What If I Do Not Match? Scrambling for a Spot and Going Outside the Match.

Matching into emergency medicine (EM) is getting progressively more competitive. Applicants must therefore prepare for the possibility of not matching and, accordingly, be ready to participate in the Supplemental Offer and Acceptance Program (SOAP). In this article, we elaborate on the SOAP and the options for applicants who fail to match during Match Week. Alternative courses of action include applying for a preliminary year, matching into a categorical residency program, or aiming to secure EM spots outside the Match through the Council of Emergency Medicine Residency Directors, Society for Academic Emergency Medicine, and American Association of Medical Colleges

Are You Applying to More Than One Specialty?

Although the majority of U.S. medical students predominantly apply to only one specialty, some apply to more than one. When it comes to emergency medicine (EM), applicants may apply to additional specialties due to several reasons: being international medical graduates as well as their inability to make a decision regarding the choice of specialty, fear from the growing competitiveness of EM, or the desire to stay in a specific geographic area. Accordingly, in this article we aim to guide medical students through the process of applying to more than one specialty, including using the Electronic Residency Application Service application, writing a personal statement, getting letters of recommendation, and an Early Match. Moreover, we elaborate on the effect of applying to more than one specialty on a student's application to a residency in EM

What Do Program Directors Look for in an Applicant?

Program directors (PDs) are faced with an increasing number of applicants to emergency medicine (EM) and a limited number of positions. This article will provide candidates with insight to what PDs look for in an applicant. We will elaborate on the performance in the emergency medicine clerkship, interview, clinical rotations (apart from EM), board scores, Alpha Omega Alpha membership, letters of recommendation, Medical Student Performance Evaluation or dean’s letter, extracurricular activities, Gold Humanism Society membership, medical school attended, research and scholarly projects, personal statement, and commitment to EM. We stress the National Resident Matching Program process and how, ultimately, selection of a residency is equally dependent on an applicant’s selection process

Outpatient Management of Cancer Patients During the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China. In no time, SARS-CoV- 2 found its way to the whole world, to be declared as a pandemic by the World Health Organization (WHO) on March 11th, 2020. As this disease continues to take its toll on the world as a whole, we, at the American University of Beirut Medical Center (AUBMC), believe that it is essential to protect those who are at a particularly high-risk for contracting the virus, namely cancer patients. Besides complying with all the protective measures recommended by WHO, we developed quality improvement plans for the outpatient management of febrile neutropenia, pneumonia and pulmonary embolism in cancer patients. The aim of such plans is to offer adequate management for cancer patients on an outpatient basis, whenever possible, and thus limit their admission rates together with their risk of contracting the novel virus, SARS-CoV- 2

A Brief Report on the Beirut Port Explosion

Over the past year, Beirut has witnessed a civil revolution, the COVID-19 pandemic, its worst economic crisis in decades, and most recently one of the largest non-nuclear explosions in history. This explosion had devastating effects on the city’s social, economic, and health infrastructure

Reducing Electronic Health Record (EHR) Click Fatigue: An Innovative Approach to Common Order Sets

Learning Objectives: Our initiative aims to develop an education innovation that contributes to: • Enhancing EHR usability through facilitating the process of placing medical orders. • Decreasing click fatigue while increasing professional satisfaction among emergency medicine residents.Introduction/Background: Bureaucratic tasks are the leading cause of burnout among emergency medicine physicians. Among those tasks is placing medical orders in the Electronic Health Record (EHR), which is a time-consuming and rigorous process that can lead to click fatigue and increase physician burnout. Therefore, we believe that optimizing the EHR experience for order placement will not only decrease the amount of time spent using the EHR but will also decrease click fatigue and improve overall satisfaction of emergency medicine physicians.Curricular Design: We designed a PowerPoint educational module for the emergency medicine residents that guides them through the process of creating their own personalized order sets. In this module, we demonstrated the step-by-step process of developing order sets for three of the more common presentations to the ED: chest pain, abdominal pain, and headache. This is a significant, minimal cost method that can be used to facilitate many patient encounters through expediting the placement of workup and management orders. After partaking in the educational module, residents were able to develop their own personalized order sets, which will inevitably reduce the number of clicks.Impact/Effectiveness: Integration of this module has been successful among the emergency medicine residents and was very well received. The number of clicks saved using the order sets presented in the PowerPoint educational module was eight, six, and fifteen clicks for the chest pain, abdominal pain, and headache order sets, respectively. This educational innovation has high transferability to other institutions that use EHRs. We expect that employing this strategy will decrease the amount of time spent on bureaucratic tasks, decrease click fatigue, and improve the overall wellness of the ED physician. Our long-term plan includes expanding our educational curriculum and utilizing qualitative assessment tools to examine its effectiveness

A Comprehensive Approach to Increase Emergency Medicine Resident Involvement in Caring for Opioid Use Disorder

Learning Objectives: To train EM residents to: •Screen and identify patients with OUD •Manage OUD by implementing evidence-based practices in EM, including initiating buprenorphine for patients in moderate to severe withdrawal •Support the transition of patients with OUD to long-term care for ongoing treatment.Introduction: Opioid use disorder (OUD) is a chronic medical condition with alarming repercussions, including death and disability. Although, healthcare organizations, nationwide, have launched multiple initiatives to put an end to this epidemic, deaths related to opioids continue to be on the rise. More specifically, initiatives that involve abstinence have been shown to be less effective and are associated with high rates of relapse, including detoxification, rehab, 12-step programs, and Narcotics Anonymous. Medications for Opioid Use Disorder (MOUD), however, seems to be a promising approach to achieve recovery and reduce relapse. Our institution received a grant from the Ohio Department of Health to implement a program, called SAFER, that provides comprehensive care for patients with OUD presenting to our emergency department (ED). Our goal is to maximize the involvement of emergency medicine (EM) residents in implementing this program.Curricular Design: The residency leadership identified three resident champions, who were involved in the process of developing and implementing SAFER in our ED, which will be launching in December 2021. The resident champions were trained by the SAFER educational specialist team. Through a train-the-trainer model, the champions will be educating their co-residents on the process of identifying the patients that can benefit from this comprehensive care program and ensuring their enrollment. This is achieved through a PowerPoint educational module that introduced the residents to the program followed by weekly updates on the evolution of the program during the didactics.Impact/Effectiveness: We believe that involving the EM residents in this program will help improve the outcomes of patients with OUD, including reducing opioid overdose deaths, increasing retention in treatment, and decreasing relapse. We will be utilizing quantitative assessment tools to examine the effectiveness of this program

A Positive Outcome Post Alteplase, ECMO and Emergent Surgery in a Case of Massive Pulmonary Embolism Cardiac Arrest Complicated by Intra-Abdominal Bleeding

Acute pulmonary embolism is stratified into three groups: low-risk, moderate-risk, and high-risk. Highrisk PE, also known as massive pulmonary embolism (MPE), is defined as an acute PE with sustained hypotension, pulselessness, and persistent bradycardia. Herein, we present a case of a 44-year-old female presenting to the emergency department with shortness of breath, chest discomfort, and central cyanosis. She was found to have MPE and arrested twice during which she received alteplase and Advanced Cardiac Life Support. In the ICU, she arrested for the third time, was resuscitated, and a decision to initiate extracorporeal membrane oxygenation deemed reasonable. The patient deteriorated and was rushed to the operating room after detecting major intra-abdominal bleeding on FAST exam. Hepatic injury was suspected and liver packing was initiated. Patient was safely discharged home neurologically intact after a prolonged hospital stay

An Introduction to the Residency Application Process.

Emergency medicine (EM) is a swiftly developing yet still relatively young discipline. We are going to present in the Medical Student Forum section of the Journal of Emergency Medicine several article series covering the key topics that medical students interested in emergency medicine will find helpful. This article introduces the topics that will be tackled in the first compilation of articles dealing with the residency application process