Career Exploration—Community-Based Emergency Medicine

Department of Surgery and Surgical Specialties

  • Course Information

    Course Number: RSRG640

    Prerequisites: Completion of the Phase 2 Internal Medicine or Family Medicine clerkship and the Phase 2 OB/GYN or Surgery clerkship

    Length of Time: 2 or 4 weeks

    Available for Phase: Phase 2 students RMED only. Phase 3 RMED preference. Registration with course director approval.
    – Preference is given to RMED students, but if available, any interested student may enroll. Students are encouraged by the participating hospitals and clinics to consider completing 2 consecutive 2-week rotations in the same community to provide for easier access to housing and more exposure to the host location.

    Credit Type: Patient-facing, acute care, or open

    Call: Some overnight emergency room shifts as determined locally. Night duty will not exceed 1 night in every 4. The UIC policy on duty hours will apply in this situation (appendix “UI duty hour rules out of town students”)

  • Contact Information

    Program Directors: Richard Jeisy, MD, Medical Director, Taylorville, IL; Joseph Burton, DO, Brent Weber, MD, Sarah Bush Lincoln Health Center; Martha A. Kelley, MD, OSF St. Mary’s Medical Center; Elias Trace, MD, Gary Hendricks, MD; Jacksonville Memorial Hospital; Russel Coulter, MD, Sparta Community Hospital; Imad Khan, DO, OSF Healthcare St. Elizabeth Medical Center – Ottawa/Peru

    Coordinators/Scheduling: Jessica McGuire (jam226@uic.edu); Allison King (aking75@uic.edu)

    Locations: Taylorville Memorial Hospital ED (201 E Pleasant Street, Taylorville, IL 62568); Sarah Bush Lincoln Health Center (1000 Health Center Dr, Mattoon, IL 61938); OSF St. Mary’s Medical Center (3333 N Seminary St, Galesburg, IL 61401);  Jacksonville Memorial Hospital (1600 W Walnut St, Jacksonville, IL 62650); Sparta Community Hospital (818 E Broadway St, Sparta, IL 62286); OSF St. Elizabeth Medical Center (1100 E Norris Dr, Ottawa, IL 61350; 925 West St, Peru, IL 61354)

Narrative Description: A 2- or 4-week rotation to allow a student to have an extended experience providing emergency room care in a more rural setting with somewhat fewer resources than the medical center where their prerequisite clerkship was completed. At no time will the student provide any patient care or entries to the medical record without their preceptor being directly present.

Learning Objectives:

  1. Describe/discuss issues facing practitioners caring for individuals, families and communities distant from a comprehensive medical center.
  2. Be able to evaluate patients and contribute to treatment planning for patients and families in small communities.
  3. Describe common health problems in rural areas.
  4. Be able to demonstrate proficiency in clinical/procedural skills for treatment and management.
  5. Describe strategies for health promotion and illness prevention.
  6. Identify available resources in the host community.
  7. Be able to determine when local treatment is appropriate, when to involve visiting subspecialties, and when to refer patients to higher levels of care. Explain why these decisions are appropriate.
  8. Describe the initial evaluation and management of common presenting complaints and note how emergency room management of these issues differs from ambulatory or hospital-based settings in the course prerequisite rotation. These conditions include:
    1. Abdominal Pain
    2. Chest Pain
    3. Fever
    4. Back Pain
    5. Dyspnea
    6. Vomiting
  9. Describe the community-based emergency room approach to mental health issues and compare it to a medical center’s approach.
  10. Describe the community-based emergency room approach to those presenting with substance use or addiction and compare it to a medical center’s approach.

Learning Activities:

  1. The student will keep a journal, summarizing their daily activities, level of participation (observed, partial or full) and their personal observations & thoughts about the experience. (see appendix “Community Electives Log Procedures”)
  2. Students will perform medical histories and physical exams as assigned by their preceptor, present their findings orally, and develop differential diagnoses and treatment plans appropriate to their experience level.
  3. Students should participate as a member of the treatment team to provide stabilization of critically ill patients who present to the emergency room as assigned. This must be done under the direct supervision of their preceptor and should be appropriate to the student’s level of training (Phase 2 student)
  4. Students will obtain feedback from their preceptor using the Direct Observation Form method as in regular required clerkships – one at the beginning of the clerkship and again at the end. Completion of this feedback and submission of the Direct Observation Form is required but the comments are formative only and will not be used for evaluation purposes.
  5. In order to help with advising and scheduling of future students, each student must complete a narrative summary of their experience in each 2-week rotation and submit this to the Phase 2/3 Director in Rockford at the end of their Grades will not be posted until this is completed.

Method of Assessment

  1. The existing Elective Evaluation form will be used to provide feedback to the student about their performance. Grading method will be consistent with College policy.
  2. Student’s journal will be reviewed by the supervising provider in the community for accuracy and completeness. (see appendix “Community Electives Log Procedures”). If possible, the same emergency room preceptor should provide both of the journal reviews (mid-clerkship and end of clerkship)
  3. Completion of Direct Observation Form requirement will be
  4. To the extent possible students should seek to perform procedures under When this is done the supervising preceptor should note successful completion of these procedures including the date, procedure name, and preceptor signature on a written prescription blank. Students will submit these to the Phase 2&3 coordinator at the end of the rotation. A list of procedures is provided in the appendix “Procedural Competencies”.

Required Reading: None required by the campus – readings as assigned by local preceptors. Students are expected to take advantage of the Medical Mobile Resources available from the UIC library (appendix “EBM- Medicine Mobile Resources for out of city students”). Given the variety of these resources at the students’ disposal, note that use of UpToDate as the only clinical resource is not acceptable.

Additional Resources: As determined by the local preceptor.

Miscellaneous Information: None