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Robert Muelleman, M.D. | Michael Wadman, M.D. |
The first six physicians of the UNMC Emergency Medicine Residency Program will begin their three-year residencies in July 2004. Physicians complete residencies, or advanced training in medical specialties, after they graduate from medical school.
“We’re very excited for the residency program to begin,” said Robert Muelleman, M.D., chief of the section of emergency medicine at UNMC and director of emergency services at UNMC’s hospital partner, The Nebraska Medical Center. “Only about one-third of the physicians practicing emergency medicine in Western Iowa and Nebraska are residency-trained and board-certified, and most of those physicians are in Lincoln and Omaha.”
First in the region
The residency program is the first in the Great Plains region, Dr. Muelleman said. That region encompasses about 20 percent of the land mass of the continental United States, including all of Nebraska, South Dakota, North Dakota and Kansas; western Oklahoma and Texas; and eastern New Mexico, Colorado, Wyoming and Montana. The closest emergency medicine residencies – in Kansas City, Minneapolis, Denver and Chicago, don’t provide many residents in rural areas, Dr. Muelleman said. “We’re hoping that through this residency, more emergency medicine-certified physicians will practice in rural Nebraska,” he said.
Dr. Muelleman credited the leaders of UNMC and The Nebraska Medical Center with helping to make the residency program a reality. He noted the work of UNMC Chancellor Harold M. Maurer, M.D., College of Medicine Dean James O. Armitage, M.D., and Glenn Fosdick, chief executive officer of The Nebraska Medical Center.
“We’re excited that the emergency residency program has been approved,” Dr. Armitage said. “Without question, this emergency residency program will be one based on excellence, both in its educational environment and its clinical opportunities.”
Said Fosdick: “Our patients and ER team will be shaping the future of emergency room physicians who will take their clinical experiences and build on them throughout their careers. This program furthers our commitment to patients across the region by training ER doctors and sending them where they are needed.”
Dr. Maurer said the program is another example of UNMC being at the forefront of serving residents of the Great Plains.
“This residency program certainly fills a need in health care for this region,” Dr. Maurer said. “We look forward to the first class of residents beginning next summer.”
Residents to gain experience in the ER
Michael Wadman, M.D., assistant professor of emergency medicine at UNMC, will direct the residency program. “The goal of the University of Nebraska Emergency Medicine Residency Program is to provide residents with outstanding clinical and educational experiences in emergency medicine,” Dr. Wadman said.
He noted that the residency’s didactic program will feature a monthly lab session with in-depth instruction combined with hands-on experience in selected emergency procedures, in addition to a weekly lecture series.
ER program review ‘very stringent’
Dr. Muelleman noted that potential residents who may be wary of a first-time residency program should rest assured: the emergency residency program review is “very stringent.”
“Potential residents can be assured that the clinical and educational resources are in place to prepare them to become skilled board certified emergency physicians,” Dr. Muelleman said. “Our faculty members trained at six different residencies; have anywhere from one to 20 years of clinical experience; have been educating medical students, residents and practicing physicians for several years; and since January, 1997 have published 39 peer-reviewed articles, presented at national and international meetings and have contributed 68 chapters to 10 textbooks.”
Features of the residency
Beginning in 2005, the residents will practice in one of the largest emergency departments in the region. The new emergency department, now under construction at The Nebraska Medical Center, will have 20,000 square feet, 16 exam rooms, 13 critical care rooms, eight observation rooms and four trauma beds.
A unique feature of the UNMC residency, Dr. Muelleman said, will be two, month-long rotations at Regional West Medical Center in Scottsbluff. The western Nebraska hospital has five board-certified emergency medicine physicians on its staff.
“We wanted to expose the residents to rural Nebraska,” Dr. Muelleman said. “The rotations in Scottsbluff will be a great opportunity for them. We hope that some of them will think about continuing to practice in rural parts of the state, after their residencies are complete.”
Urban/rural injury death rates
Dr. Muelleman said that injury death rates are higher in rural areas than in urban areas. He hopes the new residency program will help to improve rural emergency-room care. Another way in which UNMC hopes to improve that care is through an annual conference for those emergency-medicine providers in rural areas who don’t have advanced, formal emergency-medicine training. The first such conference is scheduled for March 18-20 in Omaha.
“It will be several years before this residency program can saturate the hospitals across the state with physicians who are board-certified in emergency medicine,” Dr. Muelleman. “Even then, there still will be hospitals whose ER’s are staffed by on-call family physicians. We hope that these conferences will provide those physicians with essential skills training to handle both medical and traumatic emergencies.”
Preventing the “brain drain”
The emergency-medicine residency, Dr. Muelleman said, will help to prevent the “brain drain” of physicians who want to practice emergency medicine. Until now, only one-third of students who leave Nebraska to receive their emergency-medicine residency return to the region.
“It’s been shown that a vast majority of physicians practice where they have their last training,” Dr. Muelleman said. “This residency will keep more emergency medicine-certified physicians in this region, and ultimately will provide the best care for patients who need emergency services.”