bearstanley

goin' where the climate suits my clothes
2+ Year Member
Apr 11, 2016
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i'm a fourth year at a lower tier MD school in the US. we do not have an EM residency.

i'm finishing up my home rotation next week and then doing my first away at a larger and well respected program in a big city far from home. i'm having pre-rotation anxiety about getting there and being orders of magnitude behind the other students. the ED here is very laid back and low volume. i know how to work hard, be enthusiastic, and all that jazz- i'm just scared about being disadvantaged because of where i'm coming from.

any words of advice besides "chill out and keep reading" ?
 

racerwad

7+ Year Member
Sep 8, 2009
959
733
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Resident [Any Field]
i'm a fourth year at a lower tier MD school in the US. we do not have an EM residency.

i'm finishing up my home rotation next week and then doing my first away at a larger and well respected program in a big city far from home. i'm having pre-rotation anxiety about getting there and being orders of magnitude behind the other students. the ED here is very laid back and low volume. i know how to work hard, be enthusiastic, and all that jazz- i'm just scared about being disadvantaged because of where i'm coming from.

any words of advice besides "chill out and keep reading" ?
No one cares about your clinical ability. No one. I assume after 3+ years of medical school you understand the basics of human physiology, so as long as you don't ask dumb questions about why oxygen is important in hypoxemia, you'll be fine. Your residents and faculty are more interested in your enthusiasm, teachability, and personality. If it was simply "how much do you know about the specialty," we'd have all applicants take the ABEM in-service and go from there.
 

HankTheTank910

2+ Year Member
Jan 14, 2016
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12
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Resident [Any Field]
I'm a PGYII so I obviously can't speak for administration, but I will say this:

I expect all students to be pretty dumb. They don't know the field that well, they have some pretty lousy plans sometimes, and they're in a "medical student" mentality (not an ER mentality). Obviously, if you're an outstanding student with a lot of knowledge that certainly helps, but I don't think it plays as big of a part as you think. Most students are middle of the road, and when the faculty ask us about the students come rank time their clinical skills are not the thing the first thing I think of. I consider these three to be of my top importance, in no particular order:

1. Are they on time, excited to be there, and willing to pick up patients?
2. Do they display a questioning attitude, and a willingness to learn?
3. Are they nice people?

We have a ton of students on our service right now, but one in particular is always on time, eager to learn (without the obvious brown nosing), and a normal person who is easy to talk to. We invite all the students to play on our softball team, and he's the only one who came to our last game (played third base for us). I couldn't tell you the first thing about his clinical ability, but I'll definitely be recommending him for our program.
 
Jul 5, 2014
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I came from a "low tier" DO school and I felt on the same level as other rotators. Not that I'm that smart or anything, I just think that there's less of a knowledge gap between students from "low versus high tier" schools, at least for EM. Surgery or ICU type away rotations, you might be at more of a disadvantage based on your school's reputation. With that being said, I have seen students from really reputable schools doing aways at my program and they are sometimes orders of magnitude behind students from supposed low tier schools. A lot of it is what you put into it and how hard you work.


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Nov 17, 2015
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i'm a fourth year at a lower tier MD school in the US. we do not have an EM residency.

i'm finishing up my home rotation next week and then doing my first away at a larger and well respected program in a big city far from home. i'm having pre-rotation anxiety about getting there and being orders of magnitude behind the other students. the ED here is very laid back and low volume. i know how to work hard, be enthusiastic, and all that jazz- i'm just scared about being disadvantaged because of where i'm coming from.

any words of advice besides "chill out and keep reading" ?
First of all. You are absolutely normal. Many of us are the same way with a new rotation etc... Even us experienced physicians get nervous and insecure. Take action and just do. You will find that you are smarter than you feel. You will find that you have so much to offer. Be present and be engaged. Be yourself. A lot of it is personality. You may run into a jackass or two but hopefully, that will not be the case. Try not to take it personally. Go in with open eyes and a good mindset of positivity. Be welcome to feedback if given. I would focus more on presenting properly. Presenting to ER attendings is much different than presenting to an IM attending. There are 5 min EM videos on Youtube and resources on EMRA. If you have already completed your away rotation, I am sure you exceeded your expectations. Good for you. You will be fine. Look how courageous you are for the small fact that you were able to share on here. Best of luck my friend.