If you've rotated at Denver Health Medical Center ER- Please Read!!

[binswanger]

I am doing an elective rotation out at DHMC-ER this summer. I was wondering if anyone could share their experience from their rotation or give me some tips on how to look like a superstar when I'm out there? Thanks.

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[DrQuinn]

I haven't rotated out at Denver, but I would hazard a guess that to be a star there, you would want to prepare like you would any EM audition rotation... which includes:

Getting the Top 30 Problems in EM (which you get after joining EMRA). This book is a great pocket-powered pimp-protector... you can run into the bathroom and read up on the patient you just saw before you present it to the resident/attending...

I would also brush up on procedures (read Campbell's Procedure text, I'm sure the hospital library has it. I think its Campbell's...)... like ABG, IV, Central Line, Intubation, Suturing, and anythign else you foresee coming up (different rotations allow students different levels of freedom with procedures). I would definately know how to suture... One handed ties (like when tying down a central line) can make you look like a stud, or a studette (like myself).

Read up on two or three of the patients you saw that day... likely the same presentation will show up again during your month, so you'll be ready to shine then...

And let the residents/attendings know you are interested in EM. Maybe even set up an appointment with the PD... Lastly, get your name out there, introduce yourself to EVERYBODY, and be nice. Don't ignore the nurses or patient care technicians... Its amazing how many students never introduce themselves to the nurses/staff, and they wonder why the staff is ignoring them...

Q

 

[ERMudPhud]

As an ex-chief resident at Denver Health I can tell you a few things. You can certainly get noticed by spending all your time getting to know/talking to/kissing up to the attendings but that will more than likely backfire on you. Every so often someone gets through doing this but most don't. The best way to get noticed is to be well liked by the senior residents and chief residents you work with.

At DG students are treated like interns in the ER and have primary responsibility for their patients. Any patients you sign up for will be treated only by you and most likely your senior resident. The attending may be only minimally involved. So don't spend your time smoozing with the attending, dive right in and show the senior what you can do. Keep the following in mind.

1. Try to show you can manage more than one patient at time by caring for as many as you can comfortably carry (2-4) but don't sign up for so many that their care is compromised or the department is stagnating. Don't sign up for your next patient until you have least discussed the first with your senior

2. Show that you have some idea of a differential diagnosis and treatment plan when you present the patient to the senior but don't initiate a plan (especially any crazy-ass ideas you might have) without first talking to the senior.

3. If a patient seems sicker than they should be or getting worse make sure the senior or attending knows early.

4.Participate in student rounds/lectures and don't be intimidated by the attendings.

5. We could care less if you know how to do one handed ties. most suturing is done with instrument ties anyway. You will do lots of suturing and splinting. You may get to do LP's. Central lines, Chest tubes, and intubations rarely go to students but isn't unheard of.

6.Emergency medicine secrets was written by many DG attendings so it is probably a good source for pimp material.

7. Be nice to the nurses, don't expect them to clean up after you, set stuff up for you, etc... They are busy and their opinion means a lot.

8. Have fun and be fun to work with.

9. Everyone will get to meet the Program Director but don't worry if most of the attendings don't know your name. I don't think any of them knew my name when I finished but one of the Chief Residents who I had worked with a lot did.

 

[shindog]

Originally posted by ERMudPhud
As an ex-chief resident at Denver Health I can tell you a few things. You can certainly get noticed by spending all your time getting to know/talking to/kissing up to the attendings but that will more than likely backfire on you. Every so often someone gets through doing this but most don't. The best way to get noticed is to be well liked by the senior residents and chief residents you work with.

At DG students are treated like interns in the ER and have primary responsibility for their patients. Any patients you sign up for will be treated only by you and most likely your senior resident. The attending may be only minimally involved. So don't spend your time smoozing with the attending, dive right in and show the senior what you can do. Keep the following in mind.

1. Try to show you can manage more than one patient at time by caring for as many as you can comfortably carry (2-4) but don't sign up for so many that their care is compromised or the department is stagnating. Don't sign up for your next patient until you have least discussed the first with your senior

2. Show that you have some idea of a differential diagnosis and treatment plan when you present the patient to the senior but don't initiate a plan (especially any crazy-ass ideas you might have) without first talking to the senior.

3. If a patient seems sicker than they should be or getting worse make sure the senior or attending knows early.

4.Participate in student rounds/lectures and don't be intimidated by the attendings.

5. We could care less if you know how to do one handed ties. most suturing is done with instrument ties anyway. You will do lots of suturing and splinting. You may get to do LP's. Central lines, Chest tubes, and intubations rarely go to students but isn't unheard of.

6.Emergency medicine secrets was written by many DG attendings so it is probably a good source for pimp material.

7. Be nice to the nurses, don't expect them to clean up after you, set stuff up for you, etc... They are busy and their opinion means a lot.

8. Have fun and be fun to work with.

9. Everyone will get to meet the Program Director but don't worry if most of the attendings don't know your name. I don't think any of them knew my name when I finished but one of the Chief Residents who I had worked with a lot did.

But don't your letters come from the PD and the attendings? How does it do you any good to be liked by the chief residents and staff if they're not the ones writing your letters?
Maybe if you did the rotation to get in good with that particular program. But if you're looking for strong letters I think you need to impress the attendings.

Any other thoughts?

 

[binswanger]

Thanks ERMudPhud and QuinnNSU, very informative posts. Anybody else have an opinion on Denver or preparing for ER rotations in general??

 

[ERMudPhud]

We (the seniors) evaluated all the students who worked with us and the attendings would ask for our input before writing letters. The truth is that during any given month you may work with each attending only a 2-3 times but there are only 4 seniors on for the entire month so you will work with them a lot. I'm sure my letter from DG was based almost entirely on what my senior told the attending I finally asked to write my letter.

 

[shindog]

Originally posted by ERMudPhud
We (the seniors) evaluated all the students who worked with us and the attendings would ask for our input before writing letters. The truth is that during any given month you may work with each attending only a 2-3 times but there are only 4 seniors on for the entire month so you will work with them a lot. I'm sure my letter from DG was based almost entirely on what my senior told the attending I finally asked to write my letter.

Thanks for clearing that up for me.