The fourth year elective in Emergency Medicine is a popular and rewarding clinical opportunity available to UNC medical students and to a limited number of qualified and highly motivated students from other medical schools. During the UNC EM clinical electives, medical students see patients with undifferentiated medical conditions and get the first opportunity to evaluate and diagnose a variety of medical conditions under the direct supervision of our experienced Emergency Medicine attending physicians.
Emergency medicine is exciting because patients present to the emergency department with a collection of signs and symptoms but not a definitive diagnosis. Often, the emergency department is the first place the patient gets seen with a new medical condition.
Much of the satisfaction in emergency medicine comes from bonding with the patient and then solving the diagnostic puzzles and providing the treatment that can improve or even save their lives. It often seems to students in medical school that their role is to watch residents and attendings work through this process. But in the UNC 4th year ED elective, medical students act as the primary provider for the patient with the close supervision of the ED attending physician. The medical student interviews and examines the patient, and then they have an opportunity to use the knowledge that they gained in the first 3 years of medical school to come up with a differential diagnosis and plan for initial management of the patient. After discussing and refining the differential diagnosis and plan with the attending physician, the medical student continues to function as the patient’s primary provider during their emergency department stay. This format allows for valuable one on one teaching from the attending physician and a chance to experience the joys of bonding with the patient and their family members, to interact directly with consultants, and to evaluate and make decisions based on the patient’s laboratory, EKG, and radiologic test results.
Please keep in mind that there are sometimes violent patients in the ED. If you encounter a patient that may be violent or makes you feel uncomfortable, please retreat to a safer area and notify your attending or the nursing staff. Always take another staff member with you when you go in to see a patient in the locked area for psychiatric patients. Patients in the psychiatric area are rarely violent but it is better to be safe. If a patient needs to be restrained, please do not attempt to assist with the restraint. In that situation the medical student can be very helpful by going to the computer and gathering information about the patient to report to the attending and ED staff. Helpful information includes allergies, medications, past psychiatric history, and past medical history.
- Grade determination sheet (To be signed and turned in at your orientation)
- End of Clerkship Checklist
- Grade Information Sheet
- Orientation Packet (.rtf file)
- There are comprehensive 3rd and 4th year student EM curriculum available at CDEMcurriculum.com.
This site has extensive resources for the student doing an Emergency Medicine rotation.
- Please see EM resources available to students including Tintinalli’s Emergency Medicine, 8th ed. and Rosh’s PreTest, 4th ed. on the UNC Health Sciences Library site: Access EM