On one of my first shifts of my EM rotation, a tech ran into the physician workroom shouting that she needed a doctor – a patient was having a seizure. The attending was checking on a patient in the trauma bays while the resident was admitting another patient, so all eyes were on me. I approached the patient, who was clearly postictal and confused, rose the head of the bed, and spoke calmly with him and his terrified family until the resident arrived.
Although backup came quickly in this case, emergency medicine is a fast-paced specialty requiring us to think and process information quickly.
If you’re in an EM rotation, you need to know the top five ways to keep up:
1. Be prepared for your clerkship. In terms of attire, facilities typically recommend or even require scrubs.
Most will provide them, and some even let you wear your own. You’ll be on your feet or standing almost constantly during a busy shift, so wearing compression socks under scrubs can be very beneficial.
Good footwear is a must! Most people wear sneakers or a comfortable clog like Dansko (eBay and thrift stores are great places to look for affordable medical clogs). In terms of tools, a stethoscope is definitely essential. I also found it helpful to keep a reflex hammer and trauma shears handy. Lastly, I’d recommend bringing a cheap pair of protective eyewear/goggles. Masks with eye protection are usually available during traumas, but in a pinch it’s always a good idea to be prepared and have your own.
2. Be proactive and get involved in the Emergency Room!
Regardless of whether you’re going into Emergency Medicine as a specialty, volunteer to see as many patients as possible to get the most out of your clerkship. Offer to suture that wound or apply a splint (even if it’s not for a patient you are following), and try to participate in as many traumas and stroke alerts as possible.
3. Study for your Shelf Exam between Emergency Medicine shifts or on days off.
Most EM clerkships require a set number of shifts to be completed during the month, and many students find they have a bit more free time than on other rotations as a result. Take advantage of this time to study EM material!
Individual clerkships tend to vary on whether the rotation ends with a Shelf, the SAEM test or an exam made by the clerkship director/EM faculty. Regardless, find a resource that works for you and stick with it. Many students find Case Files Emergency Medicine to be particularly helpful. If your institution provides access to the SAEM online question bank, take advantage of the opportunity to get in extra practice questions, especially if you’ll be taking the SAEM exam.
4. Be prepared for overnight shifts in the ER.
By the time the EM clerkship comes along, most medical students will have at least some experience with doing overnight shifts or night calls. Nevertheless, working an overnight is very different than working a day shift, especially for those of us who aren’t naturally night owls. The amount and frequency of night shifts students are required to work will vary from program to program. However, many facilities try to group them together, which definitely helps one’s sleep schedule. I always tried to take a nap before my first night shift – the first night is usually the hardest to transition to – but I’d also recommended bringing some caffeine, coffee, or energy drinks to help you stay focused.
5. Pack snacks and stay hydrated in the Emergency Department!
Often, you will not have time to leave the ED to get food from the cafeteria during a busy shift, so bring snacks and food to eat with you. I always made a habit of bringing snacks that were quick to eat (protein bars, peanut butter crackers, etc.) which I could stuff into my scrub pockets. ALWAYS bring a water bottle with you. It’s surprising how thirsty you can get running around the ED and sweating in the trauma bays, even on a shorter eight-hour shift. I also tried to make a habit of drinking a cup of water every hour or two to keep hydrated.
The emergency medicine rotation is an exciting experience where you’ll truly have the opportunity to put your skills as a med student to the test. To get the most out of it, stay sane, follow these five tips, and make sure to have fun!