Bridge to Emergency Medicine EM for medical student curriculum

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!

UPDATE on 4/25/20: EM:RAP has kindly made the relevant C3 podcasts OPEN ACCESS until July for all students! What an incredibly kind gesture – thanks EM:RAP! And feel free to trial a free subscription. See below under the 8-week curriculum map.

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

ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Cardiovascular
Chest pain
GI and GU
Elderly Abdominal Pain
Trauma
Head Injury Major
Cardiovascular
Tachycardia
Ear Nose Throat
Sore Throat
Blog/Podcast
Resource 1
Airway
Pre-oxygenation
Cardiovascular
The HEART Score
Trauma
Trauma Assessment
Orthopedics
Low Back Pain
Internal Med
Anaphylaxis
Blog/Podcast
Resource 2
Infectious Disease
Sepsis
Pulmonary
Bronchiolitis
Cardiovascular
Abdominal Aortic Aneurysm
Airway
BVM Ventilation
Internal Med
Diabetic Ketoacidosis
ECG Wave Maven
Case #
107, 119, 130246, 251, 2737, 39, 2917, 35, 70, 47313, 72, 106, 109
ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Pulmonary
Dyspnea 1
Cardiovascular
Bradycardia
Neurological
Altered Mental Status 1
Pediatrics
Pediatric Abdominal Pain
Neurological
Altered Mental Status 2
Blog/Podcast
Resource 1
Airway
BIPAP
Internal Med
Hyperkalemia
Orthopedics
When to Call Part 1
Cardiovascular
Acute Coronary Syndrome
Risk Factors
OB/Gyn
Ectopic Pregnancy
Blog/Podcast
Resource 2
GI and GU
Pancreatitis
Toxicology
Toxicology Basics
Trauma
Head Injury on Blood Thinner
GI and GU
Renal Colic
Orthopedics
When to Call Part 2 *
ECG Wave Maven
Case #
86, 91, 1115, 21, 4, 1092, 36, 143, 54120, 59, 149128, 78, 177, 136

* Very dense resource – Do not memorize. Instead familiarize yourself with general concepts, because you can always look up specifics later.

ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Cardiovascular
Chest Pain Young Adult
Airway
Airway Basics 1
OB/Gyn
1st Trimester Vaginal Bleeding
Airway
Airway Basics 2
GI and GU
Major GI Bleed
Blog/Podcast
Resource 1
GI and GU
Acute Cholecystitis
Ear Nose Throat
Epistaxis
Airway
Procedural Sedation Pearls
Environmental
Mammal Bites
Cardiovascular
Asymptomatic Hypertension
Blog/Podcast
Resource 2
Trauma
Elderly Traumatic Brain Injury
Pulmonary
Hemoptysis
Infectious
Sexually Transmitted Infections Treatments
Trauma
Trauma Pearls
Neurological
Elderly Delirium
ECG Wave Maven
Case #
358, 230, 81263, 202, 161297, 164, 215222, 226, 200372, 182
ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Ear Nose Throat
Ear Infections
Pulmonary
Dyspnea 2
Cardiovascular
Congestive Heart Failure
Neurological
Headache
Neurological
Stroke
Blog/Podcast
Resource 1
Cardiovascular
Aortic Dissection
Infectious
Urinary Tract
Infection Treatment
Neurological
Hyponatremia
GI and GU
Small Bowel Obstruction
Trauma
Reversal Anticoagulation
Blog/Podcast
Resource 2
GI and GU
Upper GI Bleeding
GI and GU
Renal Ultrasound
OB/Gyn
3rd Trimester Pearls
Cardiovascular
Hypertensive Emergencies
GI and GU
Priapism
ECG Wave Maven
Case #
237, 219355, 238387, 176371, 242, 223255, 274
ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Neurological
Transient Ischemic Attack
Neurological
Syncope
Pediatrics
Pediatric Fever
Cardiovascular
Atrial Fibrillation
GI and GU
Minor GI Bleed
Blog/Podcast
Resource 1
Pediatrics
Physical Abuse
Cardiovascular
Heart Failure Pearls
Pediatrics
Pediatric Urinary
Tract Infection
Ear Nose Throat
Dental Trauma
OB/Gyn
Pre-Eclampsia and Eclampsia
Blog/Podcast
Resource 2
GI and GU
Acute Urinary Retention
Cardiovascular
DVT Treatment
Orthopedics
Elderly Hip Fracture
Pediatrics
Neonatal Resuscitation
Trauma
Spinal Cord Injury
ECG Wave Maven
Case #
393493, 268232, 278314, 394326, 459
ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Pulmonary
Asthma
Orthopedics
Joint Pain
Pulmonary
Pneumonia
Orthopedics
Back Pain
Trauma
Head Injury Minor
Blog/Podcast
Resource 1
Pediatrics
C3: Pediatric Airway
GI and GU
C3: Kidney Stones
OB/Gyn
Postpartum Hemorrhage
Cardiovascular
Heart Failure Pearls 2
Infectious
C3: HIV/AIDS
Blog/Podcast
Resource 2
Orthopedics
Septic Joint Pearls
Neurological
Neuro Critical Care
ECG Wave Maven
Case #
344126331, 112282, 48573
ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
HEENT
Epistaxis
Neurological
Seizure
Pediatrics
Pediatric Seizure
HEENT
Vision Loss
OB/Gyn
Non-Pregnant
Vaginal Bleeding
Blog/Podcast
Resource 1
HEENT
C3: Eye Trauma
Orthopedics
Open Fractures Pearls
GI and GU
Abdominal Aortic Aneurysm
Pediatrics
Bulging Fontanelle
Trauma
Spinal Shock
ECG Wave Maven
Case #
23330287162147
ResourceMondayTuesdayWednesdayThursdayFriday
EM:RAP C3
Episode
Ear Nose Throat
Painful Red Eye
Psychiatric
Psychiatric Emergencies 1
Infectious
Soft Tissue Infections
Psychiatric
Psychiatric Emergencies 2
Neurological
Dizziness
Blog/Podcast
Resource 1
Hematology
Sickle Cell Disease
Procedures
C3: Wound Management 1
Infectious
Rhinosinusitis
Procedures
C3: Wound Management 2
Trauma
Refractory Shock
ECG Wave Maven
Case #
442, 467501469441, 504463, 508

To access the EM:RAP C3 content, please go to EM:RAP and click on the “Subscribe” button in the top right hand corner. On the next page, choose the “Free Trial” account and set up your login information. This new account will allow you to access the C3 material through the EM:RAP website or EM:RAP app on your iPhone or Android device.

Abbreviations used:

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