Clinical Rotations

Clinical rotations at Montefiore Einstein offer structured, hands-on training experiences in a fast-paced and diverse hospital environment. Residents apply their classroom knowledge in direct patient care under the supervision of a dynamic team of world-renowned medical professionals.

The PGY-1 year serves as the intern year of our Residency Program. The purpose of the PGY-1 year is to introduce residents to the diverse emergency medicine environments at Montefiore Einstein and to help interns acquire a broad-based knowledge in key areas essential to emergency medicine. These areas include:

• Medical critical care
• Cardiology
• General medicine
• Pediatric emergency medicine
• Ultrasonography

At Montefiore Hospital, Moses Campus and the Montefiore Einstein Emergency Departments (EDs), the PGY-1 interns will work on both the subacute and acute sides of the ED. Although all work is autonomous, interns engage in direct, one-on-one interaction with an attending physician, with whom they consult regarding patient management and clinical decision-making.

PGY-1 rotations include:

The PGY-3 resident assigns PGY-1 interns rotating in the NYC Health + Hospitals | Jacobi ED to patients and will serve as the primary care provider for all patients, including those with major traumas. Patient management is integral to this role, and training includes:

• Peripheral intravenous (IV) lines
• Endotracheal intubation
• Suturing
• Chest tubes
• Ultrasound

As second-year junior residents, the PGY-2 residents continue to learn and develop skills across all core areas of emergency medicine. At the Montefiore Einstein ED, PGY-2 residents work shifts with greater autonomy in the higher acuity area. As our residents advance, they are expected to manage a larger patient caseload and have an increasing impact on the throughput and flow of our Emergency Departments.

Moreover, while at the Jacobi ED, PGY-2 residents are assigned more high-acuity patients, gaining valuable experience in performing critical care procedures. They also have increased didactic responsibilities that include leading our Journal Clubs.

PGY-2 rotations include:

During the third year of residency, the hierarchy of the Jacobi ED allows for a truly unique role. In this rotation, the PGY-3 serves as Chief Resident, managing a heavy caseload while developing the necessary management and organizational skills to effectively oversee a busy ED. While rotating through the Montefiore Einstein Emergency Departments, PGY-3 residents serve a higher proportion of their shifts on the acute-care side of the EDs.

The Chief Resident is responsible for half of the patients admitted to the Emergency Department. In this role, residents assess each patient upon arrival, initiating the workup with laboratory orders and, when necessary, medications and imaging studies. In the chief resident role, PGY-3 residents assign patients to junior ED residents and outside rotating residents. At this juncture, the Chief Resident will:

• Monitor each patient’s progress
• Provide clinical guidance and supervision to junior residents and medical students
• Ensure that the work-up, treatment and disposition of each patient proceed in a timely manner

PGY-3 residents will also serve as team leaders during medical resuscitations and perform airway management during major trauma resuscitations.

PGY-3 rotations include:

PGY-4 in emergency medicine aims to enhance the knowledge and skills acquired during the first three years of postgraduate training to a consultant or “pre-attending” level. Fourth-year residents possess significant authority to make decisions regarding patient care that have far-reaching implications, both within the Department and throughout Montefiore Einstein.

In the Montefiore Einstein Emergency Departments, PGY-4 residents work exclusively in the critical care zone. In this role, they manage all medical and surgical notifications and take primary responsibility for overseeing critical patient care.

While at the Jacobi ED, fourth-year residents primarily assume a leadership role, focusing on supervising and teaching junior residents and medical students. Junior residents present exclusively to the PGY-4 resident, who possesses full decision-making authority (with consultation from the attending as needed).

This unique and intensive clinical experience produces exceptionally well-prepared and perceptive emergency medicine physicians. Graduates of the Montefiore Einstein and Jacobi ED Program are equipped to take on any attending role and skillfully navigate the dynamic, fast-paced and challenging environment that characterizes Emergency Medicine.

PGY-4 rotations include:

Residents learn to intubate an adult patient in the operating room (OR) and become more familiar with alternative airway tools.

Our ultrasound rotation familiarizes residents with the role of the ultrasound technician in the Emergency Department. It includes didactic instruction and hands-on training under supervision, along with independent scanning.

This rotation takes place at the New York City Poison Control Center (455 First Avenue, between 26th Street and 27th Street). Each resident will be involved in morning callbacks and afternoon rounds.

This rotation introduces residents to other vital roles of emergency medicine beyond the clinical setting. It involves reading assignments, chart review tasks, tutorials with individuals responsible for ED administration and participation in ED and hospital-wide administrative meetings.

PGY-3 residents rotate with the critical care medicine (CCM) consulting service and engage in the intensive care management and triage of patients in the emergency departments, recovery rooms and medical and surgical floors.

Residents gain experience in neonatal care, including assessment, stabilization, resuscitation and managing the care of sick and critically ill newborns.