How do you do this? ER anyone?

[wanabedoc19]

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How do you shadow a ER surgeon? What steps do you take?

 

[bbam44]

if you can get a hold of someones email at a local hospital that is in ER surg, you have a decent chance of getting in there. Often times they are very willing to have you come in and check it out. Unless you specifically know an ER surgeon already or someone that can connect you to one, I suggest the email method.

 

[Depakote]

Soooo much of this game is about connections. Who do you know that knows somebody else.

Do you know any, any doctors? I'd start with them. See if they know anybody that works in an ER. See if they can hook you up.

You can't be afraid to ask some people to make a few calls on your behalf. It's the only way to get experience and most people are perfectly willing to do so, it's how they got their start.

 

[MarzMD]

What is ER surgery?

 

[RxnMan]

What is ER surgery?

There's no such thing as an ER surgeon - there are surgeons on trauma rotation that take care of cases that come from the ER, which I think the OP is talking about. There is an emerging speciality called trauma surgery, but nothing named ER surgery specifically.

I volunteered in an ER and you meet a lot of surgeons there - they come down whenever there's a big trauma (GSW, car accident, stabbing). So volunteer there and get to know some. Sometimes they'll let you follow the patient up to the OR. It's a great experience because that way you'll see the patient come in, be triaged, get stabilized, operated upon, and then put into sugical intensive care.

 

[MarzMD]

There's no such thing as an ER surgeon - there are surgeons on trauma rotation that take care of cases that come from the ER, which I think the OP is talking about. There is an emerging speciality called trauma surgery, but nothing named ER surgery specifically.

I volunteered in an ER and you meet a lot of surgeons there - they come down whenever there's a big trauma (GSW, car accident, stabbing). So volunteer there and get to know some. Sometimes they'll let you follow the patient up to the OR. It's a great experience because that way you'll see the patient come in, be triaged, get stabilized, operated upon, and then put into sugical intensive care.

Yea I know. Im doing research in the ER until med school starts. Just wanted to point out(in a roundabout way) that there are no "ER Surgeons". There may be general surgery or ortho people coming down to the ER for the GSW or MVC patient. The only surgreon I have seen do something in the ER was an Ortho guy who reduced a ladies foot that was hanging there with a bone sticking out of the bottom/side.

To the OP: Like others have said, the only real way to shadow is a)through a connection, which may be hard due to HIPAA stuff or b)through a school sponsored program.

 

[Flopotomist]

Shadowing is virtually gone with HIPAA now - to gain the exposure previously acquired through shadowing, I would suggest volunteering somewhere.

 

[DMMD]

One thing I would recommend is check to see if your local hospital has an "Education Department." Usually they help coordinate CPR taining classes and the like, but the one at my local hospital also helped me with shadowing experience.

 

[deuist]

How do you shadow a ER surgeon? What steps do you take?

First, convince ACGME to create a residency program in ER surgery. Then, find the first residents in that program and call them. Then.... OH! You mean emergency physicians! In that case, you need to look for an EP. Are you a pre-med or a medical student? If you are pre-med, don't worry about EM just yet. Focus on shadowing general practice docs for right now. Your family physician is your best bet. If you want to disregard what I'm saying and really want the EP, call the education department---sometimes through the library---and ask about shadowing programs. If that scenario is not an option, ask your family physician is he/she knows someone who works in an emergency department.

 

[eram]

Originally Posted by Flopotomist
Shadowing is virtually gone with HIPAA now - to gain the exposure previously acquired through shadowing, I would suggest volunteering somewhere.

Really? I've shadowed on and off since like 1995 at various places and the only thing I saw changed was I was asked "have you seen that video? you know, the hippa one..." and once I said yes everything was ok :X

Maybe thats just from it being in a small town/rural area and not MGH or anything

 

[leviathan]

First, convince ACGME to create a residency program in ER surgery. Then, find the first residents in that program and call them. Then.... OH! You mean emergency physicians! In that case, you need to look for an EP. Are you a pre-med or a medical student? If you are pre-med, don't worry about EM just yet. Focus on shadowing general practice docs for right now. Your family physician is your best bet. If you want to disregard what I'm saying and really want the EP, call the education department---sometimes through the library---and ask about shadowing programs. If that scenario is not an option, ask your family physician is he/she knows someone who works in an emergency department.

Ohhh, deuist. 🙂

 

[jackbauer]

ER shadowing is very doable, but obviously connections help. If you're an undergrad at a university that has a medical school, then just search the ER doctor directory and fire off a bunch of emails to ER physicians telling them who you are and what you want to do - many docs are willing to drag you around, or at least to bring you in and tell the residents to drag you around. they were all in our shoes at one point and most i've met are pleased to return the favor

 

[Flopotomist]

Really? I've shadowed on and off since like 1995 at various places and the only thing I saw changed was I was asked "have you seen that video? you know, the hippa one..." and once I said yes everything was ok :X

Maybe thats just from it being in a small town/rural area and not MGH or anything

Well if you saw the "hippa" one, you saw the wrong one - it is HIPAA. If you saw the video, you would see that patients medical information is protected information that can't be disclosed to somebody not involved in the care of the patient - eg, a person following a doctor around to observe technically would be a HIPAA violation.

 

[badlydrawnvik]

the hospital by my house has a shadowing program in the ER, where you can actually get college credit for doing a certain number of hours and writing a couple of papers. i just did it for the experience though. also the hospital near my school has an amazing program with my college where you get credit for going into surgery twice a week at 6am and writing some paper; i know people who have seen so much amazing stuff doing this.

 

[jbar]

Well if you saw the "hippa" one, you saw the wrong one - it is HIPAA. If you saw the video, you would see that patients medical information is protected information that can't be disclosed to somebody not involved in the care of the patient - eg, a person following a doctor around to observe technically would be a HIPAA violation.

That's wrong, part of HIPAA states the medical education is part of patient care and is a necessary healthcare activity. It is my understanding that this includes not only medical students and residents, but also other educational experiences (including shadowing and volunteering.) JEMS did an article a month or two ago exploring if ambulances could have third riders who weren't EMS students. The lawyers said that it was okay, but that person still had to be educated on HIPAA, PHI, etc.

So in most cases you can shadow, but you are held to the same standards for protecting patient info as other healthcare providers.

 

[red dot]

i've actually been shadowing in the ER a few years now... but really it sort of fell into my lap. but for an ER surgeon specifically, i think the best way is to really map out your connections. if not, then you might have to write a letter and then email asking for permission, tell them what you're all about, how responsible you are, maybe have someone refer you, etc etc. good luck! 👍 ER's can be really chill/boring, weird, or really intense. it really changes by the hour. 🙂

 

[jbar]

i've actually been shadowing one/a few for a few years now... but really it sort of fell into my lap. i think the best way is to really map out your connections. if not, then you might have to write a letter and then email asking for permission, tell them what you're all about, how responsible you are, maybe have someone refer you, etc etc. good luck! 👍 ER's can be really chill/boring, weird, or really intense. it really changes by the hour. 🙂

Or you can just show up. I used to go to an ED in Spanish Harlem in NYC and ask to see the attending. I would say that I was an EMT who wanted to work on my spanish and was wondering if I could shadow for the day. They said yes about 5 times. Not alwayse that easy but the worst they can say is no. Usually if you show up they can point you to who you need to talk to.
Also just pure volume of requests can help. I called just about every hospital in nyc that does 911 ambulance transport and asked to do a ride along. I got about 8 nos but I got 3 yeses, good times.

 

[gujuDoc]

if you can get a hold of someones email at a local hospital that is in ER surg, you have a decent chance of getting in there. Often times they are very willing to have you come in and check it out. Unless you specifically know an ER surgeon already or someone that can connect you to one, I suggest the email method.

Yup. Email is the method I used to get in contact with several of the physicians affiliated with my medical school. It worked wonders in getting various surgeon contacts in neurosurgery, general surgery, ortho surgery and so forth.

 

[gujuDoc]

That's wrong, part of HIPAA states the medical education is part of patient care and is a necessary healthcare activity. It is my understanding that this includes not only medical students and residents, but also other educational experiences (including shadowing and volunteering.) JEMS did an article a month or two ago exploring if ambulances could have third riders who weren't EMS students. The lawyers said that it was okay, but that person still had to be educated on HIPAA, PHI, etc.

So in most cases you can shadow, but you are held to the same standards for protecting patient info as other healthcare providers.

Yes Hipaa allows leeway for letting students to observe, as long as they have the certification and then the patients further agree to it. A way around the employee issue matter is to get volunteer status which takes care of Hipaa certification and gets you the necessary paperwork needed to allow for observation without causing any violations.

You'll find academic physicians tend to be the nicest. At least this is true where I live.

 

[gujuDoc]

Shadowing is virtually gone with HIPAA now - to gain the exposure previously acquired through shadowing, I would suggest volunteering somewhere.

This is not true at all. Students are able to get Hipaa certified if they are medical students or if they are volunteers at a hospital and get their Hipaa certification through those means. At my university, our VA hospital does Hipaa training through the volunteer program and then the physicians will allow us to shadow them. The other academic hospital just has us do the Hipaa stuff through the website on the medical school's website. The doctor makes sure to ask the patients if they mind us observing and most of them don't generally care and are quite ok with it.

However, you'll find that the Hipaa laws make trying to shadow a nonacademic physician harder without connections because those are the people more uneasy about letting people shadow. On the other hand, academic physicians generally are open about it because they deal with students daily anyhow. They just double check with each individual patient that its ok. At least this is how it is in the office based shadowing things I've done.

I know some surgeons who've agred to let my fellow AED members shadow too, though, so I don't think it is an issue.

 

[Flopotomist]

That's wrong, part of HIPAA states the medical education is part of patient care and is a necessary healthcare activity. It is my understanding that this includes not only medical students and residents, but also other educational experiences (including shadowing and volunteering.) JEMS did an article a month or two ago exploring if ambulances could have third riders who weren't EMS students. The lawyers said that it was okay, but that person still had to be educated on HIPAA, PHI, etc.

So in most cases you can shadow, but you are held to the same standards for protecting patient info as other healthcare providers.

There remains some gray area here - and I acknowledge that and won't be as bold as to respond to you with "you are wrong" as you have done. Although HIPAA does allow non-medical staff access to PHI for education purposes, this vague and poorly written portion of the law has been interpreted by many to mean that you must be affiliated with the provider in an educational capacity (eg be a student of the physician you are shadowing aka a resident or medical student).

You are correct that a lawyer for EMS has indicated his opinion that riders are allowed, but remember that he represents an organization that will face a lawsuit if his view is not the view that the courts agree with. No court has as yet ruled on this issue. In fact, he himself quotes the portion of HIPAA whose interpretation is under question:

"Section 160.103 of the Privacy Rule specifically describes the workforce of a [HIPAA-] covered entity to be: ‘employees, volunteers, trainees and other persons whose conduct, in the performance of work for a covered entity, is under the direct control of such entity, whether or not they are paid by the covered entity"

Some schools have gotten around this issue by having students who want to shadow fall under the 'trainee' category by creating educational programs for them. You still have to go through HIPAA training for these though.

My point in all of this is that in spite of what the above poster will have you believe, shadowing is NOT as easy as it used to be, and that considering other options for gaining clinical experience might be a good idea. Volunteering would give you similar experience, and would be explicitly allowed under HIPAA.

 

[gujuDoc]

Flop,

I see your point. However, I think in most of my personal experiences the patients have been very open about students being let in their exam room to view. They generally don't really care, so as long as the patient has consented and the forms have been filled out, I don't think anyone has a reason to worry about lawsuits.

How this would work for something like surgery, I do not know. I just set up the surgery contacts, not view any of them. But for my personal office shadowing, I think it was pretty easy to get into shadowing because both patient and doctor were ok with it, and because the Hipaa certification went through easily.

 

[Flopotomist]

Flop,

I see your point. However, I think in most of my personal experiences the patients have been very open about students being let in their exam room to view. They generally don't really care, so as long as the patient has consented and the forms have been filled out, I don't think anyone has a reason to worry about lawsuits.

How this would work for something like surgery, I do not know. I just set up the surgery contacts, not view any of them. But for my personal office shadowing, I think it was pretty easy to get into shadowing because both patient and doctor were ok with it, and because the Hipaa certification went through easily.

I agree that patients tend to not mind - my bigger point (which keeps getting missed somehow) is that if the OP wants to gain clinical exposure, it would be easier to find a volunteering position that it would be to find a shadowing position in many areas.

 

[gujuDoc]

I agree that patients tend to not mind - my bigger point (which keeps getting missed somehow) is that if the OP wants to gain clinical exposure, it would be easier to find a volunteering position that it would be to find a shadowing position in many areas.

Ok. Yeah I agree with that. I posted this in another thread that I was just looking at a few minutes ago, but to the OP:

I know this is not related to your original question but it is related to the idea of clinical exposure.

In applying to medical school, I've been told by some adcom members, that the best thing to do is get a little of both. Some shadowing with more emphasis on volunteerism.

If you want to combine both, some ways to this are to volunteer in the ER at a local hospital or free clinics. If you are bilingual, volunteering at a place needing translators is a good option. Finally, the best way you might be able to shadow and volunteer in trauma surgery is to actually do an international medical mission trip where not only will you get to shadow and volunteer, but also get to do some hands on medical work in some cases.

I'd consider looking into one of those and volunteering at the ER of the nearest hospital to you.

 

[eram]

Originally Posted by Flopotomist
Well if you saw the "hippa" one, you saw the wrong one - it is HIPAA. If you saw the video, you would see that patients medical information is protected information that can't be disclosed to somebody not involved in the care of the patient - eg, a person following a doctor around to observe technically would be a HIPAA violation.

Wow good call picking up a typo on a 10 day old post.

Did you not read the part of my post that said I'm in a very small area and it might not be the same at a big hospital? It is as easy today as it was for me in my area. I'm sorry that you have had such a hard time getting shadowing. Maybe its the system; maybe its not. I was simply adding my experince to the list for the OP to hear...not for you.

 

[jbar]

"Section 160.103 of the Privacy Rule specifically describes the workforce of a [HIPAA-] covered entity to be: ‘employees, volunteers, trainees and other persons whose conduct, in the performance of work for a covered entity, is under the direct control of such entity, whether or not they are paid by the covered entity"
.

I have heard it argued that if you are doing anything to assist the healthcare facility, you are doing "work for a covered entity" and therefore are part of the workforce. This could be anything from getting blankets, to a vague "assisting doctors and nurses as needed, such as handing tools during procedures." If that is in the written description of duties for someone shadowing, then that person should be covered under HIPAA.

While I would agree that HIPAA has made some institutions reluctant to have non-staff in their hospitals, clinics, etc., the law itself shouldn't prohibit students from getting these experiences if the healthcare provider is willing to put some effort into the issue.

 

[gujuDoc]

I have heard it argued that if you are doing anything to assist the healthcare facility, you are doing "work for a covered entity" and therefore are part of the workforce. This could be anything from getting blankets, to a vague "assisting doctors and nurses as needed, such as handing tools during procedures." If that is in the written description of duties for someone shadowing, then that person should be covered under HIPAA.

While I would agree that HIPAA has made some institutions reluctant to have non-staff in their hospitals, clinics, etc., the law itself shouldn't prohibit students from getting these experiences if the healthcare provider is willing to put some effort into the issue.

This is why most people at major hospitals will get training through the voluntary services. At least that is the case at two of the hospitals I've contacted.

Generally the Hipaa and background check are the main thing they need from you.

I don't know, I just never really had problems getting in with shadowing where I am at. So i'm sorry if it is harder for you. If you are near a medical school, just try to contact people throug the med school.