Emergency Medicine Residency

The Emergency Medicine Residency Program at Adena Regional Medical Center (ARMC) in Chillicothe, OH is a four-year, AOA-accredited program that is in the advanced stages of transitioning to a three-year, ACGME-accredited program as the US Graduate Medical Education (GME) system completes its transition to a Single Accreditation System (SAS).  The program is currently fully accredited and in good standing with the AOA, and is now an ACGME Initially Accredited 3-Year Emergency Medicine Program.

The Emergency Medicine residents at Adena see a full range of pathology, including trauma victims, critically ill adult and pediatric patients, orthopedic injuries, surgical conditions, gynecologic disorders, psychiatric disorders, as well as general medicine patients representing a full spectrum of illnesses and injuries. Many patients go directly from the Emergency Department to the intensive care unit, the operating room, the catheterization lab, are admitted for medical/surgical conditions, or are transferred to Level 1 Trauma Centers or tertiary referral centers.

Over the course of the training program, the resident learns to rapidly evaluate medical/surgical problems which present to the Emergency Department, making evidence-based diagnostic and therapeutic decisions with gradually increasing independence. They develop an awareness of the ethical and legal risks that can result from therapy, understand the importance of providing cost-effective medical care, interact with a wide array of specialists and allied health professionals, become proficient in critical thinking, learn to manage mass casualty situations, and participate in disaster planning for the hospital and community.  Patient care and patient experience are both heavily stressed, as both are critical to the mission of our institution and of our program. 

In addition to clinical experience and bedside teaching, the residents attend weekly didactic learning sessions, interdisciplinary case conferences and present at conferences. The didactics program is nearing completion of a complete overhaul from a lecture-based format to a more interactive model, utilizing modern educational concepts such as the flipped classroom and spaced repetition.  The centerpiece of the didactics program is our weekly 2-hour facilitated discussions, which cover the entire core content of Emergency Medicine over the course of training.  The discussions cover EM topics in a Q&A format after the residents have completed their assigned readings on the topic (including textbook chapters, articles from the medical literature, podcasts and blogs).  These discussions are facilitated by faculty as well as upper level residents.  In addition, the didactics program incorporates regular simulation sessions, board review, biannual mock oral board sessions, case presentations, journal club, procedure labs, Lincoln-Douglas style debates on controversial topics, and structured, recurring curricula in Emergency Ultrasound, Osteopathic Manipulative Therapy, Patient Experience, Physician Wellness, Medical/Cognitive Errors, Critically Evaluating the Medical Literature, and EKG Interpretation.  Like every aspect of the program, changes in didactics components are guided by feedback aggressively sought by the Program Director from the residents as well as core faculty.

The ultimate goal is for our graduates to develop not just competence, but expertise and leadership skills in Emergency Medicine.  Through an approach that emphasizes practical application of evidence and both clinical and academic excellence, we strive to prepare our graduates for clinical practice and for leadership across the entire spectrum of Emergency Medicine - from critical access hospital to tertiary referral center, from academic departments to community practice, in urban and rural environments, across all levels of volume and acuity. 

Michael Pallaci, DO, FACEP
Clinical Professor of Emergency Medicine
Ohio University Heritage College of Osteopathic Medicine
Director, Emergency Medicine Residency Program
Adena Regional Medical Center
Chillicothe, OH


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