Common Sense, Fall 2011
Original Article Author: Ali Farzad, MD
The new academic year is in full swing, and all across the nation students, residents and new attendings continue adjusting to their new roles and responsibilities. During emergency medicine (EM) training, we encounter new and exciting challenges on a daily basis and must use this important time to develop our skills and improve the care we deliver to patients. Regardless of your level of training, balancing the long hours and the demanding nature of our job with the time needed for personal wellness can be difficult. We have all become accustomed to working hard, but to avoid neglecting ourselves and our personal lives, we need to also work smart.
Luckily, you are not alone. AAEM/RSA is dedicated to being there for you every step of the way. In writing my Editor’s Letter throughout the next year, I will specifically aim to share information that I think will help make your life easier. To that effect, I’d like to share some tips to help you maximize your time and get the most out of your training. Implement any of the following tips into your daily routine to help save time and make you more effective.
Make the most of the people and resources available to you.
Check with your program and make sure you are taking advantage of all the institutional subscriptions and educational resources that are provided for you. Seek appropriate faculty members to serve as mentors. It may not feel like it now, but being in training has its perks. It is unlikely that you will have this level of support available to you later in your career, and everything will cost more once you start making “attending money.” Being a part of professional EM organizations like AAEM/RSA gets you free or inexpensive access to tons of information and educational resources that are designed to make life easier. Start using them!
Use technology to make your life easier.
Smartphones and tablets have, and will continue to, revolutionize the way we access and use information. Find a practical way to organize your academic resources so that everything is easily accessible and there for you when you need it. Using free cloud-based products like GoogleDocs can help you access all of your documents and spreadsheets on the net from any computer. You can also use it to collaborate with colleagues by working on a single shared document at the same time. Consolidate your e-books and favorite journal articles into a format that allows you to refer to them easily. I use a computer program called Papers on my Mac to archive my important articles and effectively rid myself of the stockpiles of journal articles collecting dust from intern year. There is no point in collecting articles that won’t be there when you need the information. The program also syncs with the accompanying iPhone and iPad so you can have all of your favorite documents available in an easily searchable format to refer to or to share with colleagues. Be on the lookout for a more comprehensive review and recommendations of EM apps and programs in future Common Sense issues. In the meantime, find what works best for you, and stick to it.
Get organized, and plan to be successful.
Having gotten this far in the game, you likely already know which learning methods work best for you. Seek the appropriate resources, and figure a way to fit them into your schedule. This will be the hardest part ... but once you become familiar with how to use your resources and work them into your routine, you will have effectively set yourself up to succeed.
If you are a visual learner, you can access countless hours of topnotch EM video lectures at EMedHome.com for free as a paid AAEM/ RSA member (including recorded lectures from the AAEM Scientific Assembly). When a clinical question arises during your next shift, take a minute to watch short videos from emrap.tv to supplement your learning, and refer your students to look up videos from the NEJM Videos in Clinical Medicine or from the procedures section of Access Emergency Medicine.
If you are an auditory learner or like to multitask on your commute to work, there are several great podcasts you can listen to by leaders in EM that summarize the latest literature and teach you information that you will use to save lives. Keep a few episodes on a mobile device, and maximize time you would have otherwise wasted. EMCast, EMRAP, EMRAP: Educators Edition, and Critical Care Perspectives in EM are just a few of the good ones to get you started. There are even more EM Blogs like EMCrit, Academic Life in EM or Life in the Fast Lane that get across important information without drowning you in reading. You can even use Facebook and Twitter to deliver daily pearls to your smartphone for quick learning on the go. Start by liking the AAEM/RSA Facebook fan page to get access to the Fact of the Day for free.
If you are still kicking it old school and paper cuts and bookshelves are your thing ... make sure you have a copy of the AAEM/RSA and YPS Rules of the Road book series specific to your level of training, along with the AAEM/RSA Written Board Review Book (Emergency Medicine: A Focused Review of the Core Curriculum) amongst your arsenal when it comes time for inservice exams and boards. Keep your white coat stocked with quick reference guides like the AAEM/RSA Toxicology Handbook, the antibiotic reference guide of your choice, and the AAEM/RSA EM Survival Guide. Again, all free or discounted member resources waiting to help make your life easier. Check out the member benefits section of the AAEM/RSA website for the latest editions of these great publications and more.
Assume the worst when preparing to be your best.
The emergency department is like an unfamiliar battleground where lives are on the line and you never know for sure what you are up against. Dr. Amal Mattu has taught that “when emergency physicians hear hoof beats, we must expect lions, and tigers, and bears.” Unlike other fields of medicine that have the time to seek rare zebras, we in EM are expected to be experts in identifying and treating acute life threatening conditions. Assuming the worst not only allows us to effectively rule out the most dangerous diagnoses, but it can also be used as an effective teaching tool.
It doesn’t matter if you are working at a busy trauma center or a quiet urgent care, any chief complaint can be morphed into a potential clinical disaster for teaching purposes. The patient with “reflux” and epigastric discomfort could have an MI, PE or aortic dissection. The “virgin” teenager with abdominal pain could have a ruptured ectopic pregnancy, and her pressure is dropping. The person with a headache probably has meningitis, SAH or stroke. What do you do when the seemingly stable patient takes a turn for the worst and is crashing in front of you? What happens when you are working overnight in a rural community ED and you’re alone as the only available doctor? Asking these questions and assuming the worst is a great way to prepare yourself and your students to be ready when disaster strikes. Try this the next time you are working, and I bet you will have a more exciting shift and walk away having learned and taught more.
Remember that you are making a difference in the lives of your patients.
Together we have the enormous privilege and responsibility of caring for people who place their lives in our hands and count on us to do what is best for them. While it can be easy to get bogged down by the stress and difficult nature of our jobs, let’s not forget to recognize the importance of our line of work and focus more on the joyful and exciting moments of our time spent working at the front lines of medicine. Make the most of the people and resources available to you, and use technology to maximize the time you spend learning and teaching others. There is no better time than the present to get organized and get involved. Congratulations to you for all you’ve accomplished thus far! (I welcome your comments or suggestions at firstname.lastname@example.org).
I have no financial disclosures to make, and get no financial compensation for any of the products discussed in this article. The views expressed and recommendations made in the article are solely those of the author, shared in hopes of making the reader’s life a little easier.