EM Match Advice: The EM Rotation, ERAS, and Am I Competitive?

EM Match iconToday launches a series of Google Hangout videos, which was created and expertly facilitated by Dr. Michael Gisondi (@MikeGisondi) from Northwestern. In this series, he recruited an amazing panel of program directors from around the country, who have kindly volunteered their time to share their insights and expertise. In these videos, you get a sense of each panelist’s personalities while they outdo each other with behind-the-scenes advice and stories, which would normally be shared only at the institutional level. Our videocasts are a unique must-see for medical students, interested in and applying into Emergency Medicine (EM). Keep a look out for more videos in the future!

The EM Rotation

Dr. Gisondi facilitates a great discussion featuring esteemed residency program directors Dr. Lainie Yarris (Oregon Health Sciences University), Dr. Maria Moreira (Denver Health), and Dr. Jan Schoenberger (LAC-USC), with the occasional outburst/question by Dr. Michelle Lin (UCSF-SFGH).

Timestamps

  • 00:00  Dr. Mike Gisondi introduces the series and talks about 3 key publications to review for the EM medical student and how to succeed in the EM rotation
  • 05:11  Dr. Lainie Yarris discusses “what defines an honors level performance?”
  • 08:23  Dr. Maria Moreira discusses the differences between an away and a home rotation?
  • 11:24  Dr. Maria Moreira discusses the art of getting a Standardized Letter of Evaluation (SLOE) from their EM rotation
  • 13:43  Dr. Jan Schoenberger discusses how to be a stellar stand-out in a rotation with only a pass-fail system in the EM rotation.
  • 14:45  Dr. Michelle Lin poses the question to the PD’s about — “I didn’t get an honors, now what?”
  • 16:28  Dr. Schoenberger addresses advising/counseling approaches
  • 17:35  Dr. Lin asks about the “departmental SLOE” letter
  • 18:10  Dr. Schoenberger talks about her departmental SLOE
  • 18:45  Dr. Yarris talks about her departmental SLOE and the value of intangible, behavioral characteristics in applicants
  • 19:45  Dr. Moreira talks about her department’s SLOE approach and reminds us that programs want diversity in the program
  • 22:48  Dr. Yarris – pearls and pitfalls
  • 24:05  Dr. Moreira - pearls and pitfalls
  • 26:36  Dr. Schoenberger – pearls and pitfalls
  • 29:18  Dr. Gisondi wraps things up by asking the 3 program directors to share something awesome back their program and something that we might not know about their program.

References

  1. Mahadevan S, Garmel GM. The outstanding medical student in emergency medicine. Acad Emerg Med. 2001 Apr;8(4):402-3. PMID: 11282680.
  2. AAEM Rules of the Road for Medical Students (2003), a free PDF.
  3. Davenport C, Honigman B, Druck J. The 3-minute emergency medicine medical student presentation: a variation on a theme. Acad Emerg Med. 2008 Jul;15(7):683-7. PMID: 18691216.

 

Electronic Residency Application Service (ERAS)

Dr. Gisondi (Northwestern) facilitates a great discussion featuring star residency program directors Dr. Gene Hern (Highland-Alameda), Dr. Laura Hopson (Univ of Michigan), and Dr. Josh Broder (Duke), with an occasional question by Dr. Michelle Lin (UCSF-SFGH).

Timestamps

  • 00:00  Dr. Gisondi introduces the series and talks about 3 key publications to review about what are important in the ERAS application
  • 09:37  Dr. Hern talks about his perspectives about the ERAS and what matters to him and his program at Highland
  • 15:00  Dr. Hern discusses what parts of the ERAS the student should focus more time on.
  • 16:25  Dr. Hern reviews what doesn’t matter as much on the ERAS.
  • 17:41  Dr. Hopson drops pearls about what to do and where to focus your time on the ERAS application.
  • 21:38  Dr. Hopson shares her perspectives about looking for the well-rounded, multitasking applicant.
  • 22:15  Dr. Hopson talks about red-flags in filling out the ERAS application.
  • 26:00  Dr. Broder shares his thoughts about how a non-superstar applicant can shine on his/her application.
  • 28:37  Dr. Gisondi and Dr. Hern talk about how some red flags in the application can be addressed.
  • 31:20  Dr. Hopson recommends teaming up with your mentor/advisor in addressing any red flags in the SLOE.
  • 32:10  Dr. Broder shares his comments how he approaches thinks about any red-flag candidates.
  • 33:07  Dr. Lin shares her thoughts about the personal statement and concerns about honesty on the application.
  • 34:58  Dr. Hern talks about his 2005 BMJ Med Educ study about errors/omissions on the ERAS applications (BMJ Med Educ 2005).
  • 36:16  Dr. Hopson talks about poor integrity, in the form of inconsistent information within the application packet, being a huge red flag in applications.
  • 37:33  Dr. Broder and Dr. Gisondi banter about application misrepresentation.
  • 39:04  Dr. Hene talks about final thoughts – pearls and pitfalls
  • 41:38  Dr. Hopson talks about final thoughts – pearls and pitfalls. In a nutshell: Be yourself.
  • 42:11  Dr. Broder talks about final thoughts – pearls and pitfalls.
  • 43:13  Dr. Lin talks about final thoughts – pearls and pitfalls.
  • 44:16  The panel talks about the “drop dead” deadline for the ERAS application.
  • 45:10  Dr. Lin challenges the panel by asking about the few programs who may offer interviews before the Dean’s letter comes out.
  • 47:46  Dr. Hern shares why one should apply to Highland.
  • 49:28  Dr. Hopson shares why one should apply to University of Michigan.
  • 50:22  Dr. Broder shares why one should apply to Duke.

References

  1. Hayden SR, Hayden M, Gamst A. What characteristics of applicants to emergency medicine residency programs predict future success as an emergency medicine resident? Acad Emerg Med. 2005 Mar;12(3):206-10. PMID: 15741582.
  2. Breyer MJ, Sadosty A, Biros M. Factors Affecting Candidate Placement on an Emergency Medicine Residency Program’s Rank Order List. West J Emerg Med. 2012 Dec;13(6):458-62. PMID: 23359215. Free PDF.
  3. Green M, Jones P, Thomas JX Jr. Selection criteria for residency: results of a national program directors survey. Acad Med. 2009 Mar;84(3):362-7. PMID: 19240447.
  4. Katz ED, Shockley L, Kass L, Howes D, Tupesis JP, Weaver C, Sayan OR, Hogan V, Begue J, Vrocher D, Frazer J, Evans T, Hern G, Riviello R, Rivera A, Kinoshita K, Ferguson E. Identifying inaccuracies on emergency medicine residency applications. BMC Med Educ. 2005 Aug 16;5:30. PMID: 16105178. Free article link.

 

Mirror Mirror on the Wall: Am I Competitive?

Dr. Gisondi (Northwestern) kicks off a great conversation and debate about the knowing how competitive you are, as an applicant. This panel features star residency program directors Dr. Andrew Perron (Maine Medical Center), Dr. Madonna Fernandez (Harbor-UCLA), and Dr. Kevin Biese (UNC Chapel Hill), with comments by Dr. Michelle Lin (UCSF-SFGH).

Timestamps

  • 00:00  Dr. Gisondi launches this panel discussion on determining your competitiveness in the application process. He
  • 03:19  Dr. Gisondi delves right into a great PDF that summarizes some recent statistics about How Competitive is the EM Match that he and Jill Craig compiled. FYI, “SOAP” in the document means Supplemental Offer and Acceptance Program. For a more full listing see the NRMP website [1].
  • 07:26  Dr. Lin discusses what her take-away points after looking at the trends.
  • 09:08  Dr. Biese follows up with his take-away points from these trends.
  • 09:31  Dr. Gisondi weighs in on these trends as well. “There’s a home for (almost) every EM applicant.”
  • 11:00  Dr. Gisondi discusses relevant papers [2-4].
  • 15:58  Dr. Lin fields the first question about — how many programs should I apply to?
  • 18:00  Dr. Perron makes a grand entrance and stresses the importance of a knowledgeable advisor.
  • 19:03   Dr. Perron shares stories about application numbers.
  • 21:32   The panel debates about how many programs to interview at. What is the interview-canceling etiquette? What about couples matching? Tax-break tips?
  • 26:40  Dr. Biese talks about how applications are screened once their submitted into ERAS.
  • 30:09  Dr. Gisondi shares on his perspectives on the numbers game (i.e. USMLE scores).
  • 32:40  The panel rapid-fires about how to address stumbling blocks in one’s application (e.g. below average scores or poor shelf exam scores).
  • 37:34  Dr. Biese shares a story about why a “creative” personal statement that stands out maybe isn’t a good idea.
  • 40:04  Dr. Fernandez shares how to find a great advisor about matching into EM, especially if there’s no home EM residency department to help advise. Think about SAEM/CDEM’s e-Advisor system (application system).
  • 43:40  Dr. Fernandez and Dr. Biese describe what makes a quality advisor.
  • 47:30  Dr. Gisondi and Dr. Fernandez share who/what might be questionable resources for advice and why.
  • 51:18  Dr. Lin summarizes it all to the bottom line – Get a good advisor.
  • 52:43  Dr. Biese clarifies that there are two games afoot – get an interview vs get ranked highly on rank day.
  • 54:27  The panel each leaves a short take-away pearl/pitfall.
  • 57:30  The panel shares something that one might not know about their residency program.

References

  1. NRMP Match Results and Data 2014 (PDF)
  2. Crane JT, Ferraro CM. Selection criteria for emergency medicine residency applicants. Acad Emerg Med. 2000 Jan;7(1):54-60. PubMed PMID: 10894243.
  3. Girzadas DV Jr, Harwood RC, Delis SN, Stevison K, Keng G, Cipparrone N, Carlson A, Tsonis GD. Emergency medicine standardized letter of recommendation: predictors of guaranteed match. Acad Emerg Med. 2001 Jun;8(6):648-53. PMID: 11388941.
  4. Lotfipour S, Luu R, Hayden SR, Vaca F, Hoonpongsimanont W, Langdorf M. Becoming an emergency medicine resident: a practical guide for medical students. J Emerg Med. 2008 Oct;35(3):339-44. PMID: 18547776.

 

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

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Diagnose on Sight: Palmar Rash

palmar rashCase: A 41 year old male with one week of non-pruritic palmar rash that started on his trunk and spread to his hands. He has no history of travel, fever, joint pains, or medication use. What is your diagnosis for this palmar rash? Click on the image for a larger view.

 

Poll

 

Diagnosis

Palmar rash from secondary syphilis

Explanation

“The Great Imitator” is making a comeback. Between 2011 and 2012, the number of reported primary and secondary syphilis cases increased 12.1%. From 2005 to 2013 the number of cases nearly doubled [1]. In 2012, 75% of the reported primary and secondary syphilis cases were among men who have sex with men [2].

The rash of secondary syphilis is generally pink or dusky red and papular. The skin is indurated and there is often a superficial scale on the lesions. Though it typically involves the palms and soles, it can start on the trunk and spread to the entire body [3].

A brief review of the stages of syphilis [4]:

Stage
Time Course
Clinical Manifestations
Primary~21 days from innoculationPainless chancre
Secondary3-6 weeks after end of primary stageFever, headache, lymphadenopathy, malaise, rash, sore throat
Tertiary3-20 years after infectionDementia, granulomatous lesions (gummata), meningitis, neuropathy (tabes dorsalis), thoracic aneurysm

 

Master Clinician Bedside Pearls

Stuart Swadron, MD

 

 

 

Stuart Swadron, MD – Professor of Emergency Medicine, Keck School of Medicine of the University of Southern California (provided to ALiEM and recorded by Swadron, 2014)

 

References

  1. Patton M, Su J, Nelson R, Weinstock H. Primary and Secondary Syphilis — United States, 2005–2013. Morbidity and Mortality Weekly Report. Accessed 7/30/14
  2. Centers for Disease Control and Prevention. Syphilis & MSM (Men Who Have Sex With Men) – CDC Fact Sheet. Accessed 7/30/14.
  3. Dylewski J, Duong M. The rash of secondary syphilis. CMAJ. 2007 Jan 2;176(1):33-5. PMID: 17200385
  4. Nobay F, Promes SB. Chapter 144. Sexually Transmitted Diseases. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011.

Author information

Jeff Riddell, MD

Jeff Riddell, MD

Chief Resident

UCSF-Fresno Emergency Medicine Residency

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Essential Non-Blog FOAM Resources for the ED Practitioner

Keyboard FOAM resourceIn 2008 I joined the University of Maryland Emergency Medicine team after completing a one-year pharmacy practice residency and a two-year clinical toxicology fellowship. In my 6 years working in the ED, I’ve come across a few online FOAM resources (Free Open Access Meducation) that are essential to my practice. Inspired by ALiEM’s new How I Work Smarter series, I wanted to share these free tools in the hope that they may help you work smarter too, regardless of what your role is in the emergency management of patients.

Calculations

  • GlobalRPh: Includes opioid conversions, corticosteroid equivalents, and phenytoin dosing
  • MDCalc: Medical Calculators, Equations, Algorithms, and Scores. Developed by Dr. Graham Walker (@grahamwalker).

Medication Administration

Patient Counseling

Pharmacology and Medication Therapy

Guidelines, Clinical Policies, and Position Statements

Drug Shortages and Emergency Pharmacist Resources

Of course this is not a complete list, but they are the sites I use most frequently. I hope you find utility in them in your day-to-day practice. Please share any non-blog FOAM resources that you use.

Author information

Bryan Hayes, PharmD

Bryan Hayes, PharmD

ALiEM Associate Editor

Clinical Assistant Professor, University of Maryland (UM)

Clinical Pharmacy Specialist, EM and Toxicology

The post Essential Non-Blog FOAM Resources for the ED Practitioner appeared first on ALiEM.

I am Salim Rezaie, Editor in Chief of REBEL-EM: How I Work Smarter

How I Work Smarter LogoIn this new installment in the “How I Work Smarter” series, we are bringing it back home. We first started in the United States, then Australia, then the UK. Today we return back to the U.S. and feature Dr. Salim Rezaie (@Srrezaie), who is the Editor-in-Chief for REBEL-EM and REBEL Cast. The following summarizes Salim’s great tips.

  • Salim RezaieName: Salim R. Rezaie, MD
  • Location: San Antonio, TX
  • Current Job: I am currently a faculty physician at University of Texas Health Science Center at San Antonio (UTHSCSA) where I divide my time between the specialties of Internal Medicine and Emergency Medicine (25% and 75% respectively)
  • One Word That Best Describes How you Work: Sedulous
  • Current Mobile Device: iPhone 5S
  • Current Computer: Macbook Pro 13 inch

What’s your office workspace setup like?

I actually have an office in the hospital and a workstation at home. I get most of my productive stuff done at my workstation at home.

Home Work Station

What’s your best timesaving tip in the office or home?

Setting up one calendar with color coating and reminders.  Since I have a Mac, I use iCal and have synced all my emails and other calendars onto one. I have my calendar divided into administrative work, clinical work, vacation, birthday reminders, and personal life. When all are overlaid on each other my calendar is crazy, but I can remove different folders to help compartmentalize my life more efficiently.  I frequently set reminders for myself to remind me of different events.

Calendar Screen Shot

What’s your best timesaving tip regarding email management?

In-Box Zero. Essentially I have two solutions for this. The first is I have created sub-folders for important emails I need to store with important information that I can reference back to. The second is, I answer urgent emails rather quickly throughout the week, delete spam immediately, but I set two days a week, where I will answer the rest of my emails and get my email inbox down to zero. This has saved me a ridiculous amount of time.

What’s your best timesaving tip in the ED?

Documenting as I am interviewing the patient or talking with a resident/medical student. I find that charting at the time of interview or resident/student presentation allows for better documentation, and lets me focus more on medical decision-making. Also allows me to leave shifts on time, instead of documenting hours after my shift.

ED Charting: Macros or no macros?

Both. I do not believe in using macros to chart physical exam or review of systems, but think they are helpful in medical decision making.

What’s the best advice you’ve ever received about work, life, or being efficient?

For everything that you say yes to, you have just said no to something else. Keep this in mind as you accept new projects and tasks, as the new project may take away from family life and hobbies.

Is there anything else you’d like to add that might be interesting to readers?

  1. Be the master of your time. The only way to be efficient is to make the most out of your allotted 24 hours a day. There is a direct connection between how you spend your time and your well-being.
  2. Read a lot. Read books that will make a difference to you and your life.  Currently I am reading “How Doctors Think” by Jerome Groopman.
  3. Have big dreams: “The greatest danger for most of us is not that our aim is too high and we miss it, but that it is too low and we reach it.” – Michelangelo

Who would you love for us to track down to answer these same questions?

  • Simon Carley
  • Anand Swaminathan
  • Mike Cadogan

 

Author information

Michelle Lin, MD

ALiEM Editor-in-Chief

Editorial Board Member, Annals of Emergency Medicine

UCSF Academy Endowed Chair for EM Education

UCSF Associate Professor of Emergency Medicine

San Francisco General Hospital

The post I am Salim Rezaie, Editor in Chief of REBEL-EM: How I Work Smarter appeared first on ALiEM.

Trick of the Trade: V-to-Y flap laceration repair for tension wounds

Laceration repairYou see a patient with a large V-shaped laceration under tension requiring suture repair. Resist the temptation to simply pull the edges together and close the laceration with simple interrupted or running sutures. Excessive tension on a flap edge during the healing process can compromise its blood supply. This causes ischemia to the healing tissue, which in turn makes that flap edge more likely to dehisce, necrose, and become infected.

Trick of the Trade:

Laceration repair using V-to-Y flap technique

Consider reducing the wound tension by converting the V-flap in to a Y-shaped flap using a carefully placed half-buried horizontal mattress suture (also known as a corner suture).  An extra few minutes spent planning this closure will facilitate easier immediate closure and create a better long term outcome for your patient.

Video from Dr. Brian Lin’s website (LacerationRepair.com)

 For a more detailed diagrammatic explanation of this technique, visit the full blog post at my site.


 

Want to hear more from Dr. Brian Lin?

Brian will be one of the featured speakers at the 2015 High Risk Emergency Medicine Conference in Hawaii. There he will be talking about not only Advanced Laceration Management but also Abdominal Vascular Emergencies, Burns, and Eye Emergencies!

 

Author information

Brian Lin, MD

UCSF Assistant Professor of Emergency Medicine

Kaiser Permanente Hospital, San Francisco, CA

Founder and author, LacerationRepair.com

The post Trick of the Trade: V-to-Y flap laceration repair for tension wounds appeared first on ALiEM.

The Opioid Prescription Epidemic: Annals of EM Resident Perspectives article

opioid prescription epidemic

Misuse of prescription opioids is one of the defining health problems of our generation.  The dramatic rise of opioid analgesic prescriptions in the US and Canada has been well documented, and opioids represent the most common cause of fatal prescription overdoses. On every shift, in every emergency department in the country, physicians struggle with the concerns of patients presenting with common pain complaints. Seeking to manage their patients’ symptoms in the face of dramatically rising prescription opioid misuse and fatal overdose, emergency physicians are  challenged to distinguish those who are simply seeking pain relief, those who are seeking opioid prescriptions due to addiction, and those who fit both categories. Emergency care providers are also charged with balancing the pressures of meeting clinical care and patient satisfaction goals while fulfilling our moral obligation to provide primary and secondary prevention of opioid misuse.

 

Google Hangout with the Authors

On August 12, 2014 at 9 am EST, we will be hosting a 30 minute live Google Hangout on Air with Drs. Sabrina Poon and Margaret Greenwood-Ericksen, the authors of the Annals of Emergency Medicine Resident’s Perspective paper on the how the opioid prescription epidemic. Be sure to tune in! Later this year, a summary of this blog- and Twitter-based discussion will hopefully be published back into the journal.

  • Sabrina Poon, MD (@sjpoon): resident physician, Harvard Affiliated Emergency Medicine Residency, Brigham and Women’s Hospital, Massachusetts General Hospital (Boston, MA)
  • Margaret Greenwood-Ericksen, MD MPH: resident physician, Harvard Affiliated Emergency Medicine Residency, Brigham and Women’s Hospital, Massachusetts General Hospital (Boston, MA)
  • David Juurlink, MD (@DavidJuurlink): medical toxicologist, internal medicine physician, Division of Clinical Pharmacology and Toxicology at Sunnybrook Health Sciences Centre (Toronto, ON)
  • Maryann Mazer-Amirshahi, MD: medical toxicologist, emergency medicine physician, MedStar Washington Hospital Center (Washington, DC)

Twitter Feed with #ALiEMRP

 

Annals of EM Resident Perspective Article

Poon SJ, Greenwood-Ericksen MB. The Opioid Prescription Epidemic and the Role of Emergency Medicine. Ann Emerg Med. 2014 Jul 11. pii: S0196-0644(14)00527-7. PMID:25017821. Free PDF

 

Introduction

In the June issue of Annals of Emergency Medicine, Drs. Poon and Greenwood-Ericksen published a Resident’s Perspective around this issue entitled “The Opioid Prescription Epidemic and the Role of Emergency Medicine.” The paper reviews the scope of the issue and describes the quandaries faced by ED physicians attempting to balance high-quality care with safe, appropriate care–resulting in high variability in ED prescribing practices. It also discusses some of the solutions that have been proposed to stem the tide of the epidemic, including prescription drug monitoring programs, prescribing guidelines, and physician education.

Testament to the urgency and difficulty of these tasks are the number of blogs on this issue over the past year.

 

FOAM Discussion to Date

A comprehensive review of FOAM resources produced during the last year was conducted using the FOAMSearch platform and targeted Google searches. Since 2013, 10 blog posts and 1 podcast concerning opioid prescribing trends in the emergency department have been published as the FOAM discussion of this issue continues to evolve. For some background on the paper discussion, review any of the resources listed in the table below.

Website
Title
Author
Type
Country
Date
EM Tutorials Oxy morons. Avoid prescribing oxycodoneChris CresswellPodcastNew Zealand7/22/14
The Poison ReviewCounties in California sue manufacturers of opioid analgesicsLeon GussowBlogUSA5/24/14
Emergency Medicine Literature of NoteYour Patients Will Abuse OpiatesRyan RadeckiBlogUSA5/19/14
Emergency Physicians MonthlyOpioids: Misuse and AbuseRyan RadeckiBlogUSA5/6/14
The Poison ReviewED discharge prescriptions for opioid analgesics increased 49% from 2005 to 2010Leon GussowBlogUSA3/25/14
Emergency Medicine Literature of NoteNonsensical Opiate Overuse in Adolescent HeadacheRyan RadeckiBlogUSA3/2/14
The Skeptics Guide to Emergency MedicineDrugs in My Pocket (Opioids in the Emergency Department)Ken MilnePodcastCanada11/28/13
The Poison ReviewGuidelines for Opioid Prescription: do emergency physicians need support?Leon GussowBlogUSA4/9/13
The Poison ReviewNYC Recommendations for Prescribing Opioids in Emergency DepartmentsLeon GussowBlogUSA3/8/13
Emergency Medicine PharmDOpioid related deathsCraig Cocchio BlogUSA3/4/13
Emergency Physicians MonthlyNYC Limits ED Opioid PrescriptionsKevin Klauer and Rick BukataBlogUSA2/8/13
NJEmergencyDocsIn the ER: Too Much or Too Little Pain Medication?David AdinaroBlogUSA10/1/13

 

magnify_question_mark_400_clr_4858

Featured Discussion Questions

The ALiEM team poses the following questions to explore current practices with MMI, and perceptions about the benefits and drawbacks of this interview format. If you have additional questions, feel free to pose them!

  1. The authors cite the Joint Commission’s pain control mandate (i.e., “pain is the fifth vital sign”) and the emphasis on patient satisfaction scores as critical factors in the increase in opioid prescribing over the last decade. To what extent do these factors influence your use of opioid pain medications, both during the ED visit and upon discharge?
  2. The authors discussed potential barriers to prescription monitoring programs (PMPs). In your practice, are PMPs assisting in appropriate and safe opioid prescribing practices? If not, why? If so, how?
  3. Only three states have adopted formal guidelines for opioid prescribing from the ED. Do you think these are/will be helpful? Why do you think they have not been adopted more widely?
  4. The authors propose a resident curriculum for opioid prescribing in the ED, including lectures, journal club, case-based learning, and simulation. What have been your experiences with formal instruction around opioid prescribing? What do you think are the most effective ways to shape physician behavior around this issue?

 

Please participate in the discussion by answering either on the ALiEM blog comments below or by tweeting us using the hashtag #ALiEMRP. Please denote the question you are responding to by starting your reply with Q1, Q2, Q3, or Q4.

 

 

Best Blog and Tweet

NEW! Contest for Best Blog Comment and Tweet

Thanks to Dr. Henry Woo and his colleagues in the Twitter-based International Urology Journal Club series (#urojc) hosted by @IUroJC, we are also implementing a contest for the Best Blog Quote and Best Tweet. What, emergency physicians – competitive? No… The winners will be announced in our Annals of EM publication curating this discussion.

 

Additional Reading / References

  1. Juurlink DN, Dhalla IA, Nelson LS. Improving opioid prescribing: the New York City recommendations. JAMA [Internet]. 2013 Mar 6 [cited 2014 Jul 28];309(9):879–80. Pubmed
  2. Kahan M, Gomes T, Juurlink DN, Manno M, Wilson L, Mailis-Gagnon A, et al. Effect of a course-based intervention and effect of medical regulation on physicians’ opioid prescribing. Can Fam Physician [Internet]. 2013 May [cited 2014 Jul 28];59(5):e231–9. PMC
  3. Mazer-Amirshahi M, Mullins PM, Rasooly IR, van den Anker J, Pines JM. Trends in prescription opioid use in pediatric emergency department patients. Pediatr Emerg Care [Internet]. 2014 Apr [cited 2014 Jul 28];30(4):230–5. Pubmed
  4. Mazer-Amirshahi M, Mullins PM, Rasooly I, van den Anker J, Pines JM. Rising Opioid Prescribing in Adult U.S. Emergency Department Visits: 2001-2010. Acad Emerg Med [Internet]. 2014 Mar [cited 2014 Mar 27];21(3):236–43. Pubmed
  5. Rosenau AM. Guidelines for opioid prescription: the devil is in the details. Ann Intern Med [Internet]. American College of Physicians; 2013 Jun 4 [cited 2014 Jul 28];158(11):843–4. Abstract

This blog post was co-authored by Scott Kobner (@skobner), New York University medical student and ALiEM-EMRA fellow, and Kevin Scott, MD (@K_ScottMD), University of Pennsylvania, Assistant Professor of Emergency Medicine.

Disclaimer: We reserve the right to use any and all tweets to #ALiEMRP and comments below in a commentary piece for an Annals of Emergency Medicine publication as a curated conclusion piece for this Resident’s Perspective publication. Your comments will be attributed, and we thank you in advance for your contributions.

 

Author information

Esther Choo, MD MPH

Esther Choo, MD MPH

Assistant Professor of Emergency Medicine

Assistant Professor of Health Services, Policy and Practice

Warren Alpert Medical School of Brown University

The post The Opioid Prescription Epidemic: Annals of EM Resident Perspectives article appeared first on ALiEM.