We are very pleased that you are interested in Corewell Health Lakeland's Emergency Medicine Clerkship Rotation. We are proud of our program and all the outstanding educational opportunities it offers. With the abundance of resources provided by our residency program and our dedicated faculty, we believe our clerkship rotation will be an excellent training experience for you.

We encourage all allopathic and osteopathic medical students interested in our Emergency Medicine Residency Program to rotate with us. Our Emergency Medicine rotation is in high demand and accepts up to 8 students each month. Please apply at least three (3) months prior to your preferred start date because our clerkship slots tend to fill up far in advance. To schedule an audition/clerkship rotation, please contact our Emergency Medicine Residency Program Manager, Michele Borre, or submit an application through the Visiting Student Application Service (VSAS)

The Emergency Medicine Clerkship Rotation is designed to introduce students to the principles of acute care medicine. Students have the opportunity to evaluate patients as well as formulate effective testing and treatment strategies. Active participation in patient care and procedural skills are emphasized. The rotation consists of patient care experiences, weekly resident and student conferences, asynchronous didactics and a case presentation at the end of the rotation.

Students learn to conduct thorough but directed histories and physicals, as well as to formulate a plan for workup and care of each patient they see. Procedural skills (such as ultrasonography, suturing, intubations and central venous access, etc.) are taught and supervised by our attending physicians and/or senior residents.

• Take a directed patient history and perform a complete physical examination
• Formulate a plan of workup and treatment
• Present cases directly to the senior resident and attending physicians
• Learn techniques to improve procedural skills
• Follow patients from initial exam through discharge from the Emergency Department (includes documentation and order entry).

Competency-based objectives:

Patient care

Under direct faculty supervision, students should be given primary responsibility for patient care (of noncritical patients) and begin to act independently. Primary responsibility for patient care will help foster the student’s ability to think critically, assess their knowledge and skills, and allow them to make clinical decisions affecting patient care.

Specific learning objectives:

Obtain an accurate problem-focused history and physical examination.

Recognize immediate life and limb-threatening conditions.

Patient management skills:

• Develop an evaluation and treatment plan.
• Monitor the response to therapeutic interventions.
• Develop appropriate disposition and follow-up plans.
• Educate patients to ensure comprehension of discharge plans.

Medical knowledge

Students should develop a differential diagnosis that is prioritized on potential life and limb-threatening conditions and likelihood of disease. Students should demonstrate knowledge (or understanding) of basic diagnostic modalities and interpretation of results. Most importantly, students should cultivate an appreciation of risk stratification and pretest probabilities for selected conditions.

Specific learning objectives:

• Develop a differential diagnosis when evaluating a patient:
  1. Prioritize likelihood of diagnoses based on patient presentation and acuity.
  2. List the worst-case diagnoses.
• Create a diagnostic plan based on differential diagnoses.
• Develop a management plan for the patient with both an undifferentiated complaint and a specific disease process.

Practice-based learning

Demonstrated through systematically evaluating patient care and population features, teaching other students and health care professionals, and applying knowledge gained from a systematic evaluation of the medical literature, including study design and statistical methodology.

Specific learning objectives:

• Effectively use available information and technology, including medical record retrieval systems and other educational resources, to optimize patient care and improve their knowledge base.

Interpersonal and communication skills

Students must demonstrate interpersonal and communication skills that result in effective information exchange and interaction with patients, family members, and health care providers.

Specific learning objectives:
Basic principles:

1. Effectively communicate with patients, family members and other members of the health care team demonstrate a compassionate and nonjudgmental approach when caring for patients

Presentation skills:

1. Present cases in a complete, concise, and organized fashion
2. Effectively communicate with consultants and admitting services

Documentation:

1. Provide accurate and organized documentation in the medical record when appropriate

Professionalism

Students should learn to reflect on their professionalism during clinical rotations and learn from faculty and resident role models.

Specific learning objectives

1. Be conscientious, on time, and responsible
2. Exhibit honesty and integrity in patient care

Practice ethical decision-making

Professional behavior:

1. Exercise accountability
2. Maintain a professional appearance
3. Be sensitive to cultural issues (age, gender, culture, disability, etc.)
4. Work in a collegial manner with other members of the healthcare team

System-based practice

Demonstrate an understanding of how EM relates to other practitioners, patients, and society at large while considering the cost of health care and the allocation of health care resources. Understanding the ‘‘system’’ involves learning ways to advocate for patient care and assist patients in dealing with system complexities (such as assuring appropriate follow-up) and how to partner with healthcare providers to assess, coordinate, and improve patient care.

Specific learning objectives:

• Recognize when patients should be appropriately referred to the Emergency Department
• Recognize the importance of arranging appropriate follow-up plans for patients being discharged from the ED
• Recognize the role of EM in the community, including access to care and its impact on patient care
• Understand the indications, cost, risks, and evidence behind commonly performed ED diagnostic studies

Scheduling

Students on the EM Clerkship Rotation are scheduled one-on-one with an attending physician for their shifts. Absences due to vacations, or other such activities are not acceptable unless approved by the GME department.

Approximately two (2) weeks before the start of the rotation, clerkship students receive an email from the clerkship coordinator detailing their schedules. Every effort will be made to limit students from working more than five shifts in a row or be scheduled for more than four consecutive days off in a row. Total number of shifts may vary slightly but may be no less than 14 of 28 days for students doing four-week rotations.

Evaluations

During this rotation, students are supervised directly by attending physicians and senior EM residents who fill out daily evaluation forms. These forms are used to compile information on the student’s abilities in interpersonal relations, data acquisition, and data synthesis (problem-solving). Students are given feedback at the end of each shift. The student’s final grade is based on the shift evaluations and final case presentation. Grades assigned are Honors, High Pass, Pass, and Unsatisfactory. 90% of the final grade is based on the evaluations from faculty and residents and 10% on the results of the final case presentation. In addition to completing an individualized medical school clerkship evaluation, a “group” (i.e. authored by all EM Core Faculty) Standardized Letter of Evaluation – SLOE will be completed for 4th-year medical students applying for an emergency medicine residency.

Didactics

• EM Grand Rounds Weekly Conference: Core Content lectures provided by attending physicians and senior EM residents (5 hours)
• EM Clerkship Student Didactics: Immediately following EM Grand Rounds Weekly Conference; a symptom-based curriculum is provided by attending physicians, clerkship director, and senior EM residents
• Simulation Center and Task Trainers: Weekly educational sessions through our Simulation Center that develop competency in procedural skills and patient evaluation/management
• Asynchronous Learning: Specifically designed online curriculum for medical students with an interest in emergency medicine (i.e. blogs, podcasts, etc.)