Mission

We believe in shaping the future of military emergency medicine by caring for anyone, anywhere, at any time. Together, we are dedicated to developing ourselves as future leaders of cutting-edge research, education, policy, and military medical leadership.

Vision

• Our graduates will excel in any emergency department in the world, ranging from an urban academic trauma center to a single-coverage rural ED.
• Our graduates will save lives on the battlefield with their clinical skills and critical thinking.
• Our graduates will become innovators and leaders in our specialty.
• Our graduates will become emergency medicine educators; their skills and expertise will be shared to create a culture of health in our military.
• Medical Directors will actively recruit our graduates based upon our tradition of excellence.

Aims

Our program believes in providing amazing opportunities, aims for excellence, thoughtfully considers wellness, and ensures a ready medical force. This will be accomplished by demonstrating our graduates are:

• Lifelong learners and push to advance the science of medicine through our scholarly achievements and educational prowess.
• Leaders in the military and emergency medicine through our military accomplishments and national specialty society leadership positions.
• Provided access to novel and innovative clinical learning environments through our training rotations and access to military unique opportunities.
• The quintessential military officer and physician through their ability to lead by example, compassion, and ability to perfectly balance the needs of the military with their individual needs.
• The best versions of themselves through their achievements, successful careers, and impact on the military overall.

Overview

• On-shift Teaching is typically led by EM 3rd Year Resident, faculty, or discussions regarding the sickest patients in the Emergency Department (ED).
• Grand Rounds (GR): Grand Rounds is our didactics program that includes a combination of traditional lectures and flipped classrooms and prepares you for national emergency medicine qualifying exams.
• Asynchronous learning with supplementary readings and quizzes.

Emergency Ultrasound Curriculum

• Interns attend a comprehensive ultrasound course during their orientation month.
• A four-week block of US training is split between the EM1 and EM3 years with ultrasound procedural training, mastery of core EM Ultrasound modalities, and emergency resuscitative ultrasound under the guidance of our in-house Emergency Ultrasound Fellowship Accreditation Council (EUFAC)-Accredited Advanced Emergency Medicine Ultrasound (AEMUS) Fellowship Program. Weekly Ultrasound didactics, quality assurance, scanning shifts, and journal club.
• Emphasis on incorporating ultrasound during shifts for diagnosis and resuscitation. Residents provided immediate and quality assurance feedback on image acquisition in interpretation to enhance ultrasound skills.

Emergency Medical Systems (EMS) / Disaster Medicine Curriculum 

• Residents are required to conduct Emergency Medical Services (EMS) ride-alongs with our EMS/Disaster Medicine Fellowship Program.
• Longitudinal EMS curriculum throughout grand rounds to include journal club.
• EM3 culminating Mass Casualty (MASCAL) exercise with local EMS, medical directors, and Special Weapons and Tactics (SWAT) teams.

• The SAUSHEC EM Residency Program is three years (36 months) in length and follows the training requirements outlined by the American Board of Emergency Medicine (ABEM) and the Accreditation Council for Graduate Medical Education (ACGME).
• the SAUSHEC EM Residency Program blends military rotations (~60%) with civilian partner rotations (~40%) across eight diverse health systems, providing the broadest training experience possible.
• EM rotations consist of ED rotations at BAMC, University of Texas Health San Antonio, Baptist Health Systems, Christus Santa Rosa Health System, Methodist Hospital Systems, Methodist Children's Hospital, Dell Children's Medical Center, and Texas Children's Hospital in Houston. These rotations focus on building a foundation for professional emergency medicine practice. Residents are expected to be proactive in learning the art and science of emergency medicine and to attain a degree of proficiency in the profession to perform in an unsupervised setting upon graduation.
• Additional rotations include Pediatric Intensive Care Unit (ICU), Medical ICU, Neuro ICU, Burn ICU, Surgical Trauma ICU, Anesthesia, Toxicology, EM Electives, and OBGYN.

• Residents are authorized 2-3 elective rotations throughout the residency.
• Options include additional Community ER, urban/underserved ER, Pediatric ER, critical care/intensive care unit, operational opportunities, and international rotations.
• Residents have also used elective time to attend Critical Care Air Transport (CCAT) training, Air Assault/Airborne School, Expert Field Medical Badge training, and other military opportunities.

• BAMC ED Blocks are 8-hour shifts, with thoughtful waterfall scheduling to optimize resident wellness.
• Each resident will typically work 18 clinical shifts per month with five scheduled admin days to equal 23 out of 28 days with planned activities.
• Each resident will have at least one day (24 hours) per week free from clinical duties. The admin days will coincide with grand rounds, procedure lab, and call days to limit days off that do not feel like days off.
• During a BAMC ED block, residents are scheduled for one to two 24-hour "on-call" shifts to help cover unforeseen shift changes due to personal emergencies.

Multi-Domain Operational Curriculum

• Longitudinal and individualized military operational curriculum to prepare our residents for their first military assignment.
• Dedicated military-specific pearls during grand rounds and incorporation of operational medicine during procedure labs.
• Built-in field simulation during grand rounds to ensure our residents are experts In Damage Control Resuscitation (DCR) and Tactical Combat Casualty Care (TCCC)
• Military Unique Curriculum In Honduras (MUCH) Rotation: A capstone military rotation in Honduras was designed to prepare you for the challenges of providing trauma and medical care in an austere and resource-limited environment, like a deployment. In essence, preparing you to be a military emergency physician and not just a physician working in the military.
• Opportunities for additional operational experiences are possible. Previous operational missions include Chile, Peru, Philippines, Honduras, Uganda, El Salvador, and Guatemala.
• Capstone Operational Emergency Medicine Course/Emergency Medicine Exercise (EMX): This is a month-long course during the last EM block of your residency. This course is set up to give the senior resident a working knowledge of the operational experiences they might encounter in their military careers. The course culminates with a simulated combat field exercise, giving the resident the opportunity to put into practice the theory of operational medicine in a more realistic setting.
• Tactical Combat Medical Course (TCMC): All residents attend TCMC at Fort Sam Houston, a medical pre-deployment course that prepares them for combat readiness at point of injury through higher echelons of care.

Required courses include an intern EM crash course during first month of residency, as well as an intern research course and periodic re-certification of Advanced Life Support (ALS)/Basic Life Support (BLS)/Pediatric Advanced Life Support (PALS).

Procedure Lab

• Provides an opportunity for residents to learn life-saving procedures not commonly done by civilian emergency physicians but may be essential in deployed environments. Procedures performed include but are not limited to thoracostomy, transvenous pacing, pericardiocentesis, resuscitative thoracotomy, cricothyrotomy, suturing techniques, lateral canthotomy, and other procedures.
• At least two (2) dedicated cadaveric procedure labs are offered throughout the year.

Simulation

• Longitudinal 3-year curriculum starting intern orientation month and then weekly Grand Rounds and on-shift simulations. Residents utilize BAMC's state-of-the-art Simulation Department and train on high-fidelity simulators.
• Weekly oral board cases and culminating EM-3 oral case review to prepare for American Board of Emergency Medicine (ABEM) Oral Board exam.
• Intradepartmental training with nursing, medics, and physician assistants, and interdepartmental simulation cases with other medical specialties.

A robust curriculum for developing leaders in emergency medicine and in the military. Opportunities start from day one and increasing levels of responsibility are nurtured over the 36-months of residency. The curriculum includes:

• Leadership and team building exercises
• Peer mentorship
• Quarterly program leadership and mentoring sessions
• Progressive leadership responsibilities on shift, during medical resuscitations, and in the management of trauma patients
• Resident leadership roles, including educational, clerkship, research, wellness, etc.

Opportunities

Robust research opportunities are available with hundreds of publications generated per year and tens of millions of dollars in grant funded research. Completing a scholarly project is a requirement for graduation from the residency program.

Scholarly Track Program (STP)

An optional excellence program allows residents to dedicate up to 480 hours of their training in a specific area of interest. Residents are mentored by distinguished faculty and have the opportunity to participate in local, regional, national, and international experiences.

Available STP areas:

• Emergency Medical Services (EMS)/Disaster Medicine
• Advanced Emergency Ultrasound
• Operational and Austere Medicine
• Research
• Hyperbaric Medicine
• Toxicology
• Health Policy
• Critical Care Medicine
• Simulation

Residents participate in helping to improve the healthcare system for our patients. Residents will be educated in quality improvement and patient safety (QIPS) principles through the completion of the SAUSHEC EM QIPS core curriculum.

While developing excellent emergency medicine skills, the SAUSHEC EM Residency also focuses on developing future military EM leaders through mentoring and modeling.

Funding for residents to attend at least one professional conference during residency when presenting a scholarly activity. Residents have given national lectures, research podium presentations, held national leadership board positions, and taught procedural courses at American College of Emergency Physicians (ACEP)/Emergency Medicine Resident's Association (EMRA), American Academy of Emergency Medicine (AAEM), Society for Academic Emergency Medicine (SAEM), Government Services Chapter of American College of Emergency Physicians (GSACEP), Special Operations Medical Association (SOMA), Military Health System Research Symposium (MHSRS), Association for Military Osteopathic Physicians & Surgeons) (AMOPS), Council on Residency Directors of Emergency Medicine (CORD EM), American Association of Nurse Practitioners (AANP), Air Force Physician Assistant Refresher Course (AFPARC), and other professional societies.

Our Participating Sites include: 

• University of Texas Health San Antonio
• Texas Children's Hospital
• Christus Santa Rosa Westover Hills Medical Center
• Methodist Stone Oak Hospital
• Methodist Main Hospital
• Methodist Children's Hospital
• Methodist Texsan Hospital
• CHRISTUS Children’s
• Hospital Escuela
• Rocky Mountain Poison Center/Denver Health
• Dell Children's Medical Center
• Baptist Health System
• Christus Santa Rosa Health System
• Methodist Health System

• Our program offers rotations to fourth-year medical students, and third-year medical students on a space available basis, interested in applying to Emergency Medicine.
• Rotations are typically four weeks (one block) long and include multiple clinical shifts, didactic opportunities, simulation experiences, and catered time for learning about the values and culture of the program.
• Students interested in rotating with our program should contact dha.jbsa.brooke-amc.list.saushec-em@health.mil and follow guidance through SAUSHEC Graduate Medical Education regarding rotation logistics.

If you would like to schedule an interview with our program, please contact dha.jbsa.brooke-amc.list.saushec-em@health.mil.

Program graduates take the American Board of Emergency Medicine (ABEM) qualifying examination and oral exam, offered annually.

To become fully board certified, applicants are eligible to take board certification exam 3 months following graduation.

To be eligible to take specialty board exams, graduates must complete all pre-requisites required by the ABEM by October 31st. Board eligibility is described on the ABEM website. Graduates remain board eligible for up to two five-year periods following completion of the residency.

Residents are expected to assume increasing levels of responsibility as teachers to their peers in the department throughout their time.

Residents offered opportunity to teach courses and local, regional, national, and international conferences including ultrasound, emergency procedural skills, and lecture military and emergency medicine.

Our diverse faculty have subspecialty training in the following:

• Advanced Emergency Medicine Ultrasound
• Emergency Medical Services (EMS) and Disaster Medicine
• Critical Care Medicine
• Pediatric Emergency Medicine
• Hyperbaric Medicine
• Toxicology
• Research
• Administration

Residents are split into mentor families with assigned faculty. Mentor families participate together during grand rounds, flipped classroom, journal club, and offsite wellness events.

• The entire residency program and its curriculum have been restructured to ensure maximal opportunities for resident wellness consistently over the course of the 36-month residency. We have worked to consolidate all official activities in such a manner as to maximize off time without reducing the maximal opportunities for training.
• Residents will be afforded four (4) Resident Wellness Days every academic year.
• Residents may participate in an optional Wellness Committee geared at optimizing program wellness and involvement with hospital-wide peer wellness and support groups.