The Mount Sinai Emergency Medicine Residency Scholarly Tracks allow residents to explore and develop demonstrable expertise in areas within Emergency Medicine. Our scholarly track program is designed to expose residents to dimensions of Emergency Medicine not always experienced through clinical training, and to help residents build a broad foundation for their career. Some residents use scholarly tracks in place of a fellowship, to help shape fulfilling careers. Others use it to become one of the best-qualified fellowship applicants, or as a way to explore an area and build transferable skills in research, teaching and administration.
The Mount Sinai Emergency Medicine Residency currently offers about 20 scholarly tracks that residents can tailor to their specific backgrounds, interests and project goals. Our residency curriculum is designed so that the clinical load decreases yearly as more time is dedicated to developing expertise in areas of interest. By the PG4 year, during clinical months, residents work similar hours to attendings at academic institutions, and they have 3 months to focus on scholarly tracks and electives. Additionally, during the course of scholarly track engagement, residents complete a scholarly project, which is presented at a system-wide symposium prior to graduation. Many of our residents become involved in their area of expertise at the national level with the support of our faculty, and of funding to attend conferences for those leading committees. The tracks and their brief descriptions are below.
Our program offers countless opportunities for learning and participating in administration and departmental Our Administrative Track takes advantage of the countless opportunities for learning and participating in administration and departmental operations across all three clinical sites (MSH, EHC, and MSBI) at the hospital and system levels. Residents have opportunities to be incorporated into administrative and operational projects, committees and meetings. Most recently, this has included active involvement of residents in reorganizing operations during the COVID surge at all sites, and in planning new departmental workflows for the redesigned and renovated ED at the Mount Sinai Hospital, including creation and tailoring of the Provider-in-Triage role. Residents in this track are also exposed to hospital- and system-level leadership, including an invitation to our biweekly meetings with the Mount Sinai Hospital president, and are encouraged to join relevant hospital-wide, regional and national committees. We have supported residents to obtain LEAN training or attend ACEP’s administrative leadership programs. Several graduates of this track have been hired directly into ED administrative leadership roles such as Assistant Medical Director and Director of Observation Medicine.
Mount Sinai has long been known as a leader in critical care. The emergency departments at both the Mount Sinai Hospital and Elmhurst Hospital have large numbers of dual emergency medicine/critical care trained faculty, a large volume of high-acuity patients, and designated critical care areas. A number of emergency physicians at the Mount Sinai Hospital have appointments in both the ED and ICUs, facilitating both knowledge translation and continuity of care for critically ill patients. Many critical care electives, including Neuro Critical Care and Transplant Critical Care, are available to our residents. Those who select the critical care scholarly track gain further experience during their PGY4 year by supervising PGY2s and 3s on their “resuscitation” shifts and working on a critical-care project. Recent projects have included research into the efficacy of various vent settings and into criteria for ICU admissions, as well as development of ED protocols for critically ill patients. Dozens of our graduates have gone on to critical care fellowships for board certification at leading programs across the country.
Diversity & Inclusion / Social EM
The SEM/DEI track is for residents who have an interest in the intersection of social determinants of health as they relate to the practice of Emergency Medicine, including but not limited to those who are considering a fellowship in Social Emergency Medicine. Residents in the SEM/DEI track will gain an understanding of current SEM population-based research and become familiar with Emergency Department and community-based projects and interventions aimed at improving the health of underserved communities. The track is tailored to the resident’s interests. Objectives may include participation in didactics, resident and medical student teaching, community outreach, developing SEM/DEI residency curriculum, participation and presentation at the SEM journal club, and attending SEM and DEI monthly meetings and national meetings (ex. EMRA, ACEP, SAEM, or ADIEM). Recent scholarly projects in this track have included research into ED initiation of PrEP for HIV, and development and implementation of a high school health literacy curriculum for an underserved neighborhood.
EMS / Disaster Medicine
At Mount Sinai, our EMS and Disaster Medicine division is robust and includes nationally-known and grant-supported faculty. Residents on this track have hospital-, system- and city-wide opportunities to participate in pre-hospital leadership activities and disaster planning. We work closely with the Fire Department of New York (who runs 911 EMS in NYC) and leverage opportunities there for interested residents. Residents who complete this track will not only learn the principles of EMS, pre-hospital management, and disaster preparedness, but will also gain experience caring for critically ill patients in the field on ride-along shifts, shadow on-line medical control, attend NYC Regional Emergency Medical Services Council (REMAC) meetings, and complete an EMS- or disaster-related scholarly project. Disaster-related efforts include FEMA courses, HERT (hospital emergency response team) hands-on training for decontamination, regional preparedness efforts, and system initiatives to improve readiness. Recent projects have included analyses of pre-hospital notification efficacy and efficacy of EMS handoff strategies for EMS and ED personnel. Many residents on this track go on to top EMS and disaster fellowships and become EMS medical directors.
The Global Health track starts in the PGY-3 year, and emphasizes implementation of sustainable healthcare systems in under-resourced countries. Elective time in both the PGY3 and PGY4 years allows residents to start projects at a site during PGY-3, then assess progress and revise as needed during PGY4. The project-based curriculum is augmented by journal clubs and other activities. Most recently residents have participated in projects in countries including Liberia, Haiti, the Dominican Republic and Laos. Some funding is available for travel, and the Arnhold Institute for Global Health at Mount Sinai is in the process of working on new sites in areas of need.
The Emergency Department provides a unique window into the function, and at times dysfunction, of the healthcare system. Consistent with the Mount Sinai Department of Emergency Medicine’s overall ethos of engaging nationally in all aspects of emergency medicine, a number of Mount Sinai faculty use the vantage point of emergency medicine to perform health policy work in various forms including research and national leadership. The residency has a health policy interest group and supports residents who are heavily involved in national organizations, such as EMRA and the AMA. The scholarly track offers an opportunity to perform a deeper exploration of a single issue while learning about the pathways to creating change and basic principles of health policy. A number of our graduates have gone on the Clinical Scholars Program (formerly Robert Wood Johnson) and other policy fellowships on their way to policy-focused careers.
Ever since the Mount Sinai Department of Emergency Medicine became the first in New York City to go paperless with an electronic health record, several informatics trained faculty have led Mount Sinai to national prominence in informatics. The Mount Sinai Department of Emergency Medicine has a tailored build of its electronic health records, which is continuously being updated for our needs. Our residents have opportunities to be involved in informatics projects at the department, hospital, system, and national levels. Recently this has included working on ACEP’s Clinical Emergency Data Registry. The informatics specialty track is truly a mini-fellowship in medical informatics.
Medical Education / Simulation
The medical education scholarly track adds to the widely-available teaching opportunities at Sinai with journal clubs, education and involvement in curriculum development, involvement in simulation, and mentorship in medical education research. We have supported many of our residents who have been accepted to the Harvard Macy medical education fellowship, usually 2-3 per year. A number of graduates of this scholarly track have found Assistant Program Director or Clerkship Director roles straight from residency, and those opting to pursue fellowships place at the top of their list.
Our simulation program is robust, with faculty at all three sites involved. Both the Mount Sinai Hospital and Elmhurst Hospital have state-of-the-art simulation centers. A number of our faculty have post-residency training in simulation, and we have a full-time coordinator of simulation at Mount Sinai. Residents who have chosen to focus on simulation as part of the medical education track have completed projects and designed curricula that have been presented and disseminated nationally.
Mount Sinai hospital has a renowned Department of Palliative Care which has a strong history of engagement with emergency medicine. Palliative care is a team-based medical specialty which provides an added layer of support in end-of-life decision making and symptom management to seriously ill patients, their families, and their healthcare providers. Residents in the palliative care track improve their skills and knowledge in end-of-life discussions and palliative care best practices by spending time alongside MSH palliative care fellows and attendings. Residents will also have the opportunity to work on improving access to palliative care within the ED and to collaborate with Mount Sinai palliative care researchers on their ground-breaking research.
Our pediatric emergency medicine track benefits from exposure to over a dozen knowledgeable and highly experienced, fellowship-trained pediatric emergency medicine faculty, including 2 of our APDs. The track offers time to increase exposure to PEM including taking advantage of electives across the country, and mentorship in PEM-related projects. Participation in national PEM-related committees and activities is highly encouraged and supported. Residents who have completed our pediatrics scholarly track have gone on to complete some of the best PEM fellowships in the country, at times as the first EM-trained residents to do so.
Residents who choose this track have a wealth of opportunities to develop expertise in quality improvement at the hospital, system and national levels. All Sinai EM residents participate in the resident-run Clinical Quality Review process which informs the departmental QI process, and this program is led by QI-interested PGY-4 residents. Many on this track join the hospital-wide RCA committee, and help develop evidence-based clinical protocols within our department. There are opportunities for involvement with ACEP’s Quality and Patient Safety Committee and other regional and national groups. A number of those choosing this scholarly track have been hired directly from residency into administrative leadership roles in community and academic centers.
The Mount Sinai Department of Emergency Medicine is known as a leader in research, and is consistently one of the top-funded departments of Emergency Medicine. Our department is one of a small number of sites chosen for a K-12 grant training program which consistently successfully launches junior faculty into funded careers. All residents have a mentored research experience during their 2nd year research rotation, and most incorporate research into their scholarly track project. The department has a wealth of research-related resources which facilitate resident projects, from IRB submission to data collection to completion. We have an impressive number of research faculty and they are always interested in mentoring our residents on the research scholarly track. During the scholarly track, residents will be integrated into our research department, attending weekly research meetings and working closely with our research faculty. A number of these residents have gone on to the Clinical Scholars Program and other research fellowships. It is also possible for residents with strong research interest to start the first year of the K-12 program during PGY4-year and complete it the following year.
Residents in this track will attend sports-medicine clinic and learn alongside our fellowship-trained sports medicine/EM and orthopedic physicians. Residents also may have the opportunity to be involved in the medical oversight of the NY Marathon, New York Road Runner races, football games, and other events. Sports medicine track residents teach students and co-residents during orthopedic splinting workshops and participate in national groups such as EMRA’s sports medicine committee and SAEM’s sports medicine interest group. They also complete a sports-medicine related scholarly project, and many residents who complete this track opt to complete a sports-medicine fellowship. A number have developed post-fellowship careers including being team physicians for professional sports leagues and running their own sports medicine clinics in addition to EM practice.
Telemedicine is a newly emerging field of Emergency Medicine and Mount Sinai is at the forefront of innovation in the field. Residents who opt to do the telemedicine track will help understand and further develop our various telemedicine platforms, including MSNOW and Click4Care, which have seen increased demand during the COVID-19 Pandemic.
With multiple toxicologists at both Mount SOur robust and active toxicology division includes over half a dozen expert faculty at both Mount Sinai Hospital and Elmhurst Hospital, including several funded researchers, providing rich mentorship for residents interested in this track. The track involves participation in, and leadership of toxicology simulation sessions and journal clubs, as well as involvement in national interest groups and case-based teaching of our residents. Resident scholarly projects are usually accepted for publication and presentation at national meetings; one even earned grant funding. Graduates of this track usually go on to elite toxicology fellowships around the country and develop fulfilling careers in EM-toxicology.
Mount Sinai Emergency Medicine Residency has many ultrasound faculty at all our sites, including our vice-chair of Ultrasound is among the most popular scholarly tracks. Our Ultrasound Division is led by nationally- and internationally-known faculty educators and researchers. Several residents each year take advantage of the track’s additional clinical exposure to ultrasound, administrative experience in ultrasound QA, education in policy and program infrastructure, and the opportunities to teach medical students, residents, and faculty. All ultrasound track residents are involved in ultrasound-related research projects. The expertise built in this track has allowed residents to match at top fellowships, and on some occasions to earn ultrasound leadership positions without fellowship. The expertise gained in this track is highly relevant to both community and academic EM practice.
The Wilderness & Environmental Medicine track focuses on medical care in remote and austere settings and the unique pathology and technical skills with which it is associated. Interested residents may participate in related activities as early as PGY-2 to obtain advanced educational opportunities and training. Residents in this track assist in conducting the ‘Intro to Wilderness Medicine’ course through the medical school, which includes 1 week of field exercises while backpacking the Appalachian Trail. Relevant elective options, a scholarly project and journal clubs are also part of the track. The track prepares graduates to create and/or lead a wilderness medicine program at their future institution and works to make interested residents competitive in obtaining fellowship positions. Prior residents have gone on to complete formal fellowships at top programs. Areas of concentration may include wilderness medical education, altitude/mountain medicine and dive medicine
Gender and equity in medicine has become an increasingly important topic as we learn more about how diversity in medical providers affects outcomes. Women in medicine specifically face numerous challenging situations from persistent pay gaps, to non-existent or variable family leave policies, to gender bias that influences career progression. Residents in this track explore content that will provides evidence-based and tangible methods for personal development, along with strategies to create change in this realm. Those participating also look to explore gender bias in research, clinical medicine practices, diagnostics and pharmaceuticals through readings, talks and research projects.
With the increased attention and understanding of the importance of wellness in medicine, Mount Sinai Emergency Medicine Residency has become a leader in helping promote wellness practices on a hospital, regional and national level. Those participating on the Wellness track will learn to create and assess wellness initiatives to prevent physician burnout, foster physician mental health, and identify and publish wellness best practices. Residents in this track take on a project focusing on a specific wellness issue, with the goal of publishing or presenting the end product. Residents are also encouraged to develop experience leading the robust efforts of our programs’s Wellness Committees, as well as to participate and learn from the efforts of national professional organizations.