Best & Worst of EM Rotations

[EMClerkCoord]

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I recently started as an EM Clerkship Coordinator, and while we get ready for the 11-12 year, we will be revamping the program a bit to make it even better for our students.

Here's where you guys come in! I only see the program from the administrative side, so having input from people who have been through a clerkship will be extremely helpful.


What part of your EM rotation was the best?

Worst?

Did the school/hospital do anything unique that helped you get through the rotation?

Was there anything with the school/hospital that made your EM rotation especially difficult?

 

[gro2001]

This may get better responses in the EM forum.

There seem to be some common areas that are overlooked... anyway, here are my 2 cents:

1) Get the schedule arranged some time in advance so students can make plans for free time. 'Some time in advance' means >2 weeks before the rotation starts. If you are particularly nice, email them before you start planning and ask if there are any particular nights they want off. While you are at it, you could email them the list of topics for the morning conferences that are going to take place while the students are there. This would give them the opportunity to read up on some topics and look a little less lost

2) Get EMR access arranged in advance. There is nothing more annoying than showing up on the first day and not being able to do anything because you don't have access to a crucial part of the computer system. For some reason, this almost always happens.

3) Have clear expectations of what student is supposed to do, who to report to, etc. Would be nice if the faculty also knew about these expectations

4) Most EDs are crowded, and at places that have an EMR there is often not enough space for everyone to write the notes comfortably. The medical student often ends up getting kicked off (usually politely). Would go a long way with the students if at least one computer at a work station could be designated for medical students. 😎

5) A lot of students will need a LOR/SLOR from the rotation. The best system to facilitate this I think is the following (works at a couple of places I have rotated): have a form that the student is supposed to give to each attending he's worked with at the end of the shift, and pressure the attending to complete these. Anyone the student asks for a letter gets to look at these forms, so they can write their letter not just based on the 1 or 2 shifts they've worked with the student, but on the collective evaluation of the department. Makes asking for letters easier as a student, since you don't feel so presumptuous asking someone you've barely worked with.

 

[BigRedBeta]

As a rule (and this is true in residency programs too) good rotations have clearly set expectations (which are different than Goals and Learning Objectives). There should be limited questions regarding what students are supposed to do, and every faculty member should know that students are expected to do X but not Y. Particularly in an ER setting, where most schools allow quite a bit of autonomy, the students should know what they're allowed to see first on their own, and what they need to follow an attending or resident into a room for. There should also be discussion of procedures, traumas and difficult patients.

 

[Fiddlergirl]

Completely agree with getting the schedule out in advance. Nothing is more frustrating than sitting around the night before a rotation starts with no clue as to your schedule over the next week.

 

[Vee]

To facilitate getting a SLOR, pair each student with a faculty and guarantee 3-4 shifts together so that faculty member gets to know the student well enough to write a strong SLOR.

 

[EMClerkCoord]

Thanks for the input everyone, keep it coming!

Any good stories to tell??

 

[smq123]

This is so basic, and simple, but ensure that students have access TO THE ER. I know it seems so silly, but a lot of rotation coordinators do not bother to make sure that the students have access to areas like the ER or the OR, which frequently require swipe-card/PIN code access. I remember not having OR access as a student, and having to stand outside and beg janitors to let me in.

I agree with making sure that students have EMR access (and PACS access, if your hospital uses it) in advance. Residents frequently forget that students don't have access to these things, and will often yell at students for not looking patient records up, etc. Not cool. 👎