SYLLABUS
College of Medicine
AY 2015-2016
Course title and number
Term (e.g., Fall 200X)
Meeting times and location
EMED 800 Emergency Medicine Required Rotation
Academic year by block
8:00 a.m. first Monday of the block, locations may vary.
Course Description and Prerequisites
4-week course; students will appreciate the role of emergency medicine within the healthcare system; Acquire basic
life support skills, recognition of immediately life threatening conditions and appropriate interventions; Diagnose and
treat common acute problems; Develop skills to assess the undifferentiated patient, perform focused histories and
physical; develop appropriate differential diagnoses. Prerequisite: Satisfactory completion of year three of the medical
curriculum
Course Description (from HSC Course Catalogue) and Overview
http://www.tamhsc.edu/education/catalog/
The practice of emergency medicine entails the rapid assessment and stabilization of patients presenting with
acute injuries and illnesses as well as those with exacerbations of many chronic illnesses. At the completion of
this rotation, students will:
Better appreciate the role of emergency medicine within the healthcare system
-threatening conditions and
appropriate interventions
ms
physical and the development of an appropriate differential diagnosis
Prerequisite: Satisfactory completion of year three of the medical curriculum
Brief Overview of requirements for passing (see each section for details.)
a. Complete equivalent of 16 eight hour shifts
b. Document the mandatory diversity of procedures and then others to total 40 procedures in one 45
c. Document 60 total patient encounters in one 45
a. Document the 13 undifferentiated encounters by turning in 13 History and Physicals
d. Complete 3 PBLs
e. Pass NBME EM exam
f. Complete end of rotation evaluation
Instructor Information
Temple Campus
Course Director
Name
Telephone number
Email address
Office hours
J. Scott Wieters, M.D.
(254) 724-0884
jswieters@sw.org
By appointment
Date Created/Revised: 05/21/15 By: DD
Name
Telephone number
Email address
Office hours
Coordinator
Carla Owens
(254) 724-0884
cjowens@sw.org
By appointment
AG67, Chlapek
Education Suite, Scott
& White Memorial
Hospital and Clinic
Temple, TX 76508
Office location
Office location
AG67, Chlapek Education Suite,
Scott & White Memorial Hospital
and Clinic Temple, TX 76508
Instructor Information
College Station Campus
Elective Director
Coordinator
Dr. Jeff Smaistrla
Name
Telephone number
Email address
Office hours
Office location
Name
Contact by email
Jeffs03ags@gmail.com
By appointment
St. Joseph Regional
Health Center
2801 Franciscan Drive,
Bryan TX077802
Telephone number
Email address
Office hours
Office location
Debbie Lynn
(979) 862-8309
dlynn@medicine.tamhsc.edu
By appointment
St. Joseph Regional Health Center
2801 Franciscan Drive, Bryan
TX077802
Instructor Information
Round Rock Campus
Elective Director
Name
Telephone number
Email address
Office hours
Office location
Coordinator
Dr. Roque Ruggero
Contact by email
argenroque@gmail.com
By appointment
3950 North A.W.
Grimes Blvd., Room
N404N
Round Rock, TX
78665
Name
Telephone number
Email address
Office hours
Office location
Cynthia Kershaw
(512) 341-4928
Kershaw@medicine.tamhsc.edu
By appointment
3950 North A.W. Grimes Blvd.,
Room N404N
Round Rock, TX 78665
Instructor Information
Baylor Dallas Campus
Elective Director
Dr. Bryan Buchannan
Name
(214) 820-8739
Telephone number
Bryan.Buchanan@bayl
Email address
orhealth.edu
By appointment
Office hours
Office location
3500 Gaston Ave.
Roberts Hospital Suite
1013
Dallas, TX 75246
Coordinator
Name
Telephone number
Email address
Office hours
Office location
Instructor Information
Corpus Christi Campus
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Sarah Stein
(214) 820-2233
Sarah.Stein@baylorhealth.edu
By appointment
3500 Gaston Ave. Roberts Hospital
Suite 1013
Dallas,
TX 75246
Elective Director
Coordinator
Name
Telephone number
Email address
Dr. Kimberly Leeson
Contact by email
Office hours
By appointment
Christus Spohn
Hospital-Memorial
Graduate Medical
Education, 2606
Hospital Blvd.
Corpus Christi, TX
78405
Office location
kleeson@gmail.com
Name
Telephone number
Email address
Office hours
Office location
Lynn Carrasco
(361) 902-4499
Lynn.carrasco@christushealth.org
By appointment
Christus Spohn Hospital-Memorial
Graduate Medical Education, 2606
Hospital Blvd.
Corpus Christi, TX 78405
Instructor Information
Houston Campus
Elective Director
Name
Telephone number
Email address
Office hours
Office location
Coordinator
Dr. Joe Ybarra
Karol Franks Hall
Name
Contact by email
rjybarra5@gmail.com
By appointment
St. Joseph
MedicalCenter
1401 St. Joseph
Parkway
Houston, TX 77002
Telephone number
Email address
Office hours
(713) 677-8120
kfranks@medicine.tamhsc.edu
By appointment
TAMHSC COM
2121 W. Holcombe Blvd. Suite 1111
Houston, TX 77030-3303
Office location
Learning Outcomes & Objectives
The course goals will be achieved through a combination of clinical shifts in the emergency department under
faculty supervision along with lectures, procedural training/skill labs, practice-based learning exercises, and
simulation. During clinical shifts, students will be responsible for the care of patients with a wide range of
conditions and across the lifespan, including pediatric, traumatic, and psychiatric complaints. Discussion group
sessions, labs, and lectures will be unique to each site. These experiences will be used to supplement clinical
exposure to key concepts within the educational core. A list of required procedures and patient encounters will
also be used to ensure each student receives the appropriate breadth of experience while on the rotation.
COM Competency Based Learning Objectives: http://medicine.tamhsc.edu/academicaffairs/curriculum/objectives/
Principles and Guidelines for Curriculum Development: http://medicine.tamhsc.edu/policies/pdf/curriculumprinciples-guidelines.pdf
Upon completion of the course, students will be able to:
Course Objective:
Obtain an accurate history and physical on
patients presenting with urgent problems.
Recognize immediate life threatening
illnesses
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COM Competency
Based Learning
Objectives
(CBLO):
Taught (T)
and/or
Evaluated (E):
Shift evaluation
card
PC1, PC2, PC8
T,E
PC4
Evaluation:
T,E
Exam
Shift evaluation
card, Exam
Develop an appropriate emergent
differential diagnosis based on patient
presentation
PC4
PC10, PC14, PC5,
PC6
Identify worst case diagnosis that must be
excluded
Develop management plans for common
emergency medicine complaints
Interpret common diagnostic tests and
procedures
Perform basic procedural skills under
appropriate supervision
Discuss key concepts within the educational
core
Effectively use available technology to
improve patient care and improve
knowledge
Effectively communicate with patients and
family member.
Complete documentation that is accurate,
well organized, and appropriate for the
level of care provided.
Follow up on specific patient encounters
and incorporate lessons learned to future
patients.
Practice ethical decision making.
Work in a collegial manner with all
members of the healthcare team.
T,E
T,E
Shift evaluation
card, Exam
Shift evaluation
card, Exam
PC3
T,E
Procedure Log
PC3
T, E
Procedure Log
MK2, MK4
T,E
Exam
SBP4
T,E
Shift evaluation
card
ICS1, ICS2, ICS4
T,E
Shift evaluation
card
ICS3
T,E
Shift Evaluation
card
ICS5
T,E
Shift Evaluation
card
PBL4, PBL5
T,E
PBL Forms
PROF2, PROF3
T,E
Shift Evaluation
card
T,E
Shift Evaluation
card
PBL1, PBL2, PBL3,
PROF1, PROF6,
PROF10
Grading Policies
The final course grade will be based on the following:
Clinical Performance
EM Rotation Exam
Procedure Log
Patient Encounter Log
Practice Based Learning
Satisfactory
Unsatisfactory
50%
35%
5%
5%
5%
100%
GRADING SCALE
70-100
69 or below
Attendance and Make-up Policies
Course Schedule will be unique for each site. Refer to your site orientation for specific schedule
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Clinical Shifts
You are expected to work a total of 16 eight-hour clinical shifts over your four-week rotation. These shifts are
distributed across morning, afternoon, evening, and night shifts. Shift work is an integral and at times unpleasant
feature of Emergency Medicine. Every effort has been made to avoid isolated shifts and provide a circadianfriendly schedule progression with at least one weekend free from clinical duties. Schedule requirements:
ast 8 hours between shifts (e.g., you may not work
10p-6a, attend Thursday conference, and then work 2p-10p);
You are excused from your shifts for clerkship labs and lectures. Moving/trading a shift without approval is
unprofessional. If an act of God occurs and you need to reschedule or otherwise change one of your shifts,
please let the campus coordinator know before that shift begins. Failure to show up for a scheduled shift is
considered unprofessional behavior and will result in a failure of the professionalism component for the rotation.
Thus, Any Unexcused Absence from a clinical shift may result in a failing grade for the rotation. The shift
evaluation cards (see below) serve as a simple way to ensure that you receive credit for your clinical shift.
Please write the name of the faculty or resident with whom you worked the most in the appropriate blank and
give the card to that physician before leaving. You are encouraged to make a note of which faculty or resident
completed your shift card. This will ensure you receive credit for the shift in the unlikely event a shift card is not
received.
There will be a mid-rotation evaluation of your progress. We will expect progress on all clerkship requirements.
There will be an opportunity to address areas for improvement and monitor those who may be at risk for not
passing.
Excused Absences
In accordance with medical school policy, you are only allowed to miss 20% of the required clinical activities to
pass required rotations. Approved absences for academic needs such as residency interviews/illness/or other
emergencies will be granted for up to TWO SHIFTS, ONLY. These will be granted AFTER ALL
PERMUTATIONS OF THE SCHEDULE HAVE BEEN EXHAUSTED. Sick/bereavement/ interview days
can be one of your excused absences provided by the medical school if available or repeated during clerkship.
For whatever reason, if you miss more than two shifts you may fail. Remediation plans will be granted on a case
by case basis, depend on site director and will require approval by the course director. The remediation plan is
expected to be completed in 30 days after the end of the clerkship.
You must attend orientation day. If you foresee or anticipate missing that day even for excused absences
ie interviews, USMLE or other planned absences, you will not be excused from missing orientation day.
You are able to attend an earlier but not later orientation day to make up for planned absences. Last
minute interview requests/excuses will not be granted.
Other Pertinent Course Information
Dress Code
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While on duty, students may wear scrubs or other appropriate professional dress. Name badges should be worn
at all times while in the department. Attire for conferences is typically more relaxed; if you have any questions,
feel free to ask any of the residents and when in doubt, err on the side of caution (“over dress” rather than
under).
Clinical Duties
At the start of each shift, report to the senior resident or attending in your assigned area. The supervising
physician will assign you a patient, whom you should assess. Perform a focused history and physical exam, then
discuss your findings and develop a plan with the resident.
If at any point you believe the patient’s condition is such that immediate intervention is required, alert
your supervising physician before proceeding further.
After discussing the patient with the resident or staff, it is important to follow up on any labs or diagnostic
imaging studies you may obtain as well as to reevaluate your patient frequently. The more pro-active you are in
picking up patients and following up on them, the more learning opportunities you will have, including
opportunities to practice various procedural skills. However, your role is not to perform an H&P and then
abdicate care of the patient; you should be involved in the patient’s care from initial assessment to disposition.
Do not attempt to carry more patients than you can comfortably manage (three patients at a time is likely a
maximum, and you should not expect to start out managing three comfortably).
You may complete prescriptions, referrals, and other forms for review and signing by your supervising
physician; make sure to sign any documentation you complete and leave a space for your supervisor to co-sign.
Learning Materials and Activities
Lectures and Labs
Educational supplements will be unique to each site. A mixture of didactics and procedural sessions/skill labs
will be used to ensure that all students master the course objectives. The exact method of delivery will vary by
campus. Refer to the logistical information for your campus for further information.
Despite approved absences, you are required to attend >75% of the educational activities to receive credit for the
course. If you are planning on missing a day, you may participate in an earlier but not later day with another
rotation group IF approved by director and space is available.
Additional resources such as books, procedure videos, articles, and Power Points are also available contact your
coordinator for details.
Exit Requirements
Please take the opportunity to let us know how this rotation may be improved by completing the course
evaluation. You will also need to return any textbooks equipment and completed 40 procedure log, 60 patient
encounter log both on one45, 13 H&Ps and 3 PBLs in order to receive credit.
Procedure and Patient Encounter Logs:
Procedures
You may assist with or perform all procedures done on your patients under appropriate supervision. You will
receive a procedure list detailing seven procedures you are expected to be able to perform competently by the
conclusion of your rotation; other procedures such as thoracostomy, central venous access, and lumbar puncture
may also be performed if indicated. Log procedures on one 45 daily. Many of the procedures are common,
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simple procedures that you likely are already competent in performing; however, because students with varied
backgrounds and experiences will be rotating, the procedure log allows us to ensure that each student meets
certain basic procedural competencies.
Failure to complete this aspect of the clerkship on time may result in a failing grade.
Required Patient Encounters
You will have the opportunity to see a wide variety of patient presentations while in the Emergency Department.
Please take this opportunity to round out your medical education and become a competent undifferentiated
physician by seeing patient presentations that you may not see elsewhere in your training. As part of this goal,
you are required to document patient encounters of thirteen conditions commonly seen in the ED. You must
document and turn in H&Ps on the 13 undifferentiated chief complaints documented similar to the
charting system specific to your site:
1. Abdominal pain
2. Chest Pain
3. Dyspnea
4. Endocrine Complaint
5. Acute Severe Pain
6. Wound Care
7. Musculoskeletal Injuries
8. Pediatric Fever
9. Trauma
10. Vaginal Bleeding
11. Neurologic Emergency /AMS
12. Adult Fever/Sepsis
13. Psychiatric Complaint/Overdose
You should also document another 47 encounters for a total minimum of AT LEAST 60 total patient
encounters. Most students will be able to document well beyond 60 encounters.
You should document encounters and procedures weekly. It is unprofessional to wait until the last
minute. Documentation will be monitored weekly and at the mid-point evaluation. If your patient
encounters and procedures are not completely documented by 1700 of the last Friday of the clerkship, you
will be required to meet with the clerkship Site Director to discuss remediation process and be reported to
the Campus Dean and/or SPC for professionalism. The specifics of the remediation are to be determined
by each Clerkship Site Director and require approval by the Course Director. The Campus Dean and/or
SPC will determine consequences for the unprofessional behavior of not completing assignments on time.
Failure to complete this aspect of the clerkship on time may result in a failing grade.
EXAM
a. The NBME EM exam will be administered by the COM at each site. It is a 100 question exam
administered over 3 hrs. The lowest possible passing score will be above two SD below the national
raw mean established through validation in the prior year. Failure on the NBME test will follow the
phase III policy on NBME test failure. In short, there will be a second NBME test to take and if
failed the student will have to repeat the entire clerkship at another site and on third attempt passing
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of the NBME be required to pass the clerkship. All failures will be reported to the SPC and dealt
with on a case by case basis.
Textbooks (Required and Recommended Resources)
All course materials are available online 24/7 through www.cdemcurriculum.org. This is a website with selfdirected learning exercises on the approach to the top undifferentiated chief complaints you will encounter in
your rotation. It also contains short descriptions of the high points of dealing with specific diseases divided up
by organ systems. Students are expected to review the entire supply
of material on the “approach to” tab as well as the “specific disease” sections.
There are other resources available at sites and on line with the medical library which you may find helpful
such as electronic copies of “First Aid for EM” at: http://guides.library.tamu.edu/medicine
Americans with Disabilities Act (ADA)
The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil
rights protection for persons with disabilities. Among other things, this legislation requires that all students with
disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If
you believe you have a disability requiring an accommodation, please contact Disability Services, in Cain Hall, Room
B118, or call 845-1637. For additional information visit http://disability.tamu.edu
Any student with a disability who needs accommodation should inform the instructor at the beginning of the course.
Academic Integrity
For additional information please visit: http://aggiehonor.tamu.edu
“An Aggie does not lie, cheat, or steal, or tolerate those who do.”
College of Medicine
Professionalism and integrity Statement (Academic Honesty and Plagiarism)
All College of Medicine students are required to comply with the student code of conduct and the academic integrity and
honesty standards published in each component’s Student Handbook. Disciplinary action will be taken in accordance with
the policies of each component. Students found guilty of Academic Dishonesty will receive an “F”/Unsatisfactory in the
course. For a full list of actions qualifying as academic dishonesty, please review the College of Medicine Student
Handbook at http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf.
According to the Aggie Honor System Office, plagiarism is defined as the appropriation of another person's ideas,
processes, results, or words without giving appropriate credit. Intentionally, knowingly, or carelessly presenting the work of
another as one’s own (i.e., without crediting the author or creator). Plagiarism and other academic misconduct definitions
can be viewed on the Aggie Honor System Office website;
http://aggiehonor.tamu.edu/RulesAndProcedures/HonorSystemRules.aspx#definitions.
E-mail Access and FERPA
The College of Medicine is communicating all official information to students through the students’ TAMHSC e-mail
accounts. Please check the account frequently during the semester for updates.
This course is supported with web-based and/or e-mail activities. In order to take advantage of these additional resources
and participate fully in the course, you have been assigned an e-mail address by the Texas A&M Health Science Center.
This e-mail address is for internal use only, so that faculty may communicate with you and the entire class. By registering
Date Created/Revised: 05/21/15 By: DD
for this course, you are agreeing to allow your classmates to have access to this e-mail address. Should you have any
questions, please contact the TAMU’s Office of the Registrar at 979-845-1031.
The Family Educational Rights and Privacy Act of 1974 (FERPA), which the HSC complies fully, is intended to protect the
privacy of education records, to establish the rights of students to inspect and review their education records and to
provide guidelines for the correction of inaccurate or misleading data through informal and formal hearings. Students also
have the right to file complaints with the Family Educational Rights and Privacy Act Office of the Department of Education
in Washington, D.C., concerning alleged failures by the HSC to comply with the act.
Mistreatment of Students
The College of Medicine is committed to providing a positive learning environment in which students can meet their
academic goals based on mutual respect in the teacher/learner relationship. Both parties must be sensitive to the needs
of others and differences in gender, race, sexual orientation, religion, age or disability. As outlined in the Student
Handbook under the section titled Standards of Conduct in the Teacher-Learner Relationship, belittlement, intimidation
and humiliation are unacceptable for effective learning and undermine self-esteem. Breaches involving student
mistreatment may result in a faculty or staff member being sanctioned or the loss of faculty and/or staff appointment.
These policies address student mistreatment involving College of Medicine employees, residents, affiliate staff, or
patients. Mistreatment may be reported through the College of Medicine telephone hotline, 1(855)-397-9835 or through
an online form at http://medicine.tamhsc.edu/current/student-mistreatment-form.html. For a full list of reporting avenues,
please refer to the Student Handbook under the Mistreatment Policy.
Exposure and Occupational Hazard
The Needle Stick Policy and Bloodborne Pathogen Exposure information for Medical Students may be accessed in the
Student Handbook at: http://medicine.tamhsc.edu/student-affairs/docs/handbook.pdf
Note: More information is available on the aforementioned topics to all students on the College of Medicine website.
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