The MaineHealth Maine Medical Center (MHMMC) emergency medicine (EM) faculty is pleased to offer a senior medical student experience in the MHMMC Portland emergency department. The rotation is open to all senior level medical students in good academic standing, but preference is given to those interested in EM as a career. Enrollment is limited, so schedule early and please remember to notify us of any changes as soon as possible. The didactic program and clinical shifts cycle based on the Tufts academic calendar so please check the medical education website for details.
Past students say that major strengths of the program include exposure to the EM residency, plenty of hands-on patient care, and direct contact with academic EM faculty who are available to teach at the bedside. Recent additions to the rotation include high-fidelity simulation for medical students and the opportunity to participate in emergency medicine service (EMS) activities including Lifeflight of Maine (helicopter transport) and ground EMS. In addition, seasonal activities are available including local EM conferences, and wilderness activities (kayaking, skiing, hiking, etc).
Goal
To practice skills in the recognition of acute life-threatening conditions and exacerbation of serious disease while participating in the ED care-giving and resuscitative team response in a strictly supervised setting.
Objectives
Apply knowledge of pathophysiology learned throughout the clerkships in understanding root causes of life threats (e.g. hypoxia, acidemia, hypovolemia, sepsis). Become familiar with the use of equipment involved in the stabilization and resuscitation of patients (e.g. mechanical airway, c-collar, and defibrillator). Understand the role of the ED in the community health care delivery system. Have exposure to principles of triage, medical toxicology, and emergency medical services. Gain insight into principles of risk management as it relates to probability of disease and patient disposition. Be aware of the ethical responsibilities of a physician in times of refusal of treatment, inability to consent, or need for higher level of service.
Important aspects of this experience include:
- An expectation to rule out most immediate life threats first (non-probabilistic)
- Managing multiple patients time-efficiently to the level of ability
- A hands-on experience with acute laceration repair and fracture splinting
- Practicing focused problem-based histories, physical exams and oral presentations
- A concerted effort to limit resource utilization appropriately
- Collaboration with community physicians in the discharge planning and follow-up
- Exposure to EM residency training
- Students are assigned 14, 8 hour clinical shifts distributed over days, evenings and nights, including two weekends and at least four overnight shifts. Students have the option of doing one of these shifts with an EMS provider, which can be either Lifeflight of Maine (helicopter transport) or ground EMS. In the ED students are expected to see patients primarily and present directly to the Attending(s) or supervising PGY-3 EM resident on duty. Students assist attending faculty is writing notes and deciding on orders to be placed. Students are expected to keep their patients, the ED care team and the patient's primary care provider updated on all results of therapies, tests, consults and disposition planning. There is an emphasis on patient education by students.
- Students are required to attend a mandatory orientation session at the beginning of the month as well as a day that includes a procedure workshop and high-fidelity simulation for medical students (held during the first week). In addition, students are required to attend relevant lectures as part of the EM residency didactics, held on Wednesday mornings.
- Schedules are provided during the mandatory orientation session on the first weekday of the month.
- Additional experiences include an evidence based medicine presentation on an EM-related topic usually in the last week of the month and optional participation in residency-related activities such as journal club or interdisciplinary symposia.
- All students are expected to be present from the first weekday of the rotation until the last weekday. No credit shall be given for partial months unless previously approved by the course director.
- Housing options available (at student’s expense): 1) Clarion Hotel, 2) Rotating Room, 3) Crescent Heights, etc. FMI: Kim Murphy Kimberly.Murphy@mainehealth.org, or 207-662-7060 or UME_MedEd@mmc.org
A cumulative grade is determined by collation of specific feedback from the attending staff. Grades of Honors, High Pass, Pass, Fail, and Incomplete are given based upon a student's attitude, attendance, and performance. This includes participation in case discussions, the quality of student presentation, ability to render effective care, and professionalism while on duty. A Standardized Letter of Evaluation (SLOE) may be requested from the department.
An application must be submitted through our online application page. Due to the high volume of requests for the rotation we also require a supplemental application, which is specific to our department.
For more information please contact Kim Murphy, Program Coordinator and Lauren Wendell, M.D., Medical Student Education Director at 207-662-7142.