CJEM Articles: medical student

Objective: Emergency medicine is an evolving discipline in Canadian medical schools. Little has been published regarding student preferences for emergency medicine training during the clerkship phase of MD programs. We assessed medical students' perceptions of a newly developed emergency medicine clerkship rotation involving multiple learning modalities. The evaluation process included assessment of the rotation's instructional elements and overall educational value.

Methods: The first cohort of medical students to complete this new emergency medicine clerkship was invited to answer a questionnaire just before graduation. Students rated their preferences for components of the rotation using paired com­parisons. Open­ended questions explored students' satisfaction with the emergency medicine clerkship as well as perceptions of the rotation's impact on career development.

Results: Of the 94 students in the first clerkship cohort, 81 (86%) responded to the survey. Students found the emergency medicine clerkship highly valuable, citing the broad range of cases seen, close supervision, and opportunities to develop clinical assessment, decision­making and procedural skills. Students' curricular preferences were for advanced cardiac life support (ACLS) (26.4%), clinical shifts (20.6%), supervised clinical shifts (17.8%), procedural skills laboratories (14.8%), tutorials (10.8%) and preceptor­assisted learning sessions (9.8%).

Conclusion: This new emergency medicine clerkship program incorporated multiple learning methods within a 4­week rotation and was highly rated by students. Although clinical shifts and ACLS were generally preferred activities, students had varying individual preferences for specific learning activities. Multiple learning methods allowed all students to benefit from the rotation. This study makes a compelling case for including an emergency medicine rotation with multiple learning modalities as a core element of clerkship at every medical school.

Background: Studies indicate that a student's career interest at medical school entry is related to his or her ultimate career. We sought to determine the level of interest in emergency medicine among students at the time of medical school entry, and to describe characteristics associated with students primarily interested in emergency medicine.

Methods: We surveyed students in 18 medical school classes from 8 Canadian universities between 2001 and 2004 at the commencement of their studies. Participants listed their top career choice and the degree to which a series of variables influenced their choices. We also collected demographic data.

Results: Of 2420 surveys distributed, 2168 (89.6%) were completed. A total of 6.1% (95% confidence interval 5.1%-7.1%) of respondents cited emergency medicine as their first career choice. When compared with students primarily interested in family medicine, those primarily interested in emergency medicine reported a greater influence of hospital orientation and a lesser influence of social orientation on their career choice. When compared with students primarily interested in the surgical specialties, those primarily interested in emergency medicine were more likely to report medical lifestyle and varied scope of practice as important influences. When compared with students primarily interested in the medical specialties, those who reported interest in emergency medicine were more likely to report that a hospital orientation and varied scope of practice were important influences, and less likely to report that social orientation was important.

Conclusion: Students primarily interested in emergency medicine at medical school entry have attributes that differentiate them from students primarily interested in family medicine, the surgical specialties or the medical specialties. These findings may help guide future initiatives regarding emergency medicine education.

Objectives: Emergency medicine (EM) residents work intimately with emergency department staff, and many residents become staff at the institutions that train them. As such, it is in the interest of all training sites to attract the strongest candidates to their programs. The goal of this study was to determine what factors make programs most appealing to EM residency applicants.
Methods: A survey was developed to assess the relative importance of 20 factors used by EM residency applicants in selecting a Royal College of Physicians and Surgeons of Canada residency program. The survey was piloted on 17 University of Western Ontario EM residency candidates in 2003, and validated on 26 EM residency candidates applying to 8 sites across Canada in 2004.
Results: The 20 surveyed factors fell into 4 categories. The most important factors were those relating to interactions with the program (4.5 out of 5), followed by factors relating to the program itself (3.5), personal factors (3.4), and lastly, factors relating to the city/province (2.9).
Conclusions: These data suggest that the most important factors are "interactions with a program" and program characteristics. Both of these are largely within a program's control. By striving to make their curriculum, interview days and medical student electives more appealing a residency program can improve its ability to attract the strongest residency candidates.