shifts at Palmetto Health Baptist medical center in downtown Columbia. PGY-3 residents have the option to do a one-month elective rotation at Queen's Medical Center in Honolulu, Hawaii. All other rotations are completed at Palmetto Health Richland (including all emergency department months) unless an off-campus elective is scheduled during the senior year.

What are the facilities like at Queen's Medical Center in Honolulu?

The Queen's Medical Center, located in downtown Honolulu, Hawaii, is a private, non-profit, acute medical care facility. It is the largest hospital in Hawaii, licensed to operate with 526 acute care beds and 28 sub-acute beds. The medical center has more than 3,000 employees and more than 1,200 physicians on staff. It also is the state's trauma center. During your one-month "tourist and travel medicine" rotation at this facility, you will be providing care to a culturally diverse group of patients that live in and visit one of our most beautiful states.

How far apart are Palmetto Health Richland and Palmetto Health Baptist Medical Center?

The Palmetto Health Baptist Medical Center is 2.5 miles (approximately seven minutes over local roads) from Palmetto Health Richland.


Emergency Department Faculty

How many faculty members are on staff in the Emergency Department?

There are 24 full-time staff members. 

  • All are certified by the American Board of Emergency Medicine.
  • Two faculty physicians are boarded in toxicology.
  • Two faculty physicians are boarded in EMS.
  • Three faculty physicians are board-certified in emergency pediatrics.
  • One faculty physician is fellowship-trained in global health.
  • One faculty physician is fellowship-trained in emergency ultrasound.
  • One faculty physician is fellowship-trained in simulation medicine.

How experienced are the Emergency Department faculty members?

The average experience of all the faculty members is more than 15 years. The chairman has practiced since 1990 and has occupied his position since 2010. The program director has been practicing since 1990 and has held the position since 2001. There is very little turnover in the department's faculty.

What is faculty coverage like during Emergency Department shifts?

There is extensive attending coverage 24 hours a day. Residents staff all patients directly with attending physicians. There are four attendings available from 7 a.m.–3 p.m., five attendings available from 3 p.m.–12 a.m., and two attendings available from 12 a.m.–7 p.m.


Other

Does the department pay any professional membership dues?

The program pays each resident's dues for American College of Emergency Physicians (ACEP), the South Carolina Medical Association, the American Medical Association, and the Emergency Medicine Residents Association (EMRA).

Does the program provide residents with an educational allowance?

$650 during the PGY-2 year and $900 during the PGY-3 year that can be used for books, computer software, and travel expenses to conferences or off-campus rotations. In addition, all residents receive on-line access to two emergency medicine education websites: hippoEM and Rosh Review.

When can residents start moonlighting?

Residents are allowed to start during the second half of the PGY-2 year. Each resident that is moonlighting must be in good standing with the program and have completed all other residency-related assignments. Currently most residents moonlight at a rural emergency department run my one of our alumni.

How many hours are residents allowed to moonlight?

Residents are allowed to moonlight an average of 40 hours per month.

How much do residents typically earn when moonlighting?

Hourly rates for moonlighting at various emergency departments range are approximately $150 per hour.


Post-Graduation

What is the first time pass rate of graduates on the ABEM examinations?

The first time pass rate in the written test component of the ABEM certification exam is 99 percent from 2011 to 2015 (49 of 50).

The first time pass rate in the oral test component of the ABEM certification exam is 96 percent from 2010 to 2014 (48 of 50).

All graduates who failed on the first attempt of the written and oral boards passed on their second attempt.

Do graduates have difficulty finding jobs?

No. Emergency medicine specialists trained at our facility are in high demand.

Where do graduates practice?

Approximately 20 percent of graduates go into academic emergency medicine. Other graduates have pursued clinical practice in a mix of urban and rural locations.

The majority of graduates go on to practice in the Southeast region of the country, but we have graduates who have relocated in relocated in more than 30 states.

Since 2011, 16 residents have gone on to fellowship training. 

  • Emergency Ultrasound—3
  • EMS—5
  • Global Health—3
  • Pediatric Emergency Medicine--1
  • Simulation Medicine—3
  • Toxicology--1

What fellowships are available at Palmetto Health Richland for Emergency Medicine residents?

  • Sports Medicine
  • Emergency Ultrasound
  • EMS
  • Simulation Medicine
  • Global Health
  • Pulmonary Critical Care
  • Surgical Critical Care