Emergency Medicine: Fourth Year Rotation
About Our Rotation for Fourth-Year Medical Students
The Department of Emergency Medicine at Beth Israel Deaconess Medical center offers a 4-week clinical rotation for fourth-year medical students. One of our goals for students is to develop an understanding and appreciation for the breadth and depth of emergency medicine during their rotation. The evaluation and treatment of patients in the emergency department differs from that of patients who are on an inpatient service. The work of the emergency physician is directed toward the initial assessment, stabilization, and management of patients with a wide range of presenting complaints and problems. You should use this elective experience to hone your skills in the following areas:
- Recognize patients with acute illness
- Initiate emergent therapy to stabilize an unstable or deteriorating condition
- Create a differential diagnosis based on the patient's history and your physical examination findings
- Learn how to rule out potentially life-threatening illness
- Develop an assessment of the likely causes of the present complaint
- Help initiate a plan of treatment, whether it be through inpatient admission or outpatient care with primary physician follow-up
We encourage you to follow-up on your patients either on the inpatient floors or through their primary care physician in order to enhance your overall understanding of their illness, and to allow you to "close the loop" in your initial evaluation and treatment thoughts. You will find that patients are pleased to know that you are still interested in, and concerned about their care.
Because the evaluation of patients in the Emergency Department (ED) many times is based on a brief problem-oriented history and physical, the scope of your evaluation will be dictated in large part by the nature and level of acuity of the patient's presenting problems.
The ED provides a unique setting in which to learn and develop technical and procedural skills. The procedures which you may be able to observe or participate in will vary, but will include wound care and suturing, fracture and dislocation care, abscess incision and drainage, arthrocentesis, slit lamp examination, lumbar puncture, gastric intubation, femoral venipuncture and catheterization, and arterial puncture. Each student's exposure to these routine practices will vary, but every reasonable effort will be made to include you in the ongoing procedures while you are on a clinical shift. You will be functioning as sub-intern and will have primary patient care responsibility. There is also an extensive didactic schedule including skill and simulation sessions.
Clinical Activities
Students will be expected to work a combination of day, evening, night, and weekend shifts. You will be working side by side with residents and faculty from the Harvard Affiliated Emergency Medicine Residency at BIDMC. Your emergency medicine rotation will consist of the following:
- Clinical ED shifts at BIDMC on a rotating schedule
- Most shifts are 8 hours in length
- Clinical ED shifts at BIDMC Needham - Our community affiliate
- An optional ride-along with EMS is available
- During baseballs season, the ability to work in the first aid station at Fenway Park home of the Boston Red Sox
Didactic & Simulation Activities
An extensive didactic schedule is available to students on rotation in emergency medicine at BIDMC:
- Weekly didactic sessions with the BIDMC/HAEMR residency which include Morbidity & Mortality conference and other core emergency medicine topics
- Resuscitation and procedural training sessions using the state of the art Carl J. Shapiro Simulation and Skills Center (SASC)
- The HMS Division of Emergency Medicine student lectures series by faculty from throughout Harvard
For more information about a career in emergency medicine and how to succeed on the clerkship, you can download the EM Clerkship Primer.
Underrepresented in Medicine Scholarship
The Department of Emergency Medicine is pleased to offer financial assistance for fourth-year underrepresented in medicine (URiM) medical students who have been accepted to our visiting student clerkship. This scholarship is $2000 and is meant to offset the cost of housing and travel to Boston for the clerkship. Students must be in good academic standing at a US accredited medical school and must complete all requirements for application to the clerkship.
Interested applicants should contact Dr. Nicole Dubosh for additional information and the scholarship application when they apply for the clerkship through VSLO.