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I am interested in EM. What rotations would you recommend for the 4th year to better prepare me for internship/residency? Thanks
4th year rotations for EM prospect
- Thread starter nutka1111
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We had a sit down with our residency director just the other week.
He said PICU and SICU are good because you usually get chance to learn intubations etc. that you'll have to do as an EM doc
Neurology is better than Neuro surgery because being able to do a really good neuro exam is huge as an emergency physician.
If you have subspecialty EM rotations available to you those are handy (eg. we have ultrasound EM at our school)
He said PICU and SICU are good because you usually get chance to learn intubations etc. that you'll have to do as an EM doc
Neurology is better than Neuro surgery because being able to do a really good neuro exam is huge as an emergency physician.
If you have subspecialty EM rotations available to you those are handy (eg. we have ultrasound EM at our school)
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ICU (I prefer SICU over MICU, but both are quite beneficial), Anesthesiology, Neuro, Sports Med
ICU and Anesthesiology rotations will get you exposure to sick patients and procedures, so you can show up to your first year not as clueless. You'll get more of these rotations as a resident, but they're rotations that I think nearly every medical student should do.
Neuro or Neurosurgery, depending on what your role would be for either. The ability to do a good neuro exam is priceless, as is the ability to interpret neuro films. If your NS rotation would have you spend time in the NeuroTrauma ICU, even better (serial neuro exams, vents, ICP management).
Sports Med is fun, and gets you exposure to both primary care, and basic sports trauma. Things to take from this would include knowing what imaging techniques for various injury patterns, relocations, Ottowa ankle rules, and splinting.
After that, pick some things you enjoy. Maybe a month of Wilderness medicine, or an international elective. I just got back from a month of Wilderness/Remote medicine in Belize, which was totally awesome (live tissue lab, FTW). Some places offer Toxicology electives, which could be fun. Some rotation involving the care of sick kids (PICU, Peds ER) would also be good. Other than that, just have fun.
I will end this by stating that I am not actually going in to EM, but thought about it for quite a while before changing.
ICU and Anesthesiology rotations will get you exposure to sick patients and procedures, so you can show up to your first year not as clueless. You'll get more of these rotations as a resident, but they're rotations that I think nearly every medical student should do.
Neuro or Neurosurgery, depending on what your role would be for either. The ability to do a good neuro exam is priceless, as is the ability to interpret neuro films. If your NS rotation would have you spend time in the NeuroTrauma ICU, even better (serial neuro exams, vents, ICP management).
Sports Med is fun, and gets you exposure to both primary care, and basic sports trauma. Things to take from this would include knowing what imaging techniques for various injury patterns, relocations, Ottowa ankle rules, and splinting.
After that, pick some things you enjoy. Maybe a month of Wilderness medicine, or an international elective. I just got back from a month of Wilderness/Remote medicine in Belize, which was totally awesome (live tissue lab, FTW). Some places offer Toxicology electives, which could be fun. Some rotation involving the care of sick kids (PICU, Peds ER) would also be good. Other than that, just have fun.
I will end this by stating that I am not actually going in to EM, but thought about it for quite a while before changing.
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lots of good suggestions above.
I would add ophthalmology to the list as another good 4th year elective.
in regards to picking amongst all the rotations already listed, I would recommend asking around to find out which of these rotations are good at your school. if you're going to sit around or shadow the whole time, it's not worth your time. pick a few elective rotations where you're most likely to get the best hands-on experience, and go with those.
I would add ophthalmology to the list as another good 4th year elective.
in regards to picking amongst all the rotations already listed, I would recommend asking around to find out which of these rotations are good at your school. if you're going to sit around or shadow the whole time, it's not worth your time. pick a few elective rotations where you're most likely to get the best hands-on experience, and go with those.
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A week or two of radiology if it's not required by your school.
Ortho if you can get out of the surgery portion (since a lot of it is scopes) and spend more time in fracture clinic.
Ortho if you can get out of the surgery portion (since a lot of it is scopes) and spend more time in fracture clinic.
I'm going into EM in 1 month and can't wait. A bit of advice is that you'll want to do at least a couple away audition electives. If you can do an away elective in a EM subspecialty (tox, peds, sports, ultrasound) that still gets you exposure to the program, and you get something extra out of it, imo. As for some non-EM electives, my advice is to actually
1. Not do rotations that you'll have to do in EM residency. So I don't recommend anaesthesia to learn intubations, I don't recommend SICU or CCU for high-risk patients. Ortho and cards are another story though since you may not have set-aside time to really learn casting and EKG
2. For any rotation you do want to do, call up the department, tell them exactly what you're looking for in a rotation, and find out if you can get what you want out of the rotation while learning what they want you to learn.
So here's some thoughts on specific rotations:
1. Cardiology - but only if you get a ton of EKG training. Basic cardiac u/s also isn't a bad idea, depending on how much ultrasound is taught at your program.
2. Derm - you'll have to see plenty of rashes. It's a good idea to do a rotation just so you can learn derm lingo (if you don't, any derm consults are messy). If you're lucky, you'll see the 1 or 2 derm emergencies you'll need to recognize.
3. Optho - not all programs have you do optho. But if you do this, make sure you're going to use equipment that you'll actually have in an ED, make sure you don't have much surgical time, make sure you're not going to spend a lot of time at a glaucoma clinic or anything like that. You need to learn acute eye issues, not chronic ones, not surgical ones, not ones you need a special retinal camera to see.
4. Radiology - only bother with this if you're gonna get a lot of plain film training with ppl who read the ED and ICU films. Or if your school doesn't have it as a required rotation. Don't bother otherwise.
5. Neurology/Neurorad - only deal with this if ur neuro-required rotation is crappy or you don't do one. Otherwise, you should be able to do a good neuro exam on your own, and be able to read head CTs for masses, strokes, bleeds at this point
6. Ortho - you may not have set-aside ortho time in ur residency. So anything dealing with fractures, ortho exam, reductions, casting is good. Stay out of the OR
7. Trauma Surg - eh I don't really recommend this. EM is not a surgical field, trauma is protocol-driven. You won't get anything out of this that you can't get from ur ATLS course and 3-4 years of EM residency.
8. Anaesthesia - I know I said don't worry about intubations. But, if you can find an anaesthesia rotation where you learn lots of nerve blocks, then you will really get something out of it that you might not get in your residency. I kind of regret I didn't have time for this.
9. ICU - as I said don't bother. BUT, peds ICU, now there's something you could get a lot out of. You can never see enough sick kids. EVER.
10. Renal - I've heard it recommended by one ED PD. I don't know why he recommended it. I personally hate Renal phys. If someone can explain to you why you shoudl take this with good reasoning behind it, give it a thought.
1. Not do rotations that you'll have to do in EM residency. So I don't recommend anaesthesia to learn intubations, I don't recommend SICU or CCU for high-risk patients. Ortho and cards are another story though since you may not have set-aside time to really learn casting and EKG
2. For any rotation you do want to do, call up the department, tell them exactly what you're looking for in a rotation, and find out if you can get what you want out of the rotation while learning what they want you to learn.
So here's some thoughts on specific rotations:
1. Cardiology - but only if you get a ton of EKG training. Basic cardiac u/s also isn't a bad idea, depending on how much ultrasound is taught at your program.
2. Derm - you'll have to see plenty of rashes. It's a good idea to do a rotation just so you can learn derm lingo (if you don't, any derm consults are messy). If you're lucky, you'll see the 1 or 2 derm emergencies you'll need to recognize.
3. Optho - not all programs have you do optho. But if you do this, make sure you're going to use equipment that you'll actually have in an ED, make sure you don't have much surgical time, make sure you're not going to spend a lot of time at a glaucoma clinic or anything like that. You need to learn acute eye issues, not chronic ones, not surgical ones, not ones you need a special retinal camera to see.
4. Radiology - only bother with this if you're gonna get a lot of plain film training with ppl who read the ED and ICU films. Or if your school doesn't have it as a required rotation. Don't bother otherwise.
5. Neurology/Neurorad - only deal with this if ur neuro-required rotation is crappy or you don't do one. Otherwise, you should be able to do a good neuro exam on your own, and be able to read head CTs for masses, strokes, bleeds at this point
6. Ortho - you may not have set-aside ortho time in ur residency. So anything dealing with fractures, ortho exam, reductions, casting is good. Stay out of the OR
7. Trauma Surg - eh I don't really recommend this. EM is not a surgical field, trauma is protocol-driven. You won't get anything out of this that you can't get from ur ATLS course and 3-4 years of EM residency.
8. Anaesthesia - I know I said don't worry about intubations. But, if you can find an anaesthesia rotation where you learn lots of nerve blocks, then you will really get something out of it that you might not get in your residency. I kind of regret I didn't have time for this.
9. ICU - as I said don't bother. BUT, peds ICU, now there's something you could get a lot out of. You can never see enough sick kids. EVER.
10. Renal - I've heard it recommended by one ED PD. I don't know why he recommended it. I personally hate Renal phys. If someone can explain to you why you shoudl take this with good reasoning behind it, give it a thought.
I'm going itno EM in 1 month and can't wait. A bit of advice is that you'll want to do at least a couple away electives. If you can do an away elective in a EM subspecialty (tox, peds, sports, ultrasound) that still gets you exposure to the program, you get something extra out of it, imo. As for some non-EM electives, my advice is to actually
1. Not do rotations that you'll have to do in EM residency. So I don't recommend anaesthesia to learn intubations, I don't recommend SICU or CCU for high-risk patients. Ortho and cards are another story though since you may not have set-aside time to really learn casting and EKG
2. For any rotation you do want to do, call up the department, tell them exactly what you're looking for in a rotation, and find out if you can get what you want out of the rotation while learning what they want you to learn.
So here's some thoughts on specific rotations:
1. Cardiology - but only if you get a ton of EKG training. Basic cardiac u/s also isn't a bad idea, depending on how much ultrasound is taught at your program.
2. Derm - you'll have to see plenty of rashes. It's a good idea to do a rotation just so you can learn derm lingo (if you don't, any derm consults are messy). If you're lucky, you'll see the 1 or 2 derm emergencies you'll need to recognize.
3. Optho - not all programs have you do optho. But if you do this, make sure you're going to use equipment that you'll actually have in an ED, make sure you don't have much surgical time, make sure you're not going to spend a lot of time at a glaucoma clinic or anything like that. You need to learn acute eye issues, not chronic ones, not surgical ones, not ones you need a special retinal camera to see.
4. Radiology - only bother with this if you're gonna get a lot of plain film training with ppl who read the ED and ICU films. Don't bother otherwise.
5. Neurology/Neurorad - only deal with this if ur neuro-required rotation is crappy or you don't do one. Otherwise, you should be able to do a good neuro exam on your own, and be able to read head CTs for masses, strokes, bleeds at this point
6. Ortho - you may not have set-aside ortho time in ur residency. So anything dealing with fractures, ortho exam, reductions, casting is good. Stay out of the OR
7. Trauma Surg - eh I don't really recommend this. EM is not a surgical field, trauma is protocol-driven. You won't get anything out of this that you can't get from ur ATLS course and 3-4 years of EM residency.
8. Anaesthesia - I know I said don't worry about intubations. But, if you can find an anaesthesia rotation where you learn lots of nerve blocks, then you will really get something out of it that you might not get in your residency. I kind of regret I didn't have time for this.
9. ICU - as I said don't bother. BUT, peds ICU, now there's something you could get a lot out of. You can never see enough sick kids. EVER.
10. Renal - I've heard it recommended by one ED PD. I don't know why he recommended it. I personally hate Renal phys. If someone can explain to you why you shoudl take this with good reasoning behind it, give it a thought.
1. Not do rotations that you'll have to do in EM residency. So I don't recommend anaesthesia to learn intubations, I don't recommend SICU or CCU for high-risk patients. Ortho and cards are another story though since you may not have set-aside time to really learn casting and EKG
2. For any rotation you do want to do, call up the department, tell them exactly what you're looking for in a rotation, and find out if you can get what you want out of the rotation while learning what they want you to learn.
So here's some thoughts on specific rotations:
1. Cardiology - but only if you get a ton of EKG training. Basic cardiac u/s also isn't a bad idea, depending on how much ultrasound is taught at your program.
2. Derm - you'll have to see plenty of rashes. It's a good idea to do a rotation just so you can learn derm lingo (if you don't, any derm consults are messy). If you're lucky, you'll see the 1 or 2 derm emergencies you'll need to recognize.
3. Optho - not all programs have you do optho. But if you do this, make sure you're going to use equipment that you'll actually have in an ED, make sure you don't have much surgical time, make sure you're not going to spend a lot of time at a glaucoma clinic or anything like that. You need to learn acute eye issues, not chronic ones, not surgical ones, not ones you need a special retinal camera to see.
4. Radiology - only bother with this if you're gonna get a lot of plain film training with ppl who read the ED and ICU films. Don't bother otherwise.
5. Neurology/Neurorad - only deal with this if ur neuro-required rotation is crappy or you don't do one. Otherwise, you should be able to do a good neuro exam on your own, and be able to read head CTs for masses, strokes, bleeds at this point
6. Ortho - you may not have set-aside ortho time in ur residency. So anything dealing with fractures, ortho exam, reductions, casting is good. Stay out of the OR
7. Trauma Surg - eh I don't really recommend this. EM is not a surgical field, trauma is protocol-driven. You won't get anything out of this that you can't get from ur ATLS course and 3-4 years of EM residency.
8. Anaesthesia - I know I said don't worry about intubations. But, if you can find an anaesthesia rotation where you learn lots of nerve blocks, then you will really get something out of it that you might not get in your residency. I kind of regret I didn't have time for this.
9. ICU - as I said don't bother. BUT, peds ICU, now there's something you could get a lot out of. You can never see enough sick kids. EVER.
10. Renal - I've heard it recommended by one ED PD. I don't know why he recommended it. I personally hate Renal phys. If someone can explain to you why you shoudl take this with good reasoning behind it, give it a thought.
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Just finishing my PGY-1 in EM this month!
I would recommend at least one ICU rotation, because when I came into the SICU here in October, I had never managed a ventilator. The learning curve was steep, but it would have been less intimidating to have had some experience with this sort of thing beforehand.
I'd also recommend: a cardiology rotation, or something in which you get great EKG interpretation exposure; neurology, because it's great to solidify the exam; ortho/sports medicine, because I learned more about pre-inpatient management of sports injuries at my 4th year ski clinic rotation than as an ortho intern scut monkey; and ultrasound- you can never get enough experience with this!
I would recommend at least one ICU rotation, because when I came into the SICU here in October, I had never managed a ventilator. The learning curve was steep, but it would have been less intimidating to have had some experience with this sort of thing beforehand.
I'd also recommend: a cardiology rotation, or something in which you get great EKG interpretation exposure; neurology, because it's great to solidify the exam; ortho/sports medicine, because I learned more about pre-inpatient management of sports injuries at my 4th year ski clinic rotation than as an ortho intern scut monkey; and ultrasound- you can never get enough experience with this!
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