Emergency Medicine was my third rotation, located at NYPQ. The site is fast paced and the preceptors vary by day. Majority of the time, I was working on a team with an attending physician, resident, and intern. Most of the patients had complaints of abdominal pain, chest pain, or some nonspecific neurologic complaint. It was vital to conduct a good physical exam to truly understand what was going on with the patient, and effectively communicate that back to the team. Additionally, I was able to strengthen my procedural skills because I had the opportunity to suture, insert IVs, give injections, splint, and assist with I&Ds. I also strengthened my ability to recognize obvious pathologies on x-ray and CT scans.

During this rotation, we rotate with different teams that are organized based on patient acuity. On one of my shifts with the trauma team, I saw many interesting and acute cases, such as a subdural hematoma, STEMI activation, as well as a hemodynamically unstable patient with an upper GI bleed with a very poor prognosis. It is interesting to see how ER attendings and residents are at the forefront to organize palliative care and specialty care via consults, all while managing the emergency at hand. I was also able to see an intubation. I saw the value of closed loop communication and how much inter-professional collaboration takes place to take care of a single patient. 

Certain aspects of the rotation were difficult, as there is a learning curve when understanding how to approach emergency medicine. Many of my preceptors commonly told me: “you will not always have a diagnosis but our job in the ER is to rule out the emergent causes of these complaints.” Therefore, after a few shifts, it became easier to understand how each patient should be worked up based on their symptoms and physical exam findings. It can be a challenging rotation because the residents and attendings hold you to a high standard. I was also fasting during this rotation, as it overlapped with the month of Ramadan, which may have contributed to the challenge. However, I enjoyed the various opportunities and I think NYPQ is a great place to learn how to practice emergency medicine. I hope to use the skills I learned here on my next rotation – Family Medicine at AMZ.

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