The Emergency Medicine (EM) Clinical Clerkship at Brigham and Women’s Hospital (BWH) provides 4th year medical students from the USA and abroad an excellent opportunity to develop their skills in the assessment and management of acutely ill and ambulatory patients. With an average of 56,000 patient visits to the Emergency Department annually, our patient population consists of the most complex acute traumatic and cardiac referrals, pre- and post-transplant patients, as well as common medical, surgical and gynecological cases.
Goals
The goals for this EM rotation are to:
- Demonstrate the ability to take an accurate, appropriate and focused history;
- Demonstrate the ability to perform an appropriately thorough and focused physical examination;
- Create an intelligent differential diagnosis based on the patient’s history and one’s physical examination findings;
- Understand and apply knowledge of the basic mechanisms of medicine in order to create an assessment of the likely causes of a presenting complaint;
- Recognize and determine if a patient is acutely ill;
- Know how to initiate the basic steps of emergency therapy in order to stabilize an unstable or deteriorating condition;
- Rule out potentially life-threatening illness; and
- Know how to initiate a treatment plan, whether through inpatient admission or outpatient care with primary care physician follow-up.
Clinical Activities
During this 4-week rotation, students will work 14 to 16, 8-hour shifts: day, evening, overnight and weekend. Clinical time is devoted to the management of complicated medical and surgical problems, gynecological and orthopedic in addition to minor medical and surgical complaints. Students will be involved in a variety of clinical procedures, including wound care, suturing, fracture and dislocation care, abscess incision and drainage, arthrocentesis, slit lamp examination, lumbar puncture, gastric intubation, femoral venipuncture and catheterization, as well as arterial puncture.
Teaching Activities
The weekly Harvard Medical School (HMS)-sponsored EM Lecture Series is designed specifically for medical students enrolled in the EM electives at HMS-affiliated hospitals. These lectures address the following topics: trauma, suturing, airway, environmental emergencies, shock, toxicology, pediatric emergencies and analgesia.
Susan E. Farrell, MD (Director, BWH EM Clinical Clerkship) schedules weekly meetings with medical students to review cases and discuss topics in EM.
Medical students meet on a monthly basis with the Harvard Affiliated Emergency Medicine Residency (HAEMR) Program teaching senior resident to manage, as a team, clinical scenarios in the STRATUS Center for Medical Simulation at BWH.
All students are invited and welcome to attend the BWH/MGH HAEMR didactic and teaching sessions.
Pre-Hospital Care - Ambulance Ride Along
Pre-hospital evaluation and care of the ill or injured patient is an important part of the specialty of EM. Although not required, medical students are encouraged to spend one shift with a Boston Emergency Medical Services team.
