Third-year medical student rotations in emergency medicine: A survey of current practices

Objectives: Exposure to emergency medicine (EM) is a crucial aspect of medical student education, yet one that is historically absent from third-year medical student training. There are limited data describing the existing third-year rotations. The goal of this study is to identify the content and structure of current EM rotations specific to third-year students. Methods: An institutional review board-approved survey of clerkship characteristics was designed by consensus opinion of clerkship directors (CDs). The survey was distributed to 32 CDs at institutions with known EM clerkships involving third-year students. Results: Twenty-three (72%) CDs responded to the survey. Sixty-five percent have rotations designed specifically for third-year students, of which 33% are required clerkships. Twenty-seven percent of rotations have prerequisite rotations; 37% of rotations include shifts in the pediatric ED. Clinical time averages four 8-hour shifts per week for 4 weeks; all rotations include weekly didactic time specific to third-year students. A wide variety of textbooks are used; some programs employ simulation labs. Two-thirds of the rotations have a required write-up or presentation; 53% include a final exam. Student evaluations are written and verbal. Most rotations receive more support from the EM departments than from the medical schools for physical space, administrative needs, and faculty time. Among those surveyed, students from institutions requiring a third-year EM rotation have a higher rate of application to EM residencies. Conclusions: There is variability in the content and structure of existing third-year EM rotations, as well as in financial and administrative needs and support. These data can help to inform CDs and departments that are starting or modifying EM third-year rotations, as well as contribute to the development of curricula for such rotations.