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.