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Experiences in Emergency

As a young boy, bridges always fascinated me. To a child, a bridge is an adventure. It is a path to an unknown destination. As we grow up we realize that bridges represent more than an unknown horizon. They are an engineering feat of mankind combining our ingenuity with our need to connect with one another. In fact, children, bridges, and physicians all have something in common. They all rely on interconnectivity in order to learn and grow from one another. As I reflect upon the emergency medicine fellowship, I realize it is my bridge. It will enhance my career by connecting a diversity of experiences.  Like a bridge, I intend to use this fellowship to enhance the network of clinical skills ultimately strengthening my foundation.

I chose a residency in family medicine because of the relationships that you cultivate, and the continuity of care, which I value.  There is no other specialty that considers the physical illness, the emotional consequences and the support network more than family medicine. I now wish to enhance this residency by combining my love of clinical medicine in the office with treating the acutely ill in an emergency room. My love of emergency medicine stems from the unknown. Not knowing who is going to walk through the door is an intellectually exciting aspect of the emergency room. In one patient visit a clinician must be able to perform a lumbar puncture and run a code, or reduce a fracture and counsel on emergency contraception. It is this bridging of clinical skills that makes the emergency medicine fellowship an exciting prospect

My emergency rotations in residency have taught me that emergency medicine is more than just treating the acutely ill. Emergency physicians are often the first-line health care professional that many Canadians solely rely. Due to the shortages of family practitioners, emergency room physicians must take on many of the roles of the family physician. Linking patients to community resources, preventative health counseling, knowledge translation, and patient advocacy are incumbent upon family physicians and emergency physicians alike. It was working in the ER as a resident where I appreciated how important it is to establish trust with your patients quickly, preform more concise focused history and physicals, all while managing acute cases and patient flow. Throughout my rotation, I was challenged by the complexity of treating acutely ill patients.  As I began to develop a systematic approach of hypothesis generation and clinical investigation, I was eager to call upon the clinical, diagnostic and interpersonal skills I have acquired throughout my training.  I felt privileged to be responsible for the complete care of another individual, and to act as his or her advocate to the health care team.  It was this co-operative approach to the evolving challenges of Emergency Medicine that nurtured and solidified my passion for this fellowship.   Moreover, the fellowship emphasizes self-directed, life-long learning and a clinical approach built around social accountability and a strong therapeutic alliance. This perspective is one that parallels my personal values and has solidified my decision to become both a family and emergency room physician.

Emergency Medicine will enable me to pursue a career linking the interpersonal aspects of family medicine with the clinical acumen and excitement of acute medicine. All of my understakings, whether academic or extracurricular serve to further hone the intergration of these two seemingly dichotomous facets of medicine. Recently, in residency, I have undertaken a research project examining at the prescribing patterns of Family Physicians for Elastic Compression Stockings (ECS) in Post-Deep Vein Thrombosis (DVT). The aim of this study is to investigate the perceptions and practices of patients with DVT and their physicians within the scope of academic centres in the Toronto area. Interestingly, there is substantial evidence endorsing the high efficacy of ECS for the prevention of post thrombotic syndrome after asymptomatic DVT. And yet, despite Grade 1A evidence ECS are not prescribed universally by primary care providers. There is a clear disconnect between these research findings and clinical practice. This puzzling finding initially attracted me to the project. I thrive in environments where I must problem solve, integrate knowledge, and bridge gaps. The emergency fellowship will only enhance my training so I can better connect the principles of acute emergency medicine with the preventative care aspects of family medicine. Bridging these gaps is tremendously satisfying because they echo the two fields of medicine that I enjoy most. .

My teaching experience and academic pursuits also support my professional goals.  As a resident, I taught clinical skills to first year medical students the “The Arts and Science of Clinical Medicine”.  In clerkship, I helped publish a course compendium guide, providing first-year medical students with a clinical context to the basic science taught in the first-year curriculum.  In my last year of medical school, I served as an editor for the Infectious Disease chapter of “Toronto Notes”.  I found it gratifying being able to contribute to student education in this MCCQE review text.

My professional goals are not strictly academic.  For me, it is equally important to bring warmth and empathy to every interaction.  As a physician l bring my energy, passion for research, love of teaching, and interpersonal skills to the program.  Having been a patient myself, I strive to always consider the social and psychological backdrop that may factor in to a patient’s diagnosis and management.  My family physician treats everyone with compassion, dignity, care, and a genuine interest.  I look forward to the opportunity to contribute to medicine fellowship in a manner that matches his intellectual vigor and integrity so I too can leave a mark and affect patients the way my physician affected me

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