Anyone Have Experience With Emerg Electives/Rotations At Trillium-Mississauga?

[qszwdxefc]

I got an elective there but still deciding whether I should take it. Anyone have any thoughts?

Thanks!

[ploughboy]

Wide variety of docs, backgrounds, and clinical approaches there.  Some of my friends work there as staff, and seem to enjoy it.  I had fun on my month-long elective there a few years ago.

EL is awesome.  He worked really hard as chief to bring up the standard of care in the department and get CVH more closely connected to the downtown academic programs.  But he's one of those people who engenders bimodal responses -- in my experience a lot of people love him, but a lot of people don't.  He was always really good to me.  He had me into his office for an afternoon during my rotation at CVH and we went through a bunch of the medico-legal cases he was testifying at.  He'd pull out a file, have me read the notes and then point out things like "in this case, the ER doc is going to be just fine, because he documented x,y,z and his concerns about a,b,c.  Even though the outcome was bad for the patient, the doc acted appropriately...but in this other case (pulls file folder from tottering stack of file on desk) with a similar triage note and back story, the doc didn't document his thought process, didn't order what a reasonable emergency physician would order in these circumstances, there was a bad outcome and now he's going to get his *** sued because of it..."

That afternoon was hugely valuable to me, and influences how I think and what I write on my charts to this day.  But I was a senior EM trainee at the time, and it was what I needed.  Probably not very useful to a junior learner.  But the take-home from my rambling story is that the department chief was tuned-in to what the trainees needed and tailored their learning experience appropriately.

Would I go there as a junior, undifferentiated trainee?  Yes, because there's a big volume and a lot of pathology that goes through the department.   But when you're meeting your staff at the start of the shift, try and suss out what his/her background is, how long (s)he has been practicing, and how the nursing staff and other docs interact with him/her.   Trust your gut.  You will learn some really good things there, but some of that learning might be what *not* to do in a particular situation... 

[ploughboy]

Oh ok, looking at your post I wonder if you're talking about the 100 Queensway site.  I worked there for a month as well, but on an inpatient service so I can't comment on what it's like to work a shift in that ER.  I was down in the ER a lot though.

It's busy.  Really really busy.  Some of the highest, if not the highest, volumes in the GTA (I'm sure SJH and NYGH would dispute this).  Lots of newcomers to Canada.  Lots of SES marginalization.  Lots of pathology.  Lots and lots and lots of patients.

I can't comment on the staff docs specifically (though a quick check of the CPSO register shows that a couple of people I know are now practicing there. They are competent docs and fall within the "normal, not crazy" phenotype, for what it's worth).  The nurses there were great, especially the ones in the acute and resusc areas.  I ran far too many codes down there in my month, and I was uniformly impressed by the support I received.  I'd ask for a piece of equipment, or a drug, and it would just magically appear.  It was almost like there was an old ER nurse sitting at the desk telling the young nurses "In about 5 minutes he's going to ask for X.  Grab it/draw it up, and have it outside the room and ready for when he needs it..."  It was awesome.

So that part was great.  I trust the ER nurses there, and I can't think of a higher compliment to pay to the nursing staff.  But I've never actually worked there as an ER doc, so can't say much more than that.

[qszwdxefc]

Thanks so much for the reply, sounds like it'll be a solid experience! And yes I am referring to the 100 Queensway site. I was also wondering about logistics as an elective student such as how many shifts you get per week, whether the preceptors change, and whether they give you night shifts but it's ok if you don't know!