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After 25 yrs of school, today is my last-first-day. 3 yrs ago I’d just graduated med school & was starting residency at @StanfordEMED...sitting in a conference room listening to the brilliant @SaraCrager give a lecture on how-to-think-like-an-EM-doc as she finished ICU fellowship
Incoming emergency residents - here are a few notes that I still reference often:
1. Slow is smooth and smooth is fast. Take your time learning now, don’t rush/cut corners - youll avoid wasted time fixing mistakes & will be better for it later
1. Slow is smooth and smooth is fast. Take your time learning now, don’t rush/cut corners - youll avoid wasted time fixing mistakes & will be better for it later
2. Be decisive in the face of minimal information; you are the decider, your role in the medical system is to make decisions no one else wants to make (deciding you need more time does not = indecision)
3. Don’t conflate outcome with correctness of your decision making (getting lucky doesn’t mean you were right, bad luck doesn’t mean you were wrong)
4. Learn when to be assertive & when to be humble; you need to be highly competent in the areas where you don’t have time to ask for help
5. YOUR TIME IS A ZERO SUM GAME. Every moment you spend w/ one patient is a moment lost w/ another (time needed doesn’t necessarily correlate w/ severity of illness)
6. No multitasking (inefficient & leads to errors) - instead learn to rapid-task-switch
6. No multitasking (inefficient & leads to errors) - instead learn to rapid-task-switch
7. Keep your eye on the big picture when talking to consultants - they won’t
8. 3 things to do well by end of intern yr: identify sick vs not sick (sick doesn’t always = flashy),
in all H&Ps, EM DDx (most common & most likely to kill)
8. 3 things to do well by end of intern yr: identify sick vs not sick (sick doesn’t always = flashy),
in all H&Ps, EM DDx (most common & most likely to kill)
9. 2 jobs w/ every patient: figure out what needs to be done to dispo & what time sensitive things need to be addressed now (neither is finding a definitive dx)
10. For patients w/ vague complaints & pan-positive ROS, figure out 3 things: are they acutely sick, which complaint are they here for *today* 
happy patient, which complaint are you actually concerned about healthy patient
happy patient, which complaint are you actually concerned about healthy patient
11. Build trust w/ your ancillary staff, you won’t survive without a team
EM docs - what other tips do you have for our newest colleagues?
#July1st #EmergencyMedicine #MedTwitter
EM docs - what other tips do you have for our newest colleagues?
#July1st #EmergencyMedicine #MedTwitter
