Introduce yourself to everyone throughout your shift.
Be kind and friendly to EVERYONE you meet, including all hospital staff and patients.
Tell the residents and attendings that you’re a 3rd year student applying to EM (this is important, they will treat you differently if they know you want to do EM)
Be the intern
You should act and function as an intern. Programs are looking to hire you as an intern, and are assessing how you function as a part of their team in that capacity.
Show initiative!
Take initiative in seeing patients, writing notes, and presenting to attendings. Do not wait for someone to ask you to see a patient.
Ask if you are allowed to get patient history from EMS (some attendings want to be present, or will want a resident to be present)
Set yourself up for success
Pick up only a couple patients at a time until you get more comfortable.
Find out where the supply room is and write down the door code.
Learn how to use the EMR.
Ask where to get scrubs.
Find out where the blanket warmer, cups/water/ice, and refrigerator is.
Know where the equipment is
Scrubs
Laceration cart
Ultrasound (you may have to literally run and get one during a code, ask how they work/store images)
PPE for traumas
Find out where the free food is!
Punctuality is key.
Show up early for your shift and work hard when you are there.
Learn, learn, learn
While you are not expected to be perfect, you should still be learning every day. After all, that is why you are there in the first place.
Watch the residents do ultrasound exams and procedures to learn their techniques and refresh your knowledge.
Watch videos of procedures you hear about, write down the steps, watch a resident do it and ask to walk them through the steps to make sure you know it by heart, then you do the next one!
Ask nurses to come get you if the shift is slow so you can practice putting IVs in
Assess the program
Talk to the residents about the program and whether they are happy/what they would like to see change. Remember that you are also assessing whether the program is a good fit for you.
Ask the residents for their contact information throughout your rotation. Get to know them and stay in touch with them.
Common mistakes students make
Showing up late and leaving early or right on time (stay until someone asks you twice to leave)
Never, ever, turn down the offer to do a procedure.
"Watch one, do one, teach one"
Never, ever, do a procedure alone that you’re uncomfortable with.
Not seeing psych patients (even if they say “you don’t have to see psych patients”, offer to see them anyway)
Not looking busy at all times
Not introducing themselves to everyone on the team as the shift progresses
Taking too long to take a history on unstable patients. If something is needed urgently, leave the room and ask the doctor to order it (imaging, EKG, head CT…). They will thank you later.
If you think the patient needs a (simple) ultrasound, do it before you present the patient (if you’re comfortable)
Triangle approach
what is the patient worried about
what are we worried about
what are their vitals
A differential based approach
Not following up with your patient’s labs or imaging; not following patient through discharge
Not getting to know the nurses (some shifts you learn more from them!)
Not thinking about patient disposition.
We can give them meds and stabilize them, but what will happen when we send them home? We can help these patients in the ED.
Does your patient need a social worker?
Have they never seen a primary care doctor?
Do they have a ride home?
Do they have enough meds/supplies to get them to their next appointment?
Asking questions that could be easily found on the internet