During the rotation, students work approximately 15 clinical shifts, generally a mixture of day, evening, and overnight. The majority of the clinical shifts are done in the University of Maryland emergency department. The remainder are done in the Baltimore VA and Maryland General emergency departments. Students work one-on-one with senior residents and faculty and see a variety of patient complaints and presentations.

A lecture series is held the first week of the 4-week rotation and usually consists of 16 to 18 lectures given by emergency medicine faculty. These sessions are a mixture of PowerPoint presentations and small-group discussions. In addition, students attend 5 hours of educational conferences for the emergency medicine residents weekly.

Laboratory sessions are one of the most popular aspects of the rotation. The department of EM has the unique privilege to have access to donated human cadavers for the purpose of invasive procedure education.  Cadavers have been screen for communicable diseases and the lab is fully equipped for universal precautions. Students learn how to perform the following procedures:

• Endotracheal intubation
• Retrograde intubation using central line kit guide wire
• Cricothyrotomy
• Central venous access (internal jugular, subclavian & femoral)
• Chest tube thorocostomy
• Emergency thorocotomy (includes pericardial window and cardiac massage)

In 2005, a simulation lab using a state-of-the-art high-tech mannekin was added to the curriculum. Students are exposed to code scenarios and clinical cases and then manage the case. Discussions and debriefings are led by emergency medicine faculty. Emergency medicine residents on the academic development/teaching elective help teach in this lab.
The following labs are provided during the rotation:

• Ultrasound lab—led by Dr. Brian Euerle and Dr. Alice Tang
• Simulation lab—led by Dr. Traci Thoureen
• Cadaver (Procedure) lab—led by Dr. Mak Moayedi
• Suture lab—led by Dr. Bob Corder
• Splint lab—led by Dr. Michael Bond

Emergency Medicine Faculty Involvement
in Medical Student Education

Emergency Medicine faculty have become increasingly involved in medical student education in all years of training. During years 1 and 2, faculty give lectures and lead small groups as part of the Pathophysiology and Therapeutics course. In addition, Dr. Ken Butler has integrated other emergency medicine material into the curriculum, such as airway management and cardiopulmonary simulation case scenarios. Multiple faculty members are also involved in the Introduction to Clinical Medicine course given for first and second-year medical students. Many of the faculty also participate in the mentoring program and regularly have students in the emergency department for shadowing.


Rotation in Emergency Medicine University of Maryland Medical Center
The emergency medicine course for fourth-year students is devoted to teaching the basic, initial evaluation, stabilization, and diagnostic approach to the patient presenting with undifferentiated disease. Students are exposed to all types of patient problems, including chest pain (myocardial infarction, pulmonary embolism, acute aortic disease, esophageal rupture), headache (subarachnoid hemorrhage, brain tumor, subdural hematoma, stroke, carbon monoxide poisoning), back pain (epidural abscess, spinal fracture, cauda equina syndrome, metastatic spinal disease), abdominal pain (appendicitis, abdominal aortic aneurysm, mesenteric ischemia, perforated bowel, cholecystitis, hepatitis, pancreatitis), blunt and penetrating trauma, seizures, overdose, acute psychiatric emergencies, coma, lacerations, and fractures.

Under the direct supervision of faculty and senior residents, students develop and learn skills in wound care management (principles of wound care, sutures, complications), splinting techniques for various fracture patterns, intravenous line placement, and the initial interpretation skills of electrocardiography and radiography. Students experience emergency medicine and participate in patient care in “real time.” Supervising faculty work with students one-on-one and give students on-the-spot feedback about history-taking skills and physical examination skills. In addition, mid-month feedback is provided by the course director.

• Duration of rotation: 4 weeks
• Hours of participation: approximately 40 hours per week
• Number of students per month rotation: 10
• Location: University of Maryland Medical Center (Emergency Department and Urgent Care)
• Course Director: Rob Rogers, MD, FAAEM, FACEP

Students are given a formal orientation to the emergency department, which includes the following:

• Overview of the rotation
• Schedule of the rotation and clinical shifts
• Expectations regarding conduct and professionalism during the rotation
• Risk management review
• Review of charting and documentation expectations
• Tour of the emergency department

Students rotating through the Emergency Department should consider reading this article. The 3 Minute Emergency Medicine Medical Student Presentation: A variation on a theme. By Chip Davenport, BA, Benjamin Honingman, MD and Jeff Druck, Md

Emergency Medicine Interest Group (EMIG)
The Emergency Medicine Interest Group at the University of Maryland is a student-run organization that organizes activities that expose students to various aspects of the practice of emergency medicine. These activities range from blood draw labs to emergency medicine residency planning. Events are planned and run with the assistance of many of the emergency medicine faculty members. They are eager to provide first- and second-year medical students with opportunities to learn more about emergency medicine. Interested students may attend any or all of the events.

The Mentoring Program
The EMIG mentoring program matches first- and second-year medical students with emergency medicine residents. Students then have the opportunity to shadow the residents while they work in the emergency department. Students accompany the resident as he/she interviews patients, completes procedures, performs resuscitations, and arranges consultations. The student's role is primarily that of observer. However, depending on the resident, the student may be allowed to practice the history-taking and physical diagnosis skills learned in the Introduction to Clinical Medicine and Physical Diagnosis courses. The mentoring program is a wonderful resource for students considering a career in emergency medicine.

Any medical student that is interested in emergency medicine can be assigned to a faculty mentor to help them gain exposure to Emergency Medicine and help in navigating the residency application process.

1. Didactic instruction in study design.
2. Hands-on experience working with an established emergency medicine researcher.
3. Mentored development of student research ideas.

Research Opportunities
From time to time, students can help with research projects and gain hands-on research experience. Descriptions of these projects and the opportunities for students are circulated by email. Students who would like to be on the email list should send their name, graduation year, and email address to Dr. Michael Witting

We sincerely hope you will consider doing a rotation with us in emergency medicine

Robert L. Rogers, M.D., FAAEM, FACEP, FACP
Assistant Professor of Emergency Medicine and Medicine
Department of Emergency Medicine
Director of Undergraduate Medical Education
The University of Maryland School of Medicine