The Nuvance Health Emergency Medicine Residency Program is a three-year residency program centered at Vassar Brothers Medical Center (VBMC) overlooking the Hudson River, 75 miles north of New York City. VBMC is a large tertiary-care hospital with an ACS-accredited Level II Trauma Center, Primary Stroke Center and STEMI Center. We are a high-acuity, high-volume emergency department (ED) servicing a very large population. Our ED currently treats 77,000 visitors annually (85% adult and 15% pediatric). To accommodate this ever-growing population, we have relocated to a brand-new hospital equipped with 65 individual care rooms, three trauma bays and a helipad.

Although the majority of residency rotations occur at VBMC, the program is structured to ensure residents are exposed to a wide range of pathology and acuity in various settings. For example, residents gain community hospital experience during their rotations at Northern Dutchess Hospital (NDH) located in the historic, charming town of Rhinebeck, NY. In addition, residents spend three months of immersive pediatric care in the Pediatric Intensive Care Unit (PICU) and the Pediatric ED at the renowned Maria Fareri Children’s Hospital in Westchester, NY.

Residents also have the opportunity to select elective experiences to tailor their residency program to meet their educational goals and objectives. Two months of electives are offered in PGY3 if residents meet program and procedural requirements. Various elective options are available for residents; electives should be discussed and agreed upon with the program director. Elective rotations may be in any emergency medicine subspecialty, research month or other acceptable rotational experience. Some examples of electives are:

• Ultrasound
• Toxicology
• Addiction
• Emergency medical services
• Sports medicine
• Research

An example of one resident’s training in this program is shown below. This is just an example and may be adjusted by the program director to ensure adequate experience and ACGME compliance. The Emergency Medicine Residency Program schedule runs on a four-week block rotation.

Orientation – As a new resident, you participate in an intern boot camp and orientation during your first month here. This orientation will help you adjust to residency life and provide you with an overview of programs, topics and required information. Non-patient care and non-medical knowledge curriculum topics are covered as well, including interpersonal communication skills, professionalism, systems-based practice and practice-based learning and improvements.

Team Health Academic Consortium Zenith Channel – As a resident of the Nuvance Health Emergency Medicine Residency Program, you have access to TeamHealth’s educational resources. Included on the Zenith Channel are various scholarly activity and educational resources, such as videos, documents, electronic textbooks, webinars, presentations and additional information that can be viewed and downloaded.

ABEM In-Training Exam – Residents’ medical knowledge and clinical reasoning will be benchmarked for measuring longitudinal growth through the results of the annual American Board of Emergency Medicine (ABEM) In-Training Exam. All emergency medicine residents complete the exam at the end of February every year. Results are reviewed with the program director to inform discussions and individualization of curriculum and clinical training (e.g., reading material, board prep, and electives).

Academic Conference
Residents attend weekly, five-hour structured didactic curriculum held every Wednesday from 7:30am-12:30pm. Each academic teaching day will cover a broad range of topics via a systems-based approach, which will include lectures, interactive sessions, skills sessions, and simulations.

Board Preparation
In addition to individual studying via access to reputable online modalities such as Rosh Review and EM Coach, residents will have written and oral board preparation lectures during their didactic sessions.

Note/Chart Review Session
Residents will have ongoing chart reviews during EM shifts, as well as by designated core faculty during direct observation evaluations.

Emergency Medicine Specific Lectures
Residents will have ongoing participation in giving formal lectures to their peers throughout the academic year.

Case Conference
Once a month, faculty and residents will attend a case conference during the didactic sessions which will review interesting cases from the prior month and discuss diagnostic, treatment, and management approaches.

Grand Rounds
Once a month, faculty and residents will attend a Grand Rounds lecture given by various hospital faculty which will be specific to the system module of that month.

Journal Club
Residents will be introduced to the selection and interpretation process of reviewing relevant medical literature as it pertains to emergency medicine.

Simulation Education
Residents will get the opportunity to harness the skills necessary for independent practice through a robust simulation experience provided at the Spratt Center for Simulation & Clinical Learning. This opportunity will be available on a monthly basis during their didactic Wednesday sessions and will include individual skills, team cases, interdisciplinary scenarios and formal lectures.

The academic didactic program is a critical element of the Nuvance Health Emergency Medicine Residency Program. Residents are allotted protected time to attend all required didactic and educational sessions.

Mandatory Conferences are held on every Wednesday morning. All lectures are designed to provide residents with a broad range of knowledge on the ACGME competencies and prepare them to provide exceptional patient care.

The following lectures will occur:

Teaching Days – Weekly half-day lectures on a rotating 18-month curriculum (utilizing Foundations of Emergency Medicine topics and lectures)

Interdisciplinary Conferences – Monthly, in conjunction with the Critical Care and Internal Medicine departments

Journal Club – Monthly, presented by a PGY-1 or PGY-2 resident

Grand Rounds – Quarterly, presented by a core faculty member

Quality and Process Improvement (Q&PI) – Monthly, presented by a PGY-2 or PGY-3 resident

Save of the Month – Monthly, presented by a PGY-3 resident

Board Preparation – Monthly, presented by core faculty

All residents in the Nuvance Health Emergency Medicine Residency Program are required to participate in scholarly activity/research and quality improvement (QI). Additional research and QI participation by residents, above the minimum requirements, is highly encouraged. Residents are paired with a faculty mentor for all scholarly activity and quality improvement projects. This mentor assists residents in background research, feasibility, institutional review board (IRB) approval, study design, implementation and analysis.

The goal of the Emergency Medicine scholarly activity curriculum is to advance each resident’s knowledge of the basic principles of research, including how it is conducted, evaluated, explained to patients and applied to patient care. Residents are provided with a variety of resources to facilitate involvement in scholarly activity projects throughout their training.

The Nuvance Health Emergency Medicine Program requires residents to meet the following scholarly activity requirements before graduation.

• One Quality Improvement Project

• One Scholarly Activity Project – Many options are available, including:
  • Author/co-author of a manuscript that receives a PubMed citation
  • Author/co-author of a manuscript of publishable quality, such as a review article, textbook or online chapter, case report
  • Discussant at the national Clinical Practice & Cases competition
  • Poster or abstract presentation at local, regional or national conference
  • Significant participation (as verified by the primary investigator) in a clinical research project.

Each year, the Nuvance Health Graduate Medical Education Department sponsors a Resident Research Day where residents present posters and oral presentations of ongoing or completed research topics.

The Nuvance Health Emergency Medicine Residency Program thanks you for your interest in applying to our program. We accept all applications through the ERAS only and participate annually in the NRMP Match Program. We hope you choose to join us.

The following items are required for interview consideration:

• Personal statement
• Current CV
• Three (3) letters of recommendation and SLOE (standardized letters of evaluation) highly recommended
• USMLE Step 1 CK or COMLEX Level 1 Score
• USMLE Step 2 CS or COMLEX Level 2 PE Score
• USMLE Step 2 CK  or COMPLEX Level 2 CE Score
• MSPE (Dean’s) letter

Timeline: We will interview candidates during select dates in October, November, and December. Exact dates will be provided to the invited residency applicants via email notification.

Why should I come to the Hudson Valley for residency?

It’s beautiful here! It is lovely to enjoy four seasons with apple-picking and hiking with brilliant, colorful foliage in the fall; skiing, sledding, snowboarding and ice skating in the winter; more kayaking and biking in the spring, and enjoying swimming, outdoor concerts, drive-in movie theaters, water parks and more in the summer. We have fantastic restaurants with the Culinary Institute of America 10 minutes away from the hospital and we benefit from a lot of their graduates settling locally. We have multiple local colleges and universities which provide an array of cultural opportunities – the initial Hamilton was workshopped at our very own Vassar College by Lin Manuel Miranda and is known as the Hamilton Mixtape! There is something for everyone here. Within a 30 minute drive you can explore the cities of Poughkeepsie, Beacon, New Paltz, Rhinebeck and Kingston; you can head to the surrounding suburbs to shop at the malls or local stores and enjoy activities like the hot air balloon festival, the Great Jack-O-Lantern Blaze or sunflower festival. You can participate in local farm shares or go horseback riding. For the ultimate city experience, we are only a 1.5 hour train ride along the picturesque Hudson River to get to New York City. It is nice to train in a place where you can see people as much or as little as you like during your time off.

Where will I train?
The majority of training takes place at Vassar Brothers Medical Center in Poughkeepsie, NY, with some rotations occurring at Northern Dutchess Hospital in Rhinebeck, NY. Residents will also spend two months at Maria Fareri Children’s Hospital in Westchester, NY, for their pediatric intensive care unit and pediatric emergency room experiences.

How many residency positions are there?
We accept 10 residents each year for a total of 30 residents within the program. We want our community to be tight-knit and each resident to feel they are an important part of the program while providing an excellent educational experience. We will only be accepting PGY1 positions.

When are the interviews?
Interviews will take place on select dates in November, December and January. If you are selected for an interview, you will be notified via Thalamus.

Will I be able to work with medical students?
Yes! We have rotating MS3 and MS4 from Touro School of Osteopathic Medicine in Middletown rotating on many of the medicine rotation. There are also PA students from Marist College as well as MS4s who rotate from other medical schools.

What has been the impact of COVID-19 on the residents?
We have been fortunate that we have been able to quickly adapt to the pandemic. In the spring of 2020, we only had our inaugural intern class here and for the first wave we protected the residents from exposure to the virus given how little was known about it at the time and out of concern for PPE. Fortunately, we never were in a situation where we did not have the appropriate PPE and for the second wave, residents worked alongside the attendings to care for our patients with COVID-19 both on the medical floors and the COVID-19 dedicated ICU we needed to open up. At our peak we have had around 100 patients with COVID-19 in Vassar Brothers Medical Center. Our conferences have very rarely been interrupted though we have had to use a virtual platform to continue the conference series when the numbers are high out of concern for spread of infection. We also have been able to institute telemedicine to provide some of the outpatient care virtually.

What are the rules around vacation?
Residents have 4 weeks of vacation per year. In general, these weeks are broken down into one 2 two-week block and two 1-weeo blocks.

How do you prepare us for the Boards?
We have purchased Rosh Review for all our residents to use for board preparation. In addition, each resident has a generous annual stipend to use for board materials of their choosing. Also, we have board review as part of the didactic conference series led by faculty and chief residents which helps not only with topic review, but the approach to test questions and developing good test taking skills.

Thank you for your interest in the Nuvance Health Emergency Medicine Residency Program! If you need more information, please contact us. Julia.Demboski@Nuvancehealth.org