Tips for Med Student

[HLxDrummer]

Upon realizing that you can go into EM and not work 3 night shifts a week I have a newfound love for EM. I always liked it but knew I would be miserable working a lot of random shifts.

Anyhow, I shadow this past week and loved it. Looked at some EKGs, saw a fracture, did lots of US, etc. I have two questions for you all:

1. Do you have any tips for preparing before I shadow again? I would like to be somewhat knowledgeable and leave a good impression, but it doesn't seem like there is anyway to quickly review the basics for EM since it is so varied.

2. Do you have any tips for getting more time in the ED as a second/third year? I am almost done with the year but I have shelf exams and step 1 coming up, then third years starts. Doesn't seem like I will be able to get in there much until fourth year, sadly.

Any other info/tips/advice are appreciated.

Thanks a lot!

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[roguetwelve12]

Good to see you're interested in EM!

Regarding 1) You're right, EM can be a bit tough from this perspective. I (others may disagree) recommend reviewing the "major" things... MI, appendicitis, etc. This can be done best by just reading through Case Files: Emergency Medicine.

Regarding 2) Getting more time in the ED would be great for you both as a student and as a future applicant. If your school has an EM residency, I'd recommend getting in touch with the program director and letting him know your interest. He/she may not only be able to get you more time in the ED, but may also have other ways for you to get involved (which is vital).

If you have any other questions PM me!

 

[HLxDrummer]

Thanks for the reply! I'll definitely pick up that book.

In terms of #2, I actually just contacted the PD about shadowing her sometime (I setup the computer before class for every lecture and met her then). They do have a EM program that I would love to attend (have a free place to stay here and my fiance is planning to either go to school here or open a business here) so I figure that being a familiar face in the ED would be helpful. I will ask her if she has any ideas how to stay involved.

Again, thank you. I appreciate your reply!

 

[roguetwelve12]

Sounds like a great plan! I'd also recommend getting involved in research. Research itself isn't terribly useful as a bullet point on an application when it comes to EM, but getting to know one or two of the EM physicians well (and on a long term basis) is one of the best things you can do. This makes for great letters (and great at putting in a good word on your behalf to the program director).

If you have any other questions don't hesitate to PM me.

 

[gutonc]

2 Things from a non EP physician:

1. Come up with a good DDx for chest pain and abdominal pain.
2. Learn to identify drug seekers.

Figure those 2 out and you'll look like a superstar as an M1/2 in the ED (or on the floor for that matter).

 

[Perrin]

2 Things from a non EP physician:

1. Come up with a good DDx for chest pain and abdominal pain.
2. Learn to identify drug seekers.

Figure those 2 out and you'll look like a superstar as an M1/2 in the ED (or on the floor for that matter).

I'd be wary of trying to identify drug seekers to an attending/resident as a med student. It'd be easy for you to be seen as cynical, uncaring, or pt profiling for misidentifying a pt as a drug seeker. I'd come up with a plan for pain management that escalated or de-escalated based on findings and imaging. Under treating pain and having the pt think you are an dingus as an attending will happen, but you don't want the pt telling the attending that the med student is an dingus.

 

[gutonc]

I'd be wary of trying to identify drug seekers to an attending/resident as a med student. It'd be easy for you to be seen as cynical, uncaring, or pt profiling for misidentifying a pt as a drug seeker. I'd come up with a plan for pain management that escalated or de-escalated based on findings and imaging. Under treating pain and having the pt think you are an dingus as an attending will happen, but you don't want the pt telling the attending that the med student is an dingus.

Yeah...that part was a joke.

 

[Groove]

Upon realizing that you can go into EM and not work 3 night shifts a week I have a newfound love for EM.

Somewhat of a red flag but perhaps accidental...

EM is not a lifestyle specialty. Make certain that your interest is genuine and not misguided or you will have a miserable career. You should have a better idea at the end of your 3rd year. Shadowing and electives are a good idea. Most students (and residents for that matter) love the ED or hate it. I find very few that are on the fence. Go with your gut.

 

[Perrin]

Yeah...that part was a joke.

Need to calibrate my sarcasm meter

 

[HLxDrummer]

2 Things from a non EP physician:

1. Come up with a good DDx for chest pain and abdominal pain.
2. Learn to identify drug seekers.

Figure those 2 out and you'll look like a superstar as an M1/2 in the ED (or on the floor for that matter).

Thanks for the tip and a half lol I have begun reading the Case Files book in my spare time and it looks like it will help me get a good grasp on some of the fundamentals as you mentioned above.

I'd be wary of trying to identify drug seekers to an attending/resident as a med student. It'd be easy for you to be seen as cynical, uncaring, or pt profiling for misidentifying a pt as a drug seeker. I'd come up with a plan for pain management that escalated or de-escalated based on findings and imaging. Under treating pain and having the pt think you are an dingus as an attending will happen, but you don't want the pt telling the attending that the med student is an dingus.

When I am at the hospital/school I always try to stay positive as you said just so people don't take me the wrong way. Plus I figure I have little to no responsibilities on my shoulders now so the least I can do is be nice to people, especially patients. When I am pressured as an attending someday my attitude may change, but hopefully not.

Somewhat of a red flag but perhaps accidental...

EM is not a lifestyle specialty. Make certain that your interest is genuine and not misguided or you will have a miserable career. You should have a better idea at the end of your 3rd year. Shadowing and electives are a good idea. Most students (and residents for that matter) love the ED or hate it. I find very few that are on the fence. Go with your gut.

Thanks for the advice, but I did not mean to say I am picking it because of the low hours. I have always thought the ED was awesome and I think it fits my style well, but there was no way I could do 60 hours/week like most specialities, but on a shift schedule. When I found out you work less shifts it kind of negated the shift schedule for me if you know what I mean. So essentially if I can work in the ED for X number of hours and spend Y number of hours catching up on sleep during the day and X+Y is the same as the number of hours a surgeon or cardiologist works a week, then I consider it breaking even.

Trust me, when the PD told me they do 12 shifts a month and 3 nights/month, I probably had a huge smile on my face LOL I'm finding myself excited about school again and actually interested in learning things again. I'm anxious to shadow again, already. Doesn't help that we just had a workshop doing IV, CVC, airways, etc. and now I want to see them all done

 

[Disinence2]

Somewhat of a red flag but perhaps accidental...

EM is not a lifestyle specialty. Make certain that your interest is genuine and not misguided or you will have a miserable career. You should have a better idea at the end of your 3rd year. Shadowing and electives are a good idea. Most students (and residents for that matter) love the ED or hate it. I find very few that are on the fence. Go with your gut.

How is EM not a lifestyle specialty? Sure you work odd hours, but overall 30-40 hours a week is "Full Time" for most groups I've talked with. Its not Derm, but its on the lighter side of the spectrum. When you factor in the amount of time spent for money earned I still think its way up there.

 

[@JackShephard]

How is EM not a lifestyle specialty? Sure you work odd hours, but overall 30-40 hours a week is "Full Time" for most groups I've talked with. Its not Derm, but its on the lighter side of the spectrum. When you factor in the amount of time spent for money earned I still think its way up there.

Yes, better than most but not the best. Derm, psych, PMR, allergy seem to be the best.