Oh, the places you'll go! A qualitative study of resident career decisions in emergency medicine.

Objectives: Postresidency career choices are complex decisions that involve personal, professional, and financial preferences and may be influenced by training programs. It is unknown how residents navigate these decisions during emergency medicine (EM) residency. We explored EM residents' perspectives on career decision making and how residency programs can support career planning.

"Not just a checkbox": A qualitative study of the resident scholarly experience.

Objectives: Scholarship is a requirement of residency training; however, the scholarly productivity of trainees is highly variable. The purpose of this study was to explore the perspectives of residents who have been highly productive in scholarship.

Methods: We performed a qualitative study using a constructivist-interpretivist paradigm and conducted semistructured interviews at seven Accreditation Council for Graduate Medical Education-accredited emergency medicine residency programs in the United States.

Are patients with polycystic ovary syndrome more prone to irritable bowel syndrome?

Background: Polycystic ovary syndrome (PCOS) encompasses endocrine, reproductive and metabolic disturbances. Abdominal pain and bowel movement disturbances are common complaints of PCOS patients. It remains uncertain whether the characteristic features of PCOS are associated with an increased incidence of irritable bowel syndrome (IBS).

Lipid ratios and obesity indices are effective predictors of metabolic syndrome in women with polycystic ovary syndrome.

Background: Insulin resistance (IR) is common in women with polycystic ovary syndrome (PCOS). Metabolic syndrome (MS) involves IR, arterial hypertension, dyslipidemia, and visceral fat accumulation. Therefore, fatness indices and blood lipid ratios can be considered as screening markers for MS.

Academic springboard: The chief resident position correlates with career path in emergency medicine.

Background: The chief resident role often includes additional administrative and educational experiences beyond those of nonchief senior residents. It is unclear to what extent these experiences influence the postresidency career path of those selected as chief residents. The objective of this study was to evaluate the association of chief resident status on immediate postresidency career characteristics relative to nonchief residents in emergency medicine (EM).

Cardiovascular, anthropometric, metabolic and hormonal profiling of normotensive women with polycystic ovary syndrome with and without biochemical hyperandrogenism.

Purpose: Women with polycystic ovary syndrome (PCOS) present with or without biochemical hyperandrogenism (HAPCOS or non-HAPCOS, respectively). Cardiometabolic and hormonal abnormalities have been reported in women with PCOS, particularly those with hypertension. However, no direct comparison between normotensive (blood pressure <140/90 mmHg) patients with HAPCOS and non-HAPCOS has been made.

Emergency Medicine Residents Experience Acute Stress While Working in the Emergency Department.

Introduction: Acute stress may impair cognitive performance and multitasking, both vital in the practice of emergency medicine (EM). Previous research has demonstrated that board-certified emergency physicians experience physiologic stress while working clinically. We sought to determine whether EM residents have a similar stress response, and hypothesized that residents experience acute stress while working clinically.

Effect of Central Obesity and Hyperandrogenism on Selected Inflammatory Markers in Patients with PCOS: A WHtR-Matched Case-Control Study.

White blood cell counts (WBC), lymphocyte-to-monocyte ratio (LMR), and monocyte-to-high-density lipoprotein cholesterol ratio (MHR) are used as chronic inflammation markers. Polycystic ovary syndrome (PCOS) is a constellation of systemic inflammation linked to central obesity (CO), hyperandrogenism, insulin resistance, and metabolic syndrome. The waist-to-height ratio (WHtR) constitutes a highest-concordance anthropometric CO measure.

Establishing an Elective Rotation Director and Its Effect on Elective Opportunities and Satisfaction.

Elective rotations are valuable, allowing trainees to personalize their educational experience, focus on areas of weakness, and offer personal and professional development. Emergency medicine (EM) residency program elective rotations may be limited due to the absence of awareness of opportunities and administrative support. We sought to increase the breadth of elective rotation opportunities, improve residents' satisfaction with their elective rotations, and enhance the opportunities for clinical training.

An Evaluation of the Utility of an Orthopaedic Surgery Rotation for Emergency Medicine Residents.

Objectives: In collaboration with the Department of Emergency Medicine, we designed a hands-on orthopaedic rotation for emergency residents in their first postgraduate year (PGY1) to introduce them to the appropriate evaluation and management of common orthopaedic injuries and conditions. Our hypothesis was that after the rotation, emergency medicine residents would be more comfortable with the evaluation and management of these injuries and conditions.

Methods: We designed a survey for the emergency medicine residents to query the pre- and post-rotation level of comfort in the management of some of the most commonly encountered orthopaedic injuries and conditions that present to the emergency department.

Obstetric training in Emergency Medicine: a needs assessment.

Background: Identification and management of obstetric emergencies is essential in emergency medicine (EM), but exposure to pregnant patients during EM residency training is frequently limited. To date, there is little data describing effective ways to teach residents this material. Current guidelines require completion of 2 weeks of obstetrics or 10 vaginal deliveries, but it is unclear whether this instills competency.

Gastric Perforation Following Nasogastric Intubation in an Elderly Male.

In order to provide appropriate and timely treatment for an acute gastrointestinal bleed, it is vital to determine the site of hemorrhage. Historical clues and exam may be insufficient to differentiate upper from lower gastrointestinal bleeds and clinicians may utilize nasogastric lavage for diagnostic clarity. Nasogastric tube placement is a common procedure in the Emergency Department and is often viewed as benign.

Delayed Diagnosis of Subdural Empyema in a Septic Child.

The prompt identification of sepsis in children is challenging, but once sepsis is identified, initiation of care and determination of proper disposition may be insufficient to ensure optimal outcomes. The best opportunity for full recovery also requires rapid identification and treatment of the infectious source. Acute bacterial sinusitis is common in the pediatric population, and although intracranial complications of sinusitis are rare, they are associated with significant morbidity and mortality.

Preventing iatrogenic overdose: a review of in-emergency department opioid-related adverse drug events and medication errors.

Study Objective: We describe characteristics of patients with in-emergency department (ED) opioid-related adverse drug events, medication errors, and harm resulting from medication errors; identify patient-, provider-, and system-based factors associated with in-ED opioid-related medication errors and harm; and create a list of strategies to prevent future events.

Methods: This retrospective study was conducted at 2 urban academic EDs. Potential iatrogenic opioid overdoses were identified by querying the ED electronic medical record for cases when naloxone was administered after an opioid was administered in the ED.

Monitoring universal protocol compliance through real-time clandestine observation by medical students results in performance improvement.

Objective: To measure universal protocol compliance through real-time, clandestine observation by medical students compared with chart audit reviews, and to enable medical students the opportunity to become conscious of the importance of medical errors and safety initiatives.

Design: With endorsement from Tufts Medical Center's (TMC's) Chief Medical Officer and Surgeon-in-Chief, 8 medical students performed clandestine observation audits of 98 cases from April to August 2009. A compliance checklist was based on TMC's presurgical checklist.