Dear Applicants,

You are going to face many challenges throughout your career. As you are about to find out, emergency medicine demands of you the most intense involvement personally and intellectually. Every area of clinical medicine is practiced, every emotion is taxed. The challenge is in managing an endless variety of disease or trauma at a level of immediacy that is rarely approached in any other specialty. Residency is a critical juncture in your career, as the habits you form now will forever follow you. Here at Detroit Receiving, we think about this in designing our residency training program. We have an extraordinarily robust and diverse clinical experience with an emphasis on critical care. As an intern, you start with an orientation month and then dive right in to intense learning. You are introduced early on to ultrasound — a tool that is invaluable to the practice of EM. As you progress from a PGY1 to a PGY3, your time spent in the ED and your responsibilities increase, but one thing doesn’t change — you will still work closely with some of the finest attending physicians in the country.

Residency is a time to gain experience in a variety of practice settings. Although our base hospital is in the inner city, our residents also work at Huron Valley Hospital, which is a community hospital. You also rotate at Harper University hospital, which is a tertiary care center caring for patients with complex medical histories, including pregnancy and oncologic related-concerns. Your pediatric EM experience is also exceptional. We are fortunate to have our residents train at one of the busiest pediatric hospitals in the nation, the Children’s Hospital of Michigan.

We take pride in our weekly educational conference series. It is so popular that often there is not an empty seat available. We moved away from the traditional 1-hour lecture format — this is not the way your generation learns best — and replaced it with more active learning sessions and hands-on activities. We also look for opportunities to introduce new technologies into conference. We use the resident website (drhem.com) to post interesting and challenging cases. We have speakers from across the country give talks via Zoom, we have our own web-based Board Review website, and we are supporters of #FOAMed. This is just a taste of where we are headed with integrating the newest educational technologies into the residency. Your education also continues outside of the lecture hall with our state-of-the-art simulation center that our residents get to participate in throughout all 3 years of residency as well as cadaver lab, where you can actually take your time when performing a thoracotomy.

As you are aware, the cornerstone to advancing medicine relies on high-quality research. Our department is flush with research opportunities and is ranked 15th nationwide in NIH funding and ranked 1st overall for Emergency Medicine Foundation (EMF) grants. We have multiple clinical trials ongoing in our ED at any one time. If you have an interest in research, you can work closely with one of the research faculty to develop and implement your own project. Many residents present their research at a National Conference.

We believe in a strong academic culture and a dedication to the finest patient care. On a daily basis, you will face the challenge of administering care to opiate users who frequently overdose, to dialysis patients who utilize cocaine, to diabetics who can’t afford insulin, and alcoholics who are belligerent and abusive. But, you have taken a pledge to care for these patients no differently than the wealthy man having a heart attack or the athletic teenager with a sprained ankle. You have pledged to have an attitude of warmth and compassion, a task sometimes very difficult with our ED population. You will often find yourself acting as the last friend on earth to scores of people who are all but invisible to the majority of Americans. And in that sense, you find yourself affirming human worth and dignity among people too easily and too often dismissed.

As program director, I pledge to stimulate your professional growth, to encourage you to get involved in emergency medicine on a local, regional, and national level, to develop sound clinical reasoning skills, to practice evidence-based medicine, to feel confident in an environment of academic rigor, and to prepare you for life after residency — whether that is in academics, community medicine, as a Director of an ED, or even Chair of a department.

Its been over 40 years since Drs. Ronald Krome, Brooks Bock, Hal Jayne, and Judith Tintinalli began laying the foundation of our residency. These four pioneers dedicated their lives to creating our department, our residency, and the specialty in which we practice today. What I hope for our residents is to aim to live up to their ideals, to continue their vision, and to strive for the same excellence that they practiced since day 1. One of Dr. Ronald Krome’s favorite sayings is that he “receives the greatest joy from seeing his students achieve successes greater than his.” It is my hope that we follow in the footsteps of Dr. Krome and all of the other dedicated physicians that built our great department of emergency medicine here at Detroit Receiving.