Thank you to the Class of 2010 for giving me the opportunity to attend ACEP’s ED Direc-tors Academy (EDDA) in Dallas, Texas. This program provided me with invaluable man-agement/operations training and professional development skills that I will utilize through-out my career.
Throughout my education and training, I have strived to maximize the impact I can have for my patients by complementing my clinical training with targeted experiences and education in leadership and operations. The ED Directors Academy was a perfect opportunity for me to build on experiences that I had prior to and during residency. The Directors Academy is a management training course that brings together leaders from across the nation to partici-pate in courses addressing a wide range of topics related to managing an emergency de-partment.
This experience allowed me to not only gain knowledge on specialized topics from experts in the field but also interact and network with innovative and inspiring leaders from across the nation. The coursework included diverse topics such as leadership, operations, emer-gency department flow, patient satisfaction, hospital quality, billing, and many others. All of these provided me with concepts that I could immediately apply to my administrative work as a resident. However, potentially even more valuable than this was the accelerated professional development I obtained by networking with other leaders and learning from their unique experiences within diverse practice environments across the emergency medi-cine landscape. I gained insight into what a career in administration entails, the conflicting and multi-faceted challenges that an administrator faces, and how to balance those respon-sibilities with maintaining clinical expertise while simultaneously preventing the burnout that many administrators experience.
My long-term career goal is to become a leader within an emergency department and hospi-tal while striving to optimize operational systems, maximize efficiency, and eliminate waste in order to provide the highest level of care for my patients. I firmly believe that quality clinical care must be supported by synergistic processes and systems that allow physicians to maximize their effectiveness and enhance the patient experience. The EDDA program was a unique experience that allowed me to continue to learn and grow as a leader in emer-gency medicine and will ultimately be instrumental to my future success.
In January of 2018, I was privileged to be able to attend the “National EMS Medical Directors Course and Practicum” at the National Association of EMS Physicians Conference in San Diego, CA. This could not have been possible without the generous support from the Spirit of 2010 Award from the Northwestern EM Class of 2010 or the Goldberg Charitable Trust Scholarship. At the course I was able to learn about the not only the fundamentals of emergency medical services (EMS) medical direction from experts in the field, but also the challenges facing the field currently and in the near future for those looking to work in prehospital medicine. The course did an excellent job covering a wide variety of topics from budgeting and finances of EMS to medicolegal case studies from recent case law involving prehospital care. Another highlight of the course was the frequent small group sessions going over challenging prehospital cases that brought a wide variety of opinions and insights from across the country. Additionally, and unexpectedly, we were privileged to work with a skills lab with fresh frozen cadavers a and were guided through lateral canthotomies, perimortem C sections, difficult airway management, and resuscitative thoracotomies. This overall course and practicum helped refine not only concrete skills but also offered much in the way of leadership and professional development. The contacts made in this time were also invaluable to pursue a career in EMS and maintain relationships in relatively small community within emergency medicine.
Sincere thanks to the Class of 2010 for their support as well as the NUEM program leadership, chief residents, and program coordinators who helped make this opportunity possible!
Hashim Q. Zaidi MD
Thanks to the exceptional generosity of the Class of 2010, I was afforded to the unique opportunity to spend an elective block working in Tuba City, AZ on the Navajo Indian Reservation. My goals in pursuing this rotation were to provide care in a rural emergency medicine department and to provide care to a community that has been systematically marginalized by government policy.
My rotation occurred from March 27th to April 19th . During the rotation I worked 12, 12-hour shifts in the Tuba City Regional Health Care Center (TCRHCC) Emergency Department, a 23 bed ED that sees approximately 47,000 patients per year. TCRHCC provides care for a catchment area of 6000 square miles and is the regional referral center for 75,000 Navajo, Hopi, Southern Piute, and the occasional tourist. The patient population is exceptionally poor, with 66% of the population living below the poverty line. Additionally 33% of patients lack indoor plumbing and 25% have dirt floors in their homes. The ER has a 5% admission rate and 20% transfer rate. The TCRHCC ED is the only ED on the Navajo Reservation that is staffed entirely by board certified emergency medicine physicians. The group of physicians pride themselves on bringing cutting edge emergency care to the people of the Navajo Nation.
The rotation is billed as rural medical elective, but it is also a cultural immersion program. Although I transferred more patients via helicopter in one shift than I have in 4 years of residency, it is the interactions with the patient population that I will cherish most. I have never worked with a more caring, friendly, and appreciative patient population. Routinely patients had bypassed outlying hospitals, driving upwards of 100 miles to receive care at TCRHCC.
In addition to a unique clinical experience, days off on the rotation provided opportunity to explore many Navajo monuments and National Parks. During my off time, I was able to visit multiple National Parks including Arches, Canyonlands, and the Grand Canyon. Additionally, I was able to visit Monument Valley, Navajo National Park designated to protect mesas from private development.
Thanks to the Class of 2010’s generous gift I was able to travel to Roatán, Honduras for my 4th year elective. I spent the month teaching local physicians the basics of Point-of-Care Ultrasound (POCUS) at Clínica Esperanza. This clinic, located on Roatán, one of the three Honduran Bay Islands, is resource-limited, with no access to XR, CT or MRI. Ultrasound (US) is the only diagnostic imaging modality available to the physicians in the clinic. Unfortunately US expertise is limited on the island and the physicians are not trained in basic POCUS.
Elizabeth Dearing MD, NUEM ’15 travelled to the clinic in 2015 to lay the ground-work for US education. However, physician turn-over at the clinic is high therefore the group that Dr. Dearing trained had already left by the time I arrived. The current physicians had minimal to no experience using US, including the physician assigned to the OB/GYN patients. An on-going US educational relationship with the clinic is key.
I taught an introductory POCUS lecture and spent 6 hours per day for 3 weeks teaching hands-on US skills at the bedside to two physicians in the clinic. Initially the physicians weren’t sure how to turn on their machines, how to correctly orient the probes or even why they would consider using an US machine. By the end of my time at the clinic, they were successfully identifying intrauterine pregnancies and IUD’s on transvaginal US, checking fetal heart tones, identifying the sex of fetuses, diagnosing biliary colic, renal colic and abdominal aortic aneurysms! We even introduced the bedside diagnosis of pneumonia!
Originally the clinic had 2 small US machines- one point of care unit that was collecting dust and another small but non-portable machine. Shortly before my arrival, the clinic acquired a larger comprehensive machine which a skilled and talented local US tech used one day per week for comprehensive scans. This tech was unfortunately overwhelmed by the volume of scans and unable to complete them in a timely fashion. The introduction of POCUS was fundamental in order to decrease the number of comprehensive scans ordered in order to aid in more rapid diagnosis of time-sensitive conditions.
As a current US fellow, this elective was integral in developing my understanding of teaching US in a resource-limited setting in addition to developing skills in order to teach US novices. This experience also highlighted the importance of a longitudnal continued relationship with the clinic and I plan to return to continue the US education.
Lucky for me, Roatán is also a beautiful Caribbean island therefore downtime was as equally enjoyable. Among many other adventures, I learned to scuba-dive and met a sloth!
Thank you again to the Class of 2010- your generosity will not be forgotten!