1. Where and how long was your elective? What specialty was it in? My elective was 2 weeks in emergency medicine at Norfolk General Hospital. 2. How did you get to the elective? Did you need a car at this location? It was about an hour drive to Norfolk General from Hamilton. You would not need a car at this location if you were able to find transportation to take you there and get you home. The bus service is quite limited in Simcoe itself. There is student housing provided, which you could stay in for the entirety of any rotations there. There are many options for restaurants/groceries etc which are only a short walk from the house. 3. What were your accommodations like? Did you get any funding from the school (MacCare etc?) I did get funding from the school. MacCare funding for 2 week electives is usually $225 for commuting students, $450 for students finding housing in the community. Students completing placements in the Simcoe area are able to stay in the student housing which is a 1 minute walk from the hospital. The housing is $200 per week, and is one room out of 3 in a small house. It's quaint but perfect for a short placement! As I was completing an ED elective, which was shift-work based, I did a combination of staying in the student house and commuting back to Hamilton. 4. Describe a typical day at your elective. A typical day at my elective would be arriving at the hospital 15-20 minutes early to get changed into scrubs. I would then begin my 8 hour ED shift. This would include seeing patients, participating in trauma assessments, helping with procedures (ie suturing, I&D, casting, procedural sedation) and looking at imaging/lab work. I was always encouraged to see patient presentations which I was most interested in. After reviewing the case with the staff, I would be involved in the management of the patient depending on the issue. On one occasion, I was able to help electrically cardiovert a patient. On another, I assisted with an I&D of an abscess. I was also encouraged to follow up with my patients, including reviewing their lab work as it came in and re-assessing patients as appropriate. 5. What level of responsibility/exposure did you have as a medical student? I was the only learner in the ED so my level of responsibility and exposure was quite extensive. I was expected to follow my patients throughout the course of the shift, and was involved in practically every procedural activity undertaken in the ED during my shifts. The emergency room physicians were very proactive in grabbing me whenever something interesting came in. This made for a very broad and engaging learning environment. Their expectations for me in terms of knowledge base were high, but I found this pushed me to hone my learning throughout the elective. 6. What is your most memorable experience from this elective? I would often be involved in presenting patients to consulting services, and on one occasion I was asked to join the general surgeon in the OR for the patient I had just presented to him. It was very cool to be able to follow my patient from presentation at the ED into the OR for definitive management of their chief complaint. The learning opportunities at a rural site are often very conducive to this kind of training and the emergency physicians are very keen to help you maximize learning experiences. On many occasions, they would encourage me to shadow consulting specialists to get a sense of what management of my patients would look like from different perspectives. Additionally, it was a great elective for career planning purposes as the vast majority of emergency physicians at Norfolk are family doctors who completed rural training. As someone interested in pursuing rural family medicine training and looking to practice in a rural ED, this was a plus! 7. What was one thing you didn’t like about the elective? As noted previously, Simoce is about an hour away from Hamilton and I was the only learner staying at the student home during my time there. That meant that the elective could be somewhat isolating, which is what led to me going back and forth from Hamilton more than I had previously planned. 8. Do you have any recommendations for things to do/explore in the local area? There is a very cute stream running through town which is nice for walking! 9. Would you recommend this elective to current students? I would recommend this elective, especially for students interested in rural/family medicine training. While there wasn't necessarily the same acuity of patients as in a Hamilton ED, the preceptors were very invested in my learning and I was got more hands experience with less learners, which was a huge positive! It was also very good exposure to the resource-limited nature of practicing in a rural ED. 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? I would recommend advocating for yourself during your time there; if you appear confident and knowledgeable, the docs are keen to give you more responsibility! Also important to come into your elective with a good knowledge base of key ED presentations and management. Wellington park in Simcoe
Credit: TripAdviser, user JB
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Background credit: CBC, Emily Chung
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