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Emergency Medicine Clerkship

The Surgical Approach to the Patient (SAP) is a 12-week integrated clerkship block that is comprised of Surgery and Emergency Medicine rotations. As disciplines with a heavy emphasis on procedures and management of acute disease, Surgery and Emergency Medicine share didactic sessions and simulation-based training over the course of the rotation. An appreciation of the basic and clinical sciences, critical thinking and problem-solving in a fast-paced varied environment will be experienced by learners. Given the complexity of patients with acute and critical illness, a high degree of professionalism and emotional intelligence is an essential skill during these rotations.

General description

The Emergency Medicine Clerkship is a 3-week rotation focusing on the care of patients with undifferentiated chief complaints. Students rotate in the emergency departments at the Yale New Haven Hospital main campus and Saint Raphael's Hospital campus in integrated teams with residents, nurses, APPs and technicians. They are exposed to a wide array of patient acuity including critically ill patients.


This clerkship emphasizes clinical learning at the bedside in the emergency department while directly participating in patient care. In addition, our integrated simulation program allows students to take leadership roles in simulated cases focusing on a variety of medical and surgical pathology including myocardial ischemic disease, toxic ingestions, and acute surgical pathology. Weekly reasoning conferences are offered and focus on the metacognition underpinning clinical practice. Students also join residents for didactics including remote and in-person lectures, journal club, M&M conference, and areas of concentration.


The EM clerkship is graded on a pass/fail basis. Narrative summative assessments are collected from preceptors including attendings and residents. EM content is integrated into the final SAP self-assessment exam however exam performance is not documented in the final summative assessment. Students are also encouraged to solicit formative feedback on rotation and can use an online-based feedback form to record feedback given on shift.

Learning objectives

  • Demonstrate basic knowledge needed to evaluate, treat and disposition common presentation in the emergency department such as chest pain, abdominal pain and shortness of breath
  • Formulate weighted differential diagnoses and evidence based management plans
  • Participate in common procedures such as venipuncture, wound management and incision and drainage
  • Write a succinct note documenting important elements of the ED encounter
  • Accurately interpret common clinical tests such as EKGs, chest x-rays, and serum electrolytes
  • Understand patient concerns within the context of their social milieu including access to healthcare and community resources
  • Demonstrate a professional demeanor and a positive attitude toward patient care

Required experiences

Students must do the following checklist items Minimum no. of times Type of patient
Evaluate/help manage an endocrine disorder (metabolic derangements Of K, Ca, or Na) 1 real, simulated
Evaluate/help manage a blunt abdominal injury 1 real, simulated
Evaluate/help manage hypovolemic shock 1 real, simulated
Evaluate/help manage septic shock 2 real, simulated
Evaluate/help manage respiratory failure 2 real, simulated
Evaluate/help manage biliary colic, cholecystitis, cholangitis of pancreatitis 1 real, simulated
Evaluate/help manage chest pain 3 real, simulated
Evaluate/help manage vacular conditions (aortic aneurysm, aortic Dissection or mesenteric ischemia) 1 real, simulated
Evaluate/help manage a drug overdose 1 real, simulated
Observe/assist with a case that requires a discussion of DNAR status,a death notification or involves comfort care 1 real, simulated
Perform an IV placement 5 real, simulated
Perform suturing, stapling, or use of tissue adhesive 3 real, simulated
Obtain and interpret an EKG 3 real, simulated
Interpret a chest x-ray 2 real, simulated
Calculate a stroke scale score 1 real, simulated
Attend/assist with a modified trauma 1 real, simulated
Observe/perform a FAST 3 real, simulated
Observe/perform an ED echocardiogram 3 real, simulated