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How to prepare for A&E placement (medicine,4th year)

Help me please ge ready for my placement.
Original post by jsadasdh
Help me please ge ready for my placement.


Are you looking for book recommendations? The OHCM will set you in good stead for medical and surgical presentations though you may also want an A&E book which will cover psych, O&G, orthopaedics, ophth, etc. Either of these two should be fine:

https://www.amazon.co.uk/Lecture-Notes-Emergency-Chris-Moulton/dp/1444336665

https://www.amazon.co.uk/Handbook-Emergency-Medicine-Flexicover-Handbooks/dp/0199589569

This is a very useful website: https://litfl.com/

Try to use the placement as an opportunity to develop an approach to seeing undifferentiated patients i.e. begin to develop a system for thinking about chest pain, abdo pain, falls, weakness, dyspnoea, headache, psychosis etc.

ABCDE examination is the cornerstone of everything you will do - use every clerking as an opportunity to practice this. Do loads of clerkings. Try and go to resus and see if you can help out - it may seem intimidating at first but A&E regs and consultants are usually nice and keen on teaching.

A&E is a very good place to get experience in clinical skills e.g. cannulae, venepuncture, catheters, ABGs, suturing, basic airway management etc. You will have lots of opportunities to review ECGs, CXRs, appendicular radiographs, etc. At the start of each shift, tell whoever you're with what you'd like to particularly focus on that day (e.g. ECGs, MSK presentations, etc) so that they can help you accordingly.

Make sure you turn up on time and if you're allocated to do nights don't just leave after an hour.

This is definitely one placement where the more you put in, the more you'll get out.

(DOE: Former A&E teaching fellow)
Reply 2
Thank you. I am looking forward to it as I really struggle with clerking and presenting patients to senior and it's something I want to improve on. I think this is due to my lack of history knowledge and knowing what key questions to ask for each system. I only have one week in A&E unfortunately. Would you advise me to stick with one junior dr for the whole shift or tag alone with different staff members?
Original post by jsadasdh
Thank you. I am looking forward to it as I really struggle with clerking and presenting patients to senior and it's something I want to improve on. I think this is due to my lack of history knowledge and knowing what key questions to ask for each system. I only have one week in A&E unfortunately.


Yeah, A&E is a very good placement for practising all of that. The more you do it, the more you'll improve. It's a shame you only get a week.

Would you advise me to stick with one junior dr for the whole shift or tag alone with different staff members?


It will probably depend on what your shifts are like (and theirs).

The best thing to do is to make yourself known to the consultant in charge at the start of each shift* so they can allocate you to an area or one of the junior doctors. At some point, whoever you're with may need to go home so s/he can hopefully introduce you to someone else.

*Or whatever your med school tell you to do - hopefully you'll get some sort of guidance or induction :tongue:
Reply 4
Original post by Democracy
Yeah, A&E is a very good placement for practising all of that. The more you do it, the more you'll improve. It's a shame you only get a week.



It will probably depend on what your shifts are like (and theirs).

The best thing to do is to make yourself known to the consultant in charge at the start of each shift* so they can allocate you to an area or one of the junior doctors. At some point, whoever you're with may need to go home so s/he can hopefully introduce you to someone else.

*Or whatever your med school tell you to do - hopefully you'll get some sort of guidance or induction :tongue:

Thank you.
Original post by Democracy
Yeah, A&E is a very good placement for practising all of that. The more you do it, the more you'll improve. It's a shame you only get a week.



It will probably depend on what your shifts are like (and theirs).

The best thing to do is to make yourself known to the consultant in charge at the start of each shift* so they can allocate you to an area or one of the junior doctors. At some point, whoever you're with may need to go home so s/he can hopefully introduce you to someone else.

*Or whatever your med school tell you to do - hopefully you'll get some sort of guidance or induction :tongue:

hey great advice so far.

i'm an fy1 and my next rotation is A&E, i've forgotten so much medicine and other systems history-taking skills, do you have any advice for my rotation?
Original post by OnionRing
hey great advice so far.

i'm an fy1 and my next rotation is A&E, i've forgotten so much medicine and other systems history-taking skills, do you have any advice for my rotation?


I think the first thing to say is that FY1 jobs in A&E are pretty rare so you should be well supported. At the very least you should be discussing all your patients with a senior as you won't be expected to discharge patients independently. Have a low threshold for seeking help.

In terms of the actual work, I think it'll probably feel a bit intense for the first few weeks until you settle in. After a few weeks you'll have seen the majority of presentations and after a few months I think you'll have seen most of the common conditions.

I wrote a more detailed post here: https://www.thestudentroom.co.uk/showpost.php?p=80876288&postcount=7240

One thing I would add to that post is be extra careful about patients who are handed over to you as some doctors seem to be forever jinxed by the hospital gods to handover complex/difficult patients and it's easy to get caught out. Similarly, make sure you handover appropriate jobs and not things like referrals or discharge summaries as you're the one who's properly seen the patient.

If you admit patients, hold onto their record numbers and follow them up as they make their way through the hospital or outpatients - this is a good way of seeing what eventually happens to them as many times you won't arrive at a final diagnosis when you clerk them.

In terms of refreshing your knowledge - GeekyMedics is good for videos and quick recaps, so it might be worth taking some time to look through the neuro and MSK examinations before you change over. Search youtube for videos on ABCDE assessment e.g. https://www.youtube.com/watch?v=hLuC0T7RsKI

Final thing is to try and enjoy it (despite the tough rota) - I saw some interesting stuff when I did the job: TB, first presentation of sarcoidosis, encephalitis, erythema nodosum, some truly wacky malunions etc. Definitely getting nostalgic now :tongue:

Hope that helps.
Original post by Democracy
I think the first thing to say is that FY1 jobs in A&E are pretty rare so you should be well supported. At the very least you should be discussing all your patients with a senior as you won't be expected to discharge patients independently. Have a low threshold for seeking help.

In terms of the actual work, I think it'll probably feel a bit intense for the first few weeks until you settle in. After a few weeks you'll have seen the majority of presentations and after a few months I think you'll have seen most of the common conditions.

I wrote a more detailed post here: https://www.thestudentroom.co.uk/showpost.php?p=80876288&postcount=7240

One thing I would add to that post is be extra careful about patients who are handed over to you as some doctors seem to be forever jinxed by the hospital gods to handover complex/difficult patients and it's easy to get caught out. Similarly, make sure you handover appropriate jobs and not things like referrals or discharge summaries as you're the one who's properly seen the patient.

If you admit patients, hold onto their record numbers and follow them up as they make their way through the hospital or outpatients - this is a good way of seeing what eventually happens to them as many times you won't arrive at a final diagnosis when you clerk them.

In terms of refreshing your knowledge - GeekyMedics is good for videos and quick recaps, so it might be worth taking some time to look through the neuro and MSK examinations before you change over. Search youtube for videos on ABCDE assessment e.g. https://www.youtube.com/watch?v=hLuC0T7RsKI

Final thing is to try and enjoy it (despite the tough rota) - I saw some interesting stuff when I did the job: TB, first presentation of sarcoidosis, encephalitis, erythema nodosum, some truly wacky malunions etc. Definitely getting nostalgic now :tongue:

Hope that helps.

Thank you appreciate it!

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