An 8-week curriculum to transition from senior medical student to EM intern

You are a graduating medical student about to start an Emergency Medicine residency. Now what? If you are anything like we were as senior medical students, you feel lost in the vast abundance of learning options. Come July, you will be asked questions like, “This is the ECG of the patient in room 10, who missed dialysis yesterday. Do you want to get any medications started, doctor?” You will quickly find that you cannot just click the answer “calcium” from a multiple choice list and move on. In the real world, that requires complex decision making. Which medication should you give, at what dose, and how do you access its effectiveness? If that does not make you a little nervous, you are reading the wrong website. If it DOES make you nervous, keep reading.

We have assembled a list of free resources to get you prepare and packaged into an 8-week guide, called Bridge to EM.

But wait, did you know that we also have a newsletter dedicated to medical students pursuing a career in EM? So many rules of the game in the senior year and application process have changed. Feel up to date with the news on a monthly basis with ALiEM’s free EM Bound newsletter.

Topics

The resources have been vetted to ensure an up-to-date and broadly scoping overview of EM. We purposely did not deep-dive on very specific topics. Instead we aimed to provide practical resources addressing the diagnosis and nuanced management of conditions that you will definitely encounter in the Emergency Department. Because the breadth of knowledge needed to be a skilled emergency physician is astounding, starting with the basics and getting the big picture is the first step towards mastering the details.

We intentionally interweaved topics and built in spaced repetition for maximal long-term retention (see the ALiEM review of Make it Stick for more on how to learn well). We have also built in active learning (case-based ECG problems) and both written and auditory resources. Note that there are NO textbook chapters! 😀

General Daily Template

• EM:RAP C3 podcast episode (read the concise, high-yield show notes as well)
• 1-2 blogs and/or podcasts
• ECG Wave Maven cases

Getting Started

We recommend you follow the following steps:

1. Schedule time in your calendar each day to do the reading and/or listening. By setting aside a little time each day, you can accomplish a lot over the months from Match Day to the first day of internship.
2. Sign up for EMRA student membership online, which gets you access to EM:RAP (and tons of other great resources!)
3. Download the EM:RAP C3 podcasts (free for EMRA members) using the EM:RAP app or any other podcasting app. Consider listening to the podcasts at slightly faster speed than 1x to save you time over the long term.
4. Get used to listening to podcasts such as while driving, at the gym, or on walks as a habit that you will continue throughout residency.
5. Truly focus and get the most out of each thing you are doing (see ALiEM review of Deep Work for more on focus).

The Bridge to EM curriculum is to get you thinking like a doctor and not to memorize facts for tests. Use this roadmap as a foundation to inspire you to read more on topics to fill your knowledge gaps. Get up to speed on topics that may save a life in a few short months!

Clerkship Directors

The Bridge to Emergency Medicine and Foundations of Emergency Medicine have teamed up to present a senior medical student clerkship curriculum especially designed for this time of distance learning. It uses the first four weeks of the Bridges to Emergency Medicine curriculum and pairs this content with selected synchronous Foundations of Emergency Medicine small group sessions. The Foundations cases are oral boards style and perfect for a distance-learning format (e.g. Zoom meetings). The full curriculum includes 4 one-hour long synchronous meetings each week covering 2 cases in each session to reinforce the asynchronous content students will have reviewed on their own. There is also time built-in for optional Q&A sessions with faculty/residents to allow students to further explore the specialty. Many students will have less experience with EM as clinical time has been cut at many institutions and the opportunity to experience different practice environments will likely be impacted by the limited availability of away rotations this academic year. Finally, the full curriculum also offers a session covering medical ethics, specifically capacity and AMA discharges as pertinent to EM practice. 

The full curriculum described above is meant for those clerkships unable to offer students clinical time given institutional restrictions as the time commitment for the full curriculum is significant. However, when distance learning is over, clerkships could also use this curriculum to supplement the clinical learning and create high-yield in-person case-based learning sessions.. 

To access Foundations cases Clerkship Directors should fill out the following interest form to receive the Foundations password and further support for implementation. Please note, Foundations content is free and open-access but password protected as cases should not be shared directly with learners. We hope this curriculum is helpful to you in the time of distance learning and please feel free to contact Natasha Wheaton at [email protected] with further questions about the Foundations cases and Christina Shenvi at [email protected] about the Bridge to EM curriculum. 

Future Plans: For Educators

We had planned to release this 8-week curriculum paired with assessment quizzes, but for the sake of time, we are posting the curriculum first. Keep a lookout for assessments in ALiEMU so that you can track your medical students’ progress.

Bridge to EM Team

• Tim Wetzel, MD (Bridge to EM Co-Lead; Resident at University of North Carolina)
• Christina Shenvi, MD, PhD (Bridge to EM Co-Lead; Assistant Program Director at University of North Carolina)
• Sree Natesan, MD (Assistant Program Director, Duke University)
• Moises Gallegos, MD, MPH (Clinical Assistant Professor, Stanford University)

Bridge to EM Curriculum

Abbreviations used:

• GI: Gastrointestinal
• GU: Genitourinary
• HEENT: Head, Eyes, Ears, Nose, Throat