The great thing about most Emergency Medicine rotations is that you can pretty much make your own schedule. That being said, it is best to try and schedule a few shifts with the program director if you can. It is not a bad idea to do this after you have done a few shifts to learn the ropes, and prepare youself to impress the PD. Depending on the place, you will either do 12 hour shifts like the residents and overlap with their schedules or do 8/10 hour shifts so that you are working the same hours as the attending (if you ask me this is way better- continuity throughout the shift).
Usually either a resident or the attending you are working with will assign you your patients. You are in charge of taking the history, doing the physical, presenting, and following up on the tests you ordered (not physically, the attending will do this). Some hospitals will have you write a note on the patient some will not. As far as presenting. This is a skill we are not taught so well in my school. We are taught to present internal medicine patients and such a presentation is way too long for the ED. It takes a few shifts to get used to it, but presenting in the ED is rather easy. Filter out only the pertinent information about the patient and in 2-3 sentences present the history. Follow this with the physical exam (always start with how the patient appears and whether vital are WNL) and finally a plan. A great thing to do if u are not sure is to read a little about the patient's complaint or if you are lucky and have a resident available to discuss it with (you probably wont) so that you have a real plan ready and you can present it before the attending even asks you what your plan is. Once tests and treatments are ordered stay on top of them. Check in on your patient and when something returns from the lab let your attending know so that s/he sees you are on top of things.
As far as procedures, some rotations will have workshops to teach you suturing while others will not. Find a resident early on to show you as they are doing a suture how to do it so that when you are asked if you can suture you are ready to go. They love to let medical students practice suturing you just have to make sure they know you know how. As far as other procedures, I myself did not do any but was able to see a ton- most residents will come tell you when they are doing something they think you will find interesting.
Most programs designate Wednesday for conference day. You need to go to this- it is not only educational put it allows you the opportunity to get to know the program better and let the residents get to know you.
As far as preparing for the rotation. I personally didnt do much. What I might recommend now looking back is to review how to read and present an EKG and maybe look at a suturing video on NEJM website. There was so much I didnt know and I took the opportunity in the hospital to read about it in between my patients. The beauty of being a medical student is they give you only like 2-3 patients at a time, so there is pletny of time to read on up-to-date about certain big topics in EM.
Best overall advice. Let them see you. You want good exposure to the right people so that you leave them talking about you and therefore wanting to rank you later on. This is done through scheduling with the right people, showing an interest in your patients and learning on the spot about their illness and showing up to conference on time and ready to participate (even though you wont really!).
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