About Mark Ramzy, DO, EMT-P

Clinical Assistant Professor of Emergency Medicine
Rutgers New Jersey Medical School

Core EM Faculty and Intensivist
Departments of Emergency Medicine and Critical Care Medicine
RWJBH Community Medical Center
Toms River, New Jersey

How I Educate Series: Mark Ramzy, DO

This week’s How I Educate post features Dr. Mark Ramzy, an EM attending and Intensivist at RWJBH Community Medical Center in New Jersey. Dr. Ramzy spends approximately 90% of his shifts with learners which include emergency medicine residents, internal medicine residents, and medical students. He describes his practice environment as a split time between the ED and ICU. ED time includes a scanning shift as part of his ultrasound faculty requirements and his ICU time is split across several different units including a MICU, SICU, and CTICU. Below he shares with us his approach to teaching learners on shift.

Name 3 words that describe a teaching shift with you.

Dynamic, Accountability, and Targeted.

What delivery methods do use when teaching on shift?

Drawing on paper/whiteboards and infographics.

What learning theory best describes your approach to teaching?

Toss up between Constructivism vs Connectivism and using Andragogy with a focus on Adult Learning.

What is one thing (if nothing else) that you hope to instill in those you teach?

To trust but verify and not be afraid to question everything.

How do you balance your flow with on-shift teaching? Does this come at the expense of your documentation?

This heavily depends on where I’m working and how the day is going. If in the most critical zone/pod of the emergency department then the teaching is done in real-time with emphasis, repetition, and reinforcement as we go. The content/material is then reviewed at a later time when safe for both the patient at the learner. This typically does not come at the cost of documentation because we have scribes in the emergency department who really help with this.

When in the ICU, many small learning pearls are discussed during rounds. Assuming procedures, consultant discussions, and family meetings are completed and time allows, the afternoon is then reserved for most specific topics that the learners have expressed interest in knowing more about

What is your method for reviewing learners’ notes and how do you provide feedback on documentation?

I review learners’ notes after a shift and take notes myself on very specific items to discuss with them in more detail either via email/text or in person if we are working together within 48 hours. I have this cutoff because that patient (and note) is still fresh in their mind, thus allowing the feedback to stay SMART=Specific, Measurable, Actionable, Relevant, and Timely.

Do you feel departmental flow and metrics adversely affect teaching? What is your approach to excelling at both?

Departmental flow and metrics definitely adversely affect teaching. There has been a greater push across many healthcare systems to “see more patients” or to really prioritize patient satisfaction despite this not necessarily leading to better outcomes. As a result, the teacher and learner are directly impacted. My approach to this starts with a set expectation and in-depth discussion before the shift starts. If the waiting room is packed and there are sick patients that continue to come in, I try my best to have a talk with my learners about the importance of self-driven learning, asking for help, and utilizing resources around them. We set the expectation that the teaching will primarily be “on the go” and to have them write down topics or content that they would like to discuss further when at weekly conference or any other time off a shift. No matter how busy a shift is, learning can always happen. It doesn’t always have to take the form of ventilator settings to reduce AutoPEEP but can look like interprofessional communication, engaging with a family to deliver unfortunate news, or even electronic medical record hacks to work more efficiently.

It can be difficult to sit back and let senior learners struggle what is your approach to not taking over prematurely?

Patience not patients. I talk with my learners thoroughly about their treatment plans and we try to play out what will happen if they carry out wrong/incorrect therapies (without actually doing them of course). This way they can get an expectation of what would happen without causing harm to the patient. When it comes to procedures, I set up or have my own gown/gloves readily nearby. I jump in under three conditions: When the learner asks for help, if they are about to do something that could be detrimental to the patient without knowing or I gage that a complication/failure to complete a procedure will occur (ie. an already difficult airway, failed cannulation on limited vessel access, etc).

Do you start a teaching shift with certain objectives or develop them as a shift unfolds?

I tend to start a shift with certain objectives and explicitly ask the learner, what they would like to work on. I add to it if I’ve worked with them before and observed specific things they could improve. Additionally, we end every shift giving feedback and so we’ll try to work on those same things on the next shift if there’s an area for improvement.

Do you typically see patients before or after they are presented to you?

A mix of both, most of the time I see patients before they are presented to me.

How do you boost morale amongst learners on shift?

Humor and stories from my own experience that were teachable moments.

How do you provide learners feedback?

Also a mix of both. Time permitting, I tend to provide learners with verbal feedback. I then try to build upon that each time we work together. This all then gets incorporated into their written formal residency evaluation feedback.

What tips would you give a resident or student to excel on their shift?

Every moment is a teachable moment. Find the pearl you can take away from every patient encounter, colleague interaction, or conversation. Everything is about perspective and our failure to empathically see other viewpoints is what leads to conflict. Lastly, the best learning you can do is that which pushes you outside of your comfort zone. Learning isn’t easy, it takes time and hard work. It’s a long-term investment in yourself.

Are there any resources you use regularly with learners to educate during a shift?

I frequently reference the EMRA pocket books (digitally or hardcopy). I share many REBEL EM articles and infographics that I’ve personally made so the learner can pay attention to our discussion and then walk away with a summary of it on their phone. Also, Amal Mattu’s ECG weekly is often shared quite a bit.

What are your three favorite topics to teach during a shift?

Ventilator basics and management, pharmacology (usually sedatives), and creating differentials based on data (especially for altered mental status).

What techniques do you employ when teaching on shift?

Creating an optimal learning environment (ie. Psychological safety), spaced repetition and critically challenging learners.

What is your favorite book or article on teaching?

Book: Mindset by Carol Dweck

Article: 12 Tips for Teaching in the ICU

Who are three other educators you’d like to answer these questions?

Anand Swaminathan, Christopher Colbert and Marco Propersi.

How I Educate Series logo

Read other How I Educate posts for more tips on how to approach on-shift teaching.

By |2022-11-22T09:18:50-08:00Dec 21, 2022|How I Educate, Medical Education|

How I Work Smarter: Mark Ramzy, DO EMT-P

One word that best describes how you work?


Current mobile device

Samsung Galaxy S20


Samsung Notebook 9

What is something you are working on now?

Ultrasound Teaching Curriculum (both image review and interpretation) that can be made virtual and in very small group sessions with focused teaching and infographics.

How did you come up with this Idea/Project?

We performed a needs assessment in ultrasound learning across different divisions and specialties (IM, Anesthesia, etc) within the hospital. This didn’t just include medical students and residents/fellows, but also included attendings and faculty members with a longitudinal component to teaching. Also planning to make infographics easily referenceable on shift for quick review.

What’s your office workspace setup like?

Well since I’m a fellow, I don’t quite have an office at work. My office (and also recording space) at home consists of a custom-built desktop computer that is essentially a replica of my laptop.

What’s your best time-saving tip in the office or home?

Chunk or group together your work, especially similar tasks. If you have articles or content to review across different slack work groups, try to do it all at the same time so that you can develop a flow to your focused work. Have similar rules for work and home. For example turn off your phone notifications when “chunking”, then when you dedicate time to yourself/family/friends, also turn off your phone and be as present as possible.

What’s your best time-saving tip regarding email management?

Don’t just get your inbox to zero, have an organized system to keep everything straight. Whether that is a folder, labels, or specific inboxes, make sure you can easily find information. Also, utilize the snooze button in GMail as it helps you prioritize emails that you need to respond to but are unable to right away if viewing on your phone.

What apps do you use to keep yourself organized?

  • OneNote AND Evernote (I think the former has drawing/writing features, allowing me to take handwritten notes and easily search them
  • Business Calendar
  • Feedly

How do you stay up to date with resources?

  • Push specific content to me (ie. Utilize email notification system on PubMed and Journals for articles on specific topics)
  • Make customized lists on Twitter following particular people and hashtags

What’s your best time-saving tip in the ED?

Count your steps and limit them when you can to ultimately see more patients and save time. Also in addition to nursing staff, make every possible effort to learn the names of the unit clerk, environmental services, and any other ancillary support staff in the ED.

ED charting: Macros or no macros?

Macros for sure. I re-read it every single time on every single patient and make sure it applies to the patient after slight modifications as needed.


  • What’s the best advice you’ve ever received about work, life, or being efficient?

    • Double-dip when working on a project. Writing an article? Turn it into a blog post as well! Spin it into a deep discussion with an expert to also make it into a podcast.
    • Find a way to make your work easily accessible on shift (with or without an internet connection), Evernote and OneNote are both great options for this.
  • What advice would you give other doctors who want to get started, or who are just starting out?

    • Treat your staff (and patients) BETTER than you would want to be treated. Actively work to know their names and develop a working relationship with them so everyone can better help take care of patients together as a team.
    • Don’t gossip or talk about others no matter how tempting it is to get pulled into the “drama”
    • Be that doctor, who staff are excited to see when you come on shift and say things like “Oh Thank God it’s you…”
  • Is there anything else you’d like to add that might be interesting to readers?

    • Make sure to have one or more hobbies outside of medicine that really push your creative boundaries. For me, it’s things like graphic design, infographics, baking cheesecakes, and artistically decorating. It’s an added bonus if others can benefit from your hobby too!

Who would you love for us to track down to answer these same questions?

  • Paul Young (@DogICUma)
  • Zaf Qasim (@ResusOne)
  • Zack Shinar (@ZackShinar)
  • Joshua Niforatos (@ReverendofDoubt)
  • Shreya Trivedi (@ShreyaTrivediMD)

Read other How I Work Smarter posts, sharing efficiency tips and life advice.

By |2021-11-11T07:33:34-08:00Nov 12, 2021|How I Work Smarter, Medical Education|

Gaining the Diagnosis of Vitreous Hemorrhage with Ultrasound

A 54 year-old male presents to the emergency department with an eye complaint. The patient works as a cook and while cleaning the grill several hours ago felt something fly into his eye. He did not immediately feel pain, but notes blurred vision and an increasing pressure-like sensation in his left eye. He describes his left-sided blurred vision as a haziness, like cobwebs over his eye. He has been able to open his eye and keep it open without difficulty.


By |2020-01-29T15:55:48-08:00Jan 31, 2020|Ophthalmology, Ultrasound|

Introducing the 2020-2021 ALiEM Faculty Incubator Cohort!


We put the call out, and *wow* did the MedEd community respond! We were beyond excited this year about the quality of our applicants for the 2020-2021 ALiEM Faculty Incubator. 

This next cohort will include educators from across the globe and from all arenas of medicine including pre-clinical educators and our first nurse practitioner!


By |2020-01-20T08:46:17-08:00Jan 17, 2020|Incubators, Medical Education|
Go to Top