On one of my first shifts of my emergency medicine 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 confused postical patient, 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.
5 Ways to Shine on Your Emergency Medicine Rotation:
1. Wear scrubs and carry the proper tools.
Most emergency departments will require you to wear scrubs. Some will provide them, and some even let you wear your own.
Keep in mind that you will probably not be wearing your white coat very often in the emergency department, so make sure you find scrubs with plenty of pockets for tools and snacks.
You’ll be standing almost constantly during a busy shift, so wearing compression socks under scrubs can be very beneficial by improving leg circulation to prevent ankle swelling and tight calves.
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 to carry with you on shift, a stethoscope is definitely essential. I also found it helpful to keep a reflex hammer, penlight, and trauma shears handy.
Lastly, I recommend bringing a cheap pair of protective eyewear/goggles, especially during the COVID-19 pandemic when eye covering may be required at your institution to protect against droplets. 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.
Regardless of whether you are planning to pursue 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.
Emergency medicine residents are often carrying a large patient load and new patients will constantly be coming into the department, so a medical student can be a huge help by going to see new patients and providing a brief history to the resident so that they can put in some initial orders while taking care of other critical tasks.
If you see a patient by yourself that seems very sick or unstable, always go get the resident right away and let them know that they need to come see that patient immediately.
3. Study for your Shelf Exam on days off between shifts.
Most emergency medicine 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/emergency medicine faculty.
Regardless, find a resource that works for you and stick with it. Many students find Case Files Emergency Medicine or PreTest Emergency Medicine to be particularly helpful, or you can utilize the many free resources provided by the Emergency Medicine Residents Association (EMRA) on their website.
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.
By the time the emergency medicine clerkship comes along, most medical students will have at least some experience with doing overnight shifts or night calls. Nevertheless, working an overnight shift 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 students keep a more consistent sleep schedule.
I always tried to take a nap before my first night shift; the first night is usually the hardest transition, but I also recommend bringing some form of caffeine to help you stay focused.
5. Pack snacks and stay hydrated!
You will rarely have time to leave the emergency department to get food from the cafeteria during a busy shift, so bring snacks to eat. 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 emergency department 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!