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Emergency medicine residency formed at UNMC

The University of Nebraska Medical Center has formed a residency program

in emergency medicine, and the new program should benefit the emergency

care of citizens across Nebraska and the region.

The first six physicians of the UNMC Emergency Medicine Residency Program

will begin their three-year residencies in July 2004. Physicians complete

residencies, or advanced training in medical specialties, after they graduate

from medical school.

Were very excited for the residency program to begin, said Robert

Muelleman, M.D., chief of the section of emergency medicine at UNMC and

director of emergency services at UNMCs hospital partner, The Nebraska

Medical Center. Only about one-third of the physicians practicing emergency

medicine in Western Iowa and Nebraska are residency-trained and board-certified,

and most of those physicians are in Lincoln and Omaha.

The residency program is the first in the Great Plains region, Dr. Muelleman

said. That region encompasses about 20 percent of the land mass of the

continental United States, including all of Nebraska, South Dakota, North

Dakota and Kansas; western Oklahoma and Texas; and eastern New Mexico,

Colorado, Wyoming and Montana. The closest emergency medicine residencies

in Kansas City, Minneapolis, Denver and Chicago, dont provide many residents

in rural areas, Dr. Muelleman said.

Were hoping that through this residency, more emergency medicine-certified

physicians will practice in rural Nebraska, he said.

Dr. Muelleman credited the leaders of UNMC and The Nebraska Medical

Center with helping to make the residency program a reality. He noted the

work of UNMC Chancellor Harold M. Maurer, M.D., College of Medicine Dean

James O. Armitage, M.D., and Glenn Fosdick, chief executive officer of

The Nebraska Medical Center.

Were excited that the emergency residency program has been approved,

Dr. Armitage said. Without question, this emergency residency program

will be one based on excellence, both in its educational environment and

its clinical opportunities.

Said Fosdick: Our patients and ER team will be shaping the future of

emergency room physicians who will take their clinical experiences and

build on them throughout their careers. This program furthers our commitment

to patients across the region by training ER doctors and sending them where

they are needed.

Dr. Maurer said the program is another example of UNMC being at the

forefront of serving residents of the Great Plains.

This residency program certainly fills a need in health care for this

region, Dr. Maurer said. We look forward to the first class of residents

beginning next summer.

Michael Wadman, M.D., assistant professor of emergency medicine at UNMC,

will direct the residency program.

The goal of the University of Nebraska Emergency Medicine Residency

Program is to provide residents with outstanding clinical and educational

experiences in emergency medicine, Dr. Wadman said.

He noted that the residencys didactic program will feature a monthly

lab session with in-depth instruction combined with hands-on experience

in selected emergency procedures, in addition to a weekly lecture series.

Dr. Muelleman noted that potential residents who may be wary of a first-time

residency program should rest assured: the emergency residency program

review is very stringent.

Potential residents can be assured that the clinical and educational

resources are in place to prepare them to become skilled board certified

emergency physicians, Dr. Muelleman said. Our faculty members trained

at six different residencies; have anywhere from one to 20 years of clinical

experience; have been educating medical students, residents and practicing

physicians for several years; and since January, 1997 have published 39

peer-reviewed articles, presented at national and international meetings

and have contributed 68 chapters to 10 textbooks.

Beginning in 2005, the residents will practice in one of the largest

emergency departments in the region. The new emergency department, now

under construction at The Nebraska Medical Center, will have 20,000 square

feet, 16 exam rooms, 13 critical care rooms, eight observation rooms and

four trauma beds.

A unique feature of the UNMC residency, Dr. Muelleman said, will be

two, month-long rotations at Regional West Medical Center in Scottsbluff.

The western Nebraska hospital has five board-certified emergency medicine

physicians on its staff.

We wanted to expose the residents to rural Nebraska, Dr. Muelleman

said. The rotations in Scottsbluff will be a great opportunity for them.

We hope that some of them will think about continuing to practice in rural

parts of the state, after their residencies are complete.

Dr. Muelleman said that injury death rates are higher in rural areas

than in urban areas. He hopes the new residency program will help to improve

rural emergency-room care. Another way in which UNMC hopes to improve that

care is through an annual conference for those emergency-medicine providers

in rural areas who dont have advanced, formal emergency-medicine training.

The first such conference is scheduled for March 18-20 in Omaha.

It will be several years before this residency program can saturate

the hospitals across the state with physicians who are board-certified

in emergency medicine, Dr. Muelleman. Even then, there still will be

hospitals whose ERs are staffed by on-call family physicians. We hope

that these conferences will provide those physicians with essential skills

training to handle both medical and traumatic emergencies.

The emergency-medicine residency, Dr. Muelleman said, will help to prevent

the brain drain of physicians who want to practice emergency medicine.

Until now, only one-third of students who leave Nebraska to receive their

emergency-medicine residency return to the region.

Its been shown that a vast majority of physicians practice where they

have their last training, Dr. Muelleman said. This residency will keep

more emergency medicine-certified physicians in this region, and ultimately

will provide the best care for patients who need emergency services.