Guidelines for Foundations Learners

Expectations | Learning Pathways | Foundations Meetings | Oral Boards Cases | EKG Fundamentals | Rosh Assessments


Set high expectations- not only for what your program will do for you but for what you should do for yourself.

Hundreds of hours were donated to the development of this course and hundreds more will contribute to further growth and improvement in the coming year.  Your program is dedicating a significant amount of time, energy and faculty resources to implement Foundations at your institution.  This is not the norm; we are going above and beyond.  The purpose of this investment is to ensure that you are equipped with fundamental knowledge essential for your success as an Emergency Physician and vital to competent care of your patients.

Intern year is both exhilarating and exhausting, the scope and pace of the curriculum keeps this in mind.  However, as an adult learner, the onus is on you to hold yourself accountable.  You must prioritize and invest in your continued education within our specialty.  Prepare for Foundations Meetings.  Engage in discussion.  Your professional integrity and the best interests of your patients will depend on this.

Learning Pathways

Foundations of Emergency Medicine is based on a flipped classroom model.  This method relies on your independent review of core knowledge prior to each Foundations Meeting.  It is important for you to review all the assigned preparation materials prior to the meeting date.  The general course schedule and associated assignments can be found on this site.  Your residency leadership or Foundations Site Director will provide you with a detailed schedule for your institution and instructions on how to access resources for independent study.

There is no one “right” way to learn Emergency Medicine.  As a seasoned student who has made a commitment to lifelong learning, you should be aware of what method works best for you.  Foundations Learning Pathways allow a variety of options for your independent review.  Each pathway will cover the same weekly learning topics and is intended to take 1-2hr to complete.  Take a moment to review the options described below.  Decide what you think will work best for you but don’t hesitate to change your approach over time.  Specific assignments for Learning Pathways are divided by system and can be accessed from the Foundations main page.  Note that Learning Pathways are being newly built this year and specific assignments will be provided by the “Block Release” dates listed on the Course Schedule.

Traditional Textbook

This pathway is best suited to learners who want all the details in plain text.  It is important to note that you will not complete the entire textbook in a year.  Rather, select pages with high-yield topics are intended to help establish fundamental knowledge.  You should plan to build on this knowledge with additional reading as a more senior resident.

If you chose this pathway, you have the option of using either Rosen’s Emergency Medicine (8th Edition) or Tintinalli’s Emergency Medicine (8th Edition).  While both textbooks cover the same content, Emergency Physicians tend to have a strong preference for one of the other.  Ask around, figure out what is available to you through your institution and then decide which is best for you.

High-Yield Textbook

The resources used in this pathway are more to the point.  They are formatted to provide a general review of information rather than all the fine print.  If you chose either of the books in this pathway, you will complete the entire book by the end of the year.  You should plan to build on this knowledge with additional reading as a more senior resident.

Dr. Carol River’s Preparing for the Written Board Exam in Emergency Medicine (7th Edition), as the name suggests, is a bulleted review primarily intended for use prior to taking the board exam at the end of residency.  It summarizes important concepts and may be used as a framework for core knowledge in our specialty.  Similar to your worn out and heavily noted copy of First Aid for the USMLE Step 1, you may prefer to review this early, take additional notes from other resources and refer back to it at the end of residency.  If you’d like to use this resource, visit Ohio ACEP’s website for more details.  Foundations participants should make their order by phone (614-792-6506) in order to receive a 25% discount.

Tintinalli’s Emergency Medicine Manual (7th Edition) is an alternate choice for the high-yield text pathway.  It is formatted to be an introductory review as a smaller and more portable handbook.


The number of online resources available for reference and independent study of Emergency Medicine has grown exponentially in the last few years.  This pathway was designed to provide specifically curated, level-appropriate resources for those of you who prefer videos, podcasts and blogs to traditional textbook options.  You should plan to build on this knowledge with additional reading and review as a more senior resident.

This pathway heavily relies on educational videos created by Hippo Education.  Luckily, a collaboration between EMRA (Emergency Medicine Resident’s Association) and Hippo EM will allow free access for all Emergency Medicine PGY-1 residents.  You can learn more details about accessing this content at the following site.

Foundations Meetings

Foundations Meetings are classroom based learning sessions that correlate directly with independent study topics for any given unit in the curriculum.  Meeting time will focus on active, practice-based learning that will challenge you to make use of the knowledge you gained on your own.

During typical Foundations Meetings, you will be divided into small groups and given three different oral boards style cases.  The content of the case will be related to specific learning topics covered in your Learning Pathways assignments.  Although the small group instructor will ask for 1-2 learners to act as leaders for a given case, all group members should collaborate during the case and discuss the working differential, key management steps, etc.  Your group will have up to 10 minutes to complete each case; afterwards your instructor will review key learning points and answer any questions you may have about the case and case topic.

After each meeting, your Foundations Site Director or other curriculum leader should provide you with copies of the cases and learning points for your optional independent review.  You should definitely review these on your own after any missed Foundations Meeting in order to keep on track with learning goals for the year.  Please keep copies of these cases private (don’t post them elsewhere on the internet) as protected intellectual property and to allow learners at other Foundations sites to benefit from the course in the same way you will.

Oral Boards Cases

While you are likely unfamiliar with the oral boards format, it is a standard of assessment in our specialty and will be part of the board-certification process after you graduate residency.

Expect that it will take time and practice for you to become efficient and skilled at “playing the game” of oral boards style cases.  For tips and tricks to help introduce you to this format and help you to be successful during meeting time, please review the Learner Guidelines Handout.  If you’d like, you may also review the provided Example Oral Boards Case to get a better sense of how to complete a case.  At the beginning of each Foundations Meeting, you will be provided a Note Sheet that will remind you of the general format and strategy for oral boards cases.

EKG Fundamentals

In addition to the Foundations of Emergency Medicine curriculum, your site may also adopt an associated EKG Fundamentals curriculum. If this is the case, most Foundations Meetings will begin with review of a Challenge EKG. For more information, refer to the EKG Fundamentals page on this site.

Rosh Assessments

If your program subscribes to Rosh Review, you may be able to complete Rosh mini-tests composed of inservice and written board review style questions that directly correlate with content from each unit of the Foundations curriculum. These tests may be either assigned/required or simply made available for your optional review. Specific information and instructions for your institution will be provided by your Foundations Site Director.