About the Program


The Ohio State University Affiliated Emergency Medicine/Internal Medicine Residency is a five-year program that provides education and experience in the clinical, educational, administrative and research aspects of emergency and internal medicine and its allied fields. The clinical program is a cooperative endeavor of The Ohio State University Wexner Medical Center, Ohio State University Hospital East, Nationwide Children’s Hospital (NCH) and OhioHealth Grant Medical Center.

In developing our Emergency Medicine Internal Medicine (EM/IM) Combined Residency Program, we have combined excellence in leadership, residency training (emergency medicine and internal medicine) and academic and patient care opportunities. Together both departments provide over 40 years of residency leadership experience and have graduated hundreds of successful graduates with a widespread impact on both specialties. Our graduates have had diverse interests ranging from academic subspecialty training, to educational and teaching activities to excellence in patient care. Many graduates have attained leadership positions in a variety of medical center and academic organizations both regionally and nationally. Our Department of Internal Medicine has several ranked U.S. News and World Report programs, while the Department of Emergency Medicine continues to be one of the most competitive emergency medicine training programs in the country.

EM IM Resident Group

Curriculum

Emergency Medicine/Internal Medicine Residency curriculum

Emergency Medicine/Internal Medicine Residency curriculum

Common areas of emphasis and expertise include the treatment of critically ill patients and the use of evidence based medicine, simulation and ultrasonography to gain expertise in the management of these patients. Our programs have benefited from a medical center-wide initiative to emphasize key areas such as patient satisfaction, professionalism, communication and patient safety. This has been accomplished through education, mentorship, feedback and innovation. Even more important to our success has been the establishment of a culture of collaboration between our departments in all our mission areas.

View sample block schedule

PGY-1

The orientation curriculum in the first block is designed to familiarize and orient new residents with Nationwide Children’s Hospital and Ohio State emergency departments and the Department of Internal Medicine, to offer an intensive didactic experience highlighting management of emergent and inpatient patient conditions and to provide experience and certification in Advanced Cardiac Life Support (ACLS), Advanced Trauma Life Support (ATLS) and Pediatric Advanced Life Support (PALS). During the first year of the program, the resident will gain experience in a variety of disciplines relevant to emergency medicine and internal medicine. The resident also gains formal training in emergency ultrasound and will choose from several ambulatory elective opportunities to personalize his or her residency experience.

PGY-2 and PGY-3

The second and third years are similar to the second years of the emergency medicine and internal medicine categorical years. The second year focuses on development of progressive autonomy in patient management. In addition, the resident obtains experience in a variety of subspecialties including trauma and surgical critical care. As a member of the trauma team, the resident plays an integral role in major trauma resuscitations. In the surgical intensive care unit, the resident provides management for the most critically ill surgical and trauma patients. During this year, the cardiology CHF service, the MICU, SICU and trauma months represent significant exposure to ICU care. 

The resident gains further experience and expertise in performing procedures such as placement of central lines, airway management and emergency ultrasound. 

During the second and third year of the program, the resident is provided with the opportunity to accept responsibility for managing many patients simultaneously while supervising and teaching junior-level house officers and students in the emergency department and on the inpatient floors of The Ohio State University Wexner Medical Center and at Nationwide Children’s Hospital. This graded responsibility helps the resident to gain independence and expertise in managing the emergency department and inpatient units. The resident will receive experience in emergency department administration and management of emergency medical service systems, as well as additional ultrasound training. The resident will choose from several subspecialty ward opportunities to personalize his or her residency experience. 

PGY-4 and PGY-5

The fourth and fifth years are similar to both the emergency medicine and internal medicine third years. During these years, emphasis is placed on enhancing patient care through resident education. Three strategies employed include focusing on continuous quality improvement, instilling the commitment and skills to demonstrate competency, and providing concrete experiences to help residents become masters of effective teamwork and enhance their ability to plan and manage care transitions inherent in today’s healthcare environment. The residents will also choose from several selective opportunities to personalize their residency experience.

The fourth and fifth years of the program provide the senior resident with the opportunity to accept responsibility for managing many patients in different settings. Supervision of all levels of EM and IM residents occurs during this year. The resident also participates in MICU End of Life Discussion training during this year.

Mini Fellowship Block

This portion of the curriculum is meant to allow the trainee the opportunity to develop a unique interest or skill set. It is a continuous 12-week block of time in which residents will be supported by a mentor or advisor that will work closely with them. It will also afford the trainee the opportunity to explore possible interest in subspecialty training. 

Approximately three months prior to the start of this period, the resident will be asked to supply a one page summary indicating what they will plan to do over the 12-week period to develop their specific interest. It will include a list of measurable objectives and goals and will require approval by the program directors. They will work with a mentor or advisor on the topic of their choice. Ideally this will allow for development of skills that will promote an academic career. During this 12-week block, the trainee will remain involved with their continuity clinic. 

If the resident chooses to not be involved in the Mini Fellowship portion of the curriculum, it will be filled with other elective rotations. Some potential areas of focus for the Mini Fellowship include but are not limited to:
  • Basic science or clinical research
  • Ultrasound training working toward certification as a registered diagnostic medical sonographer
  • Administration
  • Community medicine (ie. free clinics, EMS)
  • International medicine
  • Scholarly activity involved in medical writing, possibly related to case reports or review articles
  • Opportunity to initiate graduate-level classwork towards a master's degree in a program approved by the program director

Didactics

Didactics and conferences

Didactics and conferences

The Department of Emergency Medicine at Ohio State has a strong academic history. Although it is impossible to replace hands-on experience, a variety of non-clinical formats are employed to complement this learning.

Journal Club

Emergency Medicine Journal Club typically occurs on the last Wednesday of each month, when residents and attendings gather to discuss journal articles over lunch. These sessions begin with a review of a basic research or statistical topic, followed by the presentation of three articles selected to address a particular clinical question. Journal Club is attended by faculty with a wide variety of research and clinical interests, allowing residents to draw on multiple experiences and viewpoints as they learn to navigate the medical literature.
 
Internal Medicine Journal Clubs take several formats. One format focuses on an in-depth analysis of a single article using the McMaster’s EBM format. The intent of this journal club is to teach skills of critical appraisal. The second format is a current literature potpourri. In this format, residents break into small groups, read several timely articles and summarize them for their colleagues. The intent of this format is to help residents remain abreast of the current literature. Lastly, we have a “rapid” fire journal club in our outpatient clinic that reviews a select group of recent journals and how they will impact on our practice of medicine.

Skills Lab

We are lucky at Ohio State to have access to the state-of-the-art Clinical Skills Center, and take advantage of this resource monthly during our skills labs. Coordinated and led by senior resident/faculty pair, skills lab sessions make use of both high- and low-fidelity simulators, animal and cadaveric models, volunteer patients and occasionally, even each other to review and practice emergency medicine-relevant skills. We are also fortunate to have non-emergency medicine colleagues who are often willing to lend their expertise to these activities.
 
Recent skills labs have included the following:
  • Obstetrics: Residents reviewed and practiced first trimester ultrasound on a phantom model, as well as third trimester ultrasound on a pregnant volunteer. A station covering both normal and complicated deliveries was led by an OB/GYN faculty member with an interest in education.

  • ENT: Epistaxis treatment was discussed and then practiced using a low-fidelity model. Drainage and treatment of auricular hematomas was reviewed with the use of a cadaveric model. Finally, residents were given the opportunity to perform nasopharyngoscopy on a volunteer under the direction of a speech therapist and ENT resident.

  • Airway: Residents gained familiarity with a variety of adjunct/rescue airway devices and technique using both mannequins and cadavers, all under the direction of experienced emergency medicine faculty.
The Department of Internal Medicine has special Tuesday afternoon sessions that allow further coaching of clinical and procedural skills using simulation tools, models and standardized patients/clinicians. Popular sessions have included a multidisciplinary approach to breast cancer and breast cancer detection and a communication skills workshop focusing on patient communication and patient handoffs.
Emergency medicine didactics and conferences

EM Presentations

All residents present one prepared lecture per year. These lectures are drawn from a variety of appropriate topics chosen at the beginning of each year. While these lectures are modeled after traditional one-hour PowerPoint presentations, an emphasis is placed on discussion and audience participation. Accordingly, residents are encouraged to be creative in their approach to presenting their topic. Recent examples include expert panels of both emergency medicine and non-emergency medicine faculty, and the use of social media to solicit real-time audience input.

EM Reading Club

Part of our asynchronous curriculum, the reading club is currently undergoing a transformation. We currently use Access EM, a web-based curriculum that utilizes not only selections from many major emergency medicine and internal medicine texts, but also multimedia tools, podcasts and other educational modalities. Our goal was to create a curriculum that will be repeated every eighteen months so that topics are covered twice, once during the beginning of training, and a second time when the resident has more clinical experience in which to frame the material.

EMS

The EMS experience is directed by Dr. David Keseg and has recently been adapted in response to resident feedback. Residents learn the skills necessary to become an EMS director by completing assigned readings, ride-alongs and attending EMS specific lectures throughout the residency program. Residents also deliver a lecture to EMS personnel in their second and third years. Additionally, the Department of Emergency Medicine houses The Ohio State University Center for EMS. Several faculty members serve as medical directors for local fire departments and Dr. Howie Werman is the medical director for MedFlight of Ohio. Third year residents are given the option to fly or ride along with MedFlight to fulfill part of the EMS requirements.

EM Conferences

The Emergency Medicine Lecture Series takes place on Wednesday mornings. The traditional lecture sessions covering the core content of emergency medicine is augmented by several repeating conferences. We host a monthly multi-disciplinary trauma morbidity and mortality session that is regularly attended by colleagues, which make up the multi-disciplinary trauma care team as well as staff from the medical examiner's office. Emergency medicine M&M also occurs monthly, providing an opportunity to discuss difficult cases in a collegial and collaborative setting. During pediatric and adult emergency department follow-up, residents present interesting cases in an oral board format, allowing the opportunity to not only discuss the salient medical aspects of the cases, but also to review and practice strategies for successful completion of the ABEM oral board exam.

EM Small Group Discussions

EM residents are divided into four small group discussions with two emergency medicine attendings as facilitators. The small groups are made up of residents from all levels and meet monthly for a two-hour session. Topics are usually selected based on resident requests and have included oral board review, end of life care in the emergency department, ventilator management (including several residents being "treated" with non-invasive positive pressure ventilation), and mock EMS base station calls.
 
We highly value our small group sessions for multiple reasons. The small group format emphasizes a personal approach to education that we regard highly at Ohio State. We firmly believe that, as adult learners, residents should have a certain amount of control over what they learn, and the small group format affords us this curricular latitude. There is no set small group curriculum, and groups are encouraged to be creative in their exploration of the nuances of emergency medicine. Additionally, residents are able to draw not only on the experiences of faculty members, but also work collaboratively to teach one another, enhancing our "residency family" environment.
Internal medicine didactics and conferences

IM Conferences

Internal Medicine Tuesday Conference Block is three hours of educational activity held in a block on Tuesday afternoons following a housestaff lunch. Residents on elective and CPB months are free of clinical duties on Tuesday afternoons to attend this conference. Tuesday inpatient rounding schedules are adjusted so that residents can finish most of their clinical work by noon (similar to a weekend day). The content of the conference varies from session to session. Incorporated lectures include core topics in general and subspecialty medicine.

IM Ambulatory Noon Conference

Housestaff gather between outpatient clinics or continuity clinics daily at noon (except Tuesdays). They are introduced to a variety of outpatient patient care topics, such as hypertension management, outpatient diabetic care, the approach to evaluation of headache in an outpatient setting, etc.

IM Grand Rounds

The Internal Medicine Grand Rounds weekly conference highlights recent advances in internal medicine and draws accomplished speakers and investigators from within the university as well as around the world. Topics range from comprehensive updates on common clinical problems to 
emergency medicine presentations.
 
All residents present one prepared lecture per year. These lectures are drawn from a variety of appropriate topics chosen at the beginning of each year. While these lectures are modeled after traditional one-hour PowerPoint presentations, an emphasis is placed on discussion and audience participation. Accordingly, residents are encouraged to be creative in their approach to presenting their topic. Recent examples include expert panels of both emergency medicine and non-emergency medicine faculty, and the use of social media to solicit real-time audience input.

IM Intern Report

The current interns present a case and, with one of the program directors, facilitate an in-depth discussion geared towards the needs of the interns. This is a popular conference among the interns and allows each of them the opportunity to expand their differential diagnosis and management plans, as well as become comfortable with presenting to a group of their peers.

IM Morbidity and Mortality

The OSUWMC Internal Medicine Residency has developed a nationally recognized innovation in morbidity and mortality conferences. The traditional conference has been replaced with a resident peer review conference, where residents use the tools of medical error root cause analysis and quality improvement to identify and correct problems that led to suboptimal outcomes for our patients. An emphasis is placed on systematic problem solving and prevention rather than blame.

IM Morning Report

One case from an inpatient service is presented at each of these popular conferences. A program director or other attending physician and the chief resident facilitate an in-depth discussion about the presentation, physical exam, differential diagnosis, diagnosis and patient management of a particular disease process. The application of evidence-based medicine is role modeled, including a focused question of the day. This highly educational conference remains a favorite among housestaff.

Application Process

Prospective Emergency Medicine/Internal Medicine residents

Prospective Emergency Medicine/Internal Medicine residents

Interview dates for the 2018-2019 season have not yet been finalized.  We expect to post this information in August so please check back!  If you have any additional questions regarding our program, be sure to access the Contact page from the Helpful Links menu at the bottom of the page for our contact information.

For further information, please contact the Emergency Medicine/Internal Medicine Residency program director, Dr. Daniel Martin at Daniel.Martin@osumc.edu or the associate director, Dr. Emily Kauffman at Emily.Kauffman@osumc.edu.

Interview Details

On the evening prior to your interview, there will be a casual gathering with current internal medicine residents. We will provide appetizers/food from 6:30 p.m. to 8:30 p.m. The information of where we will be meeting will be in your confirmation packet. We hope that you are able to join us for this event, as this gives us a chance to meet you in a less formal setting and allows you to ask us what it's like to be a resident at The Ohio State University Wexner Medical Center!

Important Facts about OSUWMC's Initial and "For Cause" Drug Screening Policy

All residents and fellows at OSUWMC are considered "Limited Medical Staff." As such, they are bound by medical staff policies and procedures. All residents and fellows must complete initial drug screening before credentialing can occur (spring). If the credentialing screening drug test is positive for any of the tested substances without a physician's prescription for that substance, and notification of such prior to testing, the resident's/fellow's contract and any commitment to accept the trainee will immediately be void until he/she successfully completes a substance use assessment and/or treatment at an Ohio State Medical Board approved treatment site.
 
Substances tested:
  • Marijuana/Cannabinoids*
  • Cocaine and metabolites
  • Amphetamine/methamphetamine
  • Benzodiazepines
  • Opiates
  • Barbiturates
  • Methadone
  • Oxycodone
  • Phencyclidine (PCP)
  • Propoxyphene
     
*Additional notation about marijuana:

Several states have legalized medical and/or other marijuana use. OSUWMC will continue to consider a positive test for marijuana/cannabinoids without a physician's written direction as a positive drug test. Dilute urines specimens may also be considered positive tests and repeated. Marijuana with occasional use/exposure can cause a positive drug screen for four to six weeks (even longer with more frequent use/exposure or with certain body characteristics).
 
Rotations outside OSUWMC:
 
Many hospitals, including affiliates with the residency/fellowship programs, may require repeated drug screening before residents/fellows can start rotations or have other random or for cause drug testing policies at those sites. This means that residents/fellows are likely to have additional routine drug screening throughout their training before going to other hospitals in or outside of central Ohio. A positive test at any training site will result in suspension of training and other potential action.
 
For cause screening:
 
Any medical staff member, including limited medical staff, may be required to submit to alcohol or drug testing for cause. Failure to complete screening within two hours will be considered a positive test and result in suspension and other potential action.

Highlights

Why choose Ohio State for your residency?

The Departments of Emergency Medicine and Internal Medicine have demonstrated significant academic and educational excellence. Both departments are among national leaders in research funding and have enjoyed significant increases in research support during the past several years. Although internal medicine is one of the leading contributors to the education of our medical students, the Department of Emergency Medicine has contributed more teaching hours per faculty member than any other department.

Both departments have had many faculty recognized for teaching excellence and many have been voted “professor of the year,” the highest recognition for teaching excellence from medical students. Both residency training programs continue to receive an increased number of highly qualified applications for residency training. Fellowship programs have also been added while continuing to emphasize the importance and vital role of providing primary care. Both residency programs have steadily increased their residency size as well as the expertise and numbers of their educational faculty. Both have a track record of excellence regarding residency review committee accreditation.

EM/IM Residency Faculty

Our leaders

Daniel Martin

Daniel Martin, MD, MBA

Vice Chair for Education

Emergency Medicine/Internal Medicine Residency Program Director
Professor

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Emily Kauffman

Emily Kauffman, DO, MPH

Emergency Medicine/Internal Medicine Residency Associate Program Director

Assistant Professor

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Eric Adkins

Eric Adkins, MD, MSc

Vice Chair of Clinical Affairs

Associate Professor

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Jeffrey Caterino

Jeffrey Caterino, MD, MPH

Vice Chair of Research

Associate Professor

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Diane Gorgas leader

Diane Gorgas, MD

Director, Global Health Fellowship

Associate Professor

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Wininger Slider

David Wininger, MD

Director, Internal Medicine Residency Program

Associate Professor - Clinical, Division of Infectious Diseases

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Emergency Medicine/Internal Medicine Residents

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