How do I contact the Emergency Medicine residency program?
Ashlyn Kopech, Residency Coordinator
Department of Emergency Medicine
McGovern Medical School
6431 Fannin Street, JJL 270-6
Houston, Texas 77030
Telephone: (713) 500-7882
Fax: (713) 500-0758
Email: Ashlyn Kopech
Why train at McGovern Medical School?
Two phenomenal EDs with high patient acuity, a great trauma experience, the pediatric EM experience, active NIH-funded research, and the camaraderie between our dedicated residents and faculty.
What is the accreditation status of McGovern Medical School Emergency Medicine program?
Full accreditation by the ACGME. Next RRC self-study visit 2022.
When did the Emergency Medicine residency program begin at McGovern Medical School?
The program began in 1992.
Does the emergency department have full departmental status?
Yes, we are an independent department.
How many residents are in the Emergency Medicine program?
We have a class size of 20 residents per year.
Have there been any recent changes in the program?
The biggest change in the past year has been our expansion at Memorial Hermann TMC with a new Emergency Center. While we haven’t had any major changes in leadership or structure for the past few years, we are always making adjustments based on our residents’ guidance and feedback. Recent adjustments have been focusing on expanding our DEI efforts, enhancing the clinical environment amidst the pandemic, career advising, and wellness initiatives.
Does the program give preference to applicants from the south or McGovern Medical School?
No, the program strives to have geographically diverse classes.
Can applicants observe in the Emergency Department either prior to or after the interview process?
Pre-pandemic yes, applicants were encouraged to schedule time in the Emergency Department to provide firsthand experience of our program. At this time however, we are not able to host applicants in the EC, but we hope to have the optional second looks after the interview season concludes.
Does completing a rotation at Memorial Hermann Hospital improve my chances of matching at this program?
A rotation with us is like a month long interview. We get to see your skills and abilities firsthand. That being said, most of the current residents did not complete a medical student rotation in our department prior to matriculation into the program.
Does the residency program accept physicians with previous training?
Does the residency program accept DO candidates?
Does the residency program accept applications from international medical graduates (IMGs)?
Yes, with some important caveats. IMGs need to be permanent U.S. citizens or have J-1 visas. There are no exceptions to these McGovern Medical School requirements. IMG applicants should have well above average applications (Grades, SLOEs, USMLE scores, etc.) in order to be successful in this process.
Are USMLE Step 2 scores required?
Strongly encouraged, especially with a below average USMLE Step I score, but not 100% required until final rank.
How many letters of recommendation are required?
Three letters of recommendation, in addition to the dean’s letter, are required. Two of these letters should be Standard Letters of Evaluation (SLOE): one from your Home rotation and one from an Away rotation. This is not hard and fast, but helps us compare apples to apples, and unless you are otherwise outstanding can hurt your application. Who writes the third letter matters less, and can be any faculty from any specialty or project that you’ve had a working relationship.
Does the date that I interview affect my position on the residency’s Rank Order List? Should I plan to interview only in January, for example?
No. The date that an applicant interviews in our program and their position on the rank order list does not correlate. Of note, as described in Martin-Lee LA, Park HW, Overton DL: Does Interview Date Affect Match List Position in the Emergency Medicine National Residency Matching Program Match? Acad Emerg Med 2000; 7:1022-26, the importance of interviewing in January is a myth.
What rotations do the residents complete?
EM1 | EM2 | EM3
How long is the Emergency Medicine residency?
36 months in a PGY 1, 2, 3 format.
What certifications are provided?
PALS provider and ATLS provider certifications. You are expected to have ACLS certification before orientation begins.
How many call nights do residents take on off-service rotations?
The average call schedule for rotations with call is every 4th night. All rotations comply with the ACGME standards for work duty hours.
How much exposure do residents have to Pediatric Emergency Medicine?
We have Pediatric exposure on every EM month. Residents will average 1-3 shifts of Pediatric Emergency Medicine during each MHH EM month. There is a block of Pediatric EM (PEM) at Memorial Hermann Hospital in the EM-1 year and a block of PEM at Texas Children’s Hospital in the EM-2 year. Additionally, approximately 10% of the annual census at LBJ is pediatric.
How is pre-hospital EMS integrated into the residency program?
Shifts with Houston Fire Department are scheduled throughout the EM-1 year. Shifts may include ground ambulance ride-along, quality improvement, paramedic education, urban search and rescue, and hazardous materials training. There is also an optional Pre-Hospital Medicine elective which includes time on LifeFlight.
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 and participate in both interdisciplinary education and research with our colleagues in Trauma, IM, Pediatrics, Cardiology, and Critical Care to name a few.
Is there an ultrasound teaching program?
Yes, ultrasound is an integral part of Emergency Medicine training at our program. We have a robust Ultrasound Section and Fellowship. We have seven Sonosite ultrasound machines in the Memorial Hermann Emergency Department and six Sonosite ultrasound Machines at LBJ Hospital. We have recurring ultrasound didactics and workshops during our weekly conference.
Is there an aeromedical program?
Yes, the hospital’s air ambulance service, LifeFlight, 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, a Pre-Hospital Elective is available for EM-2 and EM-3 residents. This is not required.
How are residents evaluated for ED rotations?
Faculty complete ongoing evaluations during EM months. The Clinical Competency Committee meets monthly to review residents from the prior month who rotated through the department and then deliver consensus feedback to these residents. Residents also meet with program leadership for semi-annual and annual reviews.
Residents also receive feedback on:
- Procedure logs
- Ultrasound logs
- In-training exams
- Oral board simulation performance
- Conference attendance and participation
- Conference lecture presentations
- Off-service evaluations
How are the faculty evaluated?
Residents complete an online evaluation form for each faculty member (spread out throughout the year). Residents may also discuss any specific concern at any time with their mentor, chief residents, program director, department chair or director of graduate medical education.
How are specific rotations evaluated?
Residents complete an evaluation form online for each off-service rotation. These evaluations are compiled and then discussed at the annual curriculum meeting. Any problems that need to be addressed sooner are discussed with the Program Director during the monthly Chief/PD Hour.
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 at this meeting. We are a resident-driven program in the truest sense.
Do the residents have input into the program?
Absolutely! The program would not be here if it were not for the residents. Input is sought from the residents through several venues. First, we hold a monthly Chief/PD Hour where the Residency Director and Chief Residents meet with the residents and discuss the program as well as issues in the practice of emergency medicine. Second, resident representatives are invited to the monthly education committee meeting. Furthermore, residents complete anonymous evaluations of the program and faculty each year. Finally, the residency leadership has an open-door policy to voice concerns, recommendations, or any other issues.
Which residents attend the weekly Emergency Medicine conferences?
All residents are protected attend conference unless they are on vacation, or in-between nights in the ED.
Is conference time protected for residents?
Yes, Emergency Medicine faculty and advanced practice providers cover the ED during conference time so those residents scheduled in the ED may attend conference.
When are conferences?
Conferences are scheduled from 0700 to 1200 on Thursdays for a total of five hours per week. Twice monthly residents are permitted to do online asynchronous learning and on these days conference starts at 8AM.
Who teaches at conference?
Our EM faculty and residents lecture at the vast majority of conferences. We also have interdisciplinary faculty lecturers and a monthly visiting lectureship that invites well-known and up and coming EM faculty from across the country.
Are there any recurring conference topics?
Topics regularly addressed include pediatrics, ultrasound, cardiology/EKGs, evidence-based medicine, journal club, oral boards, quality assurance, critical care, etc.
Are there conferences on business practices in emergency medicine, malpractice, coding and contracts?
Yes, several conferences are provided on a variety of business issues in emergency medicine.
Does the program provide any procedure/skill labs?
Skill labs are provided for residents to improve techniques in all emergency procedures beginning in intern orientation and scheduled regularly throughout the year.
Do you have a journal club?
Yes, we critically appraise articles at an evening journal club off-campus.
Are there scheduled times all the residents meet?
Chief/PD Hour occurs monthly during conference. In this meeting, only the residents and the residency director are present. Additionally, we have an intern lunch hour that recurs, and class specific retreats that occur in the spring.
What forms of teaching are required of residents?
Upper level residents supervise rotating third and fourth year medical students in the ED. Furthermore, our residents are involved with teaching second year medical students (not rotating in the ED) in the McGovern Medical School Technical Skills course. Residents regularly contribute to didactics, small groups, and simulation training as well.
Who is responsible for educating medical students?
Most medical students work with senior residents in the emergency department and present cases directly to them and the faculty.
Does the program have an oral board review course?
We dedicate time monthly during conference reviewing the mechanics of the oral board exam and practicing cases. Each year the faculty proctor in-house mock oral examinations for each resident in the format of the ABEM Oral Board.
What are the research requirements?
The Residency Review Committee for Emergency Medicine requires the completion of a scholarly project by each resident by the end of their training. This requirement may be met by completing original research or by participating in a scholarly project approved by the Residency Director. Examples would include a textbook chapter or setting up an educational program for the residency.
What research opportunities are available?
Faculty are involved in multiple areas of emergency medicine research. Currently, we have several million dollars in NIH funding. Additional small grant funded projects are on-going as well as unfunded research projects that residents are involved in completing. We have evolved a menu of available options for residents to choose from, as well as a monthly open door jump starter meeting for residents and faculty alike to bring their ideas and research questions for refinement and resources.
Is funding available for research projects?
Yes, the department has the resources to fund resident research projects. Additional funding is provided for travel expenses to residents who are invited to present their research at regional or national conferences (for example, SAEM, TCEP, ACEP).
How many patients are seen in the Memorial Hermann Hospital ED each year?
On average, there are more than 80,000 patient visits each year, with 30% of these being pediatric visits.
What is the admission rate from the Emergency Department?
The overall admission rate from Memorial Hermann Hospital ED is ~ 40% (national average approximately 15%). 10% of these admissions go to an ICU setting.
How are pediatric Emergency Department patients handled?
There is a separate triage and care area for pediatric patients, including a resuscitation area. Major pediatric trauma patients are also seen in the main ED trauma area.
How are trauma patients managed?
All trauma patients with a significant mechanism of injury or meeting trauma team activation criteria are managed in tandem with the trauma service. The EM resident manages the airway and performs the primary survey. EM residents also perform all of the FAST exams and a large number of orthopedic procedures. EM residents also rotate on the trauma service as an EM2.
What are general lab turnaround times?
There is a STAT lab located in the Emergency Department. Most other labs are available in 30 minutes. ABGs are available within minutes.
What radiologic services are available?
The ED houses two 128-slice CT scanners. The trauma bays have built-in digital radiography equipment providing physicians with instant images. MRI is available 24 hours per day. Ultrasound is available 24 hours per day. The radiology suite is adjacent to the ED.
Who reads radiologic films and when?
Radiographs are preliminarily read by a radiology resident with attending backup. On average reads are available within 10-30 minutes of the radiologist receiving the images.
Do residents train at other facilities? If so, how much time is spent at each facility?
Residents spend slightly more than half of their clinical time at Memorial Hermann Hospital, followed closely by LBJ General Hospital. Currently, residents spend 2-4 of their EM blocks per year at LBJ, while the rest are done at MHH. During the EM1 year, interns spend 2 weeks at the Lyndon Baines Johnson General Hospital for OB/GYN, 2 weeks in the operating room on an anesthesia rotation and a full block on the orthopedics rotation. In the second year, EM2s rotate to Texas Children’s Hospital for a block of dedicated pediatric ED experience (85,000 ED visits/year). For community experience our residents rotator at Memorial Hermann Southwest during both the EM2 & EM3 years, and at Memorial Hermann Memorial City during the EM3 year.
How many patients are seen in the Lyndon B. Johnson ED each year?
Our annualized patient visits post-Hurricane Harvey are > 95,000.
What is the admission rate from the LBJ Emergency Department?
The overall admission rate is 16%.
How many faculty members are on staff? Are all faculty Emergency Medicine board certified?
Over 70 faculty members provide coverage at the Memorial Hermann ED and LBJ ED. All EM faculty are Emergency Medicine board certified or Pediatric board certified with Pediatric EM subspecialty board certification. We currently have 5 fellows (2 PEM, 2 EMS, and 1 Admin).
How experienced are the Emergency Department faculty members?
We are proud to have a diverse faculty encompassing new residency graduates as well as seasoned emergency physicians. Several of our academic faculty returned to the academic setting after working in the community. Despite training in a tertiary care center, this provides our residents with insight into how various patient presentations would be handled in the community setting.
What is faculty coverage like during Emergency Department shifts?
Faculty coverage at the Memorial Hermann ED includes 64 hours of coverage of the Adult ED. There is an additional 24 hours of coverage each day for the Pediatric ED (staffed by EM physicians, Pediatric EM fellowship trained physicians).
What is the Emergency Medicine resident’s role in trauma? Who runs trauma resuscitations?
We have a tiered trauma response system. Patients meeting certain criteria (such as severe traumatic mechanism, vital sign abnormalities, etc.) are designated Level 1 trauma activations and the patient is taken care of by the ED and trauma team with the ED residents and faculty focusing on airway management and the FAST exam. Level 2 and 3 trauma activations are managed by emergency medicine and the trauma team is consulted as needed.
How is your relationship with the trauma service?
We have a great working relationship with the trauma service. EM residents and attendings work side-by-side with our trauma colleagues providing quality care to our injured patients.
What are the specific roles of the different classes of residents in the emergency department?
All shifts in the ED are typically covered by at least one upper level (EM2 or EM3) resident and an EM1 resident. EM residents are given progressive responsibility to manage and disposition the patients. All patients are fully supervised by the EM faculty.
Does the program pay any professional membership dues?
American College of Emergency Physicians/Emergency Medicine Resident’s Association and the Society of Academic Emergency Medicine are covered.
Does the program pay for any journal subscriptions?
Through membership in ACEP and SAEM, residents receive subscriptions to Annals of Emergency Medicine and Academic Emergency Medicine.
Does the program provide residents with a book allowance?
All residents have electronic access via the library to online textbooks, all library online subscriptions, and multiple evidence based medicine materials. The residency also pays for each resident’s subscription to Rosh Review, ECG Weekly, and HIPPO EM. In addition, there is a CME budget for each resident should they find they need a resource not already provided.
Does the program pay for residents to attend outside conferences?
Residents are encouraged to attend one departmental funded national or regional conference during their three years. Any resident presenting research at a conference also receives funding to attend in addition to this stipend.
What is the first time pass rate of graduates on the ABEM examinations?
The average first time pass rate on the written component of the ABEM certification exam is 98 percent for the past 5 years. The first time pass rate on the oral component of the ABEM certification exam is 98%.
Do residents have difficulty finding jobs?
Due to the training our residents get (including the acuity of patients our residents see), our residents have no trouble finding jobs and are recruited heavily by EM groups in the area and beyond.
Where do graduates practice?
Most of our graduates end up in community practice somewhere in Texas although we have graduates practicing across the United States and in several parts of the world. Residents have gone on to fellowships in EMS, Ultrasound, Resuscitation, Critical Care and Pediatric Emergency Medicine, Toxicology, etc. An additional group have stayed on as faculty at our program or joined other academic EM programs.
What fellowships are available at McGovern Medical School Emergency Medicine program?
We offer fellowships in EMS, Ultrasound, and Pediatric EM, as well as non-ACGME Fellowships in Administration, Quality Assurance, Research, and Medical Education.
Hyperbaric Medicine, Advanced Ultrasound, Aeromedical (LifeFlight), EMS, Ophthalmology, Dermatology, Toxicology, Research, Global Health, Administration, Teaching, and more.
When can residents start moonlighting?
Residents can start moonlighting during the second half of the PGY-2 year after the mid-year evaluation. At the mid-year evaluation it is determined if the resident meets the eligibility criteria (including, but not limited to, completion of all residency related duties, satisfactory scores on the in-training exam, etc.).
How many hours are residents allowed to moonlight?
We limit the number of hours a resident can moonlight to a total of 48 scheduled hours of moonlighting in a calendar month, and these must also comply with ACGME requirements.
Is malpractice insurance paid for when moonlighting?
Residents must have their own liability coverage to moonlight externally. They are not covered by UT professional liability insurance when working outside the residency program; but we do have internal moonlighting opportunities where you are covered by your resident insurance.