Medical program keeps scoring high

  • Published
  • By Cyndy Karras
  • 59th Medical Wing Public Affairs
LACKLAND AIR FORCE BASE, Texas (AFPN) --  The Emergency Medicine Residency Program at Wilford Hall Medical Center scored in the top three percentile in the nation in June.

Out of 152 emergency residencies across the country, the emergency residency at Wilford Hall scored above 97 percent of the other residencies on in-service training exams for emergency medicine.

The program began in 1977 and started as an Army-only residency program until the Air Force joined 10 years later. It is now the oldest joint-program combining Air Force and Army residents.

"The purpose of the residency is to treat emergency residents," said Maj. (Dr.) Robert Thaxton, assistant program director. "We spend a lot of time and focus on patient care and medical knowledge."

A faculty of 21 Air Force and 15 Army personnel are responsible for training 47 residents overall, which include 24 Air Force and 23 Army residents. Dr. Thaxton says the faculty can devote a lot of time to residents because of a relatively smaller patient volume than other emergency rooms in San Antonio.

The three-year residency includes in-house and country-wide rotations that residents must follow to satisfy graduation requirements. Some of the rotations are in cities such as Austin, Texas; Fort Hood, Texas; and New York. Other rotations are in departments such as the surgical intensive care unit, neonatal intensive care unit, orthopedics, anesthesia, cardiac care unit, toxicology and the emergency department.

Residents also are sent out in military environments to learn how to be an emergency physician in austere conditions. There also are 19 rotations outside of the emergency department from different universities giving residents a better understanding and knowledge of emergency patient care.

"We are blessed to have excellent residents and a complimentary faculty that bring a breath of experience to teach different aspects," said Maj. (Dr.) Robert Kacprowicz, incoming program director. "We are able to draw from their strengths."

What makes the program military-unique is that it aims to send residents across the country for their rotations and has a robust program curriculum where residents are expected to study hard and learn as much as they can while in it, said Dr. Thaxton. The curriculum is centered on what faculty can teach the residents using what Dr. Thaxton calls weekly 'ground-round' teaching.

Emergency residents must complete one publishable research project and participate in monthly procedural and simulation labs where both animals and simulators are used as learning tools. To graduate, residents must be able to identify all life threatening diseases, and must identify, resuscitate and treat any patient.

"When we treat patients, we have a chief complaint and don't have the advantage of knowing the patient's history," said Dr. Thaxton. "We have to analyze on the go."

Quality patient care and ranking in the top 10 percent are things both Dr. Thaxton and Dr. Kacprowicz hope to continue accomplishing.

"We want to keep and promote a joint environment where residents work toward a common goal regardless of affiliation," said Dr. Kacprowicz. 

He also said full credit should be given to Army Lt. Col. (Dr.) Robert De Lorenzo, outgoing program director, because of the work he did to help the residency program score very well.

The emergency residency program has expanded and now offers a fellowship.  That is a first for a military emergency residency. Many of the graduates have gone on to high positions, such as program directors, elsewhere.

Across the Department of Defense, the emergency residency program at Wilford Hall is the most highly sought after and had the most competitive applicants for the year 2007, said Dr. Thaxton. There were 99 applicants and only 16 slots available.

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