901 N. Washington Avenue Lansing, Michigan 48906-5137 Telephone: (517) 485-5484 FAX: (517) 485-0801 E-Mail: saem@saem.org

Mary Jo Wagner, MD, mjwagner@cris.com, Saginaw Cooperative Hospitals, Inc.

Revised by Robert Leschke, MD, Medical College of Wisconsin

Curious to find out more about emergency medicine? Want exposure to "real medicine" early? Like to belong to a group which provides practical clinical experiences in caring for all types of patients with urgent and critical problems? Then join an Emergency Medicine Club! There are now at least 40 established Emergency Medicine Clubs (EM clubs) and 18 more planned at the 124 allopathic medical schools in the United States according to a recent survey.⁽¹⁾

A typical EM club routinely offers three types of activities: workshops, lectures, and observation opportunities in a local emergency department. Workshops which teach basic skills to medical students are probably the most popular. Since Emergency Medicine touches all specialities of medicine, such skills are useful to all medical students, regardless of their ultimate career choice. Workshop topics have included airway management, basic suturing, splinting techniques, instruction on drawing blood and starting IV's, EKG and X-ray interpretation and advanced cardiac life support (ACLS) training.

Many EM clubs have a lecture series which is attended by students. These may include broad topics such as describing the field of Emergency Medicine or discussing how to get involved in research as a medical student to more narrow topics including tips on getting into an emergency medicine residency or details of the life of a cruise ship physician. Most clubs invite local emergency physicians to provide these lectures. Some clubs even tie in their lecture series to a formal series offered for practicing physicians, such as the monthly Grand Rounds lecture series.

With the contacts EM Club has with local emergency physicians, arrangements for shadowing or working in an Emergency Department (ED) are often available. These experiences range from the very informal -- showing up some day and following a doctor around the ED -- to structured observation with a formal orientation and specific goals defined for the student for their time. Some EM clubs have even arranged for students to receive credit hours for the time they spend in the Emergency Department. Even for students not interested in Emergency Medicine as a career, the unique opportunity to be involved in the patient-care setting is often not otherwise available to the first and second year medical student.

Some medical schools do not have a curriculum that includes a mandatory or elective EM experience in the junior year. For students who are considering a career in EM or who are unsure of their future choice in residency, a shadowing experience in EM is often the first, and possible only, exposure that students may have. Seeing what EM physicians do can be invaluable in assisting with this decision.

Some EM clubs also offer opportunities to participate in ongoing research projects. This opportunity is more likely to be available in medical schools which are affiliated with Emergency Medicine residencies. Other clubs arrange specific outings, both social and academic (e.g. Toxicology field trip). Arrangements are sometimes made with local EMS systems to allow students to ride with an ambulance crew. Since Emergency Medicine covers all varieties of health care problems, opportunities and experiences offered by EM Clubs to medical students are virtually unlimited.

What if a medical school has no Emergency Club?

It is not very difficult to start up a club, according to students who have recently done so at their schools. A good place to start is by obtaining information on forming an Emergency Medicine club from the Medical Student Affiliate of the Emergency Medicine Residents' Association at http://www.emra.org/index.cfm?page=123. This material suggests a step-by-step process for starting a club, a list of potential activities and events to do as a club and a list of contacts who may be able to help.

To develop an EM club, find some friends or classmates who also would like to gain the benefits of belonging to this type of organization. Putting up an announcement on a bulletin board or on e-mail at school can help find students with similar interests. It helps to have a few other committed students to share some of the basic ground work needed to have a successful club.

Next, develop some goals for the club. Will it primarily arrange for mentors or advisors for students interested in careers in Emergency Medicine or will the club have the broader focus of arranging for students to experience clinical activities early during their medical school year? Pool the resources (information, faculty contacts, etc.) that the small working group already has and begin making formal relationships with at least one faculty member willing to help as a faculty advisor.

In order to legitimize the club and possibly obtain financial and clerical support from the institution, determine the process for establishing the group as a formal medical school organization. One student who recently started a club also established his group as an university organization (not just medical school) and was then able to take advantage of the leadership training workshops and the higher level of financial support given at that level of his institution. It will probably be necessary to have official elections for officers in order to establish this type of relationship with the university. Another way to obtain funding is to apply for an EMIG Grant sponsored by the Society for Academic Emergency Medicine.

By this point, the organization should have been advertised widely in the medical school. In order to keep momentum going, to ensure that the club last longer than the charter members, students in all four medical school classes should be invited to become involved. The first official meeting should be held at an hour when everyone can attend. This often means an evening meeting to include the third and fourth year students, but arranged at a time when the first two classes are not deeply buried in their books for an upcoming exam. Successful clubs agree that meeting attendance is always enhanced by two things: food and interesting speakers. Both should be used, even for the first meeting. Perhaps the faculty advisor could be the first speaker, with a pertinent topic such as "What you should be doing now to get into a residency in the future?"

After the original meeting, some clubs break into two general sections -- the first and second year students, who may have extra speakers or activities scheduled at lunch time and around exams -- and the third and fourth years students, who generally are able to attend meetings and activities only in the evenings. If there is an Emergency Medicine residency at your school, speak to the residency director about club members joining any of their pertinent activities, such as a journal review discussion.

Finally, a new club can establish a formal system for shadowing physicians in the Emergency Department. Maintaining an organized list of contacts may be the most helpful aspect of the group initially for many students.

Belonging to an Emergency Medicine club in medical school can provide opportunities for early exposure and practical experiences in "real medicine" for all medical students, as well as coordinate resources for those with an interest in exploring a career in Emergency Medicine. If you have any further questions, please contact SAEM saem@saem.org, 517-485-5484 phone or 517-485-0801 fax.

Useful References:

1. Schlaishunt, S, Kothari, R. Grassrotts Emergency Medicine: A Survey of U.S. Medical Schools (letter). Acad Emerg Med. 1996;3:648-650.

2. Wyte, CD, Shimp RJ, Adams SL, Kramer DL, Impact of an EM club on senior elective enrollment (letter). Acad Emerg Med. 1995;2:155-156.

3. Springer, P. Get you school involved in the MSA. EM Resident, Emergency Medicine Residents' Association August 1994:9.

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