Welcome to the EMRA Medical Student Newsletter! Here you can find articles written for medicalstudents, by medical students, with an emphasis on helping our peers be prepared for an emergencymedicine residency position. Most articles are written by members of the Medical Student Council, but all medical students are welcome to submit articles. If you have any questions, article ideas you want todiscuss, or suggestions for improvement, please reach out any time to studenteditor@emra.org.

Recent Articles

Looking Ahead: The Future of Artificial Intelligence in Emergency Medicine

Zoee Castro, MSIII, University of Nevada, Reno School of Medicine
EMRA MSC Student Advising Coordinator, 2024 - 2025

Individuals are beginning to understand how AI can help with efficiency and work production, but there is also the counter debate that AI is affecting us negatively. Regardless of the ongoing debate around AI, advancements have been made to incorporate it into medical practice. Artificial Intelligence will be in our future as practicing physicians, but what exactly does this mean for the field of emergency medicine?

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Navigating the Shift: Best Online Resources to Smoothly Transition from Didactics to Clinicals in Emergency Medicine

You’ve dreamed of this day for years. You remember thinking about what it would be like to wear scrubs and see patients back when you were studying chemistry in the library in undergrad. Little did you know that after all of those hours of studying and years of school, you’d still feel completely clueless as you take on those first few months of clinicals.

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Osteopathic Update January 2024

Kyle Cohen, MS, NRP, OMS-IV, Alabama College of Osteopathic Medicine, EMRA MSC Osteopathic Coordinator 2023 - 2024

EMRA and the Medical Student Council continue to advocate for osteopathic medical students. With the NRMP match numbers for emergency medicine the last couple of years declining, osteopathic medical students have stepped up and begun to fill more spots. However, there seems to be a continued bias.

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PREVIOUS ARTICLES

Ten Ways for Medical Students to Get Involved in Wilderness Medicine

Katrina Stevens, MS-IV, David Gordon, MS-III, David Bronstein, MS-III, Christopher Walsh, MS-IV, Sidney Kimmel Medical College

Emergency Medicine has some of the most unique career options available in medicine, from aerospace and hyperbaric medicine to wilderness medicine! In this article, we will focus on highlighting ten ways to get involved in wilderness medicine, focusing on realistic, cost-effective strategies to explore this one-of-a-kind field.

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Navigating the Emotional Journey: Coping with Patient Death in Medical Training

Dakota Burke, MS IV; Ashley Sholmire, OMS IV, Isabella Maki, MS IV

Often, a medical student's first visceral experience with death is during a clerkship rotation. These experiences vary immensely between students and facilities, and no two experiences are the same.

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How to Crush your 3rd Year of Medical School

By the end of this article, you’ll hopefully have some great ideas for where to go next. We hope you can use this to succeed in your 3rd year rotations, explore areas of interest in Emergency Medicine, or strengthen your application for Sub-I rotations and beyond. We will divide up the article into different steps you can take in no particular order of importance, but we suggest you start reading from the top.

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August 2023

Tyson Lumbreras MS4, Texas Tech Foster School of Medicine, ACEP AMA-MSS Delegate
Kailey Jacobson, OMS III, Nova Southeastern University Kiran C. Patel College of Osteopathic Medicine, AMA-MSS Alt. Delegate

To many, Chicago is known for their famous deep-dish pizza, but to physicians, residents, and medical students Chicago is home to the yearly American Medical Association Conference where they gather to advocate and deliberate over healthcare policies. During this meeting, the Medical Student Section within the House of Delegates provides an avenue for medical students to advocate on the state and national level for changes in AMA policy.

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Health Policy in the Emergency Department

Katarina Jones, MPH, EMT
MSIII, University of Louisville School of Medicine
EMRA-MSC Legislative Coordinator 2023-2024

“Health policy” is one of those terms that gets thrown around a lot in speeches and interviews, on television and program websites, and by politicians and physicians. And while it affects every single one of us, it can be overwhelming to understand and intimidating to approach. In an attempt to demystify health policy, here is a short primer.

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Mentorship in Emergency Medicine

Jinger Sanders, MS
American University of Integrative Sciences
International Representative

As an IMG, navigating the challenging road of medicine is already a task, but being an IMG adds additional layers of trials. Seeking mentorship at each stage of your journey is imperative. The first mentor should be someone from your institution who is one academic level above you.

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Preference Signaling in the Emergency Medicine Match

David Bronstein, David Gordon, Katrina Stevens, Chris Walsh

The 2023 EM Match was the first to utilize preference signaling, a concept adopted from economic game theory to simplify decision-making and allocation of resources. In labor markets, preference signaling gives job applicants a finite number of ‘tokens’ to signal high interest to possible employers. Since each applicant can only signal a limited number of employers, it provides employers with valuable data.

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EM Match 2023: An Osteopathic Student Perspective

Kyle Cohen, OMS III, MS, NRP, Alabama College of Osteopathic Coordinator
EMRA MSC Osteopathic Coordinator

Congratulations to the new emergency medicine interns! The 2023 match in emergency medicine (EM) brought about some new challenges. EM has traditionally been fairly competitive until recent years.

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DEI in EM from a Mission to Results: A Student Perspective

Josué M. Rodríguez, MS-III, Emory University School of Medicine
EMRA MSC Southeast Regional Coordinator 2023-2024

Kristina Pagano, MS-II, FIU Herbert Wertheim College of Medicine
EMRA MSC Southeast Regional Representative II 2023-2024

Samantha J. Jacobson, OMS-II, Edward Via College of Osteopathic Medicine-Louisiana
EMRA MSC Southcentral Regional Representative 2023-2024

Allie Kukla, OMS-III, Edward Via College of Osteopathic Medicine-Carolinas
EMRA MSC Southeast Regional Representative I 2023-2024

Diversity, Equity, and Inclusion (DEI) are foundational values for most emergency medicine institutions. However, most educators and learners would agree that much work still needs to be done. What prevents the field of Emergency Medicine from truly welcoming all? Where do students fit into this picture?

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Riding the Off Cycle Bicycle

Ava Omidvar, MPH, FP-C, MS-IV – St. George’s University School of Medicine
EMRA MSC Mentorship Coordinator, 2023-2024

What do I do with my time after completing fourth-year rotations? Many medical students ask themselves this question, especially if they are off cycle. Off-cycle means that the student may have started early or had a delay in their medical school schedule, and now they finish their clinical rotations with either not enough time to apply to the upcoming MATCH or with too much time before the next cycle starts.

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Reflections on Interview Season

Grace Bunemann, MS4 - Campbell University School of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator, 2021-2023

Earlier this year, I wrote an article on how to research residency programs for ERAS, so it’s only fitting to write an article now that my interview season has finished.

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Emergency Medicine & Beyond: Introduction to Medical Education Fellowship

Revelle Gappy, MS-III, Oakland University William Beaumont School of Medicine

Sahar Rammaha, OMS-IV, Michigan State University College of Osteopathic Medicine

Jacques Lowe, MS-IV, Carle Illinois College of Medicine

Lifelong learning is a concept well understood and celebrated within emergency medicine. The task of training the next generation and the need for advancing medical education paved the way for a fellowship to equip future educators and leaders within the field.

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What is Social Emergency Medicine?
A Medical Student's Guide to Getting Involved

Sahar Rammaha, OMS-IV, Michigan State University College of Osteopathic Medicine
EMRA MSC Midwest Coordinator, 2021-23

Revelle Gappy, MS-III, Oakland University William Beaumont School of Medicine
EMRA MSC Great Lakes Regional Representative, 2022-23

Jacques Lowe, MS-IV, Carle Illinois College of Medicine
EMRA MSC Great Plains Regional Representative, 2022-23

Social EM is a growing field that recognizes that healthcare is not just about treating disease or injuries, but also understands the importance of considering one's social determinants of health (SDOH) as it impacts emergency care.1 The demand for social EM has always been present, and in many ways initiatives were already established before the term was coined. The first social emergency medicine fellowship was opened in 2010 at Highland Hospital in Oakland, Calif., and since then many programs followed suit. 

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Asking EM Residents: What Advice Would You Give Your Younger Self?

Breeanna Messner, MSIII - Washington State University Elson S Floyd College of Medicine
EMRA MSC West Coordinator, 2022-2023

Nicholas Rodriguez, MSIII - Kaiser Permanente Bernard J Tyson School of Medicine
EMRA MSC Pacific Regional Representative 2022-2023

Kit Sitterley, OMSIV - Burrell College of Osteopathic Medicine
EMRA MSC Southwest Regional Representative, 2022-2023

Mentorship is a key component to medical education, with students, residents, and attendings always reaching back to provide a helping hand to those following in their footsteps. This month, we reached out to three Emergency Medicine resident physicians from around the country to ask them what advice they would give to their younger selves.

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Navigating Clinical Evaluations as an MS3

Chris Walsh, MSIII Sidney Kimmel Medical College
EMRA NE2 Representative, 2022-2023

The third year of medical school marked a dramatic change for me in a lot of ways. During my preclinical years, I used to wake up at my preferred hours and study at whichever time best fit my schedule. My mind palace was overflowing with Sketchy bugs, and Sketchy drugs. My guiding forces, Dr. Ryan and Dr. Sattar, laid the foundation, while the ever-present click of my space bar helped everything stick. In some ways, I knew more then than I know now. And I found comfort in taking multiple-choice exams to assess my understanding. But then came third year.

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Summer Research: Emergency Department @Mayo Clinic Rochester, Minnesota

Coral Marí Chantada, MSII
San Juan Bautista School of Medicine in Puerto Rico

It gives me great excitement to share with you my summer research experience at the Emergency Department (ED) at Mayo Clinic College of Medicine — a Level 1 Trauma Center in Rochester, Minnesota — where ambulances and helicopters are constantly coming in and out with patients and filled with healthcare professionals who are prepared at a moment's notice to help for any level of emergency.

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AMA Hawaii Interim Meeting

Tyson Lumbreras, MS-III, Texas Tech University Health Sciences Center Paul L. Foster School of Medicine
EMRA MSC AMA-MSS Representative, 2022-23

Ian Brodka, MS-IV, University of Rochester School of Medicine and Dentistry
EMRA MSC AMA-MSS Representative, 2022-23

This year, the interim American Medical Association (AMA) meeting was held across the country in beautiful Honolulu, Hawaii November 12-15. Medical students, residents, and physicians packed their Hawaiian shirts, fine-tuned their policies, and gathered to set the AMA’s legislative agenda for the upcoming year 2023.

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EM Outside the ER: Alternative Pathways in Emergency Medicine

Shilpi Ganguly, MS-IV, University of Miami Miller School of Medicine

Matthew Lyons, OMS-IV, Lincoln Memorial University-DeBusk College of Osteopathic Medicine

Daniel Aloise, MS-IV, Florida International University Herbert Wertheim College of Medicine

Kyle Cohen, NRP, OMS-III, Alabama College of Osteopathic Medicine

Emergency medicine is a unique field that offers providers the opportunity to serve as a safety net to a diverse population with a wide range of pathologies. EM physicians are tasked with being prepared to oversee cases ranging from mild primary care-type complaints to acute life-threatening injuries and disease.

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#MedTwitter Series: Part 1

Jessica André, MS-IV, Howard University College of Medicine
EMRA MSC Northeast Regional Coordinator 2022-2023

By now, most of us have either heard of “MedTwitter” or have become a part of the community over the last few years. “MedTwitter” is a colloquial term for “Medical Twitter” where members of the medical community, students through attendings and program leadership, share their experiences, expertise, and pet photos to connect with and/or educate others.

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Get a Grip! Wilderness Medicine Meets Rock Climbing

Jacques Lowe, MS-IV, Carle Illinois College of Medicine
EMRA MSC Great Plains Regional Representative, 2022-23

Jasmine Millon, MS-IV, American University of Caribbean
EMRA MSC Mentorship Coordinator, 2022-23

Sahar Rammaha, OMS-IV, Michigan State University College of Osteopathic Medicine
EMRA MSC Midwest Coordinator, 2021-23

Revelle Gappy, MS-III, Oakland University William Beaumont School of Medicine
EMRA MSC Great Lakes Regional Representative, 2022-23

For the past 17 years, hundreds of avid climbers have gathered at the Horseshoe Canyon Ranch in northwest Arkansas for one event: The 24 Hours of Horseshoe Hell (24HHH). A grueling and exhausting competition where rock climbers from across the globe gather to compete in a 24-hour endurance rock climbing event –– one that is unlike any other on earth! Competitors tackle a dude ranch in teams of two in an attempt to climb as many routes on the ranch as possible over the 24-hour period for glory, honor, and bragging rights.

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Baggage

Shilpi Ganguly, MS-IV, University of Miami Miller School of Medicine
EMRA MSC Southeast Regional Coordinator, 2022-23

Matthew Lyons, OMS-IV, Lincoln Memorial University-DeBusk College of Osteopathic Medicine
EMRA MSC Southeast Regional Representative I, 2022-23

Daniel Aloise, MS-IV, Florida International University Herbert Wertheim College of Medicine
EMRA MSC Southeast Regional Representative II 2022-23

Kyle Cohen, NRP, OMS-III, Alabama College of Osteopathic Medicine
EMRA MSC Southcentral Regional Representative 2022-23

Having worked as a full-time paramedic firefighter for nearly 10 years, I have certainly seen my fair share of harrowing and traumatic situations that I will likely never be able to forget. These days, as I look towards my future career in emergency medicine, I find myself asking — is it okay to bring this baggage with me?

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Beginner's Guide to POCUS for Medical Students

Fathima Haseefa, MSIV – University of Arizona College of Medicine-Phoenix
EMRA MSC Legislative Coordinator, 2022-2023

Are you a medical student interested in point-of-care ultrasound? Don't know where to start? The use of POCUS has grown significantly over the last few decades. It serves as a cost-effective tool for rapid, real-time assessment of a variety of pathology and helps guide decision-making, such as administration of IV fluids based on IVC collapsibility. POCUS has also been shown to increase patient satisfaction and trust in the physician's assessment. Without further ado, let's delve into some steps you can take as a medical student to learn about POCUS!

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Burnout: What Is It and What Can We Do About It?

Breeanna Messner, MSIII - Washington State University Elson S Floyd College of Medicine
EMRA MSC West Coordinator, 2022-2023

Kit Sitterley, OMSIV - Burrell College of Osteopathic Medicine
EMRA MSC Southwest Regional Representative, 2022-2023

Nicholas Rodriguez, MSIII - Kaiser Permanente Bernard J Tyson School of Medicine
EMRA MSC Pacific Regional Representative 2022-2023

In addition to the COVID-19 pandemic, there is another kind of pandemic spreading throughout medicine in the United States: burnout. It comes in many different forms, and the statistics show that you are probably burned out yourself. While the definition of burnout varies, the National Library of Medicine would define burnout as, "a psychological syndrome featuring emotional exhaustion, depersonalization, and a reduced sense of personal accomplishment."

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National Two-Step CPR: Leading the Way in EM Philanthropy

Kevin Bennett, MS3, Florida International University Herbert Wertheim College of Medicine
EMRA MSC Southeast 2 Regional Representative, 2021-2022

Bhakti Sanghani, OMS4, Philadelphia College of Osteopathic Medicine Georgia

Chest Compression-only CPR (CC-CPR) is a concept that has been studied, practiced, and recommended as an intervention for lay-person response to out-of-hospital cardiac arrest (OHCA) for years; however, it was not until the past decade that organizations emerged with the sole purpose of mass CC-CPR education. One such organization is National Two-Step CPR, which was originally founded by a group of medical students desiring a formal way to improve their community’s response to OHCA. This humble idea snowballed into a nationwide philanthropic initiative with events hosted by medical schools across the country, local and national media coverage, and a growing sense of opportunity for medical students wanting to make a difference in their community.

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Caroline Bradford, MSIV, Liberty University College of Osteopathic Medicine
EMRA MSC Mid-Atlantic Representative, 2022-23

Jessica Andre, MSIV, Howard University College of Medicine
EMRA MSC Northeast Coordinator, 2022-23

As physicians, we must understand not only where our clinical guidelines are coming from, but the quality and applicability of those sources. It certainly looks good as a student to be able to reference a study by name to our preceptors, but it is more important to cement those studies’ evidence and conclusions into our practices at an early stage. The roster of those landmark studies is long and certainly worth a deeper dive, but this list is a good starting point to familiarize yourself with core emergency medicine studies.

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Breeanna Messner, MSIII, Washington State University Elson S. Floyd College of Medicine
EMRA MSC West Coordinator, 2022-23

Nicholas Rodriguez, MSIII, Kaiser Permanente School of Medicine
EMRA MSC Pacific regional Representative, 2022-23

Kit Sitterley, MSIV, Burrell College of Osteopathic Medicine at New Mexico State University
EMRA MSC Southwest Regional Representative, 2022-23

As medical students, like the majority in the field, we see a variety of patients. This is an invaluable time in our personal development and medical training. Yet, with it comes great responsibility. The oath we took at the beginning of this journey means different things to most. However, at its core, it signifies our duty to provide informed and empathetic care to all our patients, so when I met my first transgender patient in clinic it made me ask a very important question: As a medical student, what is my knowledge of LGBTQIA+ health?

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Nailing Your Audition Rotation

Ava Omidvar, MS4 MPH, FP-C, St. George’s University School of Medicine
EMRA MSC International Representative, 2022-23

Matt Carvey, MD, EMT-P, FP-C
EMRA MSC International Representative, 2021-22

Starting clinical rotations can be an anxiety-inducing next stage, and many students who excel academically often struggle with the transition to clinical medicine. Once completing a few rotations, it is time for the next level of clinical rotations, an EM audition rotation. Some basic steps should be taken, not of the clinical nor academic suggestion, but are practical and viable recommendations (aka – common sense).
Many have “nailed” their audition rotation for that top 10% SLOE, and so can you!

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Implications of Emergency Care post Roe v. Wade

Shilpi Ganguly, MS-IV, University of Miami Miller School of Medicine, EMRA MSC Southeast Regional Coordinator 2022-2023

Matthew Lyons, OMS-IV, Lincoln Memorial University-DeBusk College of Osteopathic Medicine, EMRA MSC Southeast Regional Representative I 2022-2023

Daniel Aloise, MS-IV, Florida International University Herbert Wertheim College of Medicine, EMRA MSC Southeast Regional Representative II 2022-2023

"On June 24th 2022, the United States Supreme Court in a 5-4 decision, overturned Roe v. Wade, the nearly 50-years-old landmark decision which established the constitutional right to abortion... Many have expressed anger and anxiety over the recent ruling, while others have rejoiced. One thing holds certain, regardless of where one stands on the spectrum, as emergency medicine physicians, it is important to consider how this decision will impact patients, and how it may affect our ability to provide comprehensive care."

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Start your Engines: Motorsports Medicine

Revelle Gappy, MS-III, Oakland University William Beaumont School of Medicine 
EMRA MSC Great Lakes Regional Representative, 2022-23

Sahar Rammaha, OMS-IV, Michigan State University College of Osteopathic Medicine
EMRA MSC Midwest Coordinator, 2021-23

Jacques Lowe, MS-IV, Carle Illinois College of Medicine
EMRA MSC Great Plains Regional Representative, 2022-23

“It’s lights out, and away we go!” says the racing operator. Motorsports racing events are held across the country and on-screen for millions of viewers annually. Popular racing series include Formula 1, IndyCar, NASCAR, and IMSA among others. The popular Netflix show, Drive to Survive, has ignited racing viewers in recent years and revamped interest in motorsports. Along with motorsports comes the unique field of motorsport medicine.

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Proposals, Politics, and Potatoes?: An Update from the Annual AMA House of Delegates

Ian Brodka, MS-IV, University of Rochester School of Medicine and Dentistry
EMRA MSC AMA-MSS Representative, 2022-23

Tyson Lumbreras, MS-III, Texas Tech University Health Sciences Center Paul L. Foster School of Medicine
EMRA MSC AMA-MSS Representative, 2022-23

After a long two years and four different AMA Meetings being conducted virtually, medical students from across the country celebrated being in person at the AMA 175th Anniversary meeting in Chicago to once again voice concerns within the House of Medicine. 

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Running up a temperature: the risks of warm weather for outdoor enthusiasts

Nicholas Rodriguez, MSII - Kaiser Permanente Bernard J Tyson School of Medicine, EMRA MSC Pacific Regional Representative 2022-2023

Breeanna Messner, MSII - Washington State University Elson S Floyd College of Medicine
EMRA MSC West Coordinator, 2022-2023

Kit Sitterley, OMSIII - Burrell College of Osteopathic Medicine
EMRA MSC Southwest Regional Representative, 2022-2023

With the arrival of Spring and record-high temperatures and humidity gripping many parts of the country, annual emergency department visits for heat stroke and other exertional heat illness have seen a frightening increase in recent years.

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Student Research of Residency Programs

Grace Bunemann, OMSIV - Campbell University School of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator, 2021-2023

Researching residency programs can be quite a task. According to ACGME, there are 279 EM residency programs including newly accredited programs with future effective dates. As a specialty, we are fortunate to have a residency database specifically for emergency medicine programs called EMRA Match. It is incredibly helpful for researching, collecting, and organizing information about residency programs.

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2022 Match Day and Beyond

Sahar Rammaha, OMS-III, Michigan State University College of Osteopathic Medicine
EMRA MSC Midwest Coordinator, 2022-23

Revelle Gappy, MS-II, Oakland University William Beaumont School of Medicine
EMRA MSC Great Lakes Regional Representative, 2022-23

Jacques Lowe, MS-III, Carle Illinois College of Medicine
EMRA MSC Great Plains Regional Representative, 2022-23

Congratulations to all who matched!
As the chaos and celebration of Match Day 2022 winds down, it is time to recap this past year’s cycle and evaluate what it means for the future of emergency medicine and for upcoming applicants.

Watch out for Lyme Disease!

Jessica André, MSIII Howard University College of Medicine
EMRA NE Coordinator, 2022-2023

Chris Walsh, MSIII Sidney Kimmel Medical College
EMRA NE2 Representative, 2022-2023

As weather in the Northeast heats up and time spent outdoors increases, children and adults alike are at higher risk of tick-borne illnesses such as Lyme Disease (LD). In fact, May is recognized as Lyme Disease Awareness Month and makes this topic increasingly relevant to shed light upon.

Take a Look at our PD Interview Repository!

Jennifer Geller, MS II – Rutgers Robert Wood Johnson Medical School
EMRA MSC Editor, 2022-2023

It is around this time of year where medical students preparing for their final year of medical school. With the residency application process looming, many students are looking to formulate and finalize their residency application list. Well, EMRA has a resource that can help so that you can hear from residency Program Directors directly answering questions that you may care about!

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Wasting Time

Kevin Bennett, MS III - Florida International University Herbert Wertheim College of Medicine
EMRA MSC Southeast 2 Regional Representative, 2021-2022

Speed. Decisiveness. Time. Certainly the currencies of EM, these principle measures of quality keep an ED flowing, save lives in the process, and mitigate real emergencies. However, considering that most of what comes through the ED is not an emergency and may be an even more insidious disease process, how do we balance the need for speed with the medical inquisition required to send a well-patient home with confidence or not lead our hospital friends down a rabbit-hole with a new admit?

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Effects of the COVID-19 Pandemic on International Medical Graduates

Matthew Carvey MD, EMT-P, FP-C
EMRA MSC International Representative, 2021-2022
Tyler Rigdon, MSIV

EMRA MSC West Coast Representative, 2021-2022

The COVID-19 pandemic has led to unprecedented impacts for the medical student community concerning scheduling of rotations, application timelines, and the opportunity to delve into emergency medicine (EM) opportunities early through an emergency medicine interest group (EMIG). For international medical graduates (IMGs) and orphan programs, in particular, these issues caused significant anxiety.

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COMLEX or COMLESS?

Grace Bunemann, OMS III - Campbell University School of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator, 2021-2023

It takes a lot to get into medical school from pre-requisites to the MCAT exam. All medical students are faced with equal requirements* for admission to both allopathic and osteopathic medical schools. Medical schools also have incredibly similar curriculums and training processes. So why is there not a single licensure examination series?

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Health Policy Fellowships in Emergency Medicine

Danielle Andrews, MSIV – Loyola University Chicago Stritch School of Medicine
EMRA MSC Great Plains Regional Representative, 2021-2022

The field of health policy is defined as the laws, regulations, actions, and decisions implemented within society to promote wellness and improve specific health goals. The rules and regulations created by organizational parties affect how care is administered and accessed by the community within their jurisdiction.

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Second Chance: Or, How I Learned To Stop Worrying And Love Being Unmatched

Matthew Turner, MS4 - Medical University of South Carolina

For all my fellow EM applicants out there, I have good news and I have bad news. Bad news first: some of us won’t match into our ideal slots. In fact, some of us won’t match at all.

I speak from personal experience...

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Profile of the Unvaccinated, and Why We Care

Sahar Rammaha, MSIII - Michigan State University College of Osteopathic Medicine
EMRA MSC Midwest Coordinator, 2021-2022

Danielle Andrews, MSIV - Loyola University Chicago Stritch School of Medicine
EMRA MSC Great Plains Regional Representative, 2021-2022

“And last question Mrs. Thomas, what is your COVID vaccination status?” I asked, while she looked at me, slightly withdrawn. “Oh, no I’m not vaccinated,” she sighed. Normally I walk away after the patient interview is complete and don’t pester her with further questions. Yet, something compelled me to ask, “I see, is there any reason for that?” Her response really surprised me.
She was trying to get the vaccine when it was first released to the public, but the available time slots were quickly filled...

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“The Big What If”, Thinking Through the SOAP Scenario

Bianca Mayfield, MSIV - Burrell College of Osteopathic Medicine
EMRA MSC Southwest Regional Representative, 2021-2022

Match week is the culmination of years of hard work, and thus, is an exciting and daunting time. The hope is to match within the Main Residency Match, but as future EM physicians, we should be prepared for anything. The other option for students who remain unmatched or partially unmatched is to enter the Supplemental Offer and Acceptance Program (SOAP). For any student who participates in the SOAP process, EMRA has your back...

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Fall 2021 AMA Updates: Emergency Medicine’s Role in Reducing Maternal Mortality

Alysa Edwards, MSIV - University of Colorado School of Medicine
EMRA MSC AMA MSS Delegate, 2021-2022

During the November Special Meeting of the American Medical Association (AMA), physicians, residents, and students from around the country gathered virtually to help set the AMA’s legislative and advocacy agenda. Discussion ranged from increasing rural physician practice to countering COVID-19 misinformation.

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International EMS Systems: Past and Future

Luke Wohlford, MS4 – University of Arizona College of Medicine – Phoenix
EMRA MSC Editor, 2021-2022

Much like emergency medicine training, Emergency Medical Services (EMS) did not even begin to exist in a meaningfully standardized way until the 1970s. The landmark “White Paper” by the National Academy of Sciences and National Research Council in 1966 changed everything. Evidence in the report demonstrated that traumatic deaths were the most common cause of death in the 1-37 year-old age range, and that ambulance systems at the time did not rise to the occasion.

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And, So it Begins!

Written by a Collaboration of Northeast EMRA MSC Members

On the morning of September 29, 2021, thousands of hopeful applicants reached a significant milestone in their quests to become physicians when their medical residency applications were officially made available to residency programs across the country. The Electronic Residency Application System (ERAS) disseminated thousands of applications that day, leaving medical students across the globe in limbo as they eagerly awaited interview invitations from residency programs.

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To Infinity and Beyond: Earthbound Emergency Medicine

Molly Sturlis, OMS-IV – Midwestern University Arizona College of Osteopathic Medicine
EMRA MSC Southeast Coordinator, 2021-2022

It is that last sentiment that often inspires people not unlike myself to look into career possibilities within wilderness and expedition medicine, but aerospace medicine is a slightly more obscure field that you may not be aware of. There are a select number of residency/fellowship training opportunities in the field, which may be perfect for an ambitious emergency physician with their eyes to the skies. 

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Leveling the Virtual Playing Field: Virtual Backgrounds in Residency Interviews as a Tool to Reduce Implicit Bias

Lucas Nelson, MSIV - Oakland University William Beaumont School of Medicine, Rochester, MI

As a response to the COVID-19 pandemic, in May 2020 The Coalition for Physician Accountability recommended that residency programs interview candidates virtually.1 This recommendation is currently being applied to the 2021-2022 interview cycle as individual specialties recommend the continuation of virtual interviews. With these updates, many students will be preparing to rearrange or otherwise alter their workspace, following the guidance of multiple organizations and lay websites for making one’s background appear more professional.

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MISC: A Pediatric Quandary for the COVID Era

Kevin Bennett, MSIV - Florida International University's Herbert Wertheim College of Medicine
EMRA MSC SE2 Regional Representative, 2021-2022

A new threat has entered the differential of every medical student presenting a pediatric patient who seems to acutely have everything wrong with them. Gone are the days of the great Mycoplasma mimic, late is the hour of the Lupus scapegoat, and Kawasaki, once a laudable suggestion, is ready for the chopping block as your astute attendings drop the latest NEJM on your assessment. 

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Rural Emergency Medicine

Nicole Ovregaard, MSII, MPH - Oregon Health & Science University
EMRA MSC Pacific Regional Representative, 2021-2022

When I first heard about this influx of EM physicians, I was not swayed from my career path but was slightly concerned about my ability to secure a job after residency. Research shows that 80% of new physicians begin their careers in urban and suburban areas, leaving rural areas underserved.

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Health Policy: Prescription Drug Pricing

Shashank Soma, MSIII - ​​Virginia Tech Carilion School of Medicine
EMRA MSC Legislative Coordinator, 2021-22

Remember the EpiPen controversy of 2016? After acquiring the rights to the EpiPen, Mylan Pharmaceuticals steadily increased the wholesale price of a 2-pack from $103.50 to $608.61 over 7 years, or by roughly 500%. When uncovered by Congress, Mylan was public excoriated, investigated, sued, and eventually fined $465 million. Another memorable example may be Martin Shkreli, the so-called “Pharma Bro” who increase the price of Daraprim by over 5,000%. At some point or another we’ve all wondered: how is this even possible?

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MedWAR: Where Medicine Meets the Great Outdoors

Tyler Rigdon, MSIV – California University of Science and Medicine 
EMRA MSC West Coordinator, 2021-2022

“Carry the vaccine however you would like during the course, but whatever you do- do NOT break it,” the announcer exclaimed across the megaphone. My teammate looked back at me, handing me a pearly white orb with a glimmer of laughter in his eyes, “You signed us up for this, it’s your responsibility”. The “vaccine” was an egg. I shook it, pondering if it was fake, hard-boiled, or possibly raw? I tucked the egg into my pocket. A few seconds later the buzzer sounded, signalling the start of the race. MedWAR had begun.

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Wilderness Pearls for USMLE exams: Spider Bites and Summertime Sun

Alexa Van Besien, MSIV - University of Maryland School of Medicine
EMRA MSC NE Coordinator, 2021-2022

Alexander Gallaer, MSIV - University of Connecticut School of Medicine
EMRA MSC NE2 Regional Representative, 2021-2022

Michelle Abrokwa, MSIV - New York Medical College
EMRA MSC NE1 Regional Representative, 2021-2022

Jessica André, MSIII - Howard University College of Medicine
EMRA MSC Mid-Atlantic Regional Representative, 2021-2022

This article is a brief summary of some wilderness medicine pearls that are high yield for USMLE board exams review and that you may encounter in your emergency department during warmer months: spider bites and hyperthermia.

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Transitioning from Medical Provider to Medical Student

Matthew Carvey MSIV, EMT-P, FP-C, TP-C - St. George’s University
EMRA MSC International Representative, 2021-2022

Medic-1 is responding to an assault in a rural location. Dispatch notifies EMS that the patient has a fever and was put on mandatory self-isolation for 14 days. On arrival, EMS dons a sterile cap, goggles, an N95 mask, face shield, gown and gloves. The patient, belligerent and intoxicated on alcohol and psilocybin, yells at EMS ‘I have the COVID!’. She rushes EMS, removes the practitioner’s mask, and coughs in his face. Police arrest the woman under the Mental Health Act, and EMS transports, only for her to spit and verbally abuse them the entire length of transport.

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New Mousetraps

Alexis Nelson, OMS II – Kansas City University College of Osteopathic Medicine

If you’ve ever seen ABC’s hit show Shark Tank, you know that the sharks love to invest in a “better mousetrap” – a product or service that addresses some need more effectively than those that are currently available. If you haven’t seen Shark Tank, take a break, whip up some popcorn, and check this task off your bucket list.

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June 2021 Update from the AMA: Excited Delirium, Ketamine, and the role of EM in Organized Medicine

Alysa Edwards, MSIV - University of Colorado School of Medicine

EMRA MSC AMA MSS Delegate, 2021-2022

Between attending kick-boxing classes and posting memes in the “Shenanigans” GroupMe, medical students from across the country met virtually earlier this month to debate and vote on health policy issues at the American Medical Association (AMA) Medical Student Section (MSS) Meeting.

Read the Update Report

How to approach your first traumatic death in the ED

Danielle Andrews, MSIII - Loyola University Chicago Stritch School of Medicine
EMRA MSC Great Plains Regional Representative, 2021-2022

Let's face it. Emergency medicine physicians are the experts at handling emergent medical crises, so traumatic events will inevitably occur, and sometimes, someone dies.

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If you hear hoofbeats it just might be a Zebra... 

Grace Bunemann, OMS II - Campbell University School of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator, 2021-2022

People always say that college will bring some pretty amazing people into your life. For me one of those people is Courtney.

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An Unprecedented Match, Part 2

Michelle Abrokwa, MSIV - New York Medical College
EMRA MSC NE1 Regional Representative, 2021-2022

This is the second of two articles dedicated to highlighting the stories of soon-to-be doctors who recently matched successfully into emergency medicine in March of 2021.

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Bridge to Care: Social Emergency Medicine and the Houseless Community

Nicole Ovregaard, MSII - Oregon Health & Science University
EMRA MSC Pacific Regional Representative, 2021-2022
Tyler Rigdon, MSIII - California University of Science & Medicine
EMRA MSC West Coordinator, 2021-2022
Bianca Mayfield, MSIII - Burrell College of Osteopathic Medicine
EMRA MSC Southwest Regional Representative, 2021-2022

Against the backdrop of the COVID-19 pandemic, the relationship between access to healthcare and social inequities has become increasingly profound. 

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The Growth of Hyperbaric Medicine in Emergency Medicine

Collin Brooks, MSIII - Wayne State University School of Medicine
EMRA MSC Great Lakes Regional Representative, 2021-2022

Danielle Andrews, MSIII - Loyola University Chicago Stritch School of Medicine
EMRA MSC Great Plains Regional Representative, 2021-2022

Hyperbaric oxygen therapy is a well-established treatment for decompression sickness, which is a common occurrence in scuba divers. But it’s also a phenomenal treatment option to treat a plethora of other conditions

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An Unprecedented Match

Michelle Abrokwa, MSIV - New York Medical College
EMRA MSC NE1 Regional Representative, 2021-2022

This is the first of two articles dedicated to highlighting the stories of soon-to-be doctors who recently matched successfully into emergency medicine in March of 2021.

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Beginners’ Guide to Toxicology for Medical Students

Alexa Peterson OMSIV - Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine
EMRA MSC SE1 Representative 2020-2021

Are you a medical student interested in Toxicology? Not sure what Toxicologists really do? Toxicology is a vast field, and as medical students, we have very limited exposure to the field while in school. There are some quick and easy steps you can take as a medical student to introduce and immerse yourself into the field of Toxicology, so without further ado, let’s talk Tox!

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Answering Common EM Interview Questions as Your Most Authentic Self

Shelby Wood, MD, MPH - St. George’s University School of Medicine
EMRA MSC International Representative 2020-2021

One piece of advice that I received consistently on the virtual interview trail was this: “be yourself.” Now that I’m on the other side of the interview process (and a matched soon-to-be intern by the time this is published!), I’d like to share my approach to answering these commonly-asked residency interview questions as your most authentic self!

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PoCUS Pitfalls

Nick Gualtieri, OMS-III, 2nd Lt, USAF, Ohio University Heritage College of Medicine
Rich Dowd, OMS-IV, Ohio University Heritage College of Medicine
EMRA MSC Midwest Coordinator
Samuel Southgate, MD, PGY-1, Regions Hospital, Saint Paul, Minnesota
EMRA Ultrasound Committee Chair-elect

In this newsletter article, we aim to identify some of the most common pitfalls encountered by novice ultrasonographers and how to avoid them.

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Just Pass the Tube: The Value of an Anesthesia Rotation

Opinion

Ryan Lucas, OMS-IV, Rocky Vista University College of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator

Ryan recounts his learning experience and value during his elective anesthesia rotation.

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To See or Not to See: An Orphan Program Student’s Perspective on Seeing Suspected COVID and COVID Positive Patients

Opinion

Kellan Etter, OMSIV, Des Moines University College of Osteopathic Medicine
EMRA MSC Great Plains Representative

Kellan shares his thoughts on the impact and perceptions of a medical student by covid on learning, seeing patients, and preparing for residency.

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Research and Applying to Emergency Medicine Residency

Katherine Rodman, MSIV, Oregon Health & Sciences University Medical School
EMRA MSC Pacific Representative

Luke Wohlford, MSIII, University of Arizona College of Medicine - Phoenix
EMRA MSC Southwest Representative

Research seems to be a topic that often strikes fear in the hearts of medical students. We’ve collected some statistics, resources, and thoughts from senior students applying to EM.

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Interprofessional Education and its Role in the Emergency Department

Katelynn Baska, MSIV, Philadelphia College of Osteopathic Medicine
EMRA MSC Northeast Coordinator
Alexa Van Besien, MSIII, University of Maryland School of Medicine
EMRA MSC Mid-Atlantic Representative

Healthcare as a “team sport” is not a new concept. Successful patient management hinges on a collaborative effort between all areas of care, including: physicians, physician assistants, nurses, pharmacists, technologists and technicians, physical therapists, rehabilitation specialists, emotional and social support services, etc. However, training in each of these fields often involves learning and practicing only with colleagues in your own profession.

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Fall 2020 AMA Delegate Report

Matthew J. Christensen, MS4, Chicago Medical School
ACEP/EMRA Primary Delegate to the AMA-MSS

Alysa F. Edwards, MS3, University of Colorado School of Medicine
ACEP/EMRA Alternate Delegate to the AMA-MSS

With November 2020 now behind us, the American Medical Association (AMA) has completed yet another annual fall conference. However, unlike the Interim Assemblies of years past, the 2020 annual fall conference tradition went fully virtual due to the ongoing coronavirus pandemic. 

Read the Delegate Report
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OPINION: Are We All Actually in the Same Boat?

Christian Casteel MSIV, Kansas City University of Medicine and Biosciences
EMRA MSC Southcentral Representative

“We are all in the same boat.” A good-faith and commiserating phrase we hear often in medical school. Whether in regard to the collective struggles and financial stressors of studying for boards or applying to residency, the implication is that every medical student endures the same level of challenges throughout this process. But is that really true?

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Fellowship Training as a Medical Student: Pursuing a Fellowship of the Academy of Wilderness Medicine (FAWM)

Alexa Van Besien, MSIII, University of Maryland School of Medicine
EMRA MSC Mid-Atlantic Representative

Alexander Gallaer, MSIII, University of Connecticut School of Medicine
EMRA MSC Northeast 2 Representative

Brendan Miccio, MSIII, Lake Erie College of Osteopathic Medicine
EMRA MSC Northeast 1 Representative

Are you interested in pursuing Wilderness Medicine and eager to do more in medical school? The Fellowship of the Academy of WIlderness Medicine (FAWM) may be for you.

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FOAMed: So Many Resources, So Little Time!

Tori Ehrhardt, MSIV, Florida International University Herbert Wertheim College of Medicine
EMRA MSC Southeast 2 Representative

Free Open Access Medical Education (FOAM) represents the vast amount of easily accessed web-based resources that anyone can use to enhance their education. This idea sprang from the interconnectedness of our century, and the relatively new ability of medical students to access any piece of medical information published online from anywhere on the globe. A few innovative individuals recognized the potential for a new world of medical education, completely online with instantly accessible information.

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Meaningful Mentorship for Students in Emergency Medicine

Lenexa Morais, MS-IV, University of Texas Medical Branch in Galveston, TX EMRA MSC West Coordinator 2020-2021, 
Sarah Smetana, MS-IV, University of Texas Medical Branch in Galveston, TX

Mentorship in Emergency Medicine takes various forms, including shadowing, clinical supervision and training, career advising, research endeavors, or casual conversations to determine the “ins and outs” of EM. Depending on a student’s needs and level of training, mentors can tailor their time and instruction to best help a student develop clinical skills and career goals. In this article, we will highlight the benefits of mentorship, how EMIGs can start their own mentorship program, how students can make their most of their experience, and mentorship through EMRA.

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Time to Mourn

Kenneth Kim MS IV David Geffen School of Medicine at UCLA
EMRA MSC Legislative Coordinator 2020-2021

I think the hardest part about Emergency Medicine is how little time we have to mourn. In our mad dash to give the best medical care to our sick patients, we often don’t have much space to take stock of what our patients have lost. What their illnesses have taken away. How their or their family’s lives have been changed forever.  Instead, we must focus on losing no more.

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Getting the Feedback You Deserve

Justin Doroshenko, M.Ed., Paramedic, MS IV
University of New England College of Osteopathic Medicine

“Keep reading.” Nearly every medical student has probably received this piece of feedback in an evaluation at some point, but it’s not particularly useful feedback. So, how can you best set yourself up to receive actionable feedback from preceptors or other educators? There are steps you can take before, during, and after rotations to set you and your preceptor up to make the feedback process as useful as possible.

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MedWAR: Where Medicine Meets the Great Outdoors

Tyler Rigdon, MSIV – California University of Science and Medicine 
EMRA MSC West Coordinator, 2021-2022

“Carry the vaccine however you would like during the course, but whatever you do- do NOT break it,” the announcer exclaimed across the megaphone. My teammate looked back at me, handing me a pearly white orb with a glimmer of laughter in his eyes, “You signed us up for this, it’s your responsibility”. The “vaccine” was an egg. I shook it, pondering if it was fake, hard-boiled, or possibly raw? I tucked the egg into my pocket. A few seconds later the buzzer sounded, signalling the start of the race. MedWAR had begun.

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Buprenorphine Induction in the ED: Innovations in the Treatment of Opioid Use Disorder

Katherine Rodman, MSIV, Oregon Health & Sciences University Medical School
EMRA MSC Pacific Regional Representative
David Jones, MD, Associate Professor of Emergency Medicine, Oregon Health & Science University Medical School

The United States has experienced an escalating crisis of opioid addiction and misuse. While the number of deaths related to overdose have steadily increased over the past two decades, treatment has not advanced at the same pace. Medication for Addiction Treatment (MAT), which utilizes opioid agonists to support detoxification, has been a staple of opioid addiction treatment for decades

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OPINION: New Kids on the Block: Is a New Residency Program Right for You?

Alexander Gallaer, MS III, University of Connecticut School of Medicine
EMRA MSC Northeast 2 Regional Representative

Think back to all the “firsts” in your life: the first day of school, the first time you drove a car, the first time you moved out of your parents’ house, the first time you forgot to include vitals when presenting to the attending on your surgery rotation. Good times!

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OPINION: Social Media in Medicine: A Force for Good

Shelby Wood, MPH, EMT-P, MS IV, St. George’s University School of Medicine
EMRA MSC International Representation 2020-2021

Social media has become a pervasive force within the medical education (#MedEd) community. Additionally, social media-based learning encourages interactions between educators and learners. It is more learner-generated, collaborative, and engaging to younger audiences.

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Virtual Interview Fundamentals

Erron Fritchman, OMS IV, Arkansas College of Osteopathic Medicine
EMRA MSC South East Coordinator
Rylan Russel, OMS IV, Arkansas College of Osteopathic Medicine
Rich Dowd, OMS IV, Heritage College of Osteopathic Medicine, Ohio University
EMRA MSC Midwest Coordinator

Typically, our mannerisms and non-verbal communication could make or break us in these in-person scenarios, but now we must rely on a webcam for a pristine performance. The virtual interview adds a layer of intricacy that requires some extra pre-game preparation.

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Spring Update from the American Medical Association

Matthew J. Christensen, MS4, Chicago Medical School
ACEP/EMRA Primary Delegate to the AMA-MSS

Alysa F. Edwards, MS3, University of Colorado School of Medicine
ACEP/EMRA Alternate Delegate to the AMA-MSS

While the healthcare landscape seemed to be turned on its head during the Coronavirus Disease 2019 (COVID-19) pandemic, the American Medical Association (AMA) and its Medical Student Section (MSS) have worked diligently to find novel ways to effectively address such a dynamic climate.

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Opinion:  Bennefits of Sholarly Concentration

Chiamara Anokwute, MS3 Indiana University School of Medicine
EMRA MSC Great Lakes Regional Respresentative

Scholarly concentrations offer medical students the opportunity to advance their scholarship in topics of interest outside of the realm of biomedical research. In tandem with their medical education and development of clinical skills, students can pursue scholarly inquiries in areas of Global Health, Aging, Informatics, Medical Education, LGBTQ Healthcare and Advocacy, Urban Medicine and Health Care Disparities, and Healthcare Design to name a few. Academic pursuits in these concentrations can have many benefits for students.

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The Things We Carry

Ryan Lucas, OMS-IV, Rocky Vista University College of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator

I don’t typically find much time for recreational reading. The majority of my time spent turning pages usually involves clicking the “Proceed to Next Item” button on UWorld. However, with clinical rotations coming to a screeching halt, I’ve found myself with more time to catch up on things outside of medicine, including reading. 

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A Seat at the Table: Getting Involved in State Legislation and Advocacy

Luke Wohlford, MSIII, University of Arizona College of Medicine – Phoenix
EMRA MSC Southwest Regional Representative 2020-21

The first time I met an Arizona state representative brought me straight back to high school – the breathlessness that comes with fear of public speaking and the annoying bead of sweat that rolls down my back both served as reminders that I was out of my element. The representative was nothing but nice, and I still couldn’t seem to calm my nerves. I was reminded of the time my father took me to an event where Senator John McCain had spoken over a decade ago.

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Virtual Learning and Medical Student Clerkships

Katelynn Baska, OMS-III, Philadelphia College of Osteopathic Medicine
EMRA MSC North East Coordinator

In the age of the internet and constantly evolving technological advancements, the use of e-learning platforms has been adopted by many medical schools to complement conventional, non-digital techniques in a blended learning approach.

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Understanding Compassion

Robert Young OMS-IV Ohio University Heritage College of Osteopathic Medicine

Not-So-Clinical Pearls is a new column in our newsletter. It focuses on using storytelling to teach lessons about the less academic side of medicine that will make us better clinicians.  

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EMRA’s Emergency Medicine Interest Group of the Year 2018-2019 Runner Up

Rich Dowd, OMS-III, Ohio University Heritage College of Osteopathic Medicine
EMRA MSC Midwest Coordinator 2020-21

The EMRA Emergency Medicine Interest Group of the Year award was created to recognize the hard work and contributions made by the most productive Emergency Medicine Interest Groups (EMIGs). EMIGs everywhere are great complements to their school’s curriculum, affording students opportunities and exposure to Emergency Medicine that they would not otherwise receive. This month we caught up with the 2018-2019 first runner-up, Wayne State University School of Medicine.

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What is Emergency Critical Care? An Interview with Dr. Alyssa Berns, DO

Santiago Batista Minaya, MSIV, St. George’s University School of Medicine
EMRA MSC International Representative 2019-2020

This month’s Pathways in EM series focuses on critical care. We spoke with Alyssa Berns, DO, the 4th year Clerkship Director for visiting medical students and EM/CCM physician at Hackensack University Medical Center. When not in the hospital, she is an avid reader, recipe experimentalist, and a self-describer amateur hiker.

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EMRA’s Emergency Medicine Interest Group of the Year 2018-2019

Rich Dowd, OMS-III, Ohio University Heritage College of Osteopathic Medicine
EMRA MSC Midwest Coordinator 2020-21

The EMRA Emergency Medicine Interest Group of the Year award was created to recognize the hard work and contributions made by the most productive Emergency Medicine Interest Groups (EMIGs). EMIGs everywhere are great complements to their school’s curriculum, affording students opportunities and exposure to Emergency Medicine that they would not otherwise receive. Among a stacked field, the EMIG at Philadelphia College of Osteopathic Medicine (PCOM) stood tall as the inaugural winner of the EMIG of the Year Award.

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Building Your Residency Rank List

Cameron Justice, OMS-IV, Pacific Northwest University of Health Sciences College of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator, 2019-20

As I enter the final weeks before Match Day on March 20, I feel a sense of relief at having certified my National Residency Matching Program (NRMP) Rank Order List (ROL). I spent some time reflecting on my rank list decisions and the motivations behind them and wanted to share them with those of you who will be drawing up the same list next January.

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Finding a Focus in Emergency Ultrasound: An Interview with Jacob Avila, MD

Samuel Southgate, MSIV, University of Connecticut School of Medicine
EMRA MSC Editor, 2019-21

Our Pathways in EM series focuses on ultrasound this month. We spoke with Jacob Avila, MD, Ultrasound Director at the University of Kentucky, Lexington, about his passion for this emergency medicine niche. He is the creator of 5 Minute Sono, frequent contributor to Ultrasound of the Week, and a member of Ultrasound Podcast and Ultrasound G.E.L. podcast.

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Pathways in Palliative Care via Emergency Medicine

Peter Mattson, MSIV, Warren Alpert Medical School at Brown University
EMRA MSC Northeast Coordinator, 2019-20

When you reflect on your experiences in the emergency department, which patient encounters stand out as the most memorable and the most challenging? Many of these encounters will likely touch on palliative care in one form or another. Palliative care is crucial for directing a patient’s goals of care, symptom management, and planning for their future.

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Preparing to Get the Away Rotations You Want

Shelby Hoebee, MSIV, University of Arizona College of Medicine - Phoenix
EMRA MSC West Coordinator, 2019-20

Students hoping to match into emergency medicine (EM) are expected to do at least one away rotation in addition to their home EM clerkship in order to secure two Standardized Letters of Evaluation (SLOEs). Where you decide to do away rotations may be influenced by a variety of factors.

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The Benefits of Compressions-Only CPR

Rich Dowd, MSIII, Ohio University Heritage College of Osteopathic Medicine - Dublin
EMRA MSC Great Lakes Regional Representative, 2019-20

Cardiopulmonary resuscitation (CPR) is something we are all familiar with as physicians-in-training. Medical students across the country are required to complete a course in Basic Life Support (BLS) prior to working with patients, and many of us have put that training to use on the wards or elsewhere. While understanding of BLS skills is lacking among the general population, individuals do not need to be BLS-certified to help save a life.

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Can Chameleons Change Their Colors?

Lenexa Morais, Chair of TCEP Medical School Committee, UTMB Class of 2021

It’s 02:30 in the UTMB Emergency Department in Galveston, TX and I’m currently googling if a chameleon can change its color to sky blue, all in the name of compassionate care.

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What is Disaster Medicine? An Interview with Natalie Moore, MD, MPH

Brock Chimileski, MSII, University of Connecticut School of Medicine

The field of disaster medicine provides exciting and challenging opportunities to travel the globe and assist some of the most vulnerable communities after major catastrophes. To learn more about it, we spoke with Dr. Natalie Moore, an emergency physician and the first graduate of the new International Disaster Medicine Fellowship program at the University of Connecticut (UConn).

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Fall Update from the American Medical Association

Matthew J. Christensen, MSIII, Chicago Medical School at Rosalind Franklin University
EMRA MSC AMA-MSS Alternate, 2019-20

November has come and gone, which means the American Medical Association has completed another annual Interim Assembly. More than 2,500 medical students, residents, and physicians gathered in San Diego, CA, from November 14-19 to propose, debate, and pass hundreds of policy resolutions between the AMA Medical Student Section (MSS) and AMA House of Delegates. Dozens of educational sessions, networking events, and socials were included in the schedule. Read on for a list of summary of key policy actions, with links to more comprehensive updates.

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How Competitive is EM Compared to Other Specialties?

Nico Ramsay, MSIV, FIU Herbert Wertheim College of Medicine
EMRA MSC Southeast Coordinator, 2019-20

Leena Owen, OMSIV, Nova Southeastern University College of Osteopathic Medicine
EMRA MSC Southeast 2 Regional Representative, 2019-2020

How competitive is our specialty, really? There are a number of ways to answer this question. The best source of data can be found in the annual publication of the NRMP Results and Data Main Residency Match. This document contains thousands of data points and can seem overwhelming. However, if you focus on the right places, it paints a clear picture.

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Navigating Social Media Use in Emergency Medicine

Adam Goodcoff (@seethemedlife), MSIV, West Virginia School of Osteopathic Medicine

“Resident physician in hot water after post on social media.” Headlines like this are all too common. It’s almost a reflexive response that social media equals bad decisions. But is it all bad? I think the answer is no. But it does raise the question: How should we be using social media?

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EM Match 2020: By The Numbers

Nico Ramsay, MSIV, FIU Herbert Wertheim College of Medicine
EMRA MSC Southeast Coordinator 2019-20

There has been a lot of chatter in recent years about emergency medicine (EM) becoming “more competitive.” But what do the numbers show? Although there are multiple ways to answer this question, one could argue that the best method is to compare the total number of applicants with the total number of available residency slots. Here we analyze some of the latest data from ERAS, which paint a more optimistic picture of this year’s application cycle.

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Do’s and Don'ts: Applying to EM as a DO Student

J. Richard Dowd, OMSIII, Ohio University Heritage College of Osteopathic Medicine - Dublin
EMRA MSC Great Lakes Regional Representative 2019-20

The single match is here! By now you’ve probably found that if you ask ten different people, you’ll get ten different responses as to what that actually means for osteopathic students’ prospects in The Match. Here are our six key do’s and don’ts, based on previously successful DO applicants, that can help maximize your chances of matching into EM.

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Building Coalitions for Learning in the Northwest

Miles McDonough, MSIV, University of Washington School of Medicine
EMRA MSC Pacific Regional Representative 2019-20

What if I told you there was a way to deliver more content, of higher quality, to your interest group members while simultaneously reducing the demand on your time as the leader and organizer of such a group? After serving as the co-leader for both our EM and wilderness medicine interest groups during my first two years of medical school, I too would find this an attractive but unrealistic proposition.

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Search and Rescue Day Marks a Milestone in Wilderness Medicine Regional Collaboration

Nathan Dreyfus, MSIV, University of Vermont Larner College of Medicine
EMRA MSC Northeast 1 Representative 2019-20

Sarah Schlein, MD FACEP FAWM
Assistant Professor of Emergency Medicine, University of Vermont Larner College of Medicine

Mount Mansfield was shrouded in rain clouds and a cool drizzle fell steadily as the first carloads of emergency medicine (EM) residents from the University of Vermont (UVM) and Dartmouth-Hitchcock Medical Center (DHMC) wound their way up the mountain road into Underhill State Park: their classroom for the day. It was an early morning in July, but light jackets were ubiquitous as faculty members and residents strung tarps overhead between a lean-to and surrounding trees – a small refuge for coffee, bagels, and introductions.

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What’s Happening to Rural Emergency Departments?

Ryan Koski-Vacirca, MSIV, Wake Forest School of Medicine
EMRA MSC Legislative Coordinator 2019-2020

This spring, a reporter for the Washington Post snapped photos as Dr. James Graham, a 41-year employee of Fairfax Community Hospital, shut down his emergency department for the last time. In rural Oklahoma, Fairfax Community serviced an area “larger than a few states,” with no other medical services available within 30 driven miles from its front doors. 

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EMRA Introduces the Government Services Committee for Military Medical Students and Residents

ENS Matthew J. Christensen, USNR: Capt Joshua da Silva, DO, USAF;
LT Katherine Lee, DO, USN; LT Danielle Wickman, MD, USN


The ACEP Government Services Chapter was founded in 1977 to give military physicians a platform and community that understood and advocated for the unique needs of military emergency physicians. EMRA is now proud to introduce our newest committee, the Government Services Committee (EMRA GS), with that same mission in mind: to provide military medical students and residents with the network and community they need to thrive in the dynamic world of military EM.

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Integrating Ultrasound into Undergraduate Medical Education: Our Experience

Jacob Freudenberger, OMSIII, Conner Reynolds, OMSIII, TCOM, Kevin Thompson, OMSIII, TCOM, Jennifer Byrd DO, PGY-2, Emergency Medicine, John Peter Smith Hospital 

Dr. Smith is making his way around the classroom. My heart pounds as he approaches me, going down the row, one medical student after another. I’m up. “What plane do you think this image is in?” he asks, pointing at an ultrasound image on the screen. Nearly 250 of my peers are about to hear how little I know about ultrasound. “I think this image is in the transverse plane,” I respond unconfidently. Then, he asks the question every medical student hates to hear: “Why?”

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A Traveler’s Trail: Tips for Interviewing Across the Nation

Emily Wilkins, MD, PGY1, University of Chicago Emergency Medicine

The interview trail can be a crazy and expensive time regardless of where you’re applying. But based on life circumstances or future goals, some applicants definitely end up taking it to the next level. As a Connecticutian (yes, that’s a word) who went on 18 interviews before couple’s matching to the Midwest, I inevitably learned various interview-scheduling and travel dos and don’ts along the way! Of course, everyone’s experience is different and ultimately you will need to make decisions that will help you feel healthy, balanced, and fulfilled along your interview journey, but here are some of my personal tips and tricks.

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Program Director Interview Series: Vicki Noble, MD

Samuel Southgate, MSIV, University of Connecticut School of Medicine
EMRA MSC Editor 2019-20

This month our Program Director Interview Series is focused on the Midwest. We spoke with Vicki E. Noble, MD, Program Director of the Center for Emergency Medicine at University Hospitals Cleveland Medical Center, about this Ohio-based program and what they look for in residency applicants.

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Program Director Interview Series: Danielle Turner-Lawrence, MD 

Amanda Amen, MSIV, Oakland University William Beaumont School of Medicine 
EMRA MSC Midwest Coordinator 2019-20

This month our Program Director Interview Series is focused on the Midwest. We spoke with Danielle Turner-Lawrence, MD, Program Director at Beaumont Hospital, Royal Oak, about the training opportunities available at this busy Level 1 Trauma Center in eastern Michigan.

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Thalidomide’s Resurgence and its Contemporary Uses

Katelynn Baska, OMSIII, Jonathan Meadows, DO, and Peter Mattson, MSIV

You are a third-year resident working in the ED one night when the following patient arrives: a 65-year-old man with a five-year history of type 2 diabetes mellitus and a less than one-year history of multiple myeloma presenting with a complaint of left lower extremity pain and paresthesias in his hands and feet. He reports that the numbness and tingling began two days ago but the onset of leg pain wasn’t until early this afternoon. His wife is present at the bedside and relays that he has also had a few episodes of confusion throughout the day, for example, mixing up the sugar and salt on the table and forgetting that their cat died, an event that occurred two years prior.

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Getting into the ED: When is the Right Time?

Willeed Rabah, MSIV, University of Connecticut School of Medicine

As a fourth year medical student applying for residency in EM, I knew I was very interested in the specialty prior to completing a four-week rotation in an emergency department. My early exposure to the field came not through medical school but from my time serving as an EMT, from volunteer experiences in a local ED, and from extensive shadowing as an undergraduate.

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Polishing Your ERAS Application

Nico Ramsay, MSIV, FIU Herbert Wertheim College of Medicine
EMRA MSC Southeast Coordinator 2019-20

Application season has finally arrived for fourth year medical students. After more than three years of hard work, it’s time to finish the job. By now you’ve likely finished Step 1, Step 2 CK, maybe even Step 2 CS, the dreaded SVI, and some home and away EM rotations with SLOEs on the way. You’ve cleared every hurdle in your path but there’s still one left: ERAS. Don’t worry, EMRA is here to help. Below is a timeline of what to expect along with some advice on each section of ERAS and how to polish your application to secure those interviews.

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Life as a Tactical Medicine Doc: An Interview With John Wipfler III, MD, FACEP

Cameron Justice, OMS-IV, Pacific Northwest University College of Osteopathic Medicine
EMRA MSC Osteopathic Coordinator 

Following our
article earlier this year focused on the EM subspeciality of tactical medicine, we spoke with one of the leaders of the field: Dr. John Wipfler III, author of the ACEP-endorsed textbook Tactical Medicine Essentials.

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Program Director Interview Series: Ryan Kirby, MD | JPS Hospital 

Jake Freudenberger, MSIII, University of North Texas Health Science Center - Texas College of Osteopathic Medicine
EMRA MSC Southwest 1 Regional Representative

This month our Program Director Interview Series turns to the West. We spoke with Ryan Kirby, MD, Program Director at John Peter Smith Hospital (JPS) in Fort Worth, Texas, about what’s on offer in the Lone Star State.

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Residency in the Caribbean?

Leonardo H. Zingg, MSIII, Ponce Health Sciences University

“Location, location, location.” This phrase, a touchstone in the real estate world, applies equally to medical students seeking residencies across the United States - and probably to you too. However, you may not have included the US territory and Caribbean island of Puerto Rico in your calculations.

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Bridging the Gap: Matching into EM as an International Medical Graduate

Santiago Batista Minaya, MSIII, St. George’s University School of Medicine

As we approach residency application season for the 2020 cycle, fourth year students are preparing to put their best foot forward to match into EM. For international medical graduates (IMGs), this process presents some unique challenges. Here, we summarize some key points of advice from a recent EMRA Hangouts session geared specifically towards US and non-US IMGs.

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Practicing Medicine in the Wilderness

Elizabeth Kleiner, MSIV, Des Moines University College of Osteopathic Medicine
EMRA MSC Great Plains Regional Representative 2019-20

Wilderness medicine is a subspecialty of EM that is typically defined as the practice of medicine in resource-poor, austere environments. Since it entails limited resources and harsh conditions, typically far away from the conveniences of modern medicine, it can be argued that Greek and Roman naval surgeons were likely the first people to practice wilderness medicine. 

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Practicing for Disaster: The Mass Casualty Drill

Kaitlin Lipner, MSIV, University of Connecticut School of Medicine

A new patient arrives at the emergency department (ED) every 45 seconds. Other than the occasional cholecystitis and stable angina, almost all of them have the same chief complaint: a seemingly simple upper respiratory tract infection. The only peculiar part of the patient presentation is that almost all say they were on a flight just hours before. About five minutes into the patient encounter, however, those same patients are coughing up blood.

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Ace Your SLOEs: An Interview with EM Clerkship Podcast's Zack Olson, MD

Samuel Southgate, MSIV, University Of Connecticut School of Medicine 
EMRA MSC Editor 2019-20

One of the things I stressed in my first episode is the importance of introducing yourself. It’s really a big deal. As an attending, you meet so many people and every day there are new nurses, new techs, new students. It’s hard to keep track of everyone. So even if you have a good first introduction where it’s very clear, it can be easy to lose track over several shifts. It’s not like you have to introduce yourself to the attending 10 times – that would just be strange. But even if you introduce yourself to nurses and residents they will overhear your name again so the whole group will get to know who you are. 

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How To Build A State Medical Student Coucil

Shelby Hoebee, MS4, University of Arizona College of Medicine - Phoenix
EMRA MSC West Coordinator 2019-20

Early on in medical school, I sought out ways to become involved in EM at a local and regional level. Beyond my school EMIG, however, I discovered few opportunities in my state: Arizona. Each year, I saw many students applying for a handful of leadership positions in my EMIG; most ended up disappointed when they were not selected and felt unable to get involved in expressing their passion for the specialty. As I searched for opportunities in the Southwest, I also noticed the lack of communication between students at different medical schools in the region. 

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Stride through SVI

Samuel Southgate, MSIV, University of Connecticut School of Medicine

For fourth year medical students, it is the season to secure those SLOEs and perfect that personal statement as the ERAS residency application portal opens. One task that is unique to applicants for emergency medicine (EM) residency spots is the Standardized Video Interview (SVI).

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Healthcare Reform on the Agenda at AMA Meeting

Ashley Tarchione, MSIV, University of Nevada, Reno School of Medicine
EMRA MSC AMA-MSS Representative 2019-20

At this year’s American Medical Association (AMA) conference, held earlier this month, medical students and physicians came together to tackle many issues facing healthcare. Most prominently at this meeting, our Medical Student Section advocated strongly for healthcare insurance reform, pressing the AMA to reverse its longstanding opposition to single-payer healthcare systems and asking the organization instead to take a neutral stance on the subject.

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Prepare to be a PGY1

Emily C. Roblee, MD
PGY1, University of Cincinnati Emergency Medicine Residency

At the end of my fourth year of medical school, I was coasting. All the tough rotations were over. I had made it beyond the end of the interview trail. My carefully-arranged rank list had been submitted. And after the exhilarating blur of Match Day, I knew where I would be spending the next four years as an EM doctor. Life was good - and easy - and nothing that I did as a med student seemed to matter much anymore.

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Design & Health Thinking In The ED

Peter C. Mattson, MSIV, Warren Alpert Medical School of Brown University
Katelyn Baska, OMSIII, Philadelphia College of Osteopathic Medicine

Strolling through modern hospitals on the interview trail, applicants are often led through the emergency department (ED) to see the latest technology on display. But beyond well-stocked resuscitation rooms and portable ultrasound devices, green spaces increasingly serve as crown jewels for hospitals and their EDs. How deep do these roots run? 

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Dismantling the Affordable Care Act

Ryan Koski-Vacirca, MSIV
EMRA MSC Legislative Coordinator 

Maybe you, like me, have read headlines for the last three years about how President Trump and the Republican Party first promised to repeal, and then later to “dismantle” the Affordable Care Act (ACA), colloquially known as “Obamacare.” What, I wondered, did the Trump administration and other Republicans mean by “dismantling” the ACA?

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