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EP16. EM Stud – Now a Part of CDEM!

emstudcdemlogoxl

EM Stud has outgrown its humble beginnings and is starting a new chapter as EM Stud-now brought to you by the Clerkship Directors in Emergency Medicine (CDEM), an academy of SAEM.

Meet our new cohost, Dr. Scott Wieters, in this episode. 

Also, I am updating my twitter handle, so if you’d like to follow me, Dr. N8, you can find me at 

EP15. How To Build a Rank List

Question markHaving trouble sorting out your rank list?  Already moved #1 to #2 and #3 to #1 a hundred times?  Don’t worry, you still have plenty of time to sort things out, and ultimately, going with your gut is a great way to start (and finish) the process.  But if you’re desperately looking for some help, maybe we can help you get organized…

Also check out these great resources!

NRMP – Main Residency Match Calendar

NRMP – How the Matching Algorithm Works

EM Advisor Rank List Run Down (2014 post, so different dates, but great advice!)

ALiEM – Top 10 tips when making your rank list (also an older post, but still a must read)

Photo Creative Commons License Leimenide via Compfight

EP14. Burnout

Fire

Being an emergency physician is a tough job, and like many other stressful occupations, it can wear you down.  Burnout is a very real risk in EM, but acknowledging the risk, looking for early signs, and using strategies to increase your resiliency can help you stay productive, optimistic, and satisfied with your career.

Further Reading and References

Physician Burnout: It Just Keeps Getting Worse – Medscape

Emergentology: Burnout: It’s All about Weird Hours, Challenging Patients, and High Stress – EM News

Job burnout: How to spot it and take action – Mayo Clinic

Avoid Burnout by Managing Your Stress – ACEP

  1. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-85.
  2. Goldberg R, Boss RW, Chan L, et al. Burnout and its correlates in emergency physicians: four years’ experience with a wellness booth. Acad Emerg Med. 1996;3(12):1156-64.
  3. Kuhn G, Goldberg R, Compton S. Tolerance for uncertainty, burnout, and satisfaction with the career of emergency medicine. Ann Emerg Med. 2009;54(1):106-113.e6.
  4. Prins JT, Gazendam-donofrio SM, Tubben BJ, Van der heijden FM, Van de wiel HB, Hoekstra-weebers JE. Burnout in medical residents: a review. Med Educ. 2007;41(8):788-800.
  5. Kimo takayesu J, Ramoska EA, Clark TR, et al. Factors associated with burnout during emergency medicine residency. Acad Emerg Med. 2014;21(9):1031-5.
  6. Schmitz GR, Clark M, Heron S, et al. Strategies for coping with stress in emergency medicine: Early education is vital. J Emerg Trauma Shock. 2012;5(1):64-9.

Photo: Chris Bentley via Compfight

EP13. Improve Your Efficiency

24H Le Mans 2013

Wish you were faster in the ED?  Believe it or not, the key to being more efficient is NOT about speed or the ability to multitask.  Instead, becoming an efficient emergency physician takes practice, experience, and the use of some key strategies to increase your productivity.  Be prepared to work hard, work smart, and learn how to task-switch effectively.

In addition, I highly recommend you read this important and informative letter, written by the CDEM Executive Committee, addressing the recent ranking of EM residency programs by U.S. News and World Report and Doximity.

And as an added bonus, check out this just-released video on presenting patients in the ED, put together by some amazingly talented peeps at EMRA and CDEM.  It is hot stuff.

References

  1. Kee R, Knott JC, Dreyfus S, Lederman R, Milton S, Joe K. One hundred tasks an hour: an observational study of emergency department consultant activities. Emerg Med Australas. 2012;24(3):294-302.
  2. Stephens RJ, Fairbanks RJ. Humans and multitask performance: let’s give credit where credit is due. Acad Emerg Med. 2012;19(2):232-4.
  3. Chisholm CD, Dornfeld AM, Nelson DR, Cordell WH. Work interrupted: a comparison of workplace interruptions in emergency departments and primary care offices. Ann Emerg Med. 2001;38(2):146-51.
  4. Chisholm CD, Weaver CS, Whenmouth L, Giles B. A task analysis of emergency physician activities in academic and community settings. Ann Emerg Med. 2011;58(2):117-22.
  5. Chisholm CD, Collison EK, Nelson DR, Cordell WH. Emergency department workplace interruptions: are emergency physicians “interrupt-driven” and “multitasking”?. Acad Emerg Med. 2000;7(11):1239-43.
  6. Laxmisan A, Hakimzada F, Sayan OR, Green RA, Zhang J, Patel VL. The multitasking clinician: decision-making and cognitive demand during and after team handoffs in emergency care. Int J Med Inform. 2007;76(11-12):801-11.
  7. Westbrook JI, Woods A, Rob MI, Dunsmuir WT, Day RO. Association of interruptions with an increased risk and severity of medication administration errors. Arch Intern Med. 2010;170(8):683-90.Photo above Creative Commons License Antoine Valentini via Compfight

EP12. EM Pharmacists

EMRx

Emergency Medicine Pharmacists are our allies in the ED.  They help us prescribe the right therapies, reduce medication errors, and provide the best possible care for our patients.  So get to know your ED pharmacist and tell them thanks for all that they do.  (And thanks to our own for sharing her thoughts with us on this podcast!)

Interested in more Pharm FOAM?  Check out these links…

Pharm FOAM on #FOAMedstudent

Emergency Medicine PharmD

And of course, tons of great pharmacy resources at ALiEM

References

  1. American Society of Health-System Pharmacists. ASHP statement on pharmacy services to the emergency department. Am J Health-Syst Pharm. 2008; 65:2380–3.
  2. Eppert HD, Reznek AJ. ASHP guidelines on emergency medicine pharmacist services. Am J Health Syst Pharm. 2011;68(23):e81-95.
  3. Ernst AA, Weiss SJ, Sullivan A, et al. On-site pharmacists in the ED improve medical errors. Am J Emerg Med. 2012;30(5):717-25.
  4. Cesarz JL, Steffenhagen AL, Svenson J, Hamedani AG. Emergency department discharge prescription interventions by emergency medicine pharmacists. Ann Emerg Med. 2013;61(2):209-14.e1.
  5. Rothschild JM, Churchill W, Erickson A, et al. Medication errors recovered by emergency department pharmacists. Ann Emerg Med. 2010;55(6):513-21.
  6. Patanwala AE, Sanders AB, Thomas MC, et al. A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department. Ann Emerg Med. 2012;59(5):369-73.