Another rotation down, folks! I finished my EM rotation a week ago and then it was a frenzy of getting ready for my first residency interview: dusting off my suit and shoes, doing a mock interview, learning everything I could about the program, etc. More on that later. I'm off to California tomorrow for a week of relaxing and eating at my home away from home with my parents before I get back on the interview trail.
EM was a really great rotation. For probably many reasons, students have a lot more independence in the ED. In the past, I worked closely with a resident and though I did my own evaluation and assessment of our patients, it was still a team effort to make and execute the plan for their care. On my EM rotation, I was essentially an intern. As long as patients were stable, I could assess them independently, write up the note and put in all the orders I thought were appropriate before presenting to my attending and then they would sign off on my orders as long as they were within reason. It was a tough transition at first because the ED is a high-speed environment, and as a student you are not really responsible for efficiency of patient management. So it was a bit of a learning curve to figure out how to thoroughly evaluate a patient, write a complete note, make sure your orders were placed and signed off in a timely fashion, and finally present the patient to the attending (who may or may not be seeing one of their 10 other patients). Once I got the hang of it, though, it was a pretty fun rotation. I saw a really good code (aka resuscitation of a cardiac arrest patient) finally, and managed patients with a huge variety of problems.
Although, what post would be complete without getting on my primary care soapbox? I definitely reaffirmed (for the 10,000th time) my desire to enter the field of family medicine. You see a similar variety of patients in a primary care office (though, less critical in nature at times), but you actually have the time to do a complete workup and have the benefit of follow-up visits with patients. Sure, it's kind of a thrill to go into that code with guns blazing: popping in arterial and central venous lines, the AutoPulse squeezing away, intubations, vasoactive drugs, etc. But, I guess in the end I will feel better about my day's work if I can prevent someone from meeting that violent end.
