Preparing for a Visiting
(Audition or Away) Rotation in Emergency Medicine
Pre-Rotation Preparation
Review the residency program's website
Mission Statement
Program Leadership (and their background [e.g. their
residency and medical school])
Current residents
Do you know any of them or did they go to the same medical
school
Clinical sites
Transportation (don't be late to lectures or shifts)
Read through all materials sent to you so you know what to
expect (e.g. the ED Chairperson will meet with your group on
day 1)
Review High-Yield EM Topics
Common Chief Complaints:chest pain, abdominal pain,
shortness of breath, headache, altered mental status, fever,
dizziness/syncope, trauma, sepsis, etc.
Differentials & worse case scenarios, initial workups,
critical steps (e.g. ABCDE's of trauma)
Resuscitation & Critical Care
ACLS, ATLS, PALS
Toxicology
Common toxidromes or poisons and their antidotes
Pediatric Emergencies
Essential Procedures
Suturing
What type of suture for certain types of wounds or areas
of the body
Absorbable vs non-absorbable, poly-filament vs
mono-filament, size (e.g. 4-0 vs 5-0)
Incision and Drainage (I&D)
Splinting
IV Insertion (with or without ultrasound) & Phlebotomy
Basic Airway Management
BVM
Basics of intubation
Point-of-Care Ultrasound (POCUS)
eFAST, RUSH, OB/Gyn
During your Rotation
Be Proactive and Show Initiative
Arrive 15 minutes early to get settled and prepare for your
shift
Look over your team's board and scout out some patients to
sign up for as soon as your shift starts
Balance between motivated and engaged vs teacher's pet
Introduce Yourself to everyone (attendings, residents,
nurses, techs, unit clerks)
Volunteer for Tasks
Offer to help
with from grabbing supplies to moving patients
Anticipate needs (e.g., getting laceration supplies before
being asked)
See Patients Efficiently
Learn to gather
focused histories and perform targeted physical exams relevant
to the chief complaint
Formulate Assessment & Plan
Move beyond the 'Reporter' stage
Verbalize your differential diagnosis (from most to least
emergent)
How will your H&P or your proposed diagnostic and
management plan help rule-in or rule-out certain diagnoses
What is your anticipated disposition
Follow Up on Patients
Keep track of
your patients' progress, labs, imaging, and disposition
Follow up on critical or interesting cases after your shift
Ask Thoughtful Questions
Don't ask questions you can look up on your own (e.g. What
is the dose of this antibiotic?)
Ask questions that show you are thinking about each case
(e.g. Why did you order an ultrasound instead of a CT for this
differential?)
Communication and Professionalism
Be Honest
If you didn't
perform a certain exam or ask a specific question, admit it.
Don't fabricate information.
Don't 'hover' over your attending's shoulder
Collaborate respectfully with everyone including nurses,
techs, and clerks
Actively seek feedback
Study and Learn Actively
Keep a list of clinical pearls, teaching points, and
interesting cases
Keep a list of
questions that arise during your shifts and research the
answers during downtime or after your shift. The next time you
see your attending or resident tell them about what you
learned and any follow-up chart checking you did on your
patients
Participate in Didactics
Attend all
mandatory conferences and actively engage in discussions
Don't fall asleep - it will be noticed
EM Resources
Textbooks
"Tintinalli's
Emergency Medicine" or "Rosen's Emergency Medicine"
Pocket Guides
EMRA booklets (e.g., "Basics of Emergency Medicine")