The elite code grey team: a new model for residency preparedness and training in advance of a disaster

Hurricane Katrina and the resulting levee failures decimated the New Orleans landscape, trapping physicians inside hospital facilities for up to 5 days. With over 2000 people trapped in the 3 primary teaching hospitals, there were only 3 fatalities. Yet despite the lack of adverse events, the experience revealed that graduate medical education is woefully underprepared to deal with disaster. As call schedules obviously did not anticipate the disaster, the assignment of physicians to these shifts was random, without regard to the ability to withstand that stress and the conditions. The group of physicians that was assigned was a heterogeneous mix of personalities, experience levels, and psychological fortitude. None of the physicians had been formally trained in the core principles of disaster management. This article reviews an innovative approach to disaster management, drawing upon the expertise of law enforcement, the airline industry, and on-going physician development programs in disaster medicine.