It is the first day of your EM audition rotation. You’ve read the orientation packet front to back. You’ve been brushing up on core EM topics. Just before you go out to your rotation, you notice a magic lamp. When you rub the lamp, a clerkship director genie appears! You can ask them three questions! What do you want to ask them?
How do I make a lasting impression?
Every program meets tons of students during audition season, you want to make sure you stand out, but for the right reasons! This can be difficult as a student because you want to be friendly, smart, and confident but at the same time not cocky or overbearing.
Be respectful of EVERYONE.
Realize that anyone you interact with at the hospital could have some input in you ending up in that program. Most EM residencies pride themselves on being one big family and that includes the support staff in the ED. Word travels fast, focus on being the best version of yourself all the time.
Spend some time prior to the rotation reviewing the program website and any information they may have sent you. Know if the program is 3 or 4 years, who is who in faculty leadership, who are the chief residents, etc… When you come in knowing a little bit about the program it shows that you’re already invested in the program and helps you get started on the right foot. It hopefully will also allow you to start off less nervous since you are not walking in completely blind.
Start brushing up on EM content prior to the rotation.
You likely have been bouncing from surgery to psych to OB so dedicate some time to reviewing EM material. EM Clerkship is a podcast that many 3rd/4th years like, each episode is only 10 minutes, so it is great to listen to while driving or doing things around your house. If you are more of a textbook person, check out EM case files. It is a great bread and butter EM resource! Each section is set up as a patient presentation with questions along the way. It does a good job of getting students into the mindset of thinking what would I do next?
Approach each shift/patient as a learning opportunity.
While you are competing for a residency spot at each audition program you need to remember that the rotation is also an opportunity to learn emergency medicine. While on shift keep track of topics you learned about that day as well as any topics you may want to do a deeper review of later. Use a post-it note or note card to reflect after your shift and determine what you want to read/listen up on.
How can I rock this rotation?
Students are often surprised to hear that doing well on your rotation is as easy as just being yourself, showing up on time, and being interested in learning. Don’t try to be someone you aren’t. Programs want students with a good attitude who they can teach. You aren’t expected to know everything!
Be on time.
This is so EASY that is boggles our minds when it doesn’t happen. Arrive to your shift 10-15 min early and be prepared to start seeing patients when the shift starts.
Have deliberate practice.
I sit down with my students about halfway through the rotation and pick two specific goals they want to work on. I send them some tips/resources on how to do this but then the rest is on them. I encourage them to let their resident know, at the start of their shift, that “Hey, I want to work on EKGs today” or “Today, I’m going to be presenting without my notes, will you give me some feedback on how I do on my presentations throughout the shift?” There is no reason that you cant do this on your own as well
If someone assigns you something to read up on during or after the shift – do it! There is a reason they’re asking and it might come up again. Not only does it make a good impression for you to have a follow up discussion about that topic but its also a great way for you to get a lot more out of the rotation. You also want to be open to feedback and constructive criticism. A student that can take feedback, invest in themselves and then show growth is the type of student that will be very successful in the match.
Embrace your role.
You are the medical student and you are not expected to know or have all the answers. If you didn’t ask something, be honest about that. If that trust between you as the student, and your preceptor for the day, gets broken it is extremely difficult to repair. Don’t promise the patient a plan, meds, or time frame, unless you’ve already had a discussion w/ the resident or the attending.
Be a team player.
Be a part of the team – we WANT you to be part of the team, you have a fresh perspective. That being said, engage with the team during didactics, down time, and during patient discussion. Remember there is no task that is below you!
Follow up on your patients.
Students are typically very good at providing a beautiful history, physical exam, and basic plan. However, where you can really shine in the ED is following up on patients as results return and discussing what the patient’s disposition will be. This doesn’t mean just updating your resident or attending when certain tests are back. Instead provide some sort of analysis of the results and what your next steps would be. As well as any updates about the patients symptoms from your reassessment. Even if your next steps are incorrect your investment in your patient and the effort you displayed can go along way.
What shouldn’t I do on this rotation that will impede my success?
Don’t be unteachable.
Emergency medicine is a team based specialty and every member of the team, whether it be the attending, resident, nurse, or tech has something they can teach you. If a program gets the vibe that you already “know everything” then they are less likely to spend any extra effort trying to teach you or point out knowledge gaps. This is not only a huge red flag for the program but will also negatively affect your SLOE. Be a sponge and be teachable!
Don’t give up if you don’t like the rotation.
Always work hard and do your best even if you realize a program isn’t the right fit for you. If a program sees you losing interest and not putting in the effort it is going to affect your grade for the rotation and your SLOE. So then a program that you do love, will get your SLOE and see this as a red flag. As frustrating as it may be, even if you recognize a place isn’t for you, continue to push yourself to learn and if nothing else, just fake it.
Don’t be disrespectful to other learners.
Be aware that you are not the only learner on your rotation. Be respectful of your role and be sure to allow others to also carry out their own objectives for their education. Some programs have medical students work with residents who are very early on in their careers. While they have more experience then you and alot they can teach you, the resident is also are also on an educational journey – don’t interrupt them when they’re on the phone with a consultant, or trying to finish up a note. Be aware of social cues and be smart about when to ask questions versus go into a more indepth discussion. Most importantly figure out how you can be helpful without being in the way!
Take Home Points
- Don’t be afraid to put yourself out there. It’s ok to be wrong, it is more important to show that you are teachable and open to learning.
- Be a sponge! Everyone can teach you something.
- Set goals for yourself
- Ultimately remember: You are interviewing the program as much as they are interviewing you. You need to find the best fit for you!
Listen to the Episode
Resources you should check out:
- The American College of Osteopathic Emergency Physicians- Resident and Student Organization: https://acoep-rso.org/
- CORD’s Osteopathic Emergency Medicine Applying Guide: https://www.cordem.org/globalassets/files/student-resources/applying-guide—osteo.pdf
- ALiEM’s EMBound Student Newsletter: https://www.aliem.com/em-bound/
- EMRA’s Medical Student Newsletter: https://www.emra.org/students/newsletter-articles/
- EM Over Easy’s other Med Students Over Easy content: https://emovereasy.com/med-students-over-easy/
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