The Goals:
Establish a systematic approach, identify common arrhythmias, distinguish normal variants from dangerous abnormalities, and maintain a strong emphasis on clinical correlation.
Core Topics
- Systematic Interpretation
- Step-by-Step Method: Rate → Rhythm → Axis → Intervals → Morphology →?
- Emphasize consistency and completeness for every ECG. Look closely at all 12-leads.
- Recommended STAT Posts:
- Basic Arrhythmias
- Atrial Fibrillation & Flutter: Recognize these rhythms, understand hemodynamic impact, and identify triggers
- Supraventricular Tachycardia (SVT): Differentiate from sinus tachycardia, identify key ECG features
- Sinus Tachycardia & Sinus Bradycardia: Common etiologies and clinical significance
- Premature Complexes: PACs and PVCs—when to worry?
- Recommended STAT Posts
- STEMI Recognition and Clinical Correlation
- Identify ST elevations in appropriate leads; look for reciprocal changes
- Correlate with patient history, symptoms, and hemodynamics—avoid relying on ST changes alone
- Recommended STAT Posts
- Simple Conduction Blocks & Common Electrolyte Disturbances
- Conduction Blocks: Recognize first-degree AV block, basic bundle branch blocks
- Electrolyte Issues: Know the typical ECG changes in hyperkalemia or hypokalemia
- Recommended STAT Posts
- Weekly ECG Rounds & Practice
- Integrate real patient scenarios in case-based discussions
- Use actual ED or inpatient tracings to enhance clinical correlation
- Recommended STAT Posts & Practice
- Acute Chest Pain DDx
- Ischemia & Infarction
- ECG Weekly Workouts
- Encourage saving favorite or high-yield posts for quick reference
Teaching and Assessment Methods
- Interactive Case Reviews
- Attend weekly sessions where faculty present recent cases and ECGs
- Discuss differential diagnosis, next steps, and management
- STAT Posts & Quizzes
- Complete suggested readings and quizzes to reinforce concepts
- Track progress and identify areas needing additional review
- Simulation & Skills Exams
- Use ECG-based simulations for bradyarrhythmias, tachyarrhythmias, and acute chest pain scenarios
- Periodically take short skills exams to measure competence and readiness for higher-level content
By following this PGY-1 Curriculum, residents will build a solid, systematic approach to ECG interpretation, gain confidence in recognizing core arrhythmias, and develop the habit of clinically correlating every finding. This foundation is crucial for the more advanced ECG challenges encountered in later training years.
A place to start! Understand the basics of ECG waveforms, normal rhythms, and the importance of clinical correlation.
Solidify a systematic approach to ECG interpretation, learn to identify life-threatening arrhythmias, and get introduced to the many different ischemia patterns.
Continue building your skills with in-depth exploration of conduction blocks, subtle ischemic changes, toxicologic & metabolic ECG patterns, and advanced arrhythmias.
Rapid recognition of more rare syndrome and complex clinical scenarios. Continue learning about difficult rhythms, and develop nuanced clinical integration of the ECG patterns you have learned for rapid decision making.
Rapid pattern recognition, expert-level case discussions, and teaching strategies for mentoring the next generation of ECG experts.
