Rural EM rotation - thoughts?

[TeddyRucpin]

Good afternoon all. Preparing for the future, I am definitely interested in EM, completing a residency/fellowship, and practicing in a smaller hospital and in particular, a rural area. I am a paramedic in both 911/CC transport roles, which I am sure will be helpful for rotations. I'm trying to set myself up for success by maintaining my paramedic credentials throughout PA school (and beyond) and completing alphabet courses that would be useful, such as ATLS. 

Looking ahead, my PA program offers an EM rotation in a big city at a Level 1 trauma center, along with the good and bad that come with that (lots of students/residents looking to obtain procedures, for example). I should be able to use an elective in EM at a rural location in the US as well. I am curious of how your experiences were, as a student, in these types of hospitals. Were you able to do more due to the lack of competition from other MD/DO/PA students and residents? Would you recommend an opportunity such as this? 

Thanks!

[Apollo1]

Depends on the timing of your rotation and is preceptor-specific. You can't control what patients come through the door, so a rural rotation might have the opposite effect.

[dphy83]

Volunteer to do nights at the big level 1 center. Try to find another local medium size community hospital for an elective. You may find less competition there but not necessarily miss out on volume. If your elective is your last rotation maybe consider setting it up at a place that is currently hiring as that may get you a foot in the door.

I did an elective at a rural ED. I was often bored. I did get some procedures, and there were no other students/learners there as competition for anything. But the volume just wasn't there for substantial hands-on learning. I did, however, score a letter of recommendation from one of the docs so it wasn't a complete waste of time.

[ohiovolffemtp]

Your best bet for EM PA school rotations would be in busy community hospitals where there are no residents, especially if they are also trauma centers, e.g. level III.  You'll have the volume and the acuity but still have a good chance to be hands on with the higher acuity patients.

[EMEDPA]

I precept everywhere I work, both at  rural and community facilities. The sweet spot seems to be departments of 15-20 beds. You see and do a lot as there are no students, but the volume is reasonable as well. At my rural jobs, some students have great experiences with multiple codes, airway disasters, procedures, etc, while some do very few procedures or see very few critical pts. It just depends on the month. My last student got to participate in both adult and peds codes, but the one before that basically did an urgent care rotation with a few chest pains and chf pts thrown in.