The Department of Emergency Medicine gained full academic status in 1994 when Dr. Sheldon Jacobson was recruited to be the first Chair. Prior to that time there was no emergency medicine residency at Mount Sinai, no medical student emergency medicine curriculum, and no defined research agenda. During his fifteen years as the Chair, Dr. Jacobson provided the vision and laid the infrastructure for a Department that has matured into a leading academic, clinical, and research force. July 1, 2009, I became the second chair of Emergency Medicine at Mount Sinai with a commitment to continue promoting the Department’s three primary missions: to provide excellence in patient care, to provide excellence in education, and to conduct research vectored towards acute clinical conditions and health services-related problems.
The Department of Emergency Medicine at Mount Sinai has evolved into a sophisticated department with nine divisions: Research, Ultrasound, Education/Simulation, Prehospital Care and Disaster Medicine/EMS, Pediatric Emergency Medicine, Toxicology, Geriatric Emergency Medicine, Informatics, and Global Health. Each division is integrated throughout our seven site consortium: The Mount Sinai Hospital, Elmhurst Hospital Center, The Mount Sinai Hospital of Queens, Jersey City Medical Center, Queens Hospital Center, North General Hospital, and St. Johns Episcopal Medical Center. The consortium treats over 400,000 patients each year. Elmhurst Hospital Center is one of the busiest level one trauma centers in New York. The Jersey City Medical Center emergency department is the only trauma center in Hudson County and is responsible for EMS medical control.
Our four-year Emergency Medicine Residency has 60 residents, fifteen residents in each year, making it the second largest residency training program at Mount Sinai and one of the largest emergency medicine residencies in the country. Our Residents receive their clinical training at Elmhurst Hospital Center, The Mount Sinai Hospital, and Jersey City Medical Center. The thrust of our training program is to provide a diversified training experience; an experience that is multi-dimensional and which provides our residents with the skills needed to successfully compete in whichever market they identify as their career path. Bedside education stresses application of classical emergency medicine principals in a humanistic and supportive patient environment. Our didactic program emphasizes both basic issues of patient care and cutting-edge emergency medicine practice. We have major new educational initiatives in the areas of ultrasound and high fidelity simulation. Each resident is expected to choose an area of focus by their third year and structure their fourth year establishing expertise in that area, i.e., the fourth year is constructed along the lines of a fellowship.
Our clinical research program is focused on health services, health outcomes, applied informatics, and neurologic emergencies. Fellowships are offered in clinical research, ultrasound, informatics, EMS, pediatric emergency medicine, and in ED administration. We have a strong commitment to multi-disciplinary research and collaborate with many of the other departments at Mount Sinai including Health Policy, Critical Care, Geriatrics, Neurology, and Palliative Care. Our faculty have been successful in securing NIH funding which includes a R01 with four supplements, a R00 and a K23. Faculty also have grants from the CDC, New York State, the RBaby Foundation, Robert Woods Johnson, the Rosenbluth Foundation, and the Brookdale Foundation. Examples of our current ongoing research include investigating the ethical issues of emergency research without informed consent, shared electronic medical records across health care systems, glycemic control in sepsis, pain management in hip fractures, use of ultrasound in the prehospital envirnoment as a guide to resuscitation, use of procoagulation concentrates in hemorrhagic stroke, variations in treatment of geriatric patients associated with ED overcrowding, clinical and diagnostic predictors of outcome from drug overdoses, and the management of traumatic brain injury.
The Department of Emergency Medicine has been instrumental in the development of the Center for Global Health at the Mount Sinai School of Medicine. Our faculty have been intimately involved in the development of emergency medicine in Italy and in Holland. Our current global health programs are active in Italy, Liberia, India, and Singapore; in addition, our faculty coordinate a center of excellence in Queens which is dedicated to treating victims of torture.
Career growth and professional satisfaction are the overarching goals for our faculty development plans. Faculty at each clinical site are responsible for activities within the five elements which constitute our career development matrix. The elements are: clinical service, education, research or other scholarly activities, administration, and community service. The formula for each faculty member differs according to their long-range career goals. Evidence that this program is working is our low rate of faculty turnover and the large number of faculty awards, books, peer reviewed publications, regional and national committee involvement, and other academic productivity indicators.
The Department of Emergency Medicine at Mount Sinai has demonstrated impressive growth since it was established in 1994. All metrics reflect the Department’s commitment to quality and to excellence. Clinically, our performance metrics are within the top 10% of the University HealthCare Consortium; as educators our faculty were awarded over 50% of the Mount Sinai Institute for Medical Education teaching excellence awards in 2009; in research funding we rank within the top 10 of NIH funded emergency departments. Healthcare is in crisis but the Department of Emergency Medicine as Mount Sinai has embraced the challenges of our times and is engaged in training future leaders and in finding innovative solutions.
Andy Jagoda, MD, FACEP
Professor and Chair of Emergency Medicine
