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Premier Physician Aids in Development of CAMC: Osteopathic Emergency Medicine Residency Program

Charleston Area Medical Center December 30, 2007

In July 2000, Charleston Area Medical Center became part of the Premier family and our first Emergency Medicine contract in West Virginia. This three-hospital system has served the state as a leader in both graduate medical education and allied health science, providing allopathic and osteopathic residencies; rotation opportunities for medical students and other health care providers; and additional medical education programs.

July 2007 saw the inauguration of an Osteopathic Emergency Medicine residency program to the CAMC system generating much excitement, opportunity and enthusiasm among the emergency department staff and those affiliated with the program and department.

After a very busy year of in-depth planning, David Seidler, MD, FACEP, Director of the Emergency Departments of CAMC; and James Turner, DO, FACOEP, FACOFP, Emergency Medicine Residency Program Director; are very pleased with the initial implementation of the program and the response of the medical community.

Dr. Turner has envisioned a unique program, “explains Dr. Seidler. “The educational model is quite distinctive.” Turner joined the Premier family in 2006, planning the core curriculum and working as a clinician within the department. A graduate of South Eastern College of Osteopathic Medicine, Dr. Turner practiced Emergency Medicine for over ten years before entering Emergency Medicine residency at Mount Sinai Medical Center in Miami Beach. His experiences of staff physician, ED Medical Director and business owner all contributed to his ambition to participate in the development of excellently trained Emergency Medicine physicians.

Depicting the program as a “non-traditional model,” the two leaders described the structures, methods, philosophies and support systems that shape the program.

Departing from the traditional training method of “see one, do one, teach one,” the program starts with a very in-depth 28-day orientation that consists of both didactic and clinical overviews, allowing new residents to gain a “view of the forest before examining the trees.”

They also utilize an extensive simulation laboratory where residents gain aptitude in specific procedures prior to performing them on actual patients. The methodology and philosophy are also progressive with a defined philosophy that puts education before service.

In creating the program, Dr. Turner, together with Dr. Gordon Green, pediatric emergency physician and Medical Director of CAMC’s simulation laboratory, made an extensive study of education methods shown to maximize retention specifically in adult learners. Rather than typical “power point-type” presentations, a method of pre-reading, followed by discussion groups, examples and demonstrations are utilized.

The program even uses simulated encounters with “patient”/actors. This goes beyond simple role play, Dr. Turner explained. For example, one encounter may have a “patient” with pulmonary emboli. The resident proceeds to do history and physical, order tests, evaluate results and create a treatment plan. The encounter, however, meets challenges as one would expect in actual practice when the “patient” goes into cardiac arrest in the middle of the work-up; the simulation even includes actors as patient family members requiring communication with the resident physician.

“This is not only a valuable education model where residents learn without risking the health of the patients; but it also allows us to identify and address areas that need work, “ explains Dr. Turner.

“We learn distinct strengths and weaknesses very early allowing us to really work with the individual resident,” adds Dr. Seidler. “This doesn’t simply address procedures and competency areas; we also work on related skills such as leadership development or testing.

The initial response has been very positive as evidenced in September during the 2008 residency application period. Within the first week of the application period the program received over 30 applicants for the four slots available in 2008.

Although the enthusiastic initial response to the program is very gratifying, Dr. Seidler is quick to note that the smooth start originated in a year of extremely intense work by Dr. Turner prior to the actual onset of the program.

Dr. Turner points out several factors and support systems that were in place to create a strong program. “First of all the CAMC system with 100,000 annual ED visits and level I trauma designation is an ideal environment,” he notes. “As a four-year program we have the strength of an additional year allowing opportunities for more research and enhancing practice skills. We’ve received excellent support from MSOPTI (Mountain State Osteopathic Post Graduate Training Institute), from Premier, and from Dr. Seidler as Emergency Medicine Director. Then CHERI (Charleston Health Education and Research Institute) has just been a tremendous resource.”

Dr. Seidler agrees noting the important contribution of CHERI president Sharon Hall as well as Dr. Green. “They’ve helped Dr. Turner and others within the program to truly be on the cutting edge of residency education,” he explains. “They combine the allopathic and osteopathic resources to provide the best possible educational environment.”

“We believe strongly in teamwork and we don’t operate in a vacuum,” adds Dr. Turner. “There is a great learning opportunity for the residents. They’re not just learning medicine, but also practice models and philosophies; respect and understanding for patients, staff and their co-workers. We’re committed to teaching more than just a text.”

Both physicians take tremendous pleasure in the academic role and the opportunity to contribute to the specialty.

“Rather than automatically doing things a certain way because that is how it has always been done, we’re looking at the research and choosing the optimal teaching methods for producing the best Emergency Medicine physicians we can,” says Dr. Seidler.

“We have an opportunity to significantly impact the way Emergency Medicine is taught and ultimately practiced, “ explains Dr. Turner. “It is a chance to contribute to creating better ER docs.”

The enthusiasm is shared by others among the ED staff noted Dr. Seidler. “The physicians really enjoy having the residents in the ED, not only for the support, but also the opportunity of working with these residents who are tremendously excited about working in Emergency Medicine and engaging in discussions about practicing Emergency Medicine.”

With four positions per year, the program has five (post graduate year 1 and 2) residents this year and will grow to sixteen residents.

The addition of the EM residency program at Charleston Area Medical Center makes the second EM residency affiliation for Premier Health Care Services. Premier affiliate hospital St. Vincent Mercy Medical Center in Toledo, Ohio is the home of one of the nation’s oldest and largest Emergency Medicine Residency Programs.

This program now in its 33rd year has produced over three-hundred Emergency Medicine physicians with many residents going on to leading roles within the specialty and making valuable contributions to the industry.

The EM residency program at St. Vincent’s is also known for the Life Flight Program, an aeromedical transport program. It is one of only a few programs in the country where 2nd and 3rd year residents participate as flight physicians, explains program director David Johnson, MD.

St. Vincent’s Emergency Medicine residency also has a strong concentration in Emergency Medical Services.

Well-known for strong clinical training, the program attracts medical students from all over the country. “We really have a diverse and well-rounded faculty,” notes Dr. Johnson citing examples such as David Ledrick, MD, a leader in the MedWAR’s program, “The diversity and experience of the faculty provides a very broad education opportunity for the residents.”

“Most of the attendings are here because of the opportunity to contribute to the development of outstanding young Emergency Medicine physicians,” says Dr. Johnson. “They consider it a reward to offer the training.”

Kim Rooney, Senior Physician Recruiter at Premier, is enthused about a second EM Residency affiliation for the group. “We derive a great recruiting benefit from our affiliations with residency programs,” she comments. “We have hired several outstanding physicians from St. Vincent’s to our Premier hospitals and look forward in the years ahead to the possibility of residents from CAMC choosing to join our group.”

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