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My Emergency Medicine Elective

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  • #1: Brooklyn, NY (elective rotation #3) - 4 weeks 

    • Adult Emergency Medicine ​

    • Shifts: 7a-3p, 3-11p, 11p-7a 

    • Required to do one week of each shift with the last week as a repeat shift of your choice; Minimum of 3 days per week and must work one full weekend 

    • About 4 students per shift 

    • Scrubs allowed ONLY on night shift (business casual for the other shifts) 

    • Lectures: Wednesday mornings 

    • Overall thoughts: I loved this rotation so much - it had everything I loved: variety, a fast-paced and busy environment, and procedure heavy.  This was my first EM rotation so I was still new at workups and forming differentials but at the end of the rotation, I had improved a lot and experienced so many new things (paracentesis, traumas, chest tubes, IV lines, lac repairs, intubations, etc). This is definitely a great rotation if you're interested in EM. The one thing I wish we could change was the scrub rule (especially if there is a trauma!). I also wish I had scheduled this rotation during a different month, but all other months were booked and I needed a rotation before applications opened in September. July is a very busy month with the new interns so there wasn't a lot of time for interacting with the attendings in order to request a SLOE. The PD also didn't work as much that month due to the new interns and new EM attendings the department had recently hired. I found it was hard to present to EM attendings since the residents had their own patients to present to them as well and there were only about 1-2 EM attending while the others were IM trained. Whenever there was time to work with the attendings, they were so patient and knowledgeable! All the residents were so great as well -  they were really nice, funny and willing to teach students. They are also great at giving advice and some of them were from my medical school!

    • *As a side note, it was EXTREMELY difficult to schedule a second EM rotation for a second SLOE since at the time (2018) my school was only affiliated with one hospital with an EM residency program, however, I spoke to the dean of my school and was able to secure a non-affiliate (which is now an affiliate hospital).  So in the meantime, I ended scheduling all different types of EM rotations regardless if they had a residency program or not. 

  • #2: Brooklyn, NY (elective rotations #4) - 4 weeks 

    • Adult Emergency Medicine​

    • Shifts: 12 hour shifts 3 times a week - schedule given by GME coordinator

    • Scrubs allowed for all shifts

    • Overall thoughts: If you are planning to apply to EM, I wouldn't recommend this rotation. Although we had 12 hour shifts, a lot of the attendings don't want to teach students and therefore will sign your sheet and send you home. There were a few physicians who were willing to teach though and would ask for your differentials and workups after presenting your H&P. Those attendings were EM trained so it was worth working with them. I even was able to obtain an LOR from one of them which I included into my application. You are able to do a few procedures if you work with the PAs or even some of the attendings (they ask if you've done a certain procedure, etc) which is nice. I also had a lot of time to study for the NBME comprehensive exam and Step 2 CK which was helpful.

  • #3: Stockton, CA (elective rotation #6) - 4 weeks 

    • Emergency Medicine​

    • Shifts: 10a-7p, 2-11p, 6p-3a - schedule made by GME coordinator

    • Scrubs allowed for all shifts

    • Lectures: Wednesday mornings 

    • Overall thoughts: This was MY favorite EM rotation. Aside from having a random schedule (which is normal), you worked like an intern. You saw your patient, performed an H&P and reported to the attending and wrote the entire note (H&P, A/P, MDM). The only thing you didn't do was place orders but you discussed your differentials and workup with the attending and they would order it for you. You also were able to assist in every procedure occurring with the resident on shift since it was usually one medical student per shift. I was the only student during the entire rotation block so I had a lot of experience. I also liked the ability to work one-on-one with the attendings since I wasn't able to do that at the other EM rotations I've done. The quality of the lectures were really great and diverse. The residents and attendings were very knowledgeable and loved to teach which was important to me. The hospital staff and the GME department was also very friendly. 

  • #4: Brooklyn, NY (elective rotation #9)  - 4 weeks 

    • Pediatric Emergency Medicine ​

    • Shifts: 10a-10p, 7p-7a 

    • Required to do two weeks of each shift; Minimum of 3 days per week and must work one full weekend

    • Overall thoughts: ​I thought this was an okay rotation. I knew Pediatric EM was my weak point especially with pediatric differentials so this rotation was a good refresher rotation. Most of the children who came into the ED pretty much came for either the flu or a viral infection, strep throat or gastroenteritis (urgent care complaints). We did see a few traumas which was interesting but most of the complaints and care was typical urgent care complaints. There was one attending in the morning shift and another at night (mix of Pediatrics, Peds EM and Adult EM) as well as one pediatrics resident, a PA, and an EM resident (only on Thursdays). 

  • Resources: EMRA books (free with membership) ​

ABOUT
Me
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Kandria Ledesma, MD

Emergency Medicine resident

NJ -> Antigua -> NY -> CA

Medicine, Running, Birds, Plants, Food, Dinos 

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  • Useful Phone Apps:  Epocrates (helps with drug names, indications, dosing), UptoDate (information), WikiEM (wikipedia for EM - amazing!) 

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Dino of the Month: Carnotaurus

Plant of the Month: Nepenthes Attenboroughii

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