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15 Tips for the Emergency Medicine Bound Student

Updated: Jul 25, 2021

As we move into July, many upcoming third and fourth year students may be starting their emergency medicine rotation and wondering--What can I do to succeed and stand out?? Dr. Michael Galuska (@gamerEMdoc!!!!) visits the blog today to share his expertise on how to succeed as an emergency medicine bound student.

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With Sub-Internships (Sub-I)/Away Rotations around the corner, I wanted to share some advice with the Emergency Medicine bound medical students. While this is aimed at EM bound students, this information is probably applicable to many other non-EM rotations as well.

Here are my top 15 tips on little things you can do to make a good impression and earn a good Letter of Recommendation/ Standard Letter of Evaluation (SLOE).

  1. Show up 10 min early to every shift.

    1. If you are late, even once, and someone writes about that on your SLOE (I see this several times a year reading applications), it looks AWFUL!

  2. Do not be hard to schedule.

    1. Rational requests are ok. But if the chief residents make the students' schedule, and you have a ton of requests and are a headache, I guarantee you that the chief resident will tell EVERYONE about it. Also, don’t schedule a rotation when you have an important life event you cannot miss. Remember- this is basically a 1-month interview.

  3. At the beginning of the shift, find out who you are working with.

    1. Are you assigned to a resident or attending? Introduce yourself and ask them how they'd like you to approach the shift. Some might want you to pick up charts anytime. Others may prefer to hand you charts.

  4. If you work with a resident, do anything you can to help them.

    1. I cannot stress this enough. If you can do little things that help the residents, I promise you, they will lobby for you come rank time. I’m not saying do ALL scut work, but if you show you're a team player, the residents will want you on their team permanently.

  5. Do not ever lie.

    1. If someone asks you a question like "does the patient have any vomiting" and you didn't ask, say you didn't ask. Don't say "no" and hope you are right. Because if you get caught in one lie, no one will forget it.

  6. Be courteous and nice to the nurses and ancillary staff at all times.

    1. We are all members of a team and many of our colleagues are our friends. If you are rude to someone, you can be certain we will know about it.

  7. Don't focus on the # of patients you see.

    1. It's great if you can see 10 patients a shift, but if all you are doing is an H+P and never following up on anything, never rechecking anyone, and never updating the person you are working with, then you are basically just scribing.

  8. Understand that sometimes, you may get pushed aside.

    1. The ED can be busy and chaotic. Sometimes, an attending/resident may just not have time for you to pick up another case with them. Don't be offended or take it personally. Offer to help in any way you can.

  9. Read and follow up on your cases.

    1. If you see something interesting, it would be crazy impressive to see the attending a week later and tell them "remember that patient with delirium the other night? I looked him up, and it turns out they found..."

  10. Don't just follow up labs and imaging.

    1. Anyone can do that. Students shine when they follow-up on the patients themselves. I promise you, if you go back and see a patient and catch something that wasn't caught before (patients do change over time), they will be VERY impressed.

  11. Time yourself in the room.

    1. Strive to eventually be able to get out of the room in 10 min or less. That's not going to be feasible when you start, but it eventually needs to happen. You'll learn what is essential to ask and what isn't. Your job isn't to do a medicine length H+P.

  12. Learn to present the PERTINENT positives/negatives during your H+P to make your presentations as brief as you can.

    1. No one wants to listen to a 5-minute long presentation with details that aren't relevant. The ED is chaotic and we have no attention span. BUT make sure you know the deeper information, if asked.

  13. Don't follow people around everywhere they go unless asked to.

    1. I understand you want to show that you are interested. But you are auditioning to be a physician, you aren't there to shadow. You don't need to walk around with the attending all shift attached at the hip.

  14. Sometimes less is more.

    1. We are experts in reading people, we make gut reactions with little to no info all the time in our field. We can spot gunners who are trying to suck up a mile away. Just. Be. Normal.

  15. Ask for feedback at the end of shift, take it to heart.

    1. DO NOT get defensive if someone gives you constructive feedback. Use the feedback to keep getting better.

Disclaimer: I believe these are some of the best ways for students to make a positive impression on their EM rotations. If your clerkship director, or someone else, disagrees- that's OK. Every ED and residency is different, and some of the tips I’ve mentioned may not apply. I wish you all the best of luck during your rotation!

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