Navigating the Shift: Best Online Resources to Smoothly Transition from Didactics to Clinicals in Emergency Medicine

Katie Tucker, OMS-III
Oklahoma State University COM at Cherokee Nation
EMRA MSC Web/Tech Coordinator

You’ve dreamed of this day for years. You remember thinking about what it would be like to wear scrubs and see patients back when you were studying chemistry in the library in undergrad. Little did you know that after all of those hours of studying and years of school, you’d still feel completely clueless as you take on those first few months of clinicals. Don’t worry - this is totally normal! You’ve put in the work, now it’s time to take the next step.

Something you learn very quickly in clinicals is that you aren’t expected to know everything… you just need to know where to find the information you need. Here is a list of some of the most high yield resources to have on your phone or computer as you make this transition into the next phase of your career.

Podcasts:

EM Basic

• Where to find it: spotify, apple music, amazon music, embasic.org
  • EM Basic totes itself as the “boot camp guide to emergency medicine.” This podcast is geared toward medical students and residents, which makes digesting the information presented in these episodes a little easier as a third year student coming straight from didactic years. Each episode starts with a common patient presentation, and the next 30 minutes of the episode are spent working through the case. This is helpful to those of us just starting to learn how to think like a clinician. It helps to bring topics from the pathophysiology we were tested on during the first two years to the diagnostics and treatment that we will continue building on in our last two years.
  • Some examples of topics covered in these 30 minute episodes:
    • Pediatric sepsis
    • Sore throat
    • Hypothermia
    • Salicylate toxicity
    • Seizures
    • Many more
  • This is a quick and easy listen that is perfect for commutes to and from shifts to get a cursory overview of really basic “bread and butter” topics.

EMRA*cast

• Where to find: spotify, apple music, amazon music, audible, emra.org/about-emra/publications/emra-cast
  • EMRA*cast is a free podcast that is mostly tailored to EM residents, but many of the episodes are helpful to medical students as well. From specialty specific episodes (like pediatric EM or critical care) to episodes on how to write your CV, this podcast will undoubtedly be a great one to have in your arsenal as you continue through your clinical years into residency.

Apps:

MDCalc

• Do you remember how to calculate an anion gap or how to correct calcium for albumin? Yeah, neither do I. Fortunately, when you’re on shift, you don’t have to remember HOW to do it, you just need to get it done. MDCalc is the app you need to have downloaded before you start your shifts because it makes quick calculations like this virtually effortless.
• Some of the most frequently utilized calculations to have favorited are:
  • Creatinine clearance
  • GFR estimates
  • MAP
  • BMI
  • Corrected QT (QTc)
  • Ideal and adjusted body weight
  • NIHSS
  • HEART score
•  A lot of these calculations will be handy to have in your presentation to your attendings and in your documentation. You will look like a rockstar if you take this extra step!
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UpToDate

• You’ve surely heard about UpToDate, but I am here to tell you that it really is an essential to keep in your toolbox. I can’t tell you how many times I’ve been faced with something I either didn’t know or didn’t remember on shift that was critical to the management of the case at hand. UpToDate is the most comprehensive and current encyclopedia of all things medicine!
• This is one of the best tools to help bridge the gaps between didactic and clinical knowledge. Each search result will help refresh your memory on pathophysiology and pharmacology. It will also help guide any kind of clinical decision making based on the latest evidence based research.
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Epocrates

• If you haven’t yet had a patient with a med list a mile long, you will. Epocrates is an incredible resource when it comes to checking drug interactions and clinical guidelines.
• Some of the most useful features are the Bugs + Drugs (which help aid in identifying superbugs in your community and what you can treat them with) and the medical calculators (making dosing a breeze).
• Not only do you have access to the most comprehensive and up to date pharmacology resource at your fingertips, but there are also highly relevant and interesting articles published daily to keep your medical knowledge sharp.
• Another feature of Epocrates is their Pill ID. You will inevitably have a patient tell you they take “the inhaler with the red button on top” and you will have to interpret what this means to your attending.
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Websites:

WikEM

• https://wikem.org/wiki/Main_Page
  • WikEM is a unique database of medical information because physicians from across the globe are able to edit and contribute. Borrowing from the Wikipedia concept, you can find just about any topic on WikEM in an easy to read format that will serve as a quick reference in a pinch.

ECG Weekly

• https://ecgweekly.com/
  • ECG Weekly was created for honing electrocardiogram interpretation skills. Sure, we learned about electrophysiology and the science of ECGs in our didactic years, but it takes lots and lots of practice learning how to interpret real life ECGs.
  • Subscribing to ECG weekly is roughly $20 annually and each case takes about 10-15 minutes to work through. Add these cases into your weekly study schedule and you’ll feel confident in your ECG interpretations in no time.

EM:RAP/CorePendium

• - https://www.emrap.org/
  • You can sign up for a “trial account” that gives you free access to new content each month. The free account gives you access to a good variety of podcasts, textbook chapters, and even live online events where Emergency Medicine physicians and residents from across the country come together once a month for grand rounds to discuss some of the most interesting and unique cases from that month.
  • For example, last month in the January 2024 episode, there was a segment of the podcast that was available for free about wide complex tachycardia. This episode talks about how to distinguish v-tach from other kinds of tachydysrhythmias. In addition to the free episode, you also have access to the CorePendium (EM:RAPs incredibly comprehensive online textbook) chapter on tachydysrhythmias. Each chapter gives a quick rapid topic overview with key concepts, pearls and pitfalls, diagnosis, treatment, and disposition.

The transition from didactics to clinicals can feel extremely overwhelming, and it’s okay to not know everything! It’s important to find resources that work for you and help boost your confidence on shift. After all, we have chosen a field in which we will need to constantly learn and grow. Get comfortable with utilizing the incredible resources available to you!