Department of Emergency Medicine
Professor and Chairman
Director of Undergraduate Medical Education
George Willis, MD
Assistant Professor
george.willis.md@gmail.com
Coordinator
Nicole Iwaszko
niwaszko@umem.org
Fourth Year
The emergency medicine course for fourth-year students is devoted to teaching the basic, initial evaluation, stabilization, and diagnostic approach to the patient presenting with undifferentiated disease. Students are exposed to all types of patient problems, including chest pain (myocardial infarction, pulmonary embolism, acute aortic disease, esophageal rupture), headache (subarachnoid hemorrhage, brain tumor, subdural hematoma, stroke, carbon monoxide poisoning), back pain (epidural abscess, spinal fracture, cauda equina syndrome, metastatic spinal disease), abdominal pain (appendicitis, abdominal aortic aneurysm, mesenteric ischemia, perforated bowel, cholecystitis, hepatitis, pancreatitis), blunt and penetrating trauma, seizures, overdose, acute psychiatric emergencies, coma, lacerations, and fractures.
Under the direct supervision of Emergency Medicine faculty and senior residents, students develop and learn skills in wound care management (principles of wound care, sutures, complications), splinting techniques for various fracture patterns, intravenous line placement, and the initial interpretation skills of electrocardiography and radiography. Students experience emergency medicine and participate in patient care in “real time.” Supervising faculty work with students one-on-one and give students on-the-spot feedback about history-taking skills and physical examination skills. In addition, mid-month feedback is provided by the course director.
During the rotation, students work approximately 15 clinical shifts, generally a mixture of day, evening, and overnight. The majority of the clinical shifts are done in the University of Maryland emergency department. The remainder are done in the Baltimore VA. Students work one-on-one with Emergency Medicine faculty at both facilities and see a variety of patient complaints and presentations.
A lecture series is held the first week of the 4-week rotation and usually consists of 16 to 18 lectures given by emergency medicine faculty. These sessions are a mixture of PowerPoint presentations and small-group discussions. In addition, students attend 5 hours of educational conferences for the emergency medicine residents weekly.
Laboratory sessions are one of the most popular aspects of the rotation. The Department of Emergency Medicine has the unique privilege to have access to donated human cadavers for the purpose of invasive procedure education. Cadavers have been screen for communicable diseases and the lab is fully equipped for universal precautions. Students learn how to perform the following procedures:
- Endotracheal intubation
- Retrograde intubation using central line kit guide wire
- Cricothyrotomy
- Central venous access (internal jugular, subclavian & femoral)
- Chest tube thorocostomy
- Emergency thorocotomy (includes pericardial window and cardiac massage)
In 2005, a simulation lab using a state-of-the-art high-tech mannekin was added to the curriculum. Students are exposed to code scenarios and clinical cases and then manage the case. Discussions and debriefings are led by Emergency Medicine faculty. Emergency medicine residents on the academic development/teaching elective help teach in this lab.
The following labs are provided during the rotation:
- Ultrasound lab
- Simulation lab
- Cadaver (Procedure) lab
- Suture lab
- Splint lab