Most Useful Clerkship Rotations For Emergency Medicine?

[Arztin]

Hi all,

I will soon enough have to apply for clerkship electives. What would be the most useful rotations for emergency medicine during clerkship?

I am thinking: anesthesiology, ortho sport/fracture, GIM emergency department consult?

Any input would be appreciated!

Also, what are the rotations that you would typically learn more from by doing them in a community hospital?

And in general, it's a weird question, how do you get a ''superior'' evaluation instead of ''meets''?

Thanks

[hking03]

Hi all,

I will soon enough have to apply for clerkship electives. What would be the most useful rotations for emergency medicine during clerkship?

I am thinking: anesthesiology, ortho sport/fracture, GIM emergency department consult?

Any input would be appreciated!

Also, what are the rotations that you would typically learn more from by doing them in a community hospital?

And in general, it's a weird question, how do you get a ''superior'' evaluation instead of ''meets''?

Thanks

Arztin,

 

You get an exceeds expectations evaluation by exceeding expectations. You have to do this in a number of capacities. I'd say for Emerg (having exceeded expectations myself) the best way is to have an academic source of info that you reference for Emerg medicine and use it to prep and also during the rotation. You should also work well with staff and nurses. You should be polite to family and patients. You should show an above average ability to work up A patient, come up with a ddx and management plan.

 

In essence you need to work your tush off.

 

As for prepping for emergency medicine residency you should do as many Emerg electives as you can. Do out of province electives. Do rotations in ICU. Do trauma. Do ccu. Do anesthesia.

 

I'd also have a backup plan like family or internal. Not that those are backups. But rather emergency medicine has been quite compeititive so you are not guaranteed anything just because you do the above. Heck, even with family and internal you aren't guaranteed easy spots anymore.

 

Good luck. Hopefully that helps.

[Arztin]

Thanks buddy,

can you also tell me which ressources you would recommend? 

[frozenarbitor]

Echoing what hking said. Emerg elective (do majority of your elective in this), Rural FM/emerg, ICU, trauma, CCU, anesthesia. 

 

Resources: litfl, emcrit, em basic, emrap, emcast, em cases, 

know the cardinal presentations well. (em basics is pretty good for this)

UofT has a good pdf book that go through the basic presentations too

http://www.emergencymedicine.utoronto.ca/Assets/EmergeMed+Digital+Assets/education/ugrad/The+ABC$!27s+of+Emergency+Medicine.pdf

[Fresh fry]

https://www.youtube.com/user/UndergroudMed/videos

[ralk]

If you're arranging electives now, I imagine these are pre-clerkship or mid-clerkship electives? If so, in addition to the excellent advice already provided, make sure to have a comprehensive, organized way to present a patient to your resident and/or staff. While you should absolutely work on your knowledge base, including developing a good DDx and working on your management plan, clerks aren't expected to be amazingly capable at those parts of medicine yet - doing a good H&P then communicating that information efficiently and effectively is what staff tend to care about at this stage. An average-knowledge but well-organized clerk often does better than a knowledgeable but disorganized clerk.

 

If your electives are coming later on in the year, it's not a huge concern - you'll have the process beaten into you on your core rotations (Internal in particular), but I know some schools have earlier electives and if this is the case for you, worry less about knowing everything there is to know in EM and more about your approach to working up a new patient.

[rogerroger]

This most important from a CaRMS perspective is emerg electives, if applying for FRCPC EM then emerg electives in academic centers.

 

From a high yield learning actual EM perspective, excluding actual EM electives so less important to CaRMS, I would personally rank the following:

 

ICU/Trauma > CCU / PICU > Anesthesia > Orthopedics / General Surgery

[W0lfgang]

Top tier evals are tough to get, as they should be.  You need to show above average knowledge, clinical acumen, and work ethic.

 

Read and study lots at home. There is no substitute or shortcut for this.

 

Work harder at work than your peers. People are lazy. Be fast, but thorough. You don't want people wondering what you've been doing with your time. Appropriately enough, most people who are slow are also not very good.

 

When you present, always give a differential.  I'm sure you recognize a lot of common diagnoses by now, but always give a list of a few possibilities and how you have/will rule them out.  This means you should also always give a plan.  You could be way off, but you show more experience and maturity by doing it.

[chromeboker]

I'm sure many residency decisions by programs are not made by exceptional clinical knowledge. Just be a team player who appears to care about what they are doing. Show up on time and don't leave until the resident tells you. Hope to get a good LoR.

[rogerroger]

I'm sure many residency decisions by programs are not made by exceptional clinical knowledge. Just be a team player who appears to care about what they are doing. Show up on time and don't leave until the resident tells you. Hope to get a good LoR.

 

As a med student this is what you need to do in a nutshell. Your clinical knowledge is icing on the cake. Just appear trainable, the knowledge becomes more important later on.

 

Don't look like a tourist on your elective. Those guys are the worst...

[LittleDaisy]

What do you mean by trainable? Humble and open to criticism? thanks

As a med student this is what you need to do in a nutshell. Your clinical knowledge is icing on the cake. Just appear trainable, the knowledge becomes more important later on.

 

Don't look like a tourist on your elective. Those guys are the worst...

[Lactic Folly]

Yes, as you said, I think of trainable as bright, curious, appreciative of and even soliciting feedback to improve. The opposite is someone who calls for help and then ignores the advice, or who becomes defensive when a mistake or area for improvement is brought to their attention. This is not to say that you should not speak up if something that a more senior person has said doesn't seem quite right - but come across as questioning and trying to understand, rather than argumentative.

[chdz05]

Hi all,

I will soon enough have to apply for clerkship electives. What would be the most useful rotations for emergency medicine during clerkship?

I am thinking: anesthesiology, ortho sport/fracture, GIM emergency department consult?

Any input would be appreciated!

Also, what are the rotations that you would typically learn more from by doing them in a community hospital?

And in general, it's a weird question, how do you get a ''superior'' evaluation instead of ''meets''?

Thanks

Hey Arztin,

I just applied in ER so maybe I can help!

 

Related to ER I did : ortho in pre-clerkship, Pediatric Emergency, Cardiology and ICU. 

(Anesthesiology could be good to learn techniques) 

 

You don't have to do an ER rotation to get an invite but it can surely help. I know a lot of people who didn't do one and decided on ER last minute and still got an invite. If you have the opportunity to do one, you could do it in a community center or at McGill if it's possible. Research is not mandatory either, but then again it could help. It also depends if your plan is to stay in Quebec or if you're planning to apply outside of the province. 

 

The best advice I could give you is to work hard in all of your rotations. A majority of programs want residents who have good evals everywhere. Just be motivated, ask questions and show you want to learn. Take initiatives. For example, if you know an ambulance is coming and you're not busy, you can directly go to the trauma room to go and take the history. Reevaluate your patients when you have time and before the attending asks you to. 

 

As of the where you could do your rotations personally I did half of my rotations in university hospitals and half in community hospitals. I think I learned a lot more in community hospitals because there are no residents and its only you and the attending. In the ICU, I put pigtails in by myself without supervision, they'd let me intubate, put in radial/femoral arterial lines. In surgery you're always the first assistant, you close all the patients. For ER, in university hospitals, you'll most probably see cooler and more complex cases (but you could still see cool and different cases in community hospitals but they will have to be transferred if they are too complicated). So it's up to you to see what's possible with your schedule. They're different environments. 

 

Don't hesitate if you have more questions.