Saturday, May 19, 2018

Acing your EM rotations

So you want to know the secrets to success on your rotation...

While there is no magic bullet that will earn you honors, the essential keys to success are easy to follow.


  • Work hard
  • Be kind
  • Be honest  
Sounds easy, right. Well amazingly many rotators can't follow these 3 simple rules.

Work Hard:
EM is not easy and there will be little down time. Be prepared to go straight through without breaks to eat or go to the bathroom. Carry snacks with you and have a covered drink to stay hydrated.
Make it obvious you will be willing to do anything and want to see and experience everything. No case is too small or too challenging for you.

Be Kind:
Imagine everyone you see and work with is someone you love - treat them as you want your loved ones treated. This applies to staff colleagues and patients. It doesn't matter how they smell, how they act, or what they are asking. Absolutely kill them with kindness at all times.

Be Honest:
While you always plan to be honest there will be a moment when you are embarrassed and the devil on your shoulder will push you to lie or omit. Imagine you didn't check the pupils of a patient with a head injury. Do you tell the truth and admit it didn't occur to you? Couldn't you just say they were fine - what's the harm.
The harm is if someone catches the lie - they will never trust you again. All the hundreds of times you were being honest will be called into question.
It just isn't worth it - be honest at all times - we will respect your admissions. And then you correct the error. Go check the pupils and you are set.


Once you have the rules set it is time to take on the greatest challenge and best opportunity to succeed - the presentation. Here is a video from EMRA and CDEM that says this better than any post can.

EM presentations are entirely different from those on your other rotations.
  1. Don't bury the lead - if they are sick (go get someone) or might be sick say it up front
  2. Focus on the chief complaint - what is happening right now
  3. Be brief - less is always more
  4. Think of the differential diagnosis - anything you say should help weight the differential bringing some up high on the list and others down low
  5. Sum it up - we weren't listening (squirrel) summarize the important details before giving your plan so your listener pays attention 
While nothing can guarantee you honors acing the presentation and avoiding pitfalls will have you doing your best.

Lucienne Lutfy-Clayton is an Associate Program Director at UMASS Baystate Health, Co-Chair of the Application Process Improvement Committee and former Clerkship Director. She has the attention span of a nat and needs shiny presentations to draw her attention. 


Monday, April 16, 2018

New EM Program for 2019 - University of Vermont Medical Center

Another new EM program will be recruiting their first class in the 2019 NRMP Match.  Here are details from their Program Director:

With great enthusiasm, I would like to announce the initial accreditation of our new Emergency Medicine Residency Program at the University of Vermont Medical Center in Burlington. Our 3-year program will start in July 2019 with the inaugural class, and we are excited to start interviewing candidates this fall. We are currently accepting visiting students as well, so please spread the word amongst any EM-bound students interested in an away rotation where they will be working one-on-one with academic faculty (and no EM residents yet).

Please visit our website (still under construction) for more information:

  
Richard Bounds, MD, FACEP, FAAEM
Program Director, Emergency Medicine
Associate Professor, Department of Surgery
University of Vermont Medical Center
Burlington, VT

Tuesday, April 10, 2018

New EM Program - Opening in July 2018

Just published to the CORD Community:

​I am incredibly pleased to announce that we just received accreditation for our new emergency medicine residency at St Joseph's Medical Center in Stockton, California, and are hoping to fill our 9 resident positions this July. We will be reviewing applications and conducting WebEx and in person interviews over the next few weeks. We are located just about a hour south of Sacramento. 
Interested individuals can contact me (jennifer.oakes@dignityhealth.org) or my coordinator at lacy.quijalvo@dignityhealth.org
Thanks! :)​

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Jennifer Oakes MDProgram Director
St. Joseph's Medical Center


This program is going to fill their first class outside the match.  Applicants without a settled landing spot for 2018-19 should consider applying to the folks listed above. 

Monday, March 26, 2018

So it's time to find the right Emergency Medicine rotations to set you up for success in the match



The skinny on where, when and how to get your sub-internships, rotations, and letters...


Throughout this post you find links to useful pages within this blog and outside resources to help you better understand  the process of applying to EM

Where?
  • Home - if your school has an EM residency, you should start with a home rotation
  • Away - even if you have multiple options at your school you should do an away
    • This gets you a second SLOE
    • This throws you into the deep end - you won't be familiar with your surroundings, you will have to learn a new system, and you will do it all while progressing forward from your first rotation
*For students who don't have a residency at their school two Aways should be scheduled

When?
  • As soon as you can get them, between May and October is ideal
    • Schools and rotations have different requirements, so start looking now
    • Earlier is better so your SLOEs are written and in your application, ready to be reviewed for interview offers
  • Many programs will review your application and consider you for interviews with one SLOE. EMRA match lists how many SLOE are required at each program for an application to be reviewed
    • Dates for electives may not match with your schools blocks
    • Review the dates carefully 
How?
Ways to succeed:
  • Many rotations ask for a letter of recommendation
    • Decide who will do this for you, and ask them ahead of time. This will allow your application to go smoothly
    • Generally the rotation wants someone to vouch for you as a student in good standing, interested in applying to EM
  • Start early 
  • A bird in the hand is worth two in the bush
    • Take what is offered to ensure you have the two early rotations you need, rather than waiting for the perfect one
  • Variety is the spice of life



Lucienne Lutfy-Clayton is an Associate Residency Director, former Medical Student Clerkship Director, a past Chair of the CORD-EM Student Advising Task Force, current co-Chair of the CORD-EM Application Process Improvement Task Force and lead author on the SATF Applying Guide and Frequently Asked Questions. 


Friday, March 9, 2018

Match Day 2018 - Contingency Planning for the Unmatched

Match Day 2018 is friday, March 16.  That day is anxiety provoking for every student in the match as they find out where they are going to continue their training.  Even more stressful is monday the 12th, sometimes called "No-Match Day".  At 12 pm all programs and applicants find out if they matched or if they are going to have to scramble for a position in the SOAP.  Most applicants will get good new on monday and their worries will quickly shift from "if I match" to "where will I match?".  

This post is for applicants who get bad news on monday.  We will outline the big decision points and connect you with additional resources.

The first thing you need to do if you are notified that you did not match is to take a little time to grieve.  Even if you knew you were at risk to not match and this news is disappointing, but not a surprise, take a little time to wrap your head around it.  

Then you need to make a plan, or put into action the plan you already made.  

The big decision:  Do you still want to match into EM?

Using the SOAP process to get into EM, or finding a spot post-match, are not viable routes to get an EM training spot.  A very few lucky folks may make this happen but there are not enough spots for this to be something you plan for.  

The most commonly recommended path to pursue in setting up a re-application to EM next year is to get clinical training in a one year internship (surgical, medical, transitional, etc.).  Other options include matching to a categorical program (full course of training, like categorical IM or FP), extending medical school graduation to improve your application, or pursuing additional experience like a research project or masters degree after graduating on time.  Which option(s) is best for you depends on a variety of factors including why you did not match, how likely are you to be successful in reapplying, and which are available.  

Resources to help you make an informed decision:



If you know of additional quality resources for the unmatched applicant to EM please share them in comments below and we will incorporate them into future resources.  

Adam Kellogg is an Associate Residency Director, former Medical Student Clerkship Director, a past Chair of the CORD-EM Student Advising Task Force, and an author on far too many of the resources for re-applicants.  Seriously, if you have some other good resources, share them!

Friday, September 22, 2017

More New Programs and Updates

Continuing the EM Program updates:

New Combined Program:  Johns Hopkins Combined EM/Anesthesia Program:

Dr. Linda Regan:


The Johns Hopkins Department of Emergency Medicine is pleased to announce that we are accepting applications for our newly accredited combined EM-Anesthesiology program.  This 6-year combined program will allow for dual board certification in the highly complementary fields of EM and Anesthesiology.   We are hoping to find some interested and well-qualified applicants with a plan to start in July of 2018 with two trainees. 
Within ERAS, students should be able to find us by either entering our ACGME program number (7962300001) or by searching for the specialty of EM-Anesthesiology, as we are currently the only program listed.

More information about our new combined program, as well as details about the rotation outline, program leadership, and links to the categorical programs of both EM and Anesthesiology can be found here:
http://www.hopkinsmedicine.org/emergencymedicine/combined-residency/
Additional questions can be directed to Linda Regan (program director) at lregan@jhmi.edu or the program coordinator for this combined program, Christina Tarleton, at ctarlet1@jhmi.edu

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New Program:  Cape Fear Valley Medical Center

Paul Kleinschmidt:

We are a new program that just started our first group of residents this year.   We were an AOA approved residency that had not taken students but went ahead and made the application for ACGME certification at the same time.   We received our initial certification in April and as such are dually accredited.   We are a four year program that takes 8 residents per year for a total of 32 at this point.
Here is a little more about our facility and program:

Cape Fear Valley Medical Center is the flagship hospital of the Cape Fear Valley Health System, that serves as the major medical system for southeastern North Carolina, and includes six hospitals. The main 110 bed emergency department is the busiest in the state of North Carolina, and easily in the top twenty nationally with over 140,000 visits per year. Our department handles over 2400 medical codes and 800 traumas a year by EMS arrival alone, along with a 30% admission rate in a high acuity population. We are a certified trauma, stroke, stemi, and sepsis center. There is also a co-located pediatric ED serving over 30,000 patients per year. In 2017 we accepted our first class of emergency medicine residents with the eventual goal of 32 residents over a four year program.  We have the volume and resources to keep residents in house for all four years with the exception of toxicology.   Being a four year program we offer some ability to make our last year unique with additional focus on ED administration and other focused interests for the residents, in anticipation of career paths or fellowships.  In addition, while we take both MD’s and DO’s, we will have an osteopathic tract and certification, even training MD’s to a standard of osteopathic principles and practices.

Website:  http://www.capefearvalley.com/residency/programs/emergency-medicine-contacts.html

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New Program: Sunrise Consortium Emergency Medicine Program in Las Vegas

Michael P. Allswede:

I am the PD of the new accredited Sunrise Consortium Emergency Medicine Program in Las Vegas, ACGME: 1103100190.  

The Sunrise Consortium Program in Emergency Medicine is a 36 month program in emergency medicine located in Las Vegas.  The program is combined between the MountainView Hospital, an 80,000 visit acute care community hospital and the Sunrise Hospital, a Level II Trauma Center and 105,000 adult and 55,000 pediatric emergency department.  At 240,000 patient visits per year, the Sunrise consortium is among the most robust clinical education experiences in emergency medicine.  The modular active learning curriculum for emergency medicine (MALCEM), is a literature based, active learning educational experience in which the resident is provided over 300 landmark and cutting edge articles to discuss and engage in a simulation environment.  The combination of astute understanding of the literature and a robust clinical experience is designed to develop superior emergency physicians."

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New Program:  Reading Hospital Emergency Residency Program in Reading, PA

Kristen M. Sandel:

The Reading Hospital Emergency Medicine Residency Program was recently accredited in April 2017 by the ACGME as a 3-year residency program.  We are currently accepting applications via ERAS for 8 residents in our inaugural class and will be participating in the NRMP match.  Reading Hospital is located in Reading, PA and our Emergency Department (ED) was recently recognized as one of the ten busiest single-site Emergency Departments in the United States.  With over 120 beds in our ED and limited other learners, we are proud to offer incoming residents the opportunity to care for a great variety and volume of patients while providing residents with an abundance of procedural experience.  

Please feel free to contact us for details concerning our program or visit our website.  https://www.rhemresidency.com/ 

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UPDATE - October 23, 2017:

AOA to ACGME: Arrowhead Regional Medical Center in San Bernadino, CA

Tom Minahan: 

Arrowhead Regional Medical Center (San Bernardino County Hospital) in California, is an AOA EM program that has now received ACGME Initial Accreditation.

websitehttp://armcemergency.org/

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Monday, September 18, 2017

New Program Alert and a Change in Format

We are going to start highlighting major changes to the landscape of Emergency Medicine residency programs.  This post contains two program updates.


New Program:

Wellstar Kennestone Hospital in Atlanta, GA

Edward Stettner, Program Director:
"...the Emergency Medicine Residency Program at Wellstar Kennestone Hospital has received our initial accreditation and that we will be accepting applications through ERAS for our first class of 12 residents to begin July 1, 2018.

The emergency department at Kennestone is the busiest in Georgia, and last year ranked as the fifth busiest nationally. We are a Level 2 trauma center, anAmerican College of Cardiology Accredited Chest Pain Center with Primary Percutaneous Coronary Intervention, and an American Heart Association Joint Commission
Certified Advanced Comprehensive Stroke Center. We are a multi-specialty tertiary care receiving facility and the hub of the Wellstar Health System. We currently have residency programs in Internal Medicine, OB-GYN, and Transitional Year, and will be looking to add additional programs in the next 3-5 years.

For residents looking to get in on the ground floor of a program with tremendous educational opportunity, this is an ideal fit. Wellstar has made a commitment to the growth of Graduate Medical Education and I am very excited about the future of medical education at Kennestone.

...contact me with any questions about the program. Our website is being updated as we speak, but contact other information is available:  http://gme.wellstar.org/"

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Format Change:

St. Joseph’s Regional Medical Center at New York Medical College in Paterson, NJ

Anthony Catapano, Clerkship Director:
"I’d like to announce that St. Joseph’s Regional Medical Center (Paterson, NJ) at New York Medical College has received approval from the ACGME to transition from a four year program to a three year program!  This change will be reflected in the current application cycle and match."

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Each year more EM programs open and a few make changes to their format.  We will feature those updates here as they are announced.