Impact of attending level supervision of the emergency department experience.

Medical experiences encountered in the activities of an emergency department are important for the development of a well-trained internist. Therefore, a rotation in the emergency department must remain an integral part of any program in internal medicine. At the University of Pittsburgh, faculty members from both the internal medicine and emergency medicine departments worked together in order to develop the emergency department to its fullest capacity as part of a broad educational program. The faculty attendings provide supervision, immediately available consultation, and an on-going curriculum, including daily lectures and chart review. The results of their programmatic change have been the following: 1) enthusiasm and satisfaction on the part of the housestaff; 2) a 20+ increase in admissions to the hospital from the emergency department; 3) decreased utilization of the observation unit; and 4) fewer patients leaving without being examined.