EM1 Overview

Your experience during the first year serves as the foundation for your emergency medicine career and emphasizes training in the emergency department, experience resuscitating and stabilizing critically ill or injured patients, as well as developing a deeper understanding of the care they experience after admission into the hospital. Rotations focus on building a knowledge and procedural base that will be vital to success in the EM2 and EM3 years, and beyond.

Your entire first-year class will begin residency with one month of interactive discussions, focused chief complaint-based educational sessions, and hands-on procedural skills labs during the highly regarded orientation block. Throughout the month there will be shifts in the DRH ED, where you can apply your skills and knowledge while getting to know the staff, flow, logistics, and routine of our ED. Weekly social events ensure that you get a chance to know your co-residents and faculty outside the hospital and familiarize yourself with the city!

Eight additional weeks in the DRH ED are built into the first year, and for most shifts, you will work with a dedicated attending and third-year resident. First year residents aren’t “shielded” from seeing high-acuity patients or patients with specific chief complaints. You will take care of the regular mix of ED patients and will begin to run resuscitations with one-on-one coaching from a faculty member toward the end of the year.

To develop a strong foundation in pediatric emergency medicine, you will spend eight weeks in the ED at the Children’s Hospital of Michigan (CHM) your EM1 year. For the remainder of residency, CHM shifts will be spread throughout each EM block during the year with a dedicated two week block in your third year, so you can also appreciate the seasonal trends in pediatric emergency medicine and bookend your residency with some solid pediatric exposure.

Two well-received critical care months anchor the off-service experience in the first year. In the Neurocritical Intensive Care Unit (NICU), you will manage patients with complex neurologic and neurosurgical emergencies, such as strokes, intracranial hemorrhage, and traumatic brain injuries. In the Medical Intensive Care Unit (MICU), you will care for a population of patients with diverse critical care needs and gain experience with ventilator management, vascular access, invasive hemodynamic monitoring, and bedside ultrasound. Both critical care rotations are structured to maximize your return on investment with transportable knowledge and skills that you can apply in the emergency department setting.

Four weeks of full-time emergency department ultrasound training will lay the foundation for integration of bedside imaging into your everyday practice as an emergency physician. The rotation is entirely in the ED and is team-taught by fellowship-trained EM ultrasound faculty and US fellows.

Trauma Surgery/Burn ICU

While on the surgical service, you will manage patients with both traumatic and non-traumatic perioperative surgical concerns. You will also develop further experience participating in trauma resuscitations in the emergency department and will have the advantage of exposure to these situations from both an emergency medicine and surgical perspective. During your Burn ICU rotation, you will gain experience caring for critically ill patients with severe burn injuries, focusing on advanced resuscitation, ventilator management, wound care, and the treatment of burn-related complications. Together, these experiences provide a strong foundation in the care of critically ill surgical and trauma patients across the continuum of care.

The anesthesia block at Huron Valley Sinai Hospital is structured to provide you with intensive experience in airway management, rapid sequence intubation, difficult airways, and procedures such as fiberoptic intubation and use of intubating LMAs. In addition, you will learn more about regional anesthesia, nerve blocks, and anesthesia pharmacology from faculty anesthesiologists and will apply your knowledge to intubation, procedural sedation, and pain management in the ED.

In addition to integrated hand surgery and spine surgery experience, you will rotate on the Orthopedic Trauma service at DRH and hone your skills in x-ray interpretation, wound management, fracture and dislocation reduction, immobilization, and splinting. This rotation is a night-based rotation, allowing you to avoid daily morning rounds and focus mainly on ED orthopedic consults and their subsequent management.

During your two weeks at Hutzel Women’s Hospital, you will have plenty of opportunity to perform routine and high-risk deliveries and to manage the complications that occur during the peripartum period. You will also become facile with obstetrical ultrasound while evaluating patients who present with pregnancy-related concerns.

Interns will spend a dedicated two weeks riding along with Detroit EMS, both on advanced life support (ALS) and basic life support (BLS) units. This valuable experience highlights where your patients are coming from, the prehospital challenges encountered in caring for them, and is a chance to see the city from an entirely different perspective. Additional time is spent performing online medical control answering radio calls and on ride time in the physician response vehicle with the EMS fellow.

Everybody has unique interests in medicine, and this is your opportunity to pursue additional training in an area of your choice. Popular electives include EKGs, pharmacology, medical student teaching, advanced EMS, additional critical care time, international medicine, and clinical or basic science research. You are also free to design your own in an area of your choice!

EM2 Overview

The second year emphasizes the development of clinical skills necessary to evaluate and treat patients in the emergency department setting. You will work closely with EM faculty to effectively investigate the chief complaint, consider “can’t miss” diagnoses, and discern which diagnostic tests or studies are necessary to either identify and exclude emergency conditions. You will be the team leader in resuscitations and learn to approach patients with life, limb, or reproductive threats in an organized manner. You will learn to multitask effectively and maintain patient flow as you gain confidence in your clinical decisions and ability to disposition patients effectively and safely. All EM blocks will have shifts at DRH, CHM, and Harper University Hospital (HUH). There will be one full EM block (4 weeks) based at Huron Valley-Sinai Hospital (HVSH) in order to obtain community medicine experience, with longitudinal shifts there monthly onwards.

Quite unique to DRH is the ED Critical Care block, during which you will spend a month in the DRH ED garnering concentrated bedside experience managing critically ill ED patients. This is not an ICU-based rotation, with 100% of time spent in the ED. With built-in faculty support, you will be responsible for participating in all medical and trauma codes and function as an adjunct “floating” resident for critical patients throughout the ED focusing on their minute-to-minute management. During downtime, you will receive focused didactic training in areas such as sepsis, oxygen delivery, shock, therapeutic hypothermia, mechanical ventilation, difficult airway management, pharmacology, and pre-hospital critical care. You will also assist the intern ultrasound resident with procedural education by overseeing their procedures as well as ultrasound scans until they are competent to perform these procedures on their own. 

Experience caring for critically ill children is highlighted in the Pediatric Intensive Care Unit at Children’s Hospital of Michigan in their newly-renovated unit. This is one of the few and one of the busiest PICUs in the state and you will care for patients who are transferred in from across the region. Teams are composed of EM and pediatric residents, PICU fellows, Pediatric Intensivists, as well as Pediatric Cardiothoracic Surgeons. You will help manage rare pediatric conditions, congenital cardiac conditions, as well as post-cardiac or transplant surgical patients. You will receive thorough didactic education during this rotation, especially during your time spent on the cardiac team. You will learn the essentials of pediatric resuscitation and pediatric critical care, treating pediatric patients of all ages, and rarely some adults admitted for known congenital issues.

Harper Medical Intensive Care Unit

A challenging but extremely rewarding rotation, the Harper MICU has been a well-received and integral part of EM2. You will function as a senior resident, managing critically-ill patients with a variety of pathologies, including patients in the cardiovascular ICU as well as Karmanos Cancer Institute ICU. This rotation highlights a slightly different patient population than the DRH MICU experience in EM1, with added responsibility as a senior EM resident and a broader breadth of pathologies seen in a quaternary care center.

Starting as a EM2, residents will complete a 4 week block at HVSH in Commerce Township, just a short drive from Detroit. A busy community hospital, HVSH provides valuable experience seeing both adult and pediatric patients, and is representative of what bread and butter emergency medicine is like. This experience will develop your communication skills in discussing cases with primary care physicians and consultants and you will gain perspective in assessing when and what types of patients need to be transferred to a higher level of care. After completing a dedicated month at HVSH, residents will be scheduled there for monthly shifts spanning the remainder of residency ensuring longitudinal community EM experience.

EM3 Overview

This year is dedicated to the complete practice of emergency medicine. During each EM block, you work shifts at DRH, CHM, Harper University Hospital, and Huron Valley-Sinai Hospital, covering the entire spectrum of emergency care. At each site, you will be exposed to a unique clinical experience, the sum of which will prepare you for virtually any academic or clinical practice for your emergency medicine career. Residents take a leadership role in the department, owning the workflow and working closely as resident teachers with rotating medical students from Wayne State University School of Medicine, Michigan State University College of Osteopathic Medicine, Central Michigan University School of Medicine, and Meharry Medical College among others.

Toxicology

As part of the Toxicology rotation, you will rotate at the Michigan Poison and Drug Information Center (MiPDC) operated by the Wayne State University School of Medicine, which is the ninth largest poison control center in the US serving 18 counties of southeastern Michigan. The PCC provides 24/7 service to the public and health care professionals with an annual call volume of approximately 70,000 calls. You will work alongside Medical Toxicologists and Toxicology Fellows answering emergent consults and reviewing cases from the area. Additionally, you will spend time seeing routine toxicology inpatient consults and medication assisted therapy addiction medicine consults in our Detroit hospitals.

Pediatric Anesthesia

During the pediatric anesthesia block, you will spend two weeks with pediatric anesthesiologists learning pediatric airway management in a controlled environment. The skills learned during this block are invaluable and easily transferable to the rest of your career as an emergency physician. By the end of the block you will have significant exposure to a variety of pediatric airways and have the skills necessary to transfer to the ED environment when needed

Research

Scientific evidence is the truly the only avenue to change that positively impacts the health and wellbeing of our patient population. The Emergency Medicine Research Program at Wayne State University has a track record of actively addressing the needs of our patients by conceiving, designing, and conducting funded research projects in the areas of neurological emergencies, resuscitation, sepsis, palliative care, toxicology and heart failure. We are one of the few programs in the country with a world class clinical and basic science program. This allows us to test new therapies at the bench and then validate them at the bedside.

The Department of Emergency Medicine at Wayne State University has a rich history of generating paradigm-shifting and practice-changing publications in the leading medical and basic science journals. Further we have an established track record of securing extramural funding from the most competitive funding sources. Our Research faculty is committed in their roles of teaching and mentoring medical students, residents and fellows in order to advance the specialty and cultivate the next generation of clinical scientists.

The Department of Emergency Medicine at Wayne State University has a rich history of excellence in both the basic science and clinical research arena. That tradition continues, with the breadth and quality constantly escalating. Our short-term goals are multiple and include the integration of a traumatic brain injury focus and the development of a multi-center collaborative. We plan to look a number of diagnostic modalities to assess patients with mild to moderate brain injuries. We plan to utilize EEG, serum markers of neuronal injury and functional MRI technology to predict long-term prognosis and predilection for post-concussive syndrome. We are also in the early stages of integrating the multiple Wayne State University affiliated emergency medicine programs into the Southeast Michigan Acute Research Trials network, (SMART). This network when established will have huge breadth both in numbers, (850,000 pts/yr) and in demographics. The network will be a collaborative effort with representatives from each of the participating centers and will serve to conceive and promulgate clinical research studies.

Our short-term goals in the basic science lab are to establish a stroke and traumatic brain injury rat model to accompany our cardiac arrest model. Our long-term goals are to establish a seamless neurologic injury translational model. Our short-term goals will allow the research, development and of therapies aimed at reducing neurologic damage from a number of insults. The therapies will be developed and tested in the basic science lab and will then be validated in clinical trial utilizing the SMART network. Further we plan to nurture and expand our excellent cadre of research scientists, train the next generation of scientists and improve the lives of our patients.

The Cerebral Resuscitation Laboratory, under the expert direction of Thomas Sanderson, Ph.D, is conducting basic and translational investigations of organellar dysfunction, growth factor signaling, and neuroprotective mechanisms in global brain ischemia, focal ischemic stroke and traumatic brain injury

Our clinical research department is blessed with bright, energetic and committed faculty under the solid direction of Robert Welch M.D. Our areas of clinical research interests are as diverse as our faculty.

WSU is a hub for the NIH sponsored Neurologic Emergency Trial Network, (NETT) site and actively participates in the direction and recruitment in these trials. Robert Welch MD is the PI for this network with Dr. O'Neil serving as a co-PI on this project. Our main neurologic research interests are stroke and mild to moderate traumatic brain injury.

Dr. Phil Levy is our passionate expert in congestive heart failure and hypertension. His studies investigate both the diagnosis and treatment of these conditions.

Dr. Robert Sherwin is our talented sepsis and critical care expert. His research interests include infectious disease, sepsis and its monitoring and resuscitation.

Dr. Brian O'Neil, in a direct extension of his basic science training, has been conducting research into the re-animation of post-cardiac arrest patients. His research has focused on therapeutic hypothermia, its utility and mechanisms and the use of cerebral oximetry to predict neurologic outcomes and direct medical therapy.

Level 1 adult trauma center in downtown Detroit
High-volume, high-acuity urban population
At DRH, virtually all admissions are initially evaluated and managed in the ED, and residents are primarily responsible for the care of nearly every patient. You will have ample opportunity to care for high-acuity patients with undifferentiated complaints and will be integrally involved in decision-making regarding diagnosis, treatment, and disposition. This is a patient population with diverse pathology and advanced stages of disease with plenty of opportunities for procedural and resuscitative experience.

Level 1 Pediatric Trauma and Burn Center
Tertiary pediatric care + “bread-and-butter” pediatric emergency medicine
CHM is adjacent to DRH on the medical campus and is the site of integrated pediatrics training throughout the residency. In this high-volume pediatric ED, you will care for infants and children with presentations typical of an inner-city emergency department side-by-side with pediatric patients with long-term, complex medical conditions. You will have concentrated pediatrics emergency medicine training for two months in the first year, spend one month in the second year managing patients in the Pediatric Intensive Care Unit (PICU), and have integrated pediatrics shifts during each emergency medicine block of the second and third years in the high acuity pod of the CHM ED.

Tertiary referral center for complex medical patients.
Routine and high-risk obstetrics and gynecology

Also co-located with DRH, Harper University Hospital will provide you experience managing patients with complex malignancies, organ transplants, and end-stage medical conditions in the Medical Intensive Care Unit (MICU) as second-year resident. In the EM3 and EM2 years, you will also be responsible for evaluating, stabilizing, and managing these patients Harper ED shifts integrated into emergency medicine blocks throughout the year.

During the first year, you will rotate on the busy obstetrics service at Hutzel Women’s Hospital inside HUH, with plenty of opportunity to perform routine and high-risk deliveries and to manage the complications that occur during the peripartum period. You will also become facile with obstetrical ultrasound while evaluating patients who present with pregnancy-related concerns.

Community-Focused Care
Located in Commerce Township in suburban Metro Detroit, Huron Valley Sinai Hospital provides a robust, high-volume, community emergency medicine experience that begins as a EM2 and continues longitudinally for the remainder of residency. Routine adult and pediatric cases are the norm here, with a greater focus on ED management as opposed to consultant management. Residents gain valuable experience performing many orthopedic and minor surgical procedures here in a practice representative of community EM. HVSH also houses the EM1 anesthesia rotation, where interns gain experience in routine airway management and regional anesthesia.

Salary (2026-2027)

Residents are paid on a PGY pay scale with an increase in salary during each year of their training.

​Meal Cards: $600/year

Resident Benefits

Memberships

Resident stipends go toward membership in both EMRA and ACEP for the duration of residency.

​Conferences/Travel

All EM2 residents travel to SAEM each year. All EM3 residents travel to ACEP each year. 

 Residents who have posters accepted to a conference are eligible for up to a $1500 reimbursement for travel and conference fees for each conference that are not within their conference travel year.

 ​Vacation and Wellness Days

• All residents receive three weeks of paid vacation every year, plus 1 week for Step 3, ITE prep or job/fellowship interviews respectively. 

• All residents are given 36 hours off with their class each year for a class retreat.

• All residents are allowed 3 personal days in addition to their usual monthly schedule requests, where they will be scheduled for one less shift during that block.

​Educational Stipend

​All residents receive $2,500/year toward educational material and/or conference travel.

All residents receive a free subscription to Rosh Review for the length of their training.

Moonlighting

Residents in good standing can start external moonlighting in their EM3 year.

​Parking/Transport​

Residents receive free employee parking at all hospital sites.

​Health Insurance

Residents and eligible dependents are provided medical, dental, vision insurance. They also receive life insurance and long-term disability insurance.