Darnall Army Medical Center’s residency program earns maximum accreditation

U.S. Army/Christie Vanover - Makeshift patient 2nd Lt. Imasore lies in a hospital room surrounded by hazards that could lead to infection as part of a training exercise for staff at Carl R. Darnall Army Medical Center during Infection Prevention Week, Oct. 17-23.

By Christie Vanover

Darnall Army Medical Center

public affairs

The Emergency Medicine Residency Program at Carl R. Darnall Army Medical Center recently earned a maximum accreditation of five years from the Accreditation Council for Graduate Medical Education.

The council assesses civilian and military residency programs around the U.S. and awards accreditation terms based on the quality of education provided.

The average accreditation cycle for the 155 emergency medicine residency programs across the U.S. is 4.4 years, according to the council's 2009-2010 data resource book

"Most of our previous accreditations here have been for about three years because of staffing issues due to deployments," said Lt. Col. Melissa Givens, residency director. "This is a civilian accreditation council. One of the things that's important to them is continuity. It took them a long time to understand how we could keep these programs running when we have people coming and going," she said.

The medical duties program is a three-year program that trains Army doctors to specialize in emergency medicine. Each year, eight active duty doctors are selected to join the program.

"We have a very strong curriculum," Givens said. "It's been a product that's been honed over years, and we worked really hard to put it together.

"We have a sophisticated faculty here. I have people on staff who understand learning theory, and we have a diverse way of teaching residents through a combination of didactics experience, written feedback, simulation and hands-on experience. We're able to combine lots of modalities to provide the best education possible."

Capt. Chris Mitchell, a chief resident who began the program in June 2008, agreed.

"The faculty is very interested in making sure that we are well-prepared as emergency physicians," he said. "Any experiences that we feel that we can't get here at Darnall based on patient population, they make sure that we get those experiences at other hospitals."

Residents attend trauma training at Breckenridge Hospital in Austin and inner-city medicine at John Peter Smith Hospital in Fort Worth. Training at the hospital includes caring for the homeless and drug abusers, which Mitchell said is an important part of emergency medicine

"Additionally, we do some of our intensive care unit rotations over at Scott & White just to make sure that we see the very sick ventilator-dependent kind of patient," he said. "A lot of those patients are ones that originate here at Darnall, so that also provides a little bit of continuity of care."

Annually, Mitchell and his classmates are tested on their abilities through an in-training exam, which ultimately prepares them for the boards.

"The last couple of years, we've done very well," he said. "Most of our residents will get in the 80th or 90th percentile among their year groups, which has actually become an expectation almost for our program.

If you step back and look at it, those are pretty high expectations. I feel like my class is very well prepared based on those numbers to take the board exams."

Givens said CRDAMC's EMRP has always been one of the top in the nation among all civilian and military emergency medicine residency programs.

"We were number one for many years running, and we've been in the top five pretty consistently for a long time," she said. "It's something we pride ourselves on."

In addition to training students to excel as doctors, Givens said her staff is responsible for molding the doctors into Army officers.

"That's what makes this program unique is we're giving them two skill sets," she said. "They can go out and work in any ER in the country, but they can also be an Army officer and do all the things associated with that."

"Every aspect of the Army Core Values are emphasized in what we do whether spoken or unspoken," said Mitchell, who never served on active duty before arriving at CRDAMC. "There's a lot about the Army that I have to learn, and it's probably based on the job because I'm focused so much on the emergency medicine aspect of things, but at the same time, the program has really helped me develop as an officer and leader, especially with opportunities like being the chief resident."

Mitchell is scheduled to graduate in June 2011.

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