The Denver Health Residency in Emergency Medicine has been developing leaders in Emergency Medicine since its inception in 1974.  Alumni have gone on to become Department Chairs, Program Directors, Fellowship Directors, Assistant and Associate Deans, Chief Executive Officers, entrepreneurs and national organization presidents.  The Program has educated physicians who hold positions of leadership at Oregon Health Sciences University, Highland General Hospital, the Mayo Clinic, Beth Israel/Deaconess, Harvard, Massachusetts General Hospital, Brigham and Women's Hospital, Tufts, Washington University, Carolinas Medical Center, Maimonides Medical Center, Emory University, NASA, the CDC, the US Air Force, and others, both nationally and internationally. The residency program is successful due to the passion and engagement of the faculty combined with the dedicated, outstanding residents.

Our primary goal is to graduate outstanding clinicians by applying deliberate practice to residency training.  We strive to expose residents to the 5 tenets of deliberate practice:  exposure, feedback, coaching, self-reflection, and repetition.  In 4 years of training our residents participate in approximately 10,000 hours of patient care which affords them the opportunity to see more than 10,000 patients.  Feedback is provided during patient encounters, at end of shifts, and in summative reports.   Faculty coach residents through modeling behavior, formal mentoring, and providing feedback to improve performance.  Residents reflect on their patient care through Morbidity and Mortality conference, Quality Assurance Projects and self-reflective narratives.  Repetitive exposure and practice leading to mastery is provided in clinical shifts, simulation experiences, and procedure labs.  Given the importance of deliberate practice to expertise, the residency leadership and faculty are committed to efforts directed at improving quality and quantity of feedback and coaching.

Jon Haidt’s book Happiness Hypothesis states ‘People need adversity, setbacks, and perhaps even trauma to reach the highest level of strength, fulfillment, and personal development’.  Challenge is required to yield greater retention of information and superior performance under stress.   At Denver Health, we strive to strike the optimum balance between challenging our residents every day and supporting them by providing responsible wellness.  Residents are exposed to a high volume of patients and learn to multi-task while providing excellent care.  In the EM4 year residents have the most challenging role of all – that of running a busy, urban, academic Emergency Department in a Level 1 Trauma Center.  The EM4s supervise junior residents and students while making decisions on patient flow and providing care for the observation area patients.  This role prepares our graduates to work in any Emergency Medicine environment anywhere in the world and excel. According to our most recent alumni survey, this role is a cornerstone of this residency program and is one of the essential roles that prepared them for their current jobs.

We routinely receive unsolicited feedback from Medical Directors who are surprised that our graduates arrive with a maturity, confidence, and poise that is far greater than they commonly see. Our graduates reinforce that sentiment, letting us know how comfortable they have felt walking into a new department, picking up a chart, and getting to work. Senior staff at those facilities recognize the confidence that outstanding training brings and embrace the new graduate’s leadership.

While we are focused on challenging our residents, we are careful not to exceed the optimal learning zone.  We use resident input and performance as measures to define this zone.  Resident input is solicited on all aspects of the residency program in order to guide change and evolution.  Every year we work to enhance our program and residents play a major role in crafting changes through Class Lunch Meetings, the Residency Advisory Council, end-of-year surveys, ACGME surveys, and Program Advisory Committee meetings, among others.  Many of our best changes have come from resident input and here at Denver Health it’s cherished and valued.  Our program is dedicated to continuously improving and we understand that to do so requires a willingness to change while maintaining the key elements that have made training successful.  

The residency also provides opportunities for exposure in many other aspects of medicine.  Residents have opportunity, funding and support for scholarly activity.  The School of Medicine, Residency Program, and Paramedic School provide residents with opportunities to teach.  The EM3 teaching rotation focuses on providing residents with the tools to be good teachers.  Residency Tracks provide focused groups within specific niches to develop projects.

Wellness within the program remains an important focus.  While we challenge our residents in order to obtain long lasting wellness in a career as an Emergency Medicine Physician, we also recognize the importance of wellness while in training.  The Wellness Committee is tasked with monitoring wellness and providing an avenue for residents to voice concerns.  We created a unique and innovative ACES (Art, Chaos, Ethics and Science) curriculum that focuses on the humanism within our field.  Residents manage the curriculum with topics such as “Taking care of the difficult patient”, “Life-Work Balance”, and “How does your career affect your family.”  We start each academic year with a Residency-Wide Retreat focused on team building.  Faculty and Residents truly work in an environment of collaboration and genuinely care about the well-being of each member of the team.

I am proud to be a graduate of the Denver Health Residency Program, and I am humbled to have been given the privilege of serving as the Residency Program Director.  The residency program is committed to producing outstanding clinicians who provide excellent patient care.  We will continue to strive to provide opportunities for deliberate practice and to challenge residents to create expertise while maintaining resident wellness and optimizing patient safety.




Maria Moreira, MD
Program Director
Denver Health Residency in Emergency Medicine