Catalogue Number: MEL 7952
Emergency Medicine Clerkship
Course Overview
Welcome to your rotation in Emergency Medicine. The faculty in the Department of Emergency Medicine is excited about the opportunity to provide you with a valuable clinical experience in which you will be evaluating undifferentiated patients that will involve concepts from virtually all medical specialties. The relatively young specialty of Emergency Medicine is rapidly growing, as is the need and demand for physicians trained in Emergency Medicine. We expect this rotation to both reinforce concepts you have already learned as well as introduce some new skills. In this clerkship you will need to differentiate truly sick patients from those needing less urgent treatment. Often times, there are patients that need immediate intervention despite very little knowledge of a patient’s background.
In particular, the course in Emergency Medicine will have several areas of focus that are frequently encountered in an Emergency Department and will round out your educational experience. Reading assignments and core lectures have been developed in the following:
- Acute Signs and Symptoms (Taking care of the ABC’s)
- Toxicology
- Environmental Medicine
- EMS/ Prehospital Care
- Trauma
The goal of this rotation is for you to learn the principles of addressing the undifferentiated emergency patient and acquire the skills to recognize truly ill patients requiring further inpatient management from those who can be treated and discharged. This must be accomplished in a short period of time with a directed history and physical and selected studies. The topics listed above must also be mastered, as these are relatively unique to Emergency Medicine, and will make up the content for the examination.
Needless to say, it would be impossible in a 4-week rotation for you to learn everything about Emergency Medicine, and we do not expect you to see clinically all of the subjects covered. The topics for reading and the lecture series have been selected based on concepts unique to Emergency Medicine that you receive little or no training in other rotations, and/or are concepts that are: 1. Commonly seen, and 2. Potentially lethal and need to be addressed expeditiously.
During this rotation, you will be interacting directly with the housestaff and attending staff, including bedside teaching and daily feedback. We hope that this interaction will make a rewarding educational experience. Remember that no two physicians are identical. By observing the approach of various physicians, you will probably notice differences in evaluations and work-ups. This does not mean that there are "right ways and wrong ways" but rather different ways to approach problems. The goal in medical education and training is to learn from all of these experiences, integrate the knowledge and practices that you learn, and develop your own style in becoming a sound practicing clinician.
If you have any questions or concerns, please feel free to contact:
In Gainesville: Beth Magyari - (352) 265-5911 magyarbj@emergency.ufl.edu
Robyn Hoelle, MD, Clerkship Director (352) 392-2002 rhoelle@ufl.edu
In Jacksonville: Everlena Owens, Clerkship Coordinator (904) 244-4046 everlena.owens@jax.ufl.edu
Tom Morrissey, M.D., Ph.D., Clerkship Director (904) 244-4046 tom.morrissey@jax.ufl.edu
Students will participate in the clerkship in either Gainesville or Jacksonville at the foloowing sites:
Gainesville:
- Shands at UF (Primary Site)
- Shands at AGH
Jacksonville:
- Shands at Jacksonville
Shands at the University of Florida
The emergency department is staffed by attending emergency physicians trained in programs from around the country with varied interests and experiences including ultrasound, toxicology, wilderness medicine, critical care, EMS, and International Medicine. Attendings are present 24 hours a day, and supervise residents from various UF housestaff. University of Florida Gainesville Emergency Medicine Residenst are also in the department and have committed to enhancing medical student education..
Shands at UF treats approximately 47,000 patients annually. Many of these patients are from rural areas with few health care resources, and Shands at UF’s Emergency Department frequently receives referrals from surrounding institutions. The department is a trauama level 1 center and has fast tracks for adult and children.
Shands at Jacksonville
The emergency department is staffed by attending physicians trained in programs from around the country. The faculty at Jacksonville have also served for years in training Emergency Physicians in an Emergency Medicine Residency Program established in 1975. Given the Residency Program, more responsibility is demanded of senior Emergency Medicine Residents. To provide medical student education attending physicians are present 24 hours a day, and oversee the emergency residents, as well as housestaff from other departments.
Shands at Jacksonville treats approximately 94,000 patients annually, and represent a much more urban experience than that of Gainesville. The emergency department itself is far larger and specialized, with a Level I Trauma Center, Intensive Care areas, Pediatric Emergency Department, and Fast Track areas. The Jacksonville campus is also home of the regional Poison Control Center.
Orientation
Students will receive an email from the clerkship administrator outlining when and where to meet for orientation. In most cases, orientation is held the 1st Monday of the rotation in your respective sites. This will include a tour of the emergency department, rules and expectations at each site, and assignment of clinical schedule. An overview of patient flow, from triage to disposition, will be discussed.
EMS Experience
An integral part of your emergency medicine experience is an exposure to emergency medical systems and prehospital experience. This will include a lecture on EMS/Prehospital care, and active participation. You will have 1 shift with paramedics in ambulance ride-alongs, noting their vital role in health care, and appreciating the difficulties and limitations of prehospital care.
In addition, if you have a particular interest in EMS, we strongly encourage you to have a shift with ShandsCair. ShandsCair is our hospital based helicopter team, providing rapid response and initial assessment and treatment for patients throughout the North Central Florida Region. This has always been a very popular and educational experience however, this is not required for your rotation. If you wish to participate in a flight, please contact the clerkship coordinator to make arrangements.
Grading/Evaluation
The final grade for the rotation will be determined as follows:
- 75%clinical performance
- 25%written examination
The evaluation is based on clinical competencies that are designed to give feedback regarding your progress in becoming an independent physician. The clinical competencies for your emergency medicine clerkship are provided in the syllabus. The final grade results from the composite competency evaluations, your performance on the written exam and participation at conferences.
The faculty understands the importance of early feedback to work on potential weaknesses and enhance clinical performance. In emergency medicine, you get some instant feedback from every patient you present. At the end of your shift you will meet with your attending and receive formative evaluations daily
The clinical performance component will be based upon a COMPOSITE evaluation from the faculty. Grades will not be released until evaluation of the course is complete and the borrowed texts are returned.
Feedback
Feedback is given in the form of daily shift summaries. Each patient you see will be discussed and managed directly with an attending. At the end of your shift, your attending will fill out a shift summary and discuss with you strengths and weaknesses and areasof improvement. The faculty member will also evaluate you according to the core competencies. This daily formative feedback gives you the opportunity to improve your skills and integrate them into your practice during the clerkship.
