Study: Thematic analysis of our “How I Work Smarter” series

In 2014-15, we hosted a “How I Work Smarter” (HIWS) series, led by Dr. Ben Azan, focusing on the individual strategies of high-performing, successful emergency physicians. After the conclusion of the series, Ben went one step further and recruited a team which included Drs. Marilyn Innes, Brent Thoma, myself, Alex Van Duyvendyk, Zafrina Poonja, and Teresa Chan to conduct a thematic analysis, which was just published in Cureus [open access full text].¹ Although the content is from 2014-15 and many of the featured contributors have moved institutions with different roles, the themes and tips remain salient and informative in today’s era of digital and cognitive overload in the clinical and non-clinical environments.

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By Michelle Lin, MD|2019-06-03T12:25:28-07:00Apr 22, 2019|How I Work Smarter, Research|

Study: High Prevalence of Physician Burnout Among Emergency Medicine Residents Across the U.S.

In March 2017, our ALiEM Wellness Think Tank launched an ambitious initiative to try to identify the prevalence rate of U.S. emergency medicine (EM) resident burnout across the country. No study to date had been done to assess this. Amazingly we got a response from over 1,500 confirmed U.S. EM residents from 193 residency programs purely through our social media, email listservs, and Wellness Think Tank outreach efforts. We measured burnout using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). This 22-item MBI-HSS is the most common, validated tool used to measure burnout in healthcare professionals. It assesses 3 subscale domains:

Emotional exhaustion (EE), which means being emotionally depleted at work
Depersonalization (DP), which means a lack of feelings or negative, cynical feelings towards others
Personal accomplishment (PA), which is a positive sense of self-evaluation and success at work.

A combination of high EE, high DP, and/or low PA scores are correlated with burnout.^1,2 This post reviews some of the highlights from our study, High Prevalence of Burnout among Emergency Medicine Residents across the US, which was recently accepted by Annals of Emergency Medicine and published online.³

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By Michelle Lin, MD|2019-06-14T18:27:10-07:00Mar 16, 2019|Research, Wellness, Wellness Think Tank|

Top 5 Reasons to Join the 2019-20 Chief Resident Incubator

The ALiEM Chief Resident Incubator (“CRincubator”) launches its fifth class today. Every year’s class has a unique personality with wide-reaching projects. But all the chief residents share consistent characteristics – a deep dedication to resident education and wellness, a growth-minded approach to learning, and a desire for ongoing professional development. Are you an incoming chief resident in emergency medicine with a similar outlook, looking for a year-long community of your peers to share ideas with and bounce ideas off of? Want access to CRincubator alumni and respected educators in our field? Sign up early enough to attend our in-person launch event in Seattle on March 31, 2019 at the Council of EM Residency Director’s Academic Assembly.

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By Michelle Lin, MD|2019-04-04T19:50:29-07:00Mar 10, 2019|Incubators, Social Media & Tech|

SAEM Research Learning Series: Exception From Informed Consent

Have you ever wondered how researchers are able to conduct prospective studies on truly emergent conditions, such as cardiac arrest and status epilepticus? How can they obtain informed consent? In this Research Learning Series podcast episode from SAEM, Dr. Jill Baren (University of Pennsylvania) shares stories, pearls, and roadblocks in her career, conducting emergency research under the Exception From Informed Consent (EFIC) regulations. As an established researcher in this area,^1–9 Dr. Baren shares advice and stories which include reaching to the community, getting angry hot-line comments, and getting push-back from the U.S. Food and Drug Administration.

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By Michelle Lin, MD|2026-06-16T16:14:17-07:00Mar 7, 2019|Research|

EM Match Advice: Promoting Diversity and Inclusion in Training

Under-represented minorities (URM) in medicine continues to be a problem that many programs, especially in emergency medicine, are addressing head on with intentional, proactive strategies. Diversity matters. This EM Match Advice episode discusses how 3 different residency programs are championing for better representation through a variety of strategies.

Podcast Episode

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Expert Panelists

Dr. Joseph Moll (Virginia Commonwealth)
Dr. Tyson Pillow (Baylor)
Dr. Bonnie Kaplan (Denver Health)

Listen to all the episodes of the EM Match Advice Series

Additional Reading

Academy of Diversity and Inclusivity in Emergency Medicine (ADIEM)
AAMC: 2018-19 Applicants and Matriculation Data
CORD: The Underrepresented Applicant Emergency Medicine Applying Guide
NRMP: Main Residency Match Data and Reports
Tunson J, Boatright D, Oberfoell S, et al. Increasing Resident Diversity in an Emergency Medicine Residency Program: A Pilot Intervention With Three Principal Strategies. Acad Med. 2016 Jul;91(7):958-61. Pubmed

By Michelle Lin, MD|2021-07-01T10:16:03-07:00Mar 1, 2019|EM Match Advice, Podcasts|

ALiEMU Capsules 12: Pharmacology of Intracranial Pressure Management

The newest installment in the popular ALiEMU Capsules series is live. This module focuses on the critical care topic of intracranial pressure management. Specific topics include hyperosmolar therapy with mannitol versus hypertonic saline and blood pressure management. Go to the ALiEMU Capsule and take the quiz for your Capsules certificate.

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By Michelle Lin, MD|2019-03-27T08:21:40-07:00Feb 27, 2019|ALiEMU, Capsules, Neurology, Tox & Medications|

Significance of a traumatic pneumothorax or hemothorax found only on CT imaging

A 32 year old woman arrives in your emergency department after being in a motor vehicle collision where she was the seat-belted driver. She undergoes chest CT imaging despite a negative chest x-ray because of her ongoing anterior chest wall diffuse tenderness. You discover a small 10% pneumothorax (PTX), but no other associated thoracic injuries. Should you place a tube thoracostomy (chest tube)? Should this patient be admitted to the hospital? A 2019 Annals of Emergency Medicine paper by the NEXUS Chest research group tackles these questions.¹