Reading Recommendations

We searched far and wide to find select articles (& videos!) that you can read in your spare time. Then we distilled the list to the key essentials. Below, find our reading recommendations for every stage in medical school, residency and beyond:

 

Must Read

These articles will help you understand the core educational resources in EM and the personal characteristics that make you a good fit for the field.

The Outstanding Medical Student in Emergency Medicine
The core professional and personal characteristics that EM residency programs are seeking in students, both during the EM rotation and when applying to residency. Written by Stanford Emergency Medicine Residency.

Dr. Gus Garmel’s recommended textbooks, readings, and resources for Emergency Medicine students and residentsDr. Gus Garmel outlines the key educational resources relevant to Emergency Medicine.  Do not try to read them all, pick what works and go with it!

Must Watch

Dr. Thomas Perara, M.D., program director at Jacobi/Montfiore and Mary Hannon, M.D., an alumnus of the program discuss what excites them about the field of EM.
Great video for anyone considering the field of emergency medicine.

Medical Student Timeline

Guide to help you navigate medical school with a focus on EM.

Preclinical Years

Limkakeng, AT. Emergency medicine national conventions: A medical student’s perspective. Journal of Emergency Medicine. 23(2):211-212, 2002 August
This article outlines reasons for medical students to attend national EM conferences (such as the ACEP Scientific Assembly), including exposure to the field, comparing EM to other specialties, and networking.

Lotfipour S, Luu R, et al. Becoming an emergency medicine resident: a practical guide for medical students. Journal of Emergency Medicine. 35(3):339-44, 2008 October
This step by step guide for medical students discusses important tasks that must be accomplished throughout medical school by those hoping to match in EM and the importance of board scores, dean’s letters, grades, and letters of recommendation.

Pitre CJ. The unique educational value of emergency medicine student interest groups. Journal of Emergency Medicine. 22(4):427-428, 2002 May
This article outlines the benefits of a successful EMIG and suggests activities for it.

3rd Year

Windish DM, Paulman PM, et al. Do clerkship directors think medical students are prepared for the clerkship years? Academic Medicine. 79(1):56-61, 2004 January
This article defines six areas of competency that students need before starting a clerkship: communication, professionalism,history/exam, life cycle, epidemiology, and care systems.  It finds that 30-50% of clerkship directors do not believe that students are sufficiently prepared in these areas for clinical clerkship work.

Wenrich M, Jackson MB, et al. Ready or not? Expectations of faculty and medical students for clinical skills preparation for clerkships.  Medical Education Online. 15. doi: 10.3402/meo.v15i0.5295. 2010 August
This study outlines the expectations of clinical skill for medical students entering clerkships and the discordance between faculty and student expectations.

4th Year

Planning Your Final Year of Medical School. Gus M. Garmel, MD
This document contains specific advice on planning rotations & interviews in the final year of medical school.  It also includes a potpourri of EM-relevant information, including a list of the major EM organizations, EM journals, certifications, and a copy of the Standardized Letter of Recommendation (SLOR).

Sub-Internships

Davenport, C, Honigman B, Druck J. The 3-Minute Emergency Medicine Medical Student Presentation: A Variation on a Theme. Academic Emergency Medicine. 15(7):683-687, 2008 July
This is THE article you must read before giving any oral patient presentation in the emergency room.

Burdick WP, Jouriles NJ, et al. Emergency Medicine in undergraduate education. Academic Emergency Medicine. 5(11):1105-1109, 1998 November
This article expounds on the key EM competencies that the authors believe should be required of all medical students, including BLS, airway & cardiovascular support, diagnosis & treatment of common acute problems, and assessment of the “undifferentiated patient.”

Manthey DE, Ander DS, et al. Emergency medicine clerkship curriculum: an update and revision. Academic Emergency Medicine. 17(6):638-43, 2010 June
The Clerkship Directors in Emergency Medicine have updated the standardized 4th year EM clerkship syllabus published in 2006 to reflect lessons learned through experience with the current curriculum and changes in guidelines.

 

Letters of Recommendation

Keim SM, Rein JA, et al. A standardized letter of recommendation for residency application. Academic Emergency Medicine. 6(11):1141-1146, 1999 November
THE original scholarly article describing the SLOR.

 

Applicant Considerations

Perina, DG, Colier RE, et al. Report of the task force on residency training information (2010-2011), American Board of Emergency Medicine. Annals of Emergency Medicine. 57(5):526-534, 2011 May
Provides baseline data on the number of emergency medicine residency positions, locations, and resident characteristics such as gender, country of origin, and EM board pass rate.

Hayden SR, Hayden M, Gamst A. What characteristics of applicants to emergency medicine residency programs predict future success as an emergency medicine resident? Academic Emergency Medicine. 12(3):206-210, 2005 March
Examines the factors most predictive of success as a resident at UCSD EM residency.  The two most important predictors were medical school attended and “distinctive factors” such as athletics, student government, etc.  Strength of Dean’s Letter was also a major predictor.

Deiorio NM, Yarris LM, Gaines SA. Emergency medicine residency applicant views on the interview day process. Academic Emergency Medicine. 16:S67-S70, 2009 December
EM residency applicants were surveyed to determine the most influential portions of interview day.

Laskey S, Cydulka RK. Applicant considerations associated with selection of an emergency medicine residency program.  Academic Emergency Medicine. 16(4):355-359, 2009 April
Discusses the variables that influence medical students when choosing an EM residency program and determine their satisfaction with that residency choice.

Topics for Interviews

These are the topics to review before residency interviews – high-yield information to discuss with your interviewers.

Institute of Medicine (IOM) Report

Institute of Medicine. The Future of Emergency Care in the United States Health System. Annals of Emergency Medicine. 48(2):115-120, 2006 August
A seminal Institute of Medicine report in 2006 calling attention to problems in the emergency care system. This article outlines the major barriers to effective emergency care in the US from the IOM report, including fragmentation of services, lack of specialists, & lack of disaster preparedness.  It provides recommendations from the IOM to improve the system.

Chisholm CD. Institute of medicine report “The Future of Emergency Care”: “Too much, too little, too late?” What is the Society for Academic Emergency Medicine’s answer to the message? Academic Emergency Medicine. 14(3):259-260, 2007 March
This spirited and potentially incendiary perspective faults EM associations for not responding vigorously enough to the IOM report and suggests that organizations will not be prepared for the deluge of ED patients on the horizon, especially with our aging population.>

Legal, Policy-Making

Napoli AM, Jagoda A. Clinical policies: Their history, future, medical-legal implications, and growing importance to physicians. Journal of Emergency Medicine. 33(4):425-432. 2007 November
This article examines the evidence base, uptake, and legal role of clinical policies and practice guidelines.

White FA, French D, et al. Care without coverage: is there a relationship between insurance and ED care? Journal of Emergency Medicine. 32(2):159-165, 2007 February
This study found that fewer uninsured ED patients were admitted to the hospital, though when standardizing a subset for acuity, admission rates were similar.

Finances

Baumann MR, Vadeboncoeur TF, et al. Financing of emergency medicine graduate medical education programs in an era of declining medicare reimbursement and support. Academic Emergency Medicine. 11(7):756-759, 2004 July
This article covers technical information on hospital funding formulas from legislative changes to Medicare.

Weeks WB, Wallace AE. Differences in the annual incomes of emergency physicians related to gender. Academic Emergency Medicine. 14(5):434-440, May 2007
This study found that female EPs made $48,000 less per year than male EPs, which was only partly explained by lower patient volume, less board certification, and fewer years in practice.

Pines JM. The economic role of the emergency department in the health care continuum: Applying Michael Porter’s five forces model to emergency medicine. Journal of Emergency Medicine. 30(4):447-453, 2006 May
This article examines emergency care from the perspectives of supplier& buyer power, threat of substitution, barriers to entry, and internal rivalry, proposed by business expert Michael Porter.

Emergency Physician Demographics

Moorhead JC, Asplin BR. Distribution of emergency medicine residency graduates. Annals of Emergency Medicine. 32(4):509-510, 1998 October
This article observes that the majority of board-certified EPs practice in urban settings, and provides suggestions to make rural settings more personally and economically appealing to graduating residents.

Wear D. The House of God: Another Look. Academic Medicine. 77(6):496-501, 2002 June
This re-analysis of Samuel Shem’s classic novel suggests that the real value of House of God  is in forcing us to re-evaluate the purpose of hospital hierarchy and our response to the incredible breadth of disease that we see every day.

Li SF, Haber M. Patient attitudes toward emergency physician attire. Journal of Emergency Medicine. 29(1):1-3, 2005 July
This study found that there was no difference in patient satisfaction between ED physicians wearing formal attire and white coats, and those wearing scrubs.

Boarding

Moskop JC, Sklar DP, et al. Emergency Department Crowding, Part 1—Concept, Causes, and Moral Consequences. Annals of Emergency Medicine. 53(5):605-11, 2009 MayPart 2
An updated review of ED crowding that defines, explains how it is measured, identifies the most important causes, and discusses its consequences.

Olshaker JS, Rathlev NK. Emergency department overcrowding and ambulance diversion: The impact and potential solutions of extended boarding of admitted patients in the emergency department. Journal of Emergency Medicine. 30(3):351-356, 2006 April
This is an excellent review of ED overcrowding—one of the biggest political topics in EM.  The authors conclude biggest driver of ED overcrowding is inability to transfer patients to inpatient beds in a timely manner.

Asplin BR. Hospital-based emergency care: a future without boarding? Annals of Emergency Medicine. 48(2):121-125, 2006 August
This editorial published in response to the 2006 IOM report includes recommendations on financing, research, and regional organization of emergency care, and most notably calls on hospitals to develop improved systems to admit patients more quickly out of the ED and continue care on the inpatient ward.

Resident Wellness

Important ideas that are applicable to medical students and residents. Also important considerations when evaluating programs.

Burnout, stress and wellness

Chisholm C, Heyborne R, et al. Reflections about "burn-out". Academic Emergency Medicine. 16(6):567-571, 2009 June
A highly regarded program director gives her opinion on factors contributing to ED burnout.

Shah M, Cydulka RK. Chronicles of an emergency medicine intern. Academic Emergency Medicine. 14(5):475-478, May 2007
Offers a first-hand account of the stresses of intern year of residency and the need for interpersonal support systems.

Hobgood C, Hevia A, et al. The influence of the causes and contexts of medical errors on emergency medicine residents’ responses to their errors: An exploration. Academic Medicine. 80(8):758-764, 2005 August
Over 93% of residents have made medical errors.  71% of them discussed the error with their attending, 28% with the patient or family.  Most residents felt remorse, guilt, inadequacy, and frustration over the error.  Negative emotions were associated with personal characteristics, job overload, and lack of institutional support.

Schmitz, G. Strategies for coping with stress in emergency medicine: Early education is vital. J Emerg Trauma Shock. 2012 Jan-Mar; 5(1): 64–69
Describes solutions to burnout and stress. Also looks at correlation between resident stress and patient satisfaction with their care.

Houry D, Schokley LW, Markovchick V. Wellness issues and the emergency medicine resident. Annals of Emergency Medicine. 35(4):394-397, 2000 April
This article discusses wellness issues including sleep, drug use, pregnancy, relationships, and safety among EM residents – key issues to consider to thrive in the ED.

Katz ED, Sharp L, Ferguson E. Depression among emergency medicine residents over an academic year. Academic Emergency Medicine. 13(3):284-287, 2006 March
Found that 12% of EM residents have depression and it is not predicted by gender, number of hours worked, or residency year.

Rotating shift work and the sleep cycle

Papp KK, Stoller EP, et al. The effects of sleep loss and fatigue on resident-physicians: A multi-institutional, mixed-method study. Academic Medicine. 79(5):394-406, 2004 May
Found that only 16% of residents could score in the normal range on the Epworth Sleepiness Scale.  Residents perceived that sleep loss and fatigue had major impact both on personal lives and on work responsibilities.

Kuhn G. Circadian rhythm, shift work, and emergency medicine. Annals of Emergency Medicine. 37(1):88-98, 2001 January
Reviews the physiological negative effects of desynchronosis, or interruption of the circadian rhythm, on physician wellbeing.

Nelson D. Prevention and treatment of sleep deprivation among emergency physicians. Pediatric Emergency Care. 23(7):498-503, 2007 July
Addresses the negative effects of sleep deprivation and reviews methods to counteract it, including caffeine, alertness-enhancing agents, and better sleep hygiene.

Occupational hazards

Dorevitch S, Forst L. The occupational hazards of emergency physicians. American Journal of Emergency Medicine. 18(3):300-311, 2000 May
Focuses on common occupational hazards including bloodborne illnesses, latex allergies, workplace violence, shift work, and emotional stress.

Gates DM, Ross CS, McQueen L. Violence against emergency department workers. Journal of Emergency Medicine. 31(3):331-337, 2006 October
Study of violence in 5 EDs over six months found that there were 319 assaults by patients and 10 assaults by visitors, of which 65% went un-reported.

Work Hours and Moonlighting

Wagner MJ, Wolf S, et al.  Duty hours in emergency medicine: balancing patient safety, resident wellness, and the resident training experience: a consensus response to the 2008 institute of medicine resident duty hours recommendations. Academic Emergency Medicine. 2010 Sep;17(9):1004-11
This consensus report addresses the effects of duty hour restrictions on emergency medicine resident training. The effect of duty hour restrictions on patient safety, resident wellness, the resident training experience, and the appropriate length of an EM residency are emphasized.

Li J, Tabor R, Martinez M. Survey of moonlighting practices and work requirements of emergency medicine residents. American Journal of Emergency Medicine. 18(2):147-151, 2000 March
This article found that there is great variation in required work hours for EM residencies, with an average of 204 hours per month.  Moonlighting is typically as a solo ED physician in an outside hospital, and doubles a resident’s salary, mostly used to pay off debt.

Chisholm C, Hedges J, Kazzi AA. EMRA’s policy on unsupervised resident moonlighting: A time to refocus indeed. Academic Emergency Medicine. 9(5) 354-356, 2002 May
This paper disagrees vigorously with EMRA’s policy supporting resident moonlighting.  The authors argue that residents should be given “dependent” medical licenses that do not permit unsupervised practice, and that moonlighting should be curtailed.

Career Options

Academics

Stead LG, Sadosty AT, Decker WW. Academic career development for emergency medicine residents: A road map. Academic Emergency Medicine. 12(5):412-416, 2005 May
This article outlines the expectations for residents who want an academic career, including research, scholarly writing, reading the literature, joining committees, competing for awards, teaching, and pursuing a fellowship.

Burkhardt, John, Terry Kowalenko, and William Meurer. "Academic career selection in American emergency medicine residents." Academic Emergency Medicine 18.s2 (2011): S48-S53
Residency characteristics associated with academic careers include program size, location and amount of research produced.

Stern S. Fellowship training: a necessity in today's academic world. Academic Emergency Medicine. 9(7):713-716, 2002 July
This article argues that fellowship training is essential for the academic emergency physician, enhances career satisfaction, and allows the development of strong mentoring relationships.

Wilson MP, Itagaki MW. Characteristics and trends of published emergency medicine research. Academic Emergency Medicine. 14(7):635-640, 2007 July
This article takes a global view of all articles published by EM departments from 1996-2005, finding that 59% were published in the US, followed by the UK with 8% and Japan with 4%.  Only 4.5% of EM studies were NIH-funded.

Pediatric EM

Woolridge DP, Lichenstein R. A survey on the graduates from the combined emergency medicine/pediatric residency programs. Journal of Emergency Medicine. 32(2):137-140, 2007 February
This survey found a very high satisfaction rate with combined EM/Peds residency.  The majority of EM/Peds trainees work in an academic institution.

Vu TT, Hampers LC, et al. Job market survey of recent pediatric emergency medicine fellowship graduates. Pediatric Emergency Care. 23(5):304-3077, 2007 May
This survey found that Pediatric EM specialists received an average of 5 job offers at completion of fellowship, with 60% of those positions being research-oriented and 40% clinical care-oriented.

International EM

Berger, E. Emergency medicine goes global: specialty steps up humanitarian role. Annals of Emergency Medicine. 47(4):344-347, 2006 April
This great article highlights stories of EPs working in difficult disaster recovery situations, outlines the demographic forces shaping EP involvement in global health, and also touches ethical and personal risks faced by humanitarian workers.

 

Foran, Mark, et al. "International emergency medicine: a review of the literature from 2009." Academic Emergency Medicine 18.1 (2011): 86-92.
The top 24 articles published in international emergency medicine in 2009. Good place to begin the current research in the field.

EM / IM

Kessler CS, Stallings LA, et al. Combined residency training in emergency medicine and internal medicine: An update on career outcomes and job satisfaction. Academic Emergency Medicine. 16(9):894-899, 2009 SeptemberThe experiences, career outcomes, and satisfaction of combined EM/IM program graduates are explored in this article.

Katz ED, Katz JT. Careers of graduates of combined emergency medicine/internal medicine programs. Academic Emergency Medicine. 9(12):1457-1459, 2002 December
This survey of combined EM/IM graduates found that 30% of graduates practice both EM and IM.  Half are involved in research, and most reported high career satisfaction, with most reporting that their reason for pursuing combined training was to be a better physician.

Other career paths

Thacker SB, Stroup DF, Sencer DJ. Epidemic Assistance by the Centers for Diseaes Control and Prevention: Role of the Epidemic Intelligence Service, 1946-2005. American Journal of Epidemiology. 174(supl 11):S4-S15, 2011 December
The Epidemic Intelligence Service (EIS) is a 2-year post-residency fellowship program of the CDC, which is popular among emergency physicians. Although the EIS is a non-clinical fellowship, some emergency medicine graduates find creative ways to keep up their clinical skills. It provides the best quantitative preparation for fieldwork and investigation of acute disease outbreaks.

Cawdery M, Burg MD. Emergency medicine career paths less traveled: cruise ship medicine, Indian health, and critical care medicine. Annals of Emergency Medicine. 44(1):79-83, 2004 July
This article provides information for residents on the career opportunities in cruise ship medicine, the Indian Health Service, and critical care medicine, and charts ways to begin pursuing these routes early in residency.

Atzema C, Poirier V. Career options in aerospace and aviation medicine. Annals of Emergency Medicine. 43(5):652-656, 2004 May
This article discusses the career paths and fellowship opportunities in aerospace medicine, in the US and abroad.

List revised and compiled in October 2013 by Jimmy Corbett-Detig. Thanks to previous authors and contributors for all their hard work.

 

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