Program Overview

Core EMS Experience

As you might expect, the core of the program is the involvement with local EMS agencies, both clinically and administratively. At a minimum, this involves two agencies: Hamilton County EMS and LIFE FORCE Air Medical Service. You will both assist with the medical direction of these services and work clinically in the field. These experiences continue longitudinally throughout the year. We have relationships with additional EMS agencies that can provide additional and alternative experiences if you so desire, which include a Private EMS agency and a Rural EMS agency.

Online Medical Control

The fellow will be assigned a radio which he/she will keep throughout the year to both assist in responding to calls and to provide online medical control when requested by crews. On-duty physicians in the ED are always available to respond to OLMC requests, but the fellow is encouraged to be the first to answer as much as possible.

Academics

Naturally, any ACGME accredited, formal training program includes an academic aspect. Your attendance and involvement in QA meetings with the two primary agencies are considered a part of didactics, as a great deal of learning how to supervise an EMS agency is learned within these sessions. Additionally, we regularly meet for more traditional didactic sessions, usually in a small group discussion format given the ratio of faculty to fellows. QA meetings always occur on a regularly recurring Tuesday of the month, and didactic sessions are generally scheduled for any other Tuesday, though the schedule is flexible. Finally, Journal Club sessions also occur throughout the year.

You will also be expected to participate in scholarly activity during the year. As you can imagine, completing an entire scholarly project within one year can be quite difficult, and may take a significant amount of your time. However, the ACGME does allow for this challenge of timing such that genuine participation in a research project, even if not completed within the year, or presentations at regional or higher professional society meetings are acceptable

Conferences

The fellow generally attends two conferences within the year: the Air Medical Transport Conference (generally in late October) and the NAEMSP Medical Director Course and Practicum (in January). He/she is encouraged to attend additional conferences as able, in particular the remainder of the NAEMSP Annual Meeting, which directly follows the Medical Director Course.

Specialty Response Teams

In addition to the EMS agencies with which we have relationships, there are multiple specialty response teams in the area for interested fellows who wish to get involved in such operations. Examples include:

-Wilderness Search and Rescue
-Swift Water Rescue
-Cave and Cliff Rescue
-Tactical EMS (with county SWAT Team)

Emergency Department Shifts

You will of course be expected to maintain your skills in general Emergency Medicine. As such, you will work in the ED for at least four shifts a month. These four shifts are considered part of the program. Should you wish to work additional time, any shifts beyond four are considered moonlighting time. Fellows generally do not work within the primary, academic hospital for their ED shifts, but rather within one of the other EDs within the Erlanger system. In most cases, these departments are single coverage departments with the fellow working 12 hour shifts.

Schedule

At the beginning of the program, there is a period of orientation during which the fellow is trained for and becomes accustomed to working with the primary agencies. In particular, the air medical experience requires some time under direct supervision before transitioning into more indirect supervision typical of EMS. As such, fellows complete a portion of the same orientation period as any other flight crew member, specifically riding as a third crew member under the supervision of a preceptor until it is felt that he/she is competent to fly as primary crew. This process generally takes about two months, during which your clinical schedule will mirror that of your flight preceptor, and consists of about 84 hours time on shift in a mixture of 24 and 12 hour shifts spaced across every other weekend.

Once flight orientation is complete, you will be expected to complete 48 hours time on flight shift a month, and the ground EMS experience will begin to ramp up. This orientation varies depending on the prior EMS experience of the particular fellow, but will include ride-alongs with an EMS supervisor and/or EMS physician in a response SUV and may include ride-along time with a standard EMS crew. Once more familiar with the service and the area, you will be able to respond at your own discretion to calls in a vehicle dedicated to the fellow. EVOC training is provided.

Once the fellow is fully oriented to both primary services, the typical schedule settles out to completing 4 ED shifts a month, at least 48 hours of flight time a month, at least 4 days a month responding to ground EMS calls, and didactic/QA time most Tuesdays. The precise schedule of when shifts occur is largely left to the fellow to manage him or herself. Naturally, days not on one of the above shifts are an opportune time to work on scholarly activity, studying for Boards, and/or working with any of the additional agency/team experience options.