Top 5 most useful skills before EM residency?

[sozme]

If you absolutely had to pick just five (5) individual skills to really become proficient in during 4th year before starting EM residency, what would they be? (i.e. EKG, chest X-ray interpretation, wound exploration/debridement, peripheral venous access, etc.)

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[racerwad]

If you absolutely had to pick just five (5) individual skills to really become proficient in during 4th year before starting EM residency, what would they be? (i.e. EKG, chest X-ray interpretation, wound exploration/debridement, peripheral venous access, etc.)

That is a pretty good list.

Consider adding to that the ability to deliver concise presentations with a good differential and plan. It is a definite skill to be able to get a H&P worthy of IM grand rounds and then compiling that data into a brief presentation. I struggled with a differential list sometimes because I'd rule it out in my head but not verbalize why/why not.

 

[TraumaBlonde]

well, Hopkins has one of the most amazing Emergency Medical Systems Paradigm i have ever seen. but anywhere there are alot of people, you will have the best, most beneficial residency

 

[gutonc]

I can't believe that "not being a douche" isn't on any of these lists yet.

 

[da8s0859q]

Drinking, getting along with different kinds of people, being fun to work with, developing a finely honed sense of dark humor, and never being offended.

This thread is too serious. I learned far more in just intern year of residency than I could have ever hoped to learn before it.

 

[BJJVP]

If I had to do it again, I would focus only on EKGs. Use the rest of the time to relax and enjoy pre-residency life.

I believe that reading EKGs is the toughest skill to master while in the midst of a busy residency (sleep deprived, being post call, stressed, just don't feel like "studying," etc) The other skills mentioned above will most likely be picked up just by being active and hardworking during your shifts. In addition, being confident and competent with EKGs will serve you well on almost all of your rotations, medicine, ICU, CCU, not just in the ED.

 

[RustedFox]

In an academic sense:

1.) EKG/CXR interpretation
2.) Good presentation skills
3.) ACLS/PALS algorithms
4.) Wound repair (in a reasonably timely fashion... don't camp all day on a lac: that's an easy dispo)
5.) That's it: residency is your time to learn everything else.

 

[The White Coat Investor]

As a general life skill, I find the inability to use Google effectively to be ridiculously common.

 

[link2swim06]

Great question. You will get ample time to develop all areas of emergency medicine during residency. But if I had to pick some areas, here we go:

1) suturing/wound management
2) acls/atls - at least the algorithms
3) ekg's - it's going to be tough to be proficient at this by simply studying - no matter how much Amal Mattu you listen to, it only gets reinforced during daily repitition - however it's so important that a basic understanding is absolutely essential
4) ultrasound guided IV's - I don't know if you would have any opportunity to practice, but if you come in able to knock these out on day one, you'll not only be extremely useful on all rotations but you'll have some quick respect from the seniors
5) basic ultrasound skills - have a good understanding of your way around the machine, as well as all the basic scans

This will make you really good at central access. It's kinda like practicing driving a car through a tunnel and then you go to do a central line and it's like going through the metaphorical grand canyon.

I didn't learn this skill till residency. And even after doing probably >30 of them they still aren't that easy to always get.

 

[RustedFox]

Yeah, no joke: I really wish that I was better at US-guided peripherals. I'm spoiled because my current gig has a "team" to do it that is very often available.

I'll have to just... practice.

 

[Sun Dog]

In a realistic sense:
1) Relax. Enjoy your time off the last few months
2) Enjoy. Your hobbies, sports, instruments or whatever makes you happy, you'll never have this much time off again for a while
3) Travel. Explore the country or the world, because you won't be able to sign up for any more caribbean cruises once you start
4) Taste. Explore some new microbrews that you have never tried. So when it comes to resident get togethers, you can be the beer expert.
5) Family and friends. Hangout with the people that you haven't seen in a while because you have been busy conquering med school and the next few years will be just as busy.

Don't sit home reading EKGs, ACLS books, sticking you little brother with IVs, sewing up the raw chicken in your fridge, or reading your 3rd year med school notes. Put that crap away and enjoy yourself. The purpose of residency is to teach you that stuff. If we were expected to know everything before we start than what would the purpose of residency be?
And please don't show up to residency as a gunner or a toolbag and claim to be an expert in anything...(except items 1-5)
Hope this helps.....

 

[Sun Dog]

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[iish]

1. How to open a beer bottle
2. How to put on a condom
3. How to pass a paternity test
4. How to forge a check
5. How to fake death

If you get really good at #2 then #3 won't be as important. It's something I didn't fully understand until PGY2