Overview
The goal of the Emergency
Medicine rotation is to acquire the skills needed to address the
undifferentiated emergency patient; that is, a patient who can present with any
complaint from medicine, surgery, orthopedics, pediatrics, gynecology, ophthalmology,
etc. Truly, anything can present to an emergency department at any time, and
you must acquire the skills to recognize truly ill patients requiring immediate
treatment and/or further inpatient management from those who can be treated and
discharged. The ED evaluation of patients must be accomplished in a short
period of time with a directed history and physical, the formulation of a ranked differential
diagnosis, and the development of a rational, cost effective management plan.
Disposition decisions of ED patients will be based on your
supervised evaluations.
Your clinical evaluation will be
accomplished by direct observation and interaction with attending and/or
residents, with documented feedback on the shift summary (see form in Documents
section). Feedback should include any and all aspects of your performance,
including aspects performed particularly well, aspects deemed needing
improvement, or areas of educational deficit that you should strive to
improve. The aggregate of these shift summaries will then be used to formulate
your Summative Evaluation (see form in Documents section).
The didactic portion of the clerkship is
composed of concepts that you receive little or no training during your other
clerkships, and are commonly encountered in Emergency Medicine. These subject
areas are the approach to acute airway management, chest pain and abdominal
pain, common problems and management in toxicology, selected environmental
medicine problems, emergency medical systems/pre-hospital care, and trauma.
These subjects will make up reading assignments, review sessions, and the
examination. Review sessions will be held weekly (check your site schedule for
times and locations) to answer any questions from the week's readings or
lectures, and then use case studies and simulation to evaluate and
manage simulated patients. The care given to these simulated patients will be
observed by Emergency Medicine faculty, who will then critique the overall
performance, and will review areas of the curriculum as needed given the
performance. All students should come prepared with a stethoscope and
other equipment as if working a shift.
During this rotation, you will be
interacting directly with Emergency Medicine house staff and attending staff at
the time of patient care. We hope that this enhanced bedside teaching will be a
rewarding clinical experience for you.
Remember that no two physicians are
identical. By observing the approach of various physicians, you will notice
differences in evaluations and work-ups. This does not mean that there are
"right ways and wrong ways" but rather different ways to approach
problems. The goal in medical education and training is to learn from all of
these experiences, integrate the knowledge and practices that you learn, and develop
your own style in becoming a sound practicing clinician. If you are unclear
about the rationale for a given patient's management, ask the resident or
attending for an explanation of the approach.
An integral part of your experience is an
exposure to