EM Clerkship - Goals & Objectives

The goal of this course is to provide a foundation for future physicians to be able to recognize and initiate first line medical treatment of the acutely ill or injured patient.

In general, students will:

  1. Build their fund of knowledge through reading.
  2. Apply the knowledge they have gained to different situations.
  3. Show how they use information in a realistic setting.
  4. Demonstrate their abilities and perform tasks in real encounters.

Society generally expects that all physicians possess basic knowledge in emergency care and the skills to manage acute problems. It is anticipated that regardless of what specialty a practitioner chooses, and irrespective of the type of setting or location of that practice, emergencies unrelated to that practitioner鈥檚 specialty will arise sooner or later. The physician should have the skills to recognize and initiate treatment of that emergency until help arrives. Also, the public expects physicians to give proper advice about when to be concerned about chest pain or a headache, or problems such as a burn or laceration, epistaxis, a sprained or potentially fractured extremity, diarrhea, or unintentional or deliberate ingestions. Once a patient carries a diagnosis, one can look in a textbook for advice. The greater challenge lies in the undifferentiated patient.  Basic skills in recognition and evaluation are critical in the education of physicians.

More specific goals for this course are:

  1. Recognize the presence of a patient with a serious condition that necessitates urgent attention.
  2. Prioritize attention to those patients with more urgent conditions.
  3. Take the first steps necessary to save a life, i.e. 
    a)  Open the airway. 
    b)  Ventilatory support with bag-mask-valve apparatus. 
    c)  Circulation augmentation with intravenous fluid. 
    d)  Hemorrhage control using external pressure.
  4. Recognize potentially treatable neurological insults.
  5. Recognize and initially manage potentially dangerous and treatable poisonings in any age group.

This could be a long list. Some examples are:

  1. Treat superficial burns and recognize when higher level of care is required.
  2. Assess injured extremities for possible fracture or dislocation and identify those requiring x-rays and possibly referral.
  3. Stabilize a patient who has had a seizure and determine the need for further evaluation.
  4. Etc.
  1. Perform a focused (when appropriate) or general history and physical 鈥� gather information and assess for emergency.
  2. Initiate emergency treatment as needed based on recognized emergency and on limited information as available.
  3. Formulate an appropriate differential diagnoses list, distinguishing diagnoses, which are emergencies versus urgencies.
  4. Conduct and follow through a work-up for the differential diagnoses.
  5. Reassess the patient for response to treatment and redirect care plan as needed.
  6. Identify which patients require further consultation or admission with or with out a final diagnosis, and who may be safely discharged home with proper follow-up.

It is expected that the student will begin learning to interpret the information gathered from the patient鈥檚 history and examination, proposing a scheme by which the patient should have their problem worked up, an assessment of the problem and developing a plan for further treatment, either inpatient or outpatient, including drug regimens.

Regardless of the specialty a physician finally enters, the clinician will have interactions with ambulances, perhaps as first responders at an accident or instead to pick up a patient who has collapsed in their office. Awareness to access to these services as well as of the capabilities is vital. Students will spend time at the 911 Center as well as spend ride-along time on an ambulance.

This includes the physicians in the emergency department, the nursing staff, ancillary support staff, as well as consulting physicians. Effective communication and interaction are valuable skills in any field, but perhaps none more so than in the emergency department.

  1. Emergency Medicine in Undergraduate Education, Burdick, et al., Academic Emergency Medicine, Nov. 1988, 5, p. 1105-1110.
  2. Undergraduate Curriculum, DeBehnke, et al., Academic Emergency Medicine, Nov. 1988; 5, p. 1110-1113.