This clerkship is designed to provide students with a rigorous patient care experience in the emergency department and the intensive care unit. Students will receive an overview of the fundamental principles and concepts of emergency medicine, focusing on common presenting complaints and procedures in undifferentiated patients. Additionally, students will observe how treatment in the emergency department influences the patient’s subsequent hospitalization. Critical care concepts such as ventilation management, hemodynamic monitoring, pressor management, and critical care pharmacology will be discussed. When not working clinically (14 shifts), students will be required to attend at least two of the emergency department’s teaching conferences, complete reading assignments and online didactics, and finish Aquifer cases. 

Attendance is required for the first day’s orientation, sim lab, splinting lab and ultrasound lab. Students are required to login for mid-clerkship evaluation and the final exam (on the final Friday of the rotation). The shift schedule during the rest of the month is flexible and will be developed by the course coordinator at least two weeks before the rotation begins. Please contact the course coordinator with any requests outside the mandatory dates at least two weeks before your rotation begins. 

See the Emergency Medicine Clerkship Curriculum: An Update and Revision. Published in 2010 by the Society for Academic Emergency Medicine.

During this course students will: 

• CO-1      Experience EM medicine from the perspective of critical care management to patient resuscitation to staffing critically ill patients with residents and faculty.
• CO-2      Experience the complexities and challenges faced in the ICU.
• CO-3       Develop the skills to evaluate an undifferentiated patient.
• CO-4      Interpret the results of common diagnostic procedures and tests.
• CO-5      Communicate and work effectively in a multidisciplinary treatment team.
• CO-6      Describe the legal and ethical issues pertinent to the care of patients in both emergency medicine and ICU settings.
• CO-7      Develop skills to safeguard patients, self and health care team.
• CO-8      Conduct oneself professionally as a physician.

This course will consist of laboratory and didactic sessions, self-directed online learning modules, emergency department and intensive care unit shifts, Aquifer cases and a final written exam.

Start dates for AY 25-26:

•    5/12/2025 – 6/6/2025
•    6/9/2025 – 7/4/2025 
•    7/7/2025 – 8/1/2025 
•    8/4/2025 – 8/29/2025 
•    9/1/2025 – 9/26/2025 
•    9/29/2025 – 10/24/2025 
•    10/27/2025 – 11/21/2025 
•    11/24/2025 – 12/19/2025
•    1/5/2026 – 1/30/2026
•    2/2/2026 – 2/27/2026  
•    3/30/2026 – 4/24/2026 

Days and times are subject to change.

Year: Fourth-Year Only
Contact Email: srmartynaseaman@arizona.edu 
Contact Phone: 520-621-5300

Goals and Objectives

This elective course provides the opportunity to develop and conduct a research project in Emergency Medicine. Please contact the coordinator for further details

Format

The research project will be arranged by the student and the instructor.

Course Requirements

Checklist to complete prior to registering for this elective: links and PDFs need to be updated

1. Complete HIPAA training online
2. Complete CITI training online
3. Decide the area of research that you want to be involved in and write it down.
4. Make a list of the type of research involvement you would like to have: Human/Clinical, Gopher, Publishing, Clinical Study, etc.
5. Look at articles published by emergency medicine faculty to see what areas they are doing research in. You can also search by name to see publications on the web. Contact the faculty member directly to inquire about possible projects you may get involved in. It is very likely that each has great projects in a drawer just waiting for someone with your interest to help!
6. Contact Dr. Mosier to set up a meeting after you have completed 1-5. The address where your meeting will take place is 1501 N. Campbell Ave., AHSL 4169A. It is just fine to have met with the faculty member you would like to work with prior to or after this meeting.
7. Complete the Selection form with the faculty member you have chosen to conduct research with.
8. Email the completed Selection form with faculty signature to Sonya Martyna-Seaman. Student will also need to provide this form to the COM-T Registrar Office to be registered for credit. Sonya Martyna-Seaman will be responsible for posting your grade at the completion of the research project.

Year: Fourth-Year Only Course 
Offered: All year-round
Director: Christopher G. Williams, MD 
Contact Phone: 520-621-5300

Goals and Objectives

This elective is designed to provide students with an intensive patient care experience, serving in an intern-like capacity in the emergency department. Students will become more familiar with common emergent problems and develop further practice habits for approaching more complex medical and surgical emergencies. Sub-interns will function like an intern but remain under resident or attending supervision and guidance. Thus, they will provide care for assigned patients in the emergency department, perform history and physical examinations, create an assessment and management plan, write orders (under direct supervision of a resident and attending), and determine the proper disposition of the patient. Sub-interns will attend and participate in EM residency conferences as well. When not working clinically, students will be expected to study emergency medicine resources in preparation for the SAEM exam at the end of the rotation. 

Course prerequisite: EMD 845 - Integrated Emergency Medicine & Critical Care (EM-CC) Clerkship Rotation or equivalent. 

Educational Objectives

This elective is designed to provide students with an intensive patient care experience, serving in an intern-like capacity in the emergency department. During this course students will:  

• Become familiar with common emergent problems.  
• Hone bedside history and physical examination skills.
• Participate in the resuscitation of sick medical and trauma patients in the ED.
• Be directly involved in patient care in the ED. The student will act like the patient’s primary provider, performing appropriate procedures, documenting the patient’s ED course in Cerner, and discussing the patient with physicians and consultants from other services. (They will be supervised throughout.)  

Course Requirements

AREM Curriculum: The original CDEM curriculum was crafted with an audience for M4 students. It was designed to capture the most common conditions a fourth-year student would encounter while rotating in the emergency department (ED). Manthey DE, Ander DS, Gordon DC, et al. Emergency Medicine Clerkship Curriculum: An Update and Revision. Acad Emerg Med. 2010;17(6):638-643. 

14 END of Clinical Shifts

Qualtrics Survey/Assessment submittals: Students will need to collect 14 END of Clinical Shifts Survey/Assessment from EACH assigned shift. Failure to collect will result in a 7% deduction from the overall grade.

Types of shifts will include:

• 1 Pharmacology shift
• 1 Ultrasound shift
• 2 Faculty shifts
• 5 Resus shifts
• 5 Resident shifts

Faculty and/or departmental residents/fellows will evaluate the student’s clinical performance by assessing: 

• Medical knowledge: Exhibits appropriate knowledge and understanding of basic pathophysiological processes; demonstrates critical thinking and clinical decision making.
• Patient Care: Conducts accurate history and physical exams; demonstrates competence in performing exam procedures.
• Practice-Based Learning: Shows progressive improvement throughout rotation; learning from mistakes.
• Interpersonal & Communication Skills: Presents concise, accurate and pertinent information; provides patient/faculty/resident with clear instructions appropriate to their educational level.
• Systems-Based Practice: Demonstrates knowledge of broader health care resources available in the community; completes patient encounters in a timely manner.
• Professionalism: Demonstrates punctuality, accountability & honesty; arrives well-prepared, actively seeks responsibility beyond the scope of expectation. 

Aquifer Cases: Complete cases when not on shift.  

SAEM Final Exam: Last day of rotation. 

Rotation Schedule

Year: Fourth-Year Only Course 
Director: Nicholas B. Hurst, MD, MS 
Contact Phone: 520-626-6016

Goals and Objectives

Format

Rotation Schedule

Year: Fourth-Year Only Course 
Offered: April 14, 2025 to April 25, 2025
Prerequisites: None
Director: Christopher G. Williams 
Contact Phone: 520-621-5300
Contact Email: srmartynaseaman@arizona.edu

Goals and Objectives

Students will learn to plan, organize, triage, diagnose and treat patients in austere or impromptu environments.

Format

Didactic lectures will be in the classroom, and practical sessions will be held in the wilderness. The didactics will be Monday through Friday the first week and Monday through Thursday the second week. Class will typically be in the morning. Throughout the course, students will be broken into smaller groups to encounter scenarios wherein they take charge, assign roles and apply learned skills. The final practical session will occur near Molino Basin Campground, about an hour from Tucson. This practical session will involve breaking into smaller groups, coming upon scenarios where the students will have to take charge, assign roles, and apply the skills they have learned. (Volunteers in moulage will man the scenarios.) A faculty member or lecturer will observe/evaluate each group.
 
Please note there is an optional — but highly recommended — camp out the night before the final practical session. (Details will be in the final schedule.) The purpose of the camp out is to enjoy one another’s company, get away from the city and revel in nature. It’s not a bad way to finish up med school! If you have camping equipment, great, but if not, we will crowd-source and make sure everyone has what they need. Please don’t feel like you have to go buy things for camping.

Course Requirements

REQUIRED Course book:

• (NEW) WLS:MP Wilderness Life Support for Medical Professionals. Della-Giustina, David. Self-published, 2023. (Available for purchase on Amazon.)

Assignments consist of:

• Read required texts
• Participate in discussions and hands-on, practical scenarios
• Take a written final test
• Participate in final practical scenarios

REQUIRED Special tools or supplies needed: Students will also need to develop their own medical kit.

* During the course, there will be a lecture on medical kits. Before this lecture, students must develop and bring a personal medical kit. This doesn’t have to be elaborate or expensive but should be realistic. (For reference see correlating chapter in your text.) For prescription medications or equipment/devices you’d like to have but can’t afford or acquire currently, just write a pretend prescription on a plain piece of paper or the name of the missing equipment on some paper and put it in there. We will go over people’s kits during/after the lecture. These kits will be used by you during our final practical scenarios. 

REQUIRED student-led discussion on medical problem in the wild: During the course everyone will have the chance to give a 5-8 minutes presentation over a “preexisting condition or other non-wilderness medical affliction” of their choice. The student will lead a discussion that addresses the presentation, differential diagnosis for the general complaint, and austere diagnosis and treatment for the specific diagnosis. This should include a summary of evacuation criteria. 

Evaluation Methods

Rotation Schedule

April 14 to April 25, 2025

Year: Fourth-Year Only Course 
Offered: Year-round (except July)
Prerequisites: EMD 845 - Emergency Medicine/Critical Care prerequisite for this course
Directors: Srikar Adhikari, MD, MS, FACEP
Josie G. Acuña, MD
Elaine Situ-LaCasse, MD
Contact Phone: 520-621-5300
Contact Email: srmartynaseaman@arizona.edu

Educational Objectives

The goal of this elective is to introduce students to the field of point-of-care emergency ultrasound. By the end of the rotation, we expect students to be proficient in the basic principles of point-of-care ultrasound. Students will be exposed to point-of-care emergency ultrasound in a variety of learning formats (e.g., lecture, podcast, online modules, hands-on) in multiple settings. During this course the students will learn the basic principles and physics of sonography. It will be a busy month, but we guarantee that by the end of it, you will be awesome at bedside ultrasound. The course materials are on D2L (https://d2l.arizona.edu/index.asp) with the course title “Emergency Ultrasound.” Become familiar with what is available here. There is a plethora of resources. 

Students will be introduced to the following basic bedside ultrasound examinations: gallbladder, aorta, cardiac, renal, endovaginal, procedural guidance including vascular access, and sonography for trauma deep venous thrombosis evaluation. 

At the completion of this course, we expect students to: 

1. Demonstrate an understanding of the basic principles and clinical role of point-of-care emergency ultrasound.
2. Recognize the indications for point-of-care emergency ultrasound.
3. Identify common pathologic findings.
4. Perform the basic bedside ultrasound examinations (as listed above).

Format

The course runs over a four-week period. Throughout this time, students will need to complete various required elements of the course. It will be up to the student to schedule and ensure completion of each element. These elements include: 

• Required attendance for orientation
• Pre-test to assess student’s knowledge of emergency ultrasound
• Completion of 14 scanning shifts with ultrasound faculty or fellows. Each shift is 9 hours long. Completion of 120 bedside ultrasound exams to be performed while on scanning shifts.
• Attendance at other ultrasound educational events occurring within the department during his or her elective time (e.g., resident orientation, conference lectures, faculty workshops, hands-on sessions for residents, ultrasound journal club, ICU ultrasound rounds).
• If interested, students are welcome to participate in ongoing research within the ultrasound division of the emergency department. This may substitute for time spent on other educational events. If this opportunity is available, this can be discussed further after the student has signed up for the rotation.
• Attend 4 QA sessions. These are session in which the ultrasound faculty review scans performed in the department and discuss cases. This occurs every Monday 8:30-11:30 a.m.
• Students are required to read chapters in the required coursebook and complete the associated quiz for each one.
• Students must pass the final proctored examination (>70% is a passing score). 

Course Requirements

Introduction PowerPoint: We have an orientation video on D2L. It gives a basic introduction to emergency ultrasound in our department and how to use the machines. You will need to review EM Ultrasound policies, Indications, Knobology, QpathE, Required Images, US probe care, and equipment. This will take about 1 hour. Please go through these prior to completion of the pre-test. There are questions from these PowerPoints on the pre-test. 

Pre-test: This is available on D2L. You need to complete it on or prior to Day 1 of the rotation. Do your best. We don’t expect you to get them all correct, but we ask that you take it until you get over 80%. You will likely learn something helpful while completing it! 

Course book: Introduction to Bedside Ultrasound, Volume 1, by Mike Mallin and Matt Dawson. This text for the rotation is an iBook. Your options for getting the book are: 

iPad iBook: Introduction to Emergency Ultrasound Vol 1 and Vol 2 is now free in the iBook store. Please try to download them prior to your first QA as they will take over an hour to download. You can bring an iPad to QA and we can help you download it if you forget. There is a pdf version on D2L. We don’t recommend that you use this version primarily as it does not have the video or interactive features (which are a large part of the book and very important for your learning). 

Required chapters:  Fast/EFast; Basic Cardiac*; Aorta; Lung*; Rush*; Renal*; Pregnancy*; Physics*; Central lines*; Fluid responsiveness*; Joint injection* 

*Quizzes on the starred chapters are on D2L and must be completed prior to the last day of the rotation. 

Rotation orientation: You will come to QA session from 8:30-11:30 a.m. on the first day of your rotation (Monday) and every Monday while you are on the rotation. This will be in the ultrasound faculty conference room. This is in Room 4150, on the 4th floor of the medical school library. Prepare for a full day on the first day. The fellows or faculty will go over machine use, QpathE and answer any questions about the rotation. After orientation, we would like for you to review a series of narrated lectures on the website: http://www.emergencyultrasoundteaching.com/index.html

Please review these lectures: Physics AEUS (click on the blue button); E-FAST AEUS; Aorta AEUS; Renal AEUS; Thoracic AEUS; Echo Part 1 AEUS; Echo Part 2 AEUS; Vascular Access - Vascular Ultrasound; Skin and Soft Tissue 

They are an excellent resource and will help you start out on the right foot with the rotation. Please expect to be busy the entire first day of the rotation.

Quality Assurance (QA) sessions: Every Monday from 8:30-11:30 a.m. we have QA sessions. *Please note that these are required sessions in addition to your scanning shifts. If you are unable to make these Monday sessions, we ask that you reschedule your rotation. Very few exceptions will be made. All the ultrasound faculty, fellows, residents on their ultrasound rotation, and students meet and go over the notable scans for the week. This in Room 4150. Be prepared to share your most exciting, most difficult or most interesting exams you had over the week. We review images and articles that are usually sent out over the weekend prior to Monday. QA sessions are required. The policy on missed shifts (see below) applies to QA sessions. 

Scanning shifts: Twelve scanning shifts will be assigned to you. You will do these shifts while faculty members and ultrasound fellows who are working clinically. The ultrasound section sets the schedule in advance for all rotators. Please contact us if you have schedule requests in advance (emus@list.arizona.edu). We will attempt to honor up to two days of requests off. You will be sent the schedule approximately 1-2 weeks before your start date. Please check that your shift schedules allow 9 hours between any shifts and no more than 6 in one week. If you have scheduling conflicts, it is your responsibility to address these in advance. You will be required to make up any missed shifts and your grade will be incomplete until scanning shifts are completed, and the minimum number of required examinations are complete. 

When working with the faculty member, your goals are the following: 

• See good pathology
• Work on getting all of the required images for every exam type
• Reach your desired number of scans 

Presentation: On your last QA day, you will present an interesting topic or mini-literature review on a particular ultrasound topic to the rest of group. This is a low-stress presentation. PowerPoint is optional. If you need help coming up with a topic, we can assign one to you. You will be evaluated by faculty based on your presentation on a general scale: Far below expectations to far above expectations. We will be looking for your topic to have 2-3 teaching points, and well-researched and presented to the group. Please ask faculty or fellows for any help you might need.

Bedside ultrasound exams: You will be required to perform 120 ultrasound exams during your scanning shifts. This will be tracked using the number of scans you have performed in QpathE. Every exam you do will be QA’d by ultrasound fellows and faculty, and you will get feedback on them. You will not get credit for exams where the worksheet was not filled out, not all required images were recorded, or if the images were inadequate.  

While on the rotation, you will do two types of exams: patient care exams and educational exams. When you show up to your shift, please check in with the faculty member you are working with, see if there are any studies they would like you to get started with, and get an ASCOM phone so that they can call you while you are there. The faculty member who you are working with will let you know if there are patient care exams that they are going to do. Do these studies first. These are studies that will be used by the attending on their patient for medical decision-making. For these studies, please go to the room and do your best to get all required images. Then call the faculty member that asked you to do the patient care exam so that they can come to the bedside and review your acquired images. The faculty member will acquire their own images and will give you pointers on your exam at that time. This is an excellent opportunity to learn one on one with the faculty.  

You can also do educational exams. If there are no patient care exams to be done, work on educational exams. You will repeat other radiology department studies that have been done. For instance, if a patient has had a RUQ ultrasound performed by radiology during their ED visit, you may do a bedside exam in order to compare your findings with theirs. Also, if a patient had a CT of the abdomen, you can do an aorta, renal and FAST exam on that patient. The attending you are working with will point you to good educational exams. These patients will likely have important pathology for you to see or good exams for you to practice, but they will be getting a confirmatory study or consult. These exams are for your education only. You are required to obtain the patient’s consent prior to doing these studies. Please explain that the study is for your education only and that they will be getting (or have already gotten) a confirmatory study. If a patient is not comfortable or does not want you to do the exam, please stop, and excuse yourself from the room. You are not required to call the faculty member to the bedside for these exams, but we recommend it so that you can get feedback on your exams. Do not perform educational exams on patients who will not have a confirmatory study.  

Other educational activities: There may be other educational opportunities offered through the ultrasound section each block. You may hear about these on Monday at the QA session or via email. These could include conference lectures, faculty workshops, hands-on sessions that we are offering for other groups, journal club, ICU ultrasound rounds or MSK ultrasound rounds at the sports medicine clinic. Five hours of other educational activities are required over the four weeks of the rotation.

Final exam: This exam will not be proctored and can be taken anytime during the last week of the rotation. A passing score is greater than 70%. Please do not use outside sources when taking this exam. We will implement the honor system here, but you should not have any issues if you have reviewed the materials above and/or below.

Other educational resources: Various resources for you to use for self-education while on the rotation: 

• http://www.ultrasoundpodcast.com DEAD LINK
• http://emergencyultrasoundteaching.com
• http://www.sonoguide.com DEAD LINK
• http://www.saem.org/narrated-lectures WRONG PAGE

Absences: If you cannot make it to a shift that you had stated you would be coming to or to a Monday morning QA session, it is your duty to alert Dr. Situ-LaCasse via email that you will not make it prior to the start time. It is also your responsibility to find another shift to replace the missed shift. Failure to properly notify faculty of an absence is grounds for failure of the rotation.  

Machine care: It is your responsibility to take good care of the machine. Watch the cords! It is also your responsibility to clean machines before and after each use. Gray-top wipe containers are attached to each machine. Use only these wipes. They must be wiped once with a wipe to remove the gel, then wiped with a second wipe and left to dry for 3 minutes.  

Sharing the machine: There are limited machines in the department. If you are using a machine and a resident or attending needs it for any reason, you must give it up. You should probably go and watch whatever they are doing because you will likely learn something. If there are other residents or fellows scanning that day, you should work with them and share the machine. 

Course evaluation: At the end of the rotation please complete the course evaluation in the quizzes section on D2L. This gives us valuable feedback about how you learned, what elements of the rotation you found helpful, and how to make it better for next year. 

Evaluation Methods

Rotation Schedule

Year: Fourth-Year Only Course 
Offered: Year-round
Prerequisites: EMD 845 - Emergency Medicine/Critical Care or equivalent is a prerequisite for this course  
Director: Christopher G. Williams, MD 

Goals and Objectives

Format

Year: Fourth-Year 
Offered: Fall
Director: Daniel Beskind, MD, MPH, FACEP 

Goals and Objectives

• To demonstrate an awareness of the importance of CPR training to individuals and to the community as a whole.
• To demonstrate commitment to teaching CPR through provision of training courses in the community.
• To demonstrate an awareness of the needs of special populations regarding CPR training, including those with learning disabilities, the elderly and other high-risk groups, and children.
• To demonstrate an awareness of common obstacles to encouraging more people to take CPR training, including the lack of access to classes, and fear of infectious disease, incompetence and litigation.
• To demonstrate an awareness of key frontiers of research currently underway in cardiac arrest and CPR.

Format

Students will participate in activities in this elective in Year 4 of their medical education. For full credit and graduation, students must complete 42 hours total of contact time with the general public, a total of two skills labs and a final exam prior to graduation. To receive credit for the two required skills labs you must complete the short quiz after the lab. Keep in mind that the CPR instructor certification is optional and that some venues require this certification to teach.

Course Requirements

• Teach CPR (AHA or Chest Compression only) You will be responsible for documenting your teaching hours on the fillable PDF form.
• Attend a minimum of two skills sessions. These sessions will be announced by REACT leadership.
• Final Exam: A Complete Critical Appraisal exercise (mock code), which will be graded by the course director (pass/fail), will be your final exam. There will be two sessions available so you have a chance to attend one or the other.
• COURSE GRADE: Grade will be P/F

Evaluation Methods

The course director will complete a qualitative evaluation of each student’s performance at the end of the course.