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Texas College of Emergency Physicians
Texas EM Residency Updates - October 2013
Welcome to another exciting installment of the Texas EM Residency Updates. We hope you enjoy this month's feature Residency.
   Christus Spohn Emergency Medicine Residency

Daniel Leverenz, MD
Co-Chief Academic Resident, 2013-14

I am a backpacker, so you will have to forgive me for the following metaphor, but this is the way I make sense of the world...

There are two ways to train for the wilderness.  The weaker way is to sit at the feet of an experienced and grizzled fellow in some sort of thinly fluorescent classroom, looking at maps and reading old books, preparing one's mind for the peaks and storms and boulder fields ahead.  The stronger way, of course, is to follow that grizzled old fellow deep into the woods, boots tasting mountain dirt, back sore from a heavy pack, hands warm by twilight fire.  It is a simultaneous training of the mind, the body, muscles, feet, and heart.

Emergency Medicine is a veritable wilderness, defined by rocky scrambles, lovely forests, wild animals, story-worthy summits, and dark night valleys.  Needless to say, our time in residency is that first rugged and weary trek that transforms limp and pale medical students into strong men and women with powerful hands, sturdy hearts, prepared minds, and steady feet.

It is with this understanding that I wish to express my profound honor in having spent the last two years in Corpus Christi as a resident at the Christus Spohn Emergency Medicine Residency Program, affiliated with the Texas A&M Health Science Center.  Having recently started my third year, I find myself looking ahead to my career beyond graduation, and - with all appropriate humility - I am thankful to express my confidence that I will be fit for the Wilderness.  For those of you who are students interested in Emergency Medicine, I want to introduce you to our program.  And for those readers already in practice, I want to solidify our burgeoning reputation as a site of excellence for training Emergency Medicine Physicians and Resuscitationists.  We are a young program in Texas, but our strength is in our youth and our energy.

We do not train at a giant academic medical center, replete with residents and fellows in every conceivable specialty and super-sub-specialty.  Instead, we have the truly unique experience of training essentially unopposed at the two critical care referral hospitals for the virtual entirety of South Texas.  What does this mean?  It means that we are first-in-line for every conceivable resuscitation, procedure, and intervention performed on our patients.  Every intubation, every reduction of a fracture or dislocation, every central line, chest tube, cardioversion, pericardiocentesis, thoracotomy, and ultrasound is ours for the taking.  When resuscitating a major trauma, we never have to "hand off" to the Trauma team, because we are the Trauma team.  The same phenomenon occurs with medical and surgical ICU patients.  Additionally, we work directly with our Attendings on every service, and never stand in line behind any other kind of resident or fellow.  This provides us with a certain proximity to expertise and camaraderie as an essential member of the medical team that is truly remarkable.  As a consequence, we are granted a degree of autonomy and exposure that I would argue is unrivaled anywhere else in Texas, or perhaps the nation.

Although we may colloquially be referred to as a "community program," the term implies that our patient population is defined by a certain degree of civility and benignity that could not be farther from the truth.  We serve a population that suffers both logistically and culturally from a profound lack of access to primary care, which leaves us up to our elbows in sick and crashing patients.  We launch ourselves into the fray every time we come to work, which grants us tremendous mastery and serenity in the face of disaster.  We are guided by a small but hardy and brilliant crew of attending physicians who are as kind and supportive as they are accomplished.  Being a relatively small program allows us to maintain a certain intimacy with our faculty that allows our shifts and conferences to be particularly productive, as they know our weaknesses, strengths, and rhythms as well as we know theirs.  Additionally, our size allows us to remain nimble and adaptive to our community, our hospital, and our residents, all of which compounds our camaraderie and enhances our experience.

Though small and "community-based," we have enjoyed consistent success at state and national competitions, and our research has been well-represented at state and national assemblies such as TCEP, ACEP, and SAEM.  Additionally, the program has enjoyed consistent improvements and progress including a technological overhaul to our Simulation Lab, the addition of Wilderness Medicine and International Medicine rotations and affiliations, and the recruitment of new faculty with qualified specializations in research, ultrasound, and toxicology.

Not only is the training exceptional, but so is the lifestyle.  Where else in Texas (or the country) can you go surfing and work a swing shift in the same day?  There is world-class fishing and kiteboarding, sea and flatwater kayaking, stand-up paddling, windsurfing, sailing, dolphin-watching, birding, and endless beaches to enjoy during our time here.  
Though most residents probably find themselves desperate to complete their training, I know that I am going to miss this place when I graduate and move on.  In keeping with the metaphor, I am so thankful for this glorious opportunity to dive deep into these thick woods and mountains, following the expert guidance of my wise mentors who are now trusting me to lead.  They have trained me well, and watched me closely to see how my hands have grown stronger and my feet have become sturdier, and I will be forever grateful for their wisdom.  This is not a place for mere thinkers or writers or speakers.  This is a place for mountaineers, fit for the wilderness.  Not just practitioners, but Physicians, rugged and brilliant, finely tuned, and trail-proven.

Texas College of Emergency Physicians
2525 Wallingwood Drive, Bldg. 13A | Austin, Texas 78746
Phone: 512.306.0605 | Toll Free: 800.TEX.ACEP | Fax: 512.329.8943

 Contact Information
Phone: 800.839.2237
E-Mail: texacep@gmail.com
Web: http://www.texacep.org/
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