What makes your department a unique place to learn emergency medicine?
We see approximately 130,000 patients per year. Our residents train in a busy Level 1 trauma center, stroke center, and gold-star STEMI center. The high volume and high-acuity patients coupled with the fact that we’re a smaller program create an incredible environment to learn how to care for multiple sick patients simultaneously. It is the perfect place for active learners who like to push themselves and learn by doing.
Everyone—attendings, residents, scribes, and nurses—has great relationships inside and outside the hospital. This is clearly evident by the number of people who were residents here and stay on as core faculty and the fact that two of our former scribes are returning as interns next year.
Queens is one of the most diverse places in the world. What kinds of challenges and opportunities does this present?
Approximately 42 percent of our patients do not speak English as their primary language, with Chinese, Spanish, and Russian being the most common. We use video interpreters or our ancillary staff to help translate the more common languages. The majority of our patients come from blue-collar immigrant families, do not speak English, and rely on their children as their conduit for translation and health care decision making. This can create a role reversal in family power dynamics that can be difficult for the parents. In these instances, it’s especially important to ensure that patients and families are on the same page regarding what is the patient’s desire and what is in their best interest.
By being exposed to such a diverse population, we have an incredible opportunity to gain insight into cultural differences. Developing a strong cultural competency enables us to deliver high-quality health care to patients from myriad backgrounds. Further, since we’re situated between two major airports, we see a good number of international travelers through our emergency department. You’ve got to keep your differential extremely broad and have a high level of suspicion for infectious diseases that you probably wouldn’t see elsewhere.
- William P, Huang V. Critical cases in orthopedics and trauma: proximal phalanx fracture. Crit Decis Emerg Med. 2020;34(10):16-17.
- Del Greco G, Brady K, Clark B, et al. A novel pediatric multisystem inflammatory syndrome during the COVID-19 pandemic. Pediatr Emerg Care. 2020;36(10):500-504.
- Riekena J, Lee I, Lui A, et al. A case report: co-presenting Covid-19 infection and acute drug intoxication. Clin Pract Cases Emerg Med. 2020;4(3):340-343.
—Marvin Mempin, MD, FACEP, assistant program director