Emergency Medicine

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Disaster Medicine Fellowship

Disaster medicine is an emerging subspecialty of emergency medicine. With the medical response needed for natural disasters, epidemics and man-made events such as terrorist attacks and wars, there is an increasing need for a specialty that recognizes the specific injury and disease patterns associated with disasters. This field is also responsible for promoting research and science into the systems-wide approach needed for disaster preparedness and response.

The Disaster Medicine fellowship at IU School of Medicine is designed to provide graduates with in-depth training in the multiple facets of disaster medicine that prepares them to earn leadership positions in disaster response agencies, hospital or public health emergency management organizations, and policy and preparedness organizations. This one-year fellowship takes a multi-disciplinary approach to disaster preparedness, response and recovery. The fellowship provides a wide exposure to multiple areas of disaster medicine and offers educational experiences at the local, regional, national and international levels.

Curriculum

This fellowship is largely conducted in Indianapolis at one of the primary educational sites but also requires rotations at outside educational facilities or other clinical sites. Since the availability of these educational opportunities may change from year to year, and the individual fellow’s academic or research interests may vary, some flexibility is built into the curriculum.

The dynamic curriculum in this program immerses the fellow in a variety of EMS settings:

MESH Coalition is a non-profit, public/private partnership of health care systems whose mission is to assist local healthcare facilities in their disaster preparedness activities. These activities include training and hospital-based emergency management activities. The fellow works closely with the staff at MESH as part of his or her educational experience and can expect to participate in quarterly District 5 meetings, monthly meetings with the emergency management committee for IU Health Methodist Hospital; Riley Hospital for Children at IU Health; and Sidney and Lois Eskenazi Hospital, as well as quarterly MESH grand rounds sessions.

The Disaster Medicine fellow works closely with Indianapolis EMS and with the IU School of Medicine EMS fellow. The fellow participates in bi-monthly ride-along shifts with individual EMS crews, duty officers or district lieutenants; daily monitoring of the mass casualty paging system; responding to all mass casualty incident pages, either at the MedMACC or on-scene (typically one per month); monitoring and responding on scene to all hazmat incident pages; working with IEMS leadership and EMS fellow to plan for a mass gathering event; and observing one EOC activation.

Many opportunities exist for quality training at off-site locations, whether through formal courses or via experiential learning. During a typical year, the Disaster Medicine fellow attends four or five off-site activities, which are determined on a case-by-case basis with the fellow and the fellowship directors depending on availability and the fellow’s academic interests. Possible activities include USAMRID/USAMRCD chemical and biological casualty care course at Ft. Detrick in Maryland; health care surge course at the Center for Domestic Preparedness in Anniston, Alabama; hazmat course at the Center for Domestic Preparedness or at an alternate site; international rotation at JFK Hospital in Monrovia, Liberia; health policy rotation at the Veterans Administration, Center for Medicare/Medicaid Services (CMS), the Centers for Disease Control (CDC) or the office of the Assistant Secretary for Preparedness and Response (ASPR); rotation at the Indiana State Department of Public Health; and wilderness medicine course, combat medicine course or confined space medicine course at various training locations.

The official textbook for the Disaster Medicine fellowship is Koenig and Schultz’s Disaster Medicine. Disaster Medicine fellows complete regular reading assignments and discussions each week. Each month, the fellow is required to find, discuss and critically appraise one current study in disaster medicine. This monthly journal club is open to faculty, residents, medical students and others interested in disaster medicine.

During the year-long program, the Disaster Medicine fellow develops and completes a scholarly project, which may be a research project, curriculum development or other scholarly activity approved by fellowship directors. Early in the year, the fellow undergoes an intensive, two-week research mentorship project with one of the IU School of Medicine Emergency Medicine research faculty, who assists the Disaster Medicine fellow in development of his or her academic project. The scholarly project should result in a publication or a presentation at a national-level conference.

The Disaster Medicine fellow works a total of six clinical shifts per month at Eskenazi Hospital, one of the three primary teaching sites for the IU School of Medicine Department of Emergency Medicine. The fellow is responsible for direct supervision and clinical teaching of the Emergency Medicine residents, medical students and other rotators in the department. The Disaster Medicine fellow is responsible for ensuring that his/her clinical duties do not interfere with required fellowship responsibilities, and all scheduling is completed through the assigned departmental representative. Any additional clinical time must not violate duty hour limits as set forth by the RRC.