AED Meeting Minutes: Emergency Medicine Panel
President Update:
-Upcoming events:
-Social event on 10/14, Bowling at Goldy’s Gameroom, 6:30-8:30. $5 for nonmembers,
free for members. RSVP to Julie our treasurer.
-Health Careers Fair on 10/14, 2-5PM, Coffman Memorial Union. Great opportunity to
learn about medical school volunteer and internship opportunities!
-Volunteer event on 10/27: Cook for Kids at the Ronald McDonald House – we will
prepare and serve a meal to patients and families at the local Ronald McDonald house.
Open to local members only, 4-8 PM, up to 11 members can sign up. RSVP to Matt.
-AED MCAT Course Auction, week of 10/27-10/31. Bidding will be via email through
Rachel.
Medicine in the News: Julie
-Energy Drinks and Health:
A recent Johns Hopkins University study called for a warning label on high-caffeine
energy drinks. The amount of caffeine in these drinks is not regulated by the FDA. Caffeine
intoxication can have multiple negative effects including tachycardia and in some cases death.
Keisha, The Princeton Review:
- Paid local members of AED automatically receive a $150 discount for MCAT courses
and a $100 discount for other courses (GRE, LSAT, etc).
- TPR is having a $200 discount in grad-school preparation programs that will end next
Friday, October 17.
- The location of TPR in the Dinkydome will remain the same throughout the construction
period.
- $30,000 giveaway for the first year of grad school – forms were given out for interested
members.
Dr. Ankel, Emergency Medicine Residency Director: ankel001@umn.edu
- Did undergrad at UW Milwakee, medical school @ UW, residency at Chicago 1989-92,
and has been the Residency Director @ Regions since 2000.
Historical Overview of the Specialty:
- 1968 – American College of Emergency Physicians – formation was stimulated by the
realization that emergency medicine during the Vietnam War was better than it was in the
continental U.S.; therefore, training of physicians was necessary to improve acute care.
- Late 1970s – Board certification became available
- Now, about 8-9% of medical students match in emergency medicine residencies.
Relevancy:
- 110 million visits per year occur in the U.S. at an emergency room. (about 1/9)
- There will always be a job in emergency medicine – job market is wide open since the
specialty is new, and the complexity of acute medicine has risen so quickly. Experience
of emergency medicine physicians is desirable for leadership positions within hospitals as
well.
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Characteristics of the Specialty:
- The ER is the only place required by law to take care of everyone who seeks medical
help.
- Often, the limiting factor is time: how can physicians make a difference early on,
especially when multiple high-acuity patients need care at the same time.
- Not only do emergency physicians get to use their brain, but their hands as well. This
combo of thinking and doing, breadth and depth is important.
- Examples of procedures given: ABCDs (airway, breathing, circulation, disability)
- Pre-hospital care is also vital. In the U.S., most of this care is given by non-physicians
such as EMTs, paramedics.
- Emergency physicians often make life-and-death decisions. Example: had to choose
which patient to leave behind in a trauma situation where only one could be airlifted out.
- Emergency medicine physicians’ everyday is the worst day of most patients and families
lives.
- Career options are vast: location of practice can be rural or urban. You can have an
academic, community, or hybrid practice. You can get specific expertise through
fellowships in EMS, toxicology (drug overdoses), pediatric EM, hyperbaric medicine
(dive injuries, wound care), and disaster medicine.
- Common sense and personality are important as well as brains. Emergency medicine is a
team sport. Physicians must make decisions based on limited data in nonideal conditions.
They have the ability to connect with their patients in a very short time.
- 3 residency programs in MN: Mayo, HCMC, Regions
- International work possible as well.
Dr. Dahms, Assistant Residency Director, Regions Hospital:
Rachel.a.dahms@healthpartners.com
-Started out as an engineer @ the U of M. Started working as an EMT at HCMC, decided to
change to pre-med. Microbiology major, was a pre-medical scholar at the U of M and did not
have to take the MCAT. She started out medical school knowing that she wanted to go into
emergency medicine. Medical school was simply a conformation of her desire to be in the ER.
She went to Indiana for residency, and ended up at Regions hospital.
Average Day:
- Deal with chemical dependency problems, child and spousal abuse, small things such as
cuts, bumps. From one minute to the next, patient acuity can change drastically. They
rule out the bad first, and then get to the diagnosis. They have to send people home
everyday without finding an affirmative diagnosis. Emergency med might not be the best
specialty if you need to follow things through to a definitive diagnosis.
- Urban centers are busy! Emergency medicine is very much a team effort – physicians
must be the leader.
- Seeing people on the worst day of their life and being able to make a difference is one of
the main draws to EM for her.
- Deal with a lot of blood and guts – EM is not for the faint of heart.
- Don’t get to see the follow-up: emergency physicians must multi-task, some of it is an
inherent skill rather than learned.
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Dislikes: Extremely stressful – emergency medicine physicians must have a personality
that thrives on working under pressure. You have to distance yourself from your patients
– must be able to deliver extremely awful news to patients and their families and go back
to continue working on more patients. Work on a shift schedule. Work all days, all shifts,
holidays, and weekends. Schedule always changes.
- Important issues of today: ERs are mandated to see everyone that comes into the door.
Resources and funding often do not match this mandate. Emergency departments are
closing down nationwide and the emergency departments that stay open are being
flooded with patients, resulting in overcrowding and long wait times for access to
medical units. Problem in MN is not so bad; however, psychiatric patients can often wait
for days before an inpatient mental health bed opens up.
- Advice: If you’re okay with blood and guts, like doing procedures but also like cognitive
thinking, EM might be the specialty for you. Opportunities for shadowing can help you
decide. Must be able to multitask, communicate, manage people, and work in a team in
order to be successful as an emergency medicine physician.
Questions:
1. How long are your shifts, how many hours per week do you work?
-Variable depending on where you work. Busier the place – shifts can be 8-12 hours. In rural
hours, can be 24 hours. Average hours per week run 40-50 hours a week (lower than almost any
other specialty!). Lifestyle: don’t have to go on-call, don’t have to take work home.
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2. What is a typical day like?
Dr. Ankel:
-60% bureaucrat, 40% MD. Must recruit, evaluate, deal with budget factors, etc. for residency
program.
-Spoke about time spent in ER @ Hudson last Friday – resource management is always a priority
issue.
-Sometimes you feel like you don’t do anything but stamp out fires for the entire shift.
-Attending physicians mostly supervise residents
-Bureaucrat: meetings about how to influence behavior, policy-making, education, etc. He is
currently in charge of running a conference for the specialty, in addition to consulting hospitals
looking to start residency programs.
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