Medical Student Elective in Emergency Medicine – Yasmin Chishti

This post has been written by Yasmin Chishti, a Dalhousie Medicine New Brunswick (DMNB) Med 1 student. Yasmin describes her experience on elective in the Saint John Regional Hospital Emergency Medicine Department and offers advice for those considering doing a similar elective.

Medical Student Elective in Emergency Medicine – April 2014

As part of my first year of medical school, I chose to spend my elective in the Emergency Department (ED) under the direction of Dr. Lewis. I chose this area of medicine in order to gain exposure to a broad spectrum of acute care. Not only was I able to practice history taking and physical exam skills taught in the first year clinical curriculum, but also I was able to expand on concepts taught in the classroom. Learning in a clinical context helped me to solidify previously learned concepts, and also to enhance my knowledge with the help of my preceptor. I learned about many important examination skills and diagnostic tests that I had not yet encountered in my curriculum, such as ultrasound and electrocardiograms. I also learned practical skills such as suturing and drawing blood. I had more independence and patient interaction than expected, which allowed me to work on my communication skills and learn how to interact with patients in a realistic setting. I also had a great deal of exposure to other health professions and developed a greater understanding of interprofessional teamwork. To mention a few, I was given the opportunity to learn from medical residents, pharmacists, nurses, nurse practitioners, licensed practical nurses, and x-ray technicians. All of the professionals I encountered in the ED were very receptive to learners, and were eager to share their knowledge and created a very comfortable learning environment. Although there were many occasions in which I was out of my comfort zone, in terms of clinical exposure and knowledge, someone was always there to walk me through the procedures and concepts.

If you are considering an elective in the ED, I would highly recommend familiarizing yourself with the bony anatomy with focus on the hands, wrists, arms shoulders, legs and feet, as you will be exposed to a high volume of x-rays. I would also recommend finding a resource for understanding electrocardiograms (I used the highly recommended “Rapid Interpretation of EKG’S”, by Dale Dubin). I was also exposed to many ultrasounds; therefore, familiarizing oneself with the anatomy of the abdomen would be very helpful. There are also many smartphone apps I found to be helpful with trying to determine differential diagnoses, clinical presentations, and to remember key medical history and physical exam points (ERRes, UpToDate, OnExam, etc.). Also, to help with taking medical histories and physical exams, I brought pocket-sized cards, which summarized key points by system. In order to prepare for each session I reviewed medical history questions and physical exam components learned in the first year curriculum. Lastly, I would recommend leaving the white coat at home and opting for scrubs, as they are far more comfortable and worry free!

Gaining this experience early on in medical education has been very valuable to me as I feel I have learned a great deal of new knowledge, I can relate things learned in the classroom to a clinical setting, and I have a better understanding of interprofessional team work. I would recommend the ED as an elective to anyone regardless of which area of medicine they would like to enter, as the skills I learned as a first year student are very valuable in preparing for pre-clerkship and clerkship years.

Yasmin Chishti, DMNB Med 1

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