Written by: Daire Fitzpatrick, McMaster Medical School c2023 Hamilton Campus 1. Where and how long was your placement? What specialty was it in? 2 weeks, Emergency Medicine (first clerkship elective.) 2. How did you get to the elective? Did you need a car at this location? Done through CPM. Yes, I needed to drive to get to Guelph General from Hamilton. Though, you could take a bus in the city if you stay on accommodations. 3. What were your accommodations like? Did you get any funding from the school (MacCare etc?) I got funding from MacCare for an AirBnB for two weeks. Which was better than commuting from Hamilton everyday. The accommodations were nice and it was a short commute to the hospital each day, definitely worthwhile to stay in Guelph. 4. Describe a typical day at your elective. Everyday you'll work with a different emergency doctor working various shift times, for eight hours every day. You start at 'See & Treat' for 2 hours: patients who are triaged and can be easily seen and then sent home (unless you find something serious.) See & Treat is a lot of fun because you will see a lot high acuity presentations and get to practice all of your physical exams. Most attendings will let you go have lunch for thirty minutes before you head back to the main emergency ward. In the main ward you'll see the more severe presentations where you will have to perform a lot more interventions and/or admit them to the hospital. Here you'll get to do more thorough examinations, take more detailed patient histories, order many more investigations, and call other departments to consult. Once on the main ward, you'll also circle back to See & Treat to discharge or admit your patients (so don't forget to go back and check on your patients!). 5. What level of responsibility/exposure did you have as a medical student? As little or as much as you would like, and it is preceptor dependent. All the doctors understand where you are in your training, and will accommodate you. If you are just starting out, you can shadow the doctor until you get a hang of the ward. If you are more advanced (and more ambitious) you can operate almost independently: seeing patients on your own, ordering your own medications, and investigations, and calling your own consults. Typically, the doctor will look at the cases and give you a patient to see, but you can also ask to see certain patients if you would like. But you had to check in with your preceptor after you've seen your patients to make sure you are doing the right thing! 6. What is your most memorable experience from this elective? Cardioversion! I had a patient come in with chronic atrial fibrillation. This wasn't her first rodeo and explained she was feeling lightheaded and her heart was racing. She said she knew she needed to "get zapped" to reset her heart. Sure enough, her ECG was a textbook afib, and listening to her heart was like hearing improv jazz drumming. We wheeled her to the trauma bay where I helped order the sedation for her procedure. We put the pads on her, and then my doctor asked me: "Would you like to do the cardioversion?". I was so excited! After doing it on practice models for ACLS for so long, I was finally getting to really practice! I charged the machine, called "Clear!" and pressed the button. The patient shook for a moment, and I looked at the monitors: we had successfully reset her heart. After the sedation wore off, she was able to walk out of the emerg and go home. It felt great to help a patient so quickly. 7. What was one thing you didn’t like about the core? Getting started was very confusing, I arrived an hour early to my first day, and it seemed like no one knew where I was supposed to be going, or where to meet my preceptor. But once that was settled, everything went very smoothly! 8. Has this elective influenced your career decisions? If so, how? Yes! It has definitely pushed me towards pursuing a career in emergency medicine! I loved the culture, the workload and the lifestyle of Guelph Emerg. It has shown me how interesting and valuable emergency medicine can be 9. Do you have any recommendations for things to do/explore/eat in the local area? Unfortunately, a lot of places were closed because of Covid, and it was a cold December, making it difficult to do a lot. However, I would recommend getting 'Victoria's Pizza' one of the best pizzas I have ever had. And, if you are going in the summer, I highly recommend the Guelph Arboretum, it is a gorgeous nature park with fantastic trails. 10. What’s one thing you wish you knew before doing this elective/future advice you have for students doing an elective here in the future? Create an organized and efficient presentation: emerg doctors are very restless and get bored easily, make sure to tell them a story quickly with the important positives and negative. Review all your physical exams. Make sure to review all your major physical exams and key signs before heading into emerg, you will get to practice ALL of them. Have an approach to Headaches, Chest Pain, Shortness of Breath, Abdominal Pain and Fatigue. 50% of the patients will have one of these and you should know the 'scary' diagnoses to rule out. Not all diagnoses, but the three to six life-threatening ones and what to do to rule them out 11. Would you recommend this elective to current students? Yes! 100% I think every student would have a great experience! If you are thinking about emerg at all, Guelph will show you one of the best emerg experiences in the province. Guelph General Hospital. Kenneth Armstrong/Guelph Today file photo
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Guelph General Hospital.
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