Emergency Department


Exposure to critically ill patients begins immediately in our Emergency Medicine Residency program. First we start with the big picture via a month of orientation. We focus on the system and community you will be working in for three years. You get to meet the new faculty through social events, and get transitioned in to the ED with orientation shifts. We also have you work with our scribes to learn some valuable charting skills using our EMR. During orientation, interns get an introduction to the different parts of our ED and health care system, including where we receive our patients and where they go when they leave the ED. This includes visits to our nursing homes and homeless shelters, and meeting with community leaders, and specialists. Interns meet every team member in the ED, and receive presentations from respiratory therapists, clinical pharmacists, nurses, chaplains, patient advocates, and social work/case management. Each is focused on enhancing residents ability to work with other professionals in the department. We want you to understand how important the team is from day one and participate effectively. We foster inter-professional development and strive for the best in team based-care.

This orientation is also where each intern meets their ENCoRe (Emergency Nurse Collaboration with Residents) mentor. These are special EM nurses who will be your partner throughout your three years, helping you in the department and beyond. Interns work several shifts in their first year with their ENCoRe nurse. This provides the opportunity to get to know the other nurses, learning how to work with them and understand their scope of practice. It's also a great way to learn how to be efficient in our department and figure out where everything is! ENCoRe nurses also participate with resident didactics and simulation cases to foster team work and provide interaction with a realistic environment.

During orientation we also give an intense ultrasound orientation with 20 hours of didactics and hands on training, making our interns facile in ultrasound. This allows them to use it in the clinical setting in all rotations immediately and expand their experience from day one. Our medical school and hospital system make extensive use of bedside ultrasound. The ED faculty teaches and directs this intense experience to many of the other interns in the hospital. An advanced ultrasound block is also provided later in the intern year.


While rotating in the ED, interns are paired one on one with an attending and work the shift side by side to allow exposure to critical patients from day one that includes appropriate supervision and intense bedside teaching. Second year residents will experience more critical care time and pediatric EM, but will mainly lead the charge in the trauma section of our ED. The second year EM resident is responsible for all trauma airways. Third year residents will lead a care team that is responsible for the "main side", a 16 bed section where our most critical patients land. Third year's also direct critical trauma resuscitations. We ask our residents to work fewer shifts than most programs, with the goal that their leadership, research, and teaching experiences are given adequate time to be meaningful and contribute to the specialty of EM and beyond. Our residents are given the opportunity to teach other residents and students at all levels of their training, even as interns.

The curriculum incorporates a core didactic component and the clinical schedule is based on block rotations.


  • Carilion Roanoke Memorial Hospital
  • Carilion Franklin Memorial Hospital
  • Blue Ridge Poison Center