MS-III EM Rotations?

[Future Doc B]

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I plan to enter EM and I have an elective available in 3rd year. My questions are:
1) Is a 3rd year MS rotation beneficial for EM?
2) Does anyone know of any places that take 3rd years?

I tried the SAEM rotation webpage, but some of the programs listed that say they take 3rd years, don't take away rotating 3rd years. Plus, I emailed some of the contacts from that webpage and I haven't heard any response.

Thanks,

FDB

 

[WallowaWanderer]

Does your home program not have an EM residency or an affiliation with a hospital with an EM residency?

 

[dmitrinyr]

I plan to enter EM and I have an elective available in 3rd year. My questions are:
1) Is a 3rd year MS rotation beneficial for EM?
2) Does anyone know of any places that take 3rd years?

I tried the SAEM rotation webpage, but some of the programs listed that say they take 3rd years, don't take away rotating 3rd years. Plus, I emailed some of the contacts from that webpage and I haven't heard any response.

Thanks,

FDB

What city or state are you from? I am in NY city and there are a few hospitals that I know of off the top of my head that accept 3rd years for an EM rotations. I know that Brooklyn hospital has a 6 week rotation for 3rd years where you rotate through adult and peds ED and present to senior residents. I'm pretty sure SUNY Downstate has an EM rotation for their 3rd years. Honestly I'm not sure how useful an EM rotation in 3rd year will be because I believe that you need to go through your entire list of 3rd year rotations (OB, peds, IM, surg, psych) to be exposed to enough pt presentations to be able to formulate a thorough list of differential dx. Otherwise I think you might get in the way as a 3rd year in the ED. Still, I have know a few really good and thorough 3rd year students that have worked along side of me in the ED. But, I have also seen many 3rd years in the ED that just kind of stand around and have not yet mastered simple H&P taking and formulating of a diff dx and so slow things down, which is not needed in an already busy ED. Maybe I'm wrong with my opinion, but I think students should have developed a certain level of skills prior to starting their ED rotation and that's what 3rd year is about.

 

[SoCuteMD]

I honestly would discourage you from doing an EM rotation third year. The difference between EM and a lot of the other fields that you don't rotate through during third year is that all the core rotations are ESSENTIAL to good performance on an EM rotation. At an absolute minimum you need to have had: medicine, surgery, ob/gyn (abd pain in a female of childbearing age was one of the most common complaints I saw), and peds. Family medicine will be a huge help too.

My $0.02 - spend the time taking something that will add to your fourth year EM experiences. Ideas:

• ophtho to learn a slit lamp exam
• radiology to learn, well, radiology
• anesthesia to learn the basics of intubating
• ENT to learn foreign body removal for those long nights in the peds ED (haha!)
• Ortho (hopefully with a clinic rather than an OR focus) to learn management of sprains, strains, and automobiles

Those are some of the things I can think of off the top of my head. I'm sure I could come up with more if I had a course catalog in front of me.

PS - excuse my lame attempts at humor. I'm postcall

 

[WallowaWanderer]

Does your home program not have an EM residency or an affiliation with a hospital with an EM residency?

Actually, I was just thinking that you wouldn't even need to be at a place that has an EM residency to have the rotation. Does your school not offer and EM rotation at all??

 

[Universe_Explorer]

OP,
The prevailing opinion of MS3 rotations on this forum usually is negative - like SoCute said, you need to have the experience of other core rotations in order to shine. However, I disagree - third year is about learning in the ins and outs of different specialties - 4th year rotations are the time to try to impress. What better way to shine on a 4th year rotation than to gain experience in it as a third year? I spent a lot of time in the ED as a third year, and it was extremely helpful. Of course, you shouldn't do this early in 3rd year - but the ER is a great place to practice focused H&P's, get experience with procedures, etc. I would suggest scheduling a rotation at your home school or nearby. See how you like it, if EM is for you, you'll be scheduling a couple "audition rotations" fourth year anyway. Good luck

 

[Dr. Dukes]

OP,
The prevailing opinion of MS3 rotations on this forum usually is negative - like SoCute said, you need to have the experience of other core rotations in order to shine. However, I disagree - third year is about learning in the ins and outs of different specialties - 4th year rotations are the time to try to impress. What better way to shine on a 4th year rotation than to gain experience in it as a third year? I spent a lot of time in the ED as a third year, and it was extremely helpful. Of course, you shouldn't do this early in 3rd year - but the ER is a great place to practice focused H&P's, get experience with procedures, etc. I would suggest scheduling a rotation at your home school or nearby. See how you like it, if EM is for you, you'll be scheduling a couple "audition rotations" fourth year anyway. Good luck

I know a couple of MS-IVs at my school who last year (when they were MS-IIIs) persuaded ED attendings (whom they met while doing IM/Surg/whatever) to let them come in on their free time and do some EM shifts. They did maybe 5-10, the first couple to see if they liked it and to get the general flow of the ED, and then the rest they worked as if they were doing an audition rotation (had the attendings PIMP them and expect a lot from them). They all said it was a great experience, cause they figured out they really wanted to do EM, and they were that much more familiar with EM by the time they did their audition rotations.

 

[Universe_Explorer]

I know a couple of MS-IVs at my school who last year (when they were MS-IIIs) persuaded ED attendings (whom they met while doing IM/Surg/whatever) to let them come in on their free time and do some EM shifts. They did maybe 5-10, the first couple to see if they liked it and to get the general flow of the ED, and then the rest they worked as if they were doing an audition rotation (had the attendings PIMP them and expect a lot from them). They all said it was a great experience, cause they figured out they really wanted to do EM, and they were that much more familiar with EM by the time they did their audition rotations.

That's pretty much exactly what I did. If we had a required EM clerkship - or even the chance to take an elective 3rd year - I definitely would have rather gotten EM experience that way, but since we didn't, I went about it myself.

 

[WallowaWanderer]

OP,
The prevailing opinion of MS3 rotations on this forum usually is negative - like SoCute said, you need to have the experience of other core rotations in order to shine. However, I disagree - third year is about learning in the ins and outs of different specialties - 4th year rotations are the time to try to impress. What better way to shine on a 4th year rotation than to gain experience in it as a third year? I spent a lot of time in the ED as a third year, and it was extremely helpful. Of course, you shouldn't do this early in 3rd year - but the ER is a great place to practice focused H&P's, get experience with procedures, etc. I would suggest scheduling a rotation at your home school or nearby. See how you like it, if EM is for you, you'll be scheduling a couple "audition rotations" fourth year anyway. Good luck

I'm with the Explorer on this one. Well said.

 

[Northeaster]

Many of our first year residents took ED ultrasound months as students and were ahead of the game when they started. Seems like a good idea to me. Otherwise I think radiology and ophtho are good.

 

[vtucci]

We have a required 3rd year rotation in Emergency and Urgent Care. I do not know if they take 3rd years from other institutions.

 

[Future Doc B]

Thanks for the replies, I really appreciate all the different points of view (and no Fatty McFattypants or In & Out innuendo 😉).

In all seriousness, I wouldn't be asking for places if I hadn't completed my core rotations since most (if not all) places I looked at for a 3rd year rotation required completion of at least IM, Surg, Psych, OB/GYN, Peds. Luckily, my elective time in 3rd year is after completion of all my cores (all of the above + FM). So, in this situation, my feeling is that I'm essentially a 4th year by that time and this will help to confirm my decision to pursue EM. Also, a SLOR will ease my mind heading into 4th year since my required school EM rotation isn't until October...

FDB