A faculty-led resident strike team as a force expander during disaster





disaster, force expansion, residents, strike team, pandemic


The emergence of the coronavirus disease 2019 (COVID-19) pandemic produced an unprecedented strain on the United States medical system. Prior to the pandemic, there was an estimated 20,000 physician shortage. This has been further stressed by physicians falling ill and the increased acuity of the COVID-19 patients. Federal medical team availability was stretched to its capabilities with the large numbers of deployments.

With such severe staffing shortages, creative ways of force expansion were undertaken. New Orleans, Louisiana, was one of the hardest hit areas early in the pandemic. As the case counts built, a call was put out for help. The Louisiana State University (LSU) system responded with a faculty-led resident strike team out of the LSU Health Shreveport Academic Medical Center.

Residents and faculty alike volunteered, forming a multispecialty, attending-led medical strike team of approximately 10 physicians. Administrative aspects such as institution-specific credentialing, malpractice coverage, resident distribution, attending physician oversight, among other aspects were addressed, managed, and agreed upon between the LSU Health Shreveport and the New Orleans hospital institutions and leadership prior to deployment in April 2020.

In New Orleans, the residents managed patients within the departments of emergency medicine, medical floor, and intensive care unit (ICU). The residents assigned to the medical floor became a new hospitalist service team. The diversity of specialties allowed the team to address patient care in a multidisciplinary manner, leading to comprehensive patient care plans and unhindered team dynamic and workflow. During the first week alone, the team admitted and cared for over 100 patients combined from the medical floor and ICU.

In a disaster situation compounded by staff shortages, a resident strike team is a beneficial solution for force expansion. This article qualitatively reviews the first published incidence of a faculty-led multispecialty resident strike team being used as a force expander in a disaster.


Author Biographies

Angela P. Cornelius, MD, MA

Core Faculty, John Peter Smith Hospital, Fort Worth Emergency Medicine Residency; Associate Professor, Clinical Emergency Medicine TCU/UNT, Fort Worth, Texas; Associate Professor, Louisiana State University-Shreveport Academic Medical Center, Shreveport, Louisiana

Axel Rodrigues-Rosa, MD

Resident Physician, Louisiana State University-Shreveport, Shreveport, Louisiana


Louisiana Coronavirus COVID-19: State of Louisiana: Department of Health. Available at http://ldh.la.gov/coronavirus/. Accessed April 11, 2020.

Coronavirus Disease (COVID-19): World Health Organization. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/. Accessed April 15, 2020

Centers for Disease Control and Prevention: CDC confirms possible instance of community spread of COVID-19 in US. 2020. Available at https://www.cdc.gov/media/releases/2020/s0226-COVID-19-spread.html. Accessed April 15, 2020.

Official Seal of the State of Louisiana: Gov. Edwards confirms Louisiana’s first presumptive positive case of COVID-19. Available at https://gov.louisiana.gov/index.cfm/newsroom/detail/2392. Accessed April 11, 2020.

Halpern NA, Tan KS, DeWitt M, et al.: Intensivists in US acute care hospitals. Crit Care Med. 2019; 47(4): 517-525. DOI: https://doi.org/10.1097/CCM.0000000000003615

Wax RS: Preparing the intensive care unit for disaster. Crit Care Clin. 2019; 35(4): 551-562. DOI: https://doi.org/10.1016/j.ccc.2019.06.008

Houston B: New Orleans residents respond to coronavirus outbreak on social media. The Advertiser. March 28, 2020. Available at https://www.theadvertiser.com/story/news/2020/03/28/coronavirus-new-orleans-social-media-twitter-louisiana-covid-19-cases/2933111001/. Accessed February 15, 2020.

Hospital Medicine: 44,000 and counting. Today’s Hospitalist. June 16, 2016. https://www.todayshospitalist.com/hospital-medicine-44000-and-counting/. Accessed May 2, 2022.

Bhatla A, Ryskina KL: A shortage of doctors with experience treating hospitalized patients looms. Stat. November 20, 2020. Available at https://www.statnews.com/2020/11/20/a-shortage-ofphysicians-with-experience-treating-hospitalized-patients-couldthreaten-the-next-surge-response/. Accessed September 23, 2021.

The Complexities of Physician Supply and Demand: Projections from 2019 to 2034. 2022. Available at https://www.aamc.org/datareports/workforce/data/complexities-physician-supply-and-demandprojections-2019-2034. Accessed October 3, 2022.

Bolger DP: Americans at War 1975-1986, an Era of Violent Peace. Novato, CA: Presidio Pr, 1988: 275.

Zwilling M: Every business needs force multipliers to survive. Forbes. May 14, 2015. Available at https://www.forbes.com/sites/martinzwilling/2015/05/14/every-business-needs-force-multipliersto-survive/#4344ac4d1e25. Accessed May 2, 2022.

Harris GH, Baldisseri MR, Reynolds BR, et al.: Design for implementation of a system-level ICU pandemic surge staffing plan. Crit Care Explor. 2020; 2(6): e0136. DOI: 10.1097/CCE.0000000000000136. DOI: https://doi.org/10.1097/CCE.0000000000000136

Aziz S, Arabi YM, Alhazzani W, et al.: Managing ICU surge during the COVID-19 crisis: Rapid guidelines. Intensive Care Med. 2020; 46: 1303-1325. DOI: 10.1007/s00134-020-06092-5. DOI: https://doi.org/10.1007/s00134-020-06092-5

NDMS Teams: Phe.gov. Available at https://www.phe.gov/Preparedness/responders/ndms/ndms-teams/Pages/default.aspx. Accessed May 7, 2020.

Toof R: Army combat medics serve as a force multiplier. 2020. Available at https://www.army.mil/article/233215/army_combat_medics_serve_as_a_force_multiplier. Accessed April 17, 2022.

Kime P: DOD readies 1,000 troops to aid in COVID-19 response nationwide. 2021. Available at https://www.military.com/dailynews/2021/12/21/dod-readies-1000-troops-aid-covid-19-responsenationwide.html. Accessed May 2, 2022.

US Northern Command: Military hospital support to FEMA to begin in Massachusetts, expand in Arizona. 2022. Available at https://www.northcom.mil/Newsroom/News/Article/Article/2930507/military-hospital-support-to-fema-to-begin-in-massachusettsexpand-in-arizona-m/. Accessed May 2, 2022.

Innovative Readiness Training: Delta regional authority. 2022. Available at https://dra.gov/initiatives/promoting-a-healthy-delta/innovative-readiness-training/. Accessed May 2, 2022.

ICS 300.usda.gov: Available at https://www.usda.gov/sites/default/files/documents/ICS200Lesson03.pdf. Accessed October 5, 2020.

Patel VM, Dahl-Grove D: Disaster preparedness medical school elective: Bridging the gap between volunteer eagerness and readiness. Pediatr Emerg Care. 2018; 34(7): 492-496. DOI: https://doi.org/10.1097/PEC.0000000000000806

Dynes RR: Community emergency planning: False assumptions and inappropriate analogies. Int J Mass Emerg Disasters. 1994; 12(2): 141-158. DOI: https://doi.org/10.1177/028072709401200201

Neal DM, Phillips BD: Effective emergency management: Reconsidering the bureaucratic approach. Disasters. 1995; 19(4): 327-337. DOI: 10.1111/j.1467-7717.1995.tb00353.x. DOI: https://doi.org/10.1111/j.1467-7717.1995.tb00353.x

Ward MJ, Ferrand YB, Laker LF, et al.: The nature and necessity of operational flexibility in the emergency department. Ann Emerg Med. 2015; 65(2): 156-161. DOI: 10.1016/j.annemergmed.2014.08.014. DOI: https://doi.org/10.1016/j.annemergmed.2014.08.014

ACGME: Education site verification. 2022. Available at https://www.acgme.org/what-we-do/overview/education-site-verification/. Accessed May 2, 2022.

O’Byrne L: Medical students and COVID-19: The need for pandemic preparedness. J Med Ethics. 2020; 46: 623-626. DOI: 10.1136/medethics-2020-106353. DOI: https://doi.org/10.1136/medethics-2020-106353

Role of Administration in an Emergency: Care toolkit. Available at https://www.careemergencytoolkit.org/programme-support/4-administration/1-role-of-administration-in-an-emergency/. Accessed May 2, 2022.

Carr ER, Abrahams D, de la Poterie AT, et al.: Vulnerability assessments identity and spatial scale challenges in disaster-risk reduction. Jamba. 2015; 7(1): 201. DOI: https://doi.org/10.4102/jamba.v7i1.201

ASPR TRACIE: Hazard vulnerability/risk assessment. Available at https://asprtracie.hhs.gov/technical-resources/3/hazard-vulnerability-risk-assessment/. Accessed May 10, 2020.

Molyneaux R, Gibbs L, Bryant RA, et al.: Interpersonal violence and mental health outcomes following disaster. BJPsych Open. 2020; 6(1): e1. DOI: https://doi.org/10.1192/bjo.2019.82

Rezaeian M: The association between natural disasters and violence: A systematic review of the literature and a call for more epidemiological studies. J Res Med Sci. 2013; 18(12): 1103-1107.

Harrald JR: Agility and discipline: Critical success factors for disaster response. Ann Am Acad Polit Soc Sci. 2006; 604(1): 256-272. DOI: https://doi.org/10.1177/0002716205285404

Almutairi MR, Alkshali SJ: The effect of human resource flexibility on crises management effectiveness in Kuwaiti contracting companies. Int J Sci Technol Res. 2020; 9(9): 203-209.



How to Cite

Cornelius, A. P., and A. Rodrigues-Rosa. “A Faculty-Led Resident Strike Team As a Force Expander During Disaster”. American Journal of Disaster Medicine, vol. 19, no. 1, Feb. 2024, pp. 5-13, doi:10.5055/ajdm.0467.