Emergency Medicine

Sites: BWH
Director(s): Erik Alexander, Andrew Eyre, Kathleen Wittels
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month.
Location: BWH - Brigham and Women's Hospital (23)
Open to Exclerks: US/Canadian
Description: This course is designed to expose students to the fundamentals of emergency care with a focus on the initial triage, evaluation and management of the undifferentiated patient. Priority is placed on the "complaint-based" evaluation with a principle goal of identifying and treating life-threatening injuries and illnesses. Students will be supervised by senior residents and attending emergency physicians and will manage a wide variety of cases from minor illnesses to major trauma. Skills acquisition will be highlighted throughout the course both in the emergency department and through a series of workshops and simulation training. Procedures include (but are not limited to) bag-mask ventilation, endotracheal intubation, cardiac defibrillation, laceration repair, splinting, lumbar puncture, central venous access, and abscess drainage. Additionally, students can expect special training in the use of emergency ultrasound for diagnostic and therapeutic maneuvers. Lectures on core topics, taught by emergency medicine faculty, will occur weekly and include management of the poisoned patient, environmental emergencies, shock, and trauma resuscitation. Opportunities for pre-hospital ride-alongs are available as well as the potential for involvement in departmental research projects.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science concepts and evidence-based medicine are integrated into the decision-making, both diagnostic and therapeutic, of each patient seen in the ED. This is further strengthened through evidence-based resident and student lectures throughout the month.
Grade Criteria:
Honors with Distinction:
The Honors with Distinction grade will be awarded to students who are deemed to be clinically outstanding, have an exceptional fund of knowledge, and demonstrate superior interpersonal and communication skills and professionalism, as well as a commitment to practice-based learning. In general, approximately one-third of students will achieve the Honors with Distinction grade.
In addition, consideration for an Honors with Distinction grade will require the production of a scholarly work or a final presentation by the student on a focused topic in emergency medicine. This may include, but is not limited to the following:
- A written, evidence-based literature review and assessment of a clinical problem
- A publishable case report and discussion
- A presentable scholarly educational offering
This work is a minimum requirement for consideration of the Honors with Distinction grade, but does not ensure an Honors with Distinction grade for this elective. This requirement for eligibility for Honors with Distinction applies to all EM and Pediatric EM clerkships offered through HMS, and must be submitted on or before the last Friday of the clerkship. Attendance at lectures is mandatory unless it conflicts with an overnight shift.
The majority of students are expected to achieve the Honors grade. To do so, a student must demonstrate sound medical knowledge and its application in the clinical setting; compassionate, appropriate and effective patient care; professionalism; an affinity for practice-based learning and improvement; and effective interpersonal and communication skills. An Honors student performs thorough and efficient histories and physical exams, delivers succinct yet complete patient presentations, generates appropriate differential diagnoses and management plans, reliably carries through on care plans, communicates effectively with the healthcare team and patients, and independently engages in practice-based learning.
Examples of performance meriting a Pass grade include: performing histories and physical exams that are in general complete but occasionally miss relevant details, exhibiting a passable depth of medical knowledge, delivering verbal presentations that convey relevant material but that are sometimes rambling or disjointed, demonstrating an immature ability to formulate a differential diagnosis or follow through on a plan of care, employing adequate communication skills, demonstrating a modest interest in practice-based learning and improvement.
Examples of performance meriting an Unsatisfactory grade includes, but is not limited to: performing histories and physical exams that miss important details or require excessive time to complete, delivering patient presentations that do not focus on the clinical situation at hand or that lack relevant information, demonstrating an inability to generate appropriate differential diagnoses or carry out patient plans, exhibiting superficial medical knowledge without a demonstrated interest to develop a deeper knowledge base, utilizing ineffective communication skills, engaging in unprofessional or dishonest behavior, failing to show up for lectures.