A faculty's perspective: Doing well on your EM clerkship


To follow-up with Dr. Connolly's post about the Top 10 tips for medical students to rock the EM clerkship rotation, I thought I would post some additional tips. Here are some more pearls:

11. Take ownership of your patients. 
This means that you should take it upon yourself to make sure that your patient's care is stellar, addresses key clinical and social issues, and is timely. Constantly check for your patient's results. Don't be the last to hear of your patient's lab or imaging results. Figure out why there are unexpected delays. Address any psychosocial issues which may hamper your patient's clinical improvement in the ED.

12. Have a learning plan on shift.
It's helpful to yourself and others to have a focused learning plan for each shift. For instance, this might be -- I want to get better at reading plain films. Let the senior resident and attending know. This fulfills two purposes. First, you'll likely get pulled in to view and read films even though they might not involve your patient. Usually the senior resident or attending will keep a lookout for interesting findings. Second, this shows that you are an active learner who is seeking out learning opportunities rather than letting them passively and randomly occur.

13. Don't be late to your shift.
'Nuff said.

14. In addition to trauma shears, carry a very bright pen light. 
A bright light source comes in handy all the time. I use a bright LED pen light and I constantly use it on shift. This works well especially when trying to examine for laceration, foreign bodies, and other such injuries.

15. Befriend the nurses.
This is a good general rule of thumb for everyone. The nurses are a key part of the medical team and have great clinical gestalt about what is going on with the patients. Introduce yourself to them at the start of your shift. Listen seriously to their concerns and comments. They are a wealth of wisdom and can help answer many of your questions.

16. Clean up your sharps and equipment after procedures.
This is a corollary to rule #15.

17. Start learning about bedside ultrasonography.
This bedside tool is constantly being used in the Emergency Department an. Read up a little on the more common types of ultrasound exams. The most common are probably vascular ultrasounds for central line access and the FAST exam. If you can, try to get some hands-on experience on your cases. Hey, maybe your learning plan for one of your shifts might be to become more adept at bedside ultrasonography!

Good luck to the new MS4 medical students!