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.
You will receive a detailed Course Manual several weeks before your clerkship begins.
- The CDEM M4 Curriculum is a free comprehensive EM advanced clerkship curriculum for medical students and is an excellent place to start.
- Tintinalli’s Emergency Medicine: A Comprehensive Study Guide [Onyen login needed] on Access EM is great for expanding upon the CDEM curriculum to study for the final exam. It is also a good starting place to read about topics listed on your shift card.
- Rosh’s PreTest on Access EM lets you create sample practice tests to prepare for the final exam. [Onyen]
- Note that these questions are more difficult than the actual final exam questions!
- Several other high-quality textbooks are available at Access EM on the UNC Health Sciences Library website. [Onyen]