Successfully reported this slideshow.

EM and Med Students

354 views

Published on

  • Be the first to comment

  • Be the first to like this

EM and Med Students

  1. 1. Emergency Medicine An evolving specialty
  2. 2. Outline <ul><li>Presenters </li></ul><ul><li>Profile of the typical Emerg doc </li></ul><ul><li>A typical day in the ED </li></ul><ul><li>Why EM / Why not? </li></ul><ul><li>Evolution of EM in North America </li></ul><ul><li>Emergency care in Canada </li></ul><ul><li>Routes of training </li></ul><ul><li>How to navigate through CaRMS </li></ul>
  3. 3. The Typical Emerg Doc: Quiz <ul><li>Songs on IPOD at gym </li></ul><ul><li>Favourite kind of music </li></ul><ul><li>Favourite AM drink after night shift </li></ul><ul><li>Most common excuse for missing meetings </li></ul><ul><li>Attention span-long vs short </li></ul><ul><li># of near death experiences per week </li></ul>
  4. 4. Who am I?
  5. 5. GORDON RAYMOND JONES
  6. 6. ER DOCS: who are they? <ul><li>Varied personality </li></ul><ul><li>Big picture </li></ul><ul><li>Multitasking </li></ul><ul><li>Less detail </li></ul><ul><li>Sense of humor </li></ul><ul><li>Like people </li></ul><ul><li>Compassionate </li></ul><ul><li>Hands on </li></ul><ul><li>Unpredictable life style </li></ul><ul><li>Unpredictable work environment </li></ul><ul><li>Thick skin </li></ul><ul><li>Broad clinical knowledge </li></ul><ul><li>The “surfer dudes” of Medicine </li></ul>
  7. 7. Types of patient seen in ED anywhere: <ul><li>Sick pts with complex underlying disease </li></ul><ul><li>Trauma minor-serious </li></ul><ul><li>20-30% peds, infectious and trauma </li></ul><ul><li>10% psych/social </li></ul><ul><li>1% critical care </li></ul><ul><li>10% life threatening </li></ul>
  8. 8. Emerg MDs skill set: <ul><li>Procedural skills </li></ul><ul><li>Procedural sedation </li></ul><ul><li>Resuscitation/trauma/violence </li></ul><ul><li>Toxicology </li></ul><ul><li>Environmental emergencies </li></ul><ul><li>Reassurance </li></ul><ul><li>Consultation/ Gate keeper </li></ul>
  9. 9. Skill set continued <ul><li>Primary care providers to 30% </li></ul><ul><li>Expert at dealing with undifferentiated pts </li></ul><ul><li>Disaster medicine </li></ul><ul><li>Safety net to the poor </li></ul>
  10. 10. Post residency fellowships <ul><li>Trauma </li></ul><ul><li>Toxicology </li></ul><ul><li>Critical care </li></ul><ul><li>International health </li></ul><ul><li>Forensics </li></ul><ul><li>Peds emerg </li></ul><ul><li>Medical education </li></ul><ul><li>Ultrasound </li></ul><ul><li>Critical care </li></ul><ul><li>Simulator medicine </li></ul><ul><li>Environmental medicine </li></ul><ul><li>Research </li></ul><ul><li>Administration </li></ul><ul><li>Sports medicine </li></ul><ul><li>EMS/Disaster Med </li></ul>
  11. 11. Evolution of Emergency Care <ul><li>Emerg depts 60s -70s staffed by: </li></ul><ul><ul><ul><li>All members of medical staff </li></ul></ul></ul><ul><ul><ul><li>Moonlightng residents </li></ul></ul></ul><ul><ul><ul><li>Immigrant MDs who could not work elsewhere </li></ul></ul></ul><ul><ul><ul><li>Evolution of EMS, residency programs </li></ul></ul></ul>
  12. 12. Emergency/unscheduled care in Canada <ul><li>Primary care office setting </li></ul><ul><li>Walk in clinics </li></ul><ul><li>Urgent Care centers </li></ul><ul><li>Hospitals: </li></ul><ul><ul><ul><li>Small, medium and large community hospitals </li></ul></ul></ul><ul><ul><ul><li>Tertiary Care Centers </li></ul></ul></ul><ul><ul><ul><li>Quaternary care centers </li></ul></ul></ul>
  13. 13. Family MDs provide the majority of E.D. care <ul><li>20-30 FRCP graduates per year </li></ul><ul><li>100- CCFP-EM graduates per year </li></ul><ul><li>About 100 FPs per year take CCFP EM special competency exam </li></ul><ul><li>Hundreds of CCFP grads per year </li></ul><ul><li>Many MDs with 1 yr internship do EM </li></ul>
  14. 14. FRCP program <ul><li>5 years </li></ul><ul><li>Started mid 1980s </li></ul><ul><li>Most grads in urban tertiary care </li></ul><ul><li>Leadership roles-teaching, admin, subspecialty </li></ul><ul><li>1 year of program: fellowship interest </li></ul>
  15. 15. FRCP PGY 1 <ul><li>Internal medicine 2 mo </li></ul><ul><li>Gen Surg 2 mo </li></ul><ul><li>Peds 1 mo </li></ul><ul><li>Peds EM 1 mo </li></ul><ul><li>Psych 1 mo </li></ul><ul><li>OBGYN 1 mo </li></ul><ul><li>Emerg 4 mo </li></ul>
  16. 16. FRCP PGY 2 <ul><li>Neurosurg 1 mo </li></ul><ul><li>Plastics 1 mo </li></ul><ul><li>Ortho 2 mo </li></ul><ul><li>Anaesthesia 2mo </li></ul><ul><li>ICU 2mo </li></ul><ul><li>Emerg 4 mo </li></ul>
  17. 17. FRCP PGY 3 <ul><li>Cardiology 2 mo </li></ul><ul><li>Peds EM 2 mo </li></ul><ul><li>Emerg 8 mo </li></ul>
  18. 18. FRCP PGY 4 <ul><li>Toxicology 2 mo </li></ul><ul><li>Administration 1 mo </li></ul><ul><li>Emerg/elective 9 mo </li></ul>
  19. 19. FRCP PGY 5 <ul><li>Emerg/elective </li></ul><ul><li>Exam prep--consequences </li></ul>
  20. 20. CaRMS <ul><li>Canadian programs-25 + spots </li></ul><ul><li>Queens 50-60 applicants per year </li></ul><ul><li>Interview-(1 day)-20-25 candidates </li></ul>
  21. 21. We look for <ul><li>Career interest in EM </li></ul><ul><li>Well rounded teachable </li></ul><ul><li>Some emerg electives </li></ul><ul><li>Emerg references </li></ul><ul><li>Research + or – </li></ul>
  22. 22. 5 year program: Pros <ul><li>Clinical comfort at graduation </li></ul><ul><li>Expertise/ego </li></ul><ul><li>Fellowship opportunities </li></ul><ul><li>Leadership in EM opportunities </li></ul><ul><li>Less burnout </li></ul><ul><li>Academic centers </li></ul>
  23. 23. 5 yr Program cons <ul><li>5 years is a long time </li></ul><ul><li>Limited to larger center practice </li></ul><ul><li>Not financially better </li></ul><ul><li>Exam hard-cant work until you pass </li></ul><ul><li>Competitive entry process </li></ul>

×