Scoring Procedures

One of the goals most students have for an EM rotation is to get some procedural exposure and experience.  There are some procedures that that the residents will happily give to you, like ABG's, NG tubes, suturing, and anything involving pus.

However, the procedures you are really hoping for are the ones with greater complexity, like intubation, central venous access, and lumbar puncture.  These are usually much harder to get.  You may even be in competition with an intern for these, especially in July and August.

Here are some tips that can result in more complex procedural opportunities:

1. Be involved - Your supervisors will be much more interested in finding cool stuff for you to do if you are engaged and participating in what the team does.  
2. Be ready - You need to have background knowledge on indications, contraindications, landmarks, and technique for any procedures you would hope to get the chance to do.  Your supervisors may use screening for this knowledge to decide if you get the chance to do the procedure.  Also, take any chance you get to practice on a simulator before trying this on a real person.  
3. Be proactive - It does not hurt to ask for the opportunity.  The worst thing that happens is they say, "no".
4. Be honest - Actually, the worst thing that can happen is that you claim to have experience you do not have, get found out, and then get demolished in your evaluation and letter.  Lack of experience won't keep you from some opportunities but lack of honesty will  

What in the world is FOAM... and where can I get some???

The new education trend sweeping Emergency Medicine is FOAM (Free Open Access Medical-education), also known as #FOAMed.

Offering medical knowledge free to the world is a break from the pay-to-learn model that has existed in medicine (buy a textbook, subscribe to a newsletter, pay for CD's, etc. etc.).  But information wants to be free and educators are finally embracing that it is more satisfying to expose a larger audience to what you have to teach.

Everything a student of Emergency Medicine could want to know is now out there for free. The challenge has become:  how do you find what you want to know.

As a student just getting started in this specialty you are faced with a daunting mountain of resources.  And many of these sites, blogs, and twitter feeds are not targeted to the early EM learner.  So where should you begin?

Well, two of the best sites for students recently posted some great content on getting the most out of this  wonderful new world:
Academic Life in Emergency Medicine 
iTeachEM

Enjoy!

Should I do combined EM/IM residency?

If you ask most people who trained in just Emergency Medicine they will tell you that EM/IM training is not necessary.  They may even look at you funny for voluntarily doing more ward medicine months.

As an advisor, my best "pro" for dual training was that it left open the option for Board Certification in Medical Critical Care.  With that pathway now open to those who train solely in EM prior to Critical Care Fellowship, I have had to reevaluate who I recommend EM/IM too.

But instead of listening to me, take a look at what Dr. Matt Astin had to say about his own experience over at Academic Life in Emergency Medicine.