What’s life like for a fourth-year medical student (M4) at WMed?
If you had asked M4 Carlynn Gasser that question in early February as she was finishing up her final clerkship for medical school – Advanced Emergency Medicine – she would have told you her day begins right about the time most everyone else might be making dinner or – at the very least – dinner plans.
Around 5 p.m., she rolls out of bed at her Kalamazoo apartment and starts her “morning” with a cup of coffee. She has a little less than six hours before she’s to report for her shift in the emergency room at Bronson Methodist Hospital.
On the menu is breakfast which, given the time of day, might be your normal breakfast fare or sometimes it’s take-out or leftovers from the day before. She takes time to study at home, a task she likes to complete because the clerkship – a four-week rotation for fourth-year students – doesn’t always lend itself to much downtime during the eight-hour shift.
“The ER can be very fast paced,” said Gasser, a native of Belleville, Michigan, who came to Kalamazoo in 2021 after graduating from Wayne State University with a degree in biology.
After she catches up on studying, Gasser spends time catching up on emails and texts, and scrolling through the day’s news. She also takes time for some self-care – cleaning up her apartment, washing her face. Next, she logs into Epic on her laptop to get an idea of what cases and patients might be awaiting her when she arrives at the hospital.
By 9:30 in the evening, she fixes her hair, puts on make-up, and changes into her scrubs. She packs snacks and a meal for the shift that will begin at 11 p.m. and then checks to make sure her laptop is charged and that her stethoscope is in tow. By 10:30, she’s out the door and on her way with the plan to arrive at the ER by 10:45 p.m.
“With every rotation, they tell you to get there 15 minutes before your shift starts,” Gasser said.
Once she walks through the door at the Bronson ER, Gasser checks in with the attending physician and lets them know she’ll be the M4 working that night. She inquires about the attending’s expectations for the shift.
“I did four night shifts at one point and I had three different attendings who wanted things done differently so I try to clarify that,” Gasser said.
- 5 p.m. – Wake up and “breakfast”. Typical morning fare or leftovers from the day before.
- 6 p.m. – Catching up on studying, emails, and texts from friends and family.
- 7 p.m. – Tidying up her apartment and a little time for some self-care. Grabs her laptop and logs into Epic to see what cases and patients might be awaiting her for her shift in the emergency room at Bronson Methodist Hospital.
- 9:30 p.m. – Make-up and hair prep. Time to change into her scrubs and pack her snacks and a meal for the eight-hour shift. Ensures her laptop is charged and that her stethoscope is in tow.
- 10:30 p.m. – Departs her apartment for the 15-minute drive to Bronson.
- 10:45 p.m. – Arrival to Bronson where she checks in with the attending physician and the resident physician.
- 11 p.m. – Shift underway. She begins pulling charts and checking which patients she can see first. After each physical and patient history, she checks in with the attending physician to map out a treatment plan. Any downtime is spent updating her notes in Epic and checking on patients’ test results and imaging.
- 6 a.m. – Shift begins to wind down. Ensures her notes in Epic are up to date. Before leaving, she reminds the attending physician to fill out a feedback form for her, an important step for the aspiring physician.
- 7 a.m. – Homeward bound.
- 7:15 a.m. – Arrives back to her apartment. Breakfast for dinner before a shower and prep for bed.
- 8:30 a.m. – Bedtime.
A Day in the Life of M4 Carlynn Gasser
After chatting with the attending physician, Gasser introduces herself to the resident physician, logs into her computer, and starts grabbing charts to check which patients she should see first.
“Something I really like about the Advanced Emergency Medicine rotation is they really treat you like a (sub-intern) and you’re seeing your own patients and conducting the patient history and physical,” Gasser said.
After she sees each patient, Gasser checks in with the attending physician and gives an oral presentation of her findings. This is the point in the shift, Gasser says, where her education for the rotation really happens.
“They ask me what I think is going on,” Gasser said. “They want me to be able to come up with a differential of what a diagnosis could be based on the patient’s symptoms. Then the next question is ‘What do you want to do about it?’ As a doctor, what are you going to do for this patient?”
Gasser said she finds enormous value in the back and forth as she and the attending physician map out a treatment plan. Their conversations are followed by a trip into the patient’s room together where Gasser gets the chance to observe the highly experienced physician interact with the patient.
“I like to see how the attending talks to the patient and I’m trying to be a sponge and catch all of the nuances because everyone does things – and talks to patients – differently,” she said.
That process of seeing patients on her own and then working with the attending physician repeats itself throughout her shift at the hospital, Gasser said. When there is downtime in her shift – a rarity – or a lull in the number of patients who need to be seen, she uses that time to log her notes in Epic. Other times, she’ll check to see if results from lab work or a CT scan for a patient are available to review.
The opportunity to do those things, though, doesn’t always present itself until the end of a shift in the ER, Gasser said, especially if the care team gets word that a patient with traumatic injuries is being brought into the ER.
“In the ER, it’s anything goes,” she said. “You could see anything from a heart attack to a stroke to the sniffles and a stomachache to traumas like an infant with burns. There’s a huge spectrum of what you get to see in the ER and it’s unique compared to our other rotations.”
During one shift, Gasser recalled helping treat a patient who had suffered a self-inflicted gunshot wound. In another instance she rode along in MSU-1 – the medical school’s Emergency Medicine resident-staffed Medical Support Unit – and responded to a cardiac arrest where she was tasked with giving the patient chest compressions.
When she’s working in the ER at Bronson, Gasser’s shift tends to wind down by 6 a.m. She uses her last hour at the hospital to make sure her notes in Epic are up to date and continues following up on tests and imaging for patients who are awaiting results. She also reminds the attending physician to fill out a feedback form for her, a step that will help her as an aspiring physician as she looks for ways to improve and excel as Match Day and residency training quickly approach.
By 7 a.m., she’s leaving the hospital and headed home. She’s hungry by the time she arrives to her apartment so she will typically make “breakfast for dinner,” she said. Then it’s a shower to “wash the hospital off” and by 8:30 a.m. Gasser is in bed and resting up for her next shift.
“I wake up a lot during the day so I usually plan to sleep a little later before I wake up so I can get a good eight hours of sleep,” Gasser said.