Stuff for Students: EM Basic

EM Basic is a podcast and blog by Dr. Steve Caroll.  The sub-heading on his home page reads: "Your Boot Camp Guide to Emergency Medicine".  That about sums it up.

Listening to this podcast will give you a solid foundation in clinical Emergency Medicine.  He started with approaches to common clinical complaints like chest pain, abdominal pain, etc., and progressed to reviewing essential evidence and discussing elements of EM practice like trauma resuscitation, procedural sedation, and much more.

You can find EM Basic on iTunes or download the files from his website.

Enjoy!

Stuff for Students: ALiEM and Patwari Academy videos

Academic Life in Emergency Medicine (ALiEM) is a wonderful blog started by Dr. Michelle Lin for Emergency Medicine enthusiasts.  There is now a stable of authors providing useful content for anyone interested in EM.

Particularly helpful for students and early residents are the Patwari Academy videos they post every Sunday.  These are short videos, Kahn Academy style, of an expert breaking down an EM topic on a "whiteboard".  Here is a link to the most recent on Salter Harris Fracture classification.  Other recent topics include Early Goal Directed Therapy, Approach to Altered Mental Status, and a series on Chest Trauma.

To get caught up you can go to the ALiEM blog and go back through the posts, OR search the blog for all "patwari" posts.

Enjoy!

Stuff for Students: SAEM Website

SAEM is the Society for Academic Emergency Medicine.  A natural part of their mission is to provide resources for medical students, especially those with an interest in a career in academics.  They recently revised their website to make it more functional.  There are still a few bugs and misplaced links, but there is also a ton of resources for students.

Follow the "Membership" tab to the "Medical Students" page and have a look around.  What follows are a few of the most useful resources.  You do not need to be a member to use any of these, but membership does confer additional benefits, though at a not insubstantial price.

Full disclosure:  I am a member of an SAEM committee whose mission is to find ways to better serve  medical student's and resident's.  I do not think this creates any conflicts of interest.

The most invaluable resource SAEM provides are their Directories, including their Clerkship Directory and their Residency Directory.  These are interactive maps of the U.S. with links to information on most of the EM rotations and all of the Allopathic EM residencies.  This is a great place to start researching the programs you may want to apply to.  The information here is very helpful.  A word of warning: not all of the details are right (I found several errors on my home institutions page).  A residencies actual website, usually linked to in the profile, should be considered a more definitive source of information.

Another incredibly useful service provided is the E-Advisor program.  This is a great way to get advising on a different region of the country from where you go to school.  This is also a great way to connect with an adviser if you do not have a local EM program.

One more to highlight is their collection of Student Resources.  Included are a variety of documents answering common questions and providing advice on numerous issues facing students applying to EM.

There is a lot more as well including award and grant opportunities, and information on the Annual SAEM meeting (next week in Atlanta).  Enjoy!

Acing your EM Clerkship

Acing your EM Clerkship

Here are five things you can do to shine during your rotation

1. You are on stage all month: present yourself well at every opportunity. Residents, nurses, and secretaries notice how you act, and will make their thoughts known. Be polite, be agreeable, be willing to bend as needed. Be WHERE you are expected WHEN you are expected: be eager from minute one, until you leave. 
2. Yes, but... At some point you will be asked to do something you have never done before. Accept the challenge but explain your limitations. This way your supervisor knows where you are starting from. When asked if you would like to suture a child's face answer "yes, but this will be my first experience suturing a child’s face. Can you walk me through it."
3. Anticipate the next step: Students who interpret are noticed. If you sent a urine to check for infection, decide what antibiotic you want to use if it is positive. Be flexible, plans will change, patient's status will worsen, exams will change- don't be too invested in any one direction, flow with the needs of those around you.
4. Presentations present you: Be concise, succinct, and focused. Take a moment after seeing the patient to put your thoughts together and practice your presentation. Focus on the complaint and the differential, and let them guide your presentation of the history, exam, differential, and plan. The following is a great article on EM presentations: The 3-minute emergency medicine medical student presentation: a variation on a theme. Davenport C, Honigman B, Druck J.Acad Emerg Med. 2008 Jul;15(7):683-7.
5. Demand timely, useful feedback: at the end of the shift residents and attendings are rushing to finish. Rather than asking how you did at the end, give your supervisor an area to concentrate on right from the start. As you begin a shift let them know the area you want to work on. "Today I'd really like to work on my presentations, can you help me with that." Now your supervisor has a focus, and you've enlisted them to be your ally.

Applying Pages

Several new resource pages have been added to this blog that should be of help to those applying for the 2014 match.  All the "pages" can be found in the right hand column.

An Intro to the Application should get you started with some basic over-view of what you need to know now.

The pages below then elaborate on the five main components of your application:

The ERAS Application
The Personal Statement
The Dean's Letter and Transcript
The Boards
Letters of Recommendation

 Now is a great time to find out what you are going to need to do.

Spring To Do List for Fourth Years

To Do List:

1. OWN OCCUPATION Disability insurance-  As you finish up medical school you have an opportunity to get disability insurance that will cover you within your specialty of choice EM, at a steep discount. ON OC covers you if you can no longer practice in your specialty. This is imperative as many policies will stop covering if you can practice in another area of medicine. 
2. COBRA Health insurance - this is health insurance through your medical school to cover any gap from your coverage during school and your coverage at your residency hospital. Check your paperwork for coverage dates and ensure you are covered. Accidents happen, please think ahead and protect yourself.
3. PAPERWORK- Whether electronic or in paper the stack is huge. Your residency and hospital have a lot for you to fill in. While it may seem pointless and often redundant, you have an obligation to get them done and done quickly. You will be working with your residency coordinator for three to four years- don’t make her life harder by needing nagging to meet your obligation.
4. CAPSTONE- if your school doesn’t have a capstone course to get you in gear for residency then make your own. See our section on designing your own  https://www.blogger.com/blogger.g?blogID=5950597211152538922#editor/target=post;postID=5649412330569209983;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=5;src=postname
5. TAKE SOME TIME - you have an opportunity to use your time this spring to explore, travel and renew yourself. Residency will be exhilarating but the hardest work of your life. Don’t waste the time you have, enjoy it.

Away Rotations - Keeping Bridges Unburned

After working so hard, and stressing so much, over securing the Away Rotations that are going to make your application for EM perfect, it can be really hard to let those rotations go.  What is the harm in hanging onto that spot until the last minute, just in case?

Please do not do this.  Once you know you will not be completing a rotation, politely withdraw.  Three groups are hurt if you wait to the last minute to vacate that spot:

1.  You - that program that you were recently interested in enough to rotate at will now treat you like persona-non-grata.  Drop them at the last minute and you should not bother wasting money on an application.  The repercussions could be even broader than burning bridges at one program.  All the Clerkship Directors know each other.  

2.  The Clerkship and Program left with an empty spot - they are trying to get as many students an opportunity to rotate as they possibly can.  Canceling at the last minute just makes their job harder.  Clerkship Directors, as a rule, are really nice people.  Generous with their time and very much invested in helping students navigate the path to an EM Residency.  They are a difficult group to make angry.  Leaving them with a last minute unfilled spot in the rotation they pour so much of their personal and professional time into, is a very reliable way to make them angry.   

3.  The other students in the applicant pool - somebody else would have really liked that rotation opportunity that it may now be too late to fill.  Emergency Medicine is a team sport and cut-throat, self-serving behavior has no place in it.  If you even occasionally suffer from these "qualities", now is the time to remove them from your character.  

While I cannot guarantee that Groups 2 and 3 matter to you, I am pretty sure that Group 1 does.

No rationale person, including Clerkship Directors, will be angry if a student withdraws more than a month before their start date.  They may not even notice, and they certainly will not put you on a list of students whose careers they must crush.  No one has that kind of time.

Withdraw at the last minute, or no show, and that Clerkship Director may decide to make the time.