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Background Prescription opioid related deaths have increased dramatically over the past 17 years. Although emergency physicians (EPs) have not been the primary force behind this rise, previous literature has suggested that EPs could improve their opioid prescribing practices. We designed this study to evaluate the trend in emergency department (ED) opioid prescriptions over time during the US opioid epidemic. Methods We conducted a retrospective cohort study from July 1, 2012 to June 30, 2018, evaluating all adult patients who presented to two study EDs for a pain-related complaint and received an analgesic prescription upon ED discharge. We compared these data to trends in lay media and medical literature regarding the opioid epidemic. We also evaluated the incidence of repeat ED visits based on the type of analgesic prescriptions provided. Results Opioid prescriptions decreased from 37.76% to 13.29% over the six year study period. This coupled with an increase in non-opioid medications from 6.12% to 11.33% and an increase in "no prescription" from 56.12% to 75.37%. This corresponded with an increase in the number of publications on the opioid epidemic within the lay-public and medical literature. Additionally, those patients that received no opiates were less likely to require a repeat ED visit. Conclusions ED physicians are prescribing less opiates, while increasing the amount of non-narcotic analgesic prescriptions. This may be in response to the literature suggesting that prescription opioids play a large role in the opioids crisis. This decrease in opioid prescriptions did not increase the need for repeat ED visits.

The COVID-19 pandemic has dramatically affected medical education. Emergency medicine (EM) requires excellence in multiple core competencies, including leadership, teamwork, and communication skills as well as procedural experience. To meet these How to cite this article: Austin A, Rudolf F, Fernandez J, et al.COVID-19 educational innovation: Hybrid in-person and virtual simulation for emergency medicine trainees. AEM

Standard letter of recommendation writers are inaccurate in estimating the ROL position of the applicant using the GAS tier criteria. The GAS tiers were accurate only 26% of the time. Because of the valuable role that the SLOR plays in determining an applicant's competitiveness in the National Resident Matching Program (NRMP) in EM, future discussion should focus on improving the consistency and accuracy of the GAS section. Furthermore, there needs to be a national dialogue to reassess the utility of the criterion-based GAS within the SLOR.

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Emergency medicine (EM) educators have published several curricular guides designed for medical student rotations and experiences. These guides primarily provided brief overviews of opportunities to incorporate EM into all 4 years of the medical student curriculum, with one specific to the fourth year. However, there are no published guidelines specific to third-year medical students rotating in EM. Given the differences between third-year and fourth-year students in terms of clinical experience, knowledge, and skills, the Clerkship Directors in Emergency Medicine (CDEM) established the Third-year EM Medical Student Curriculum Work Group to create a third-year curriculum. The work group began this process by developing consensus-based recommendations for the content of a third-year medical student EM rotation, which are presented in this syllabus.ACADEMIC EMERGENCY MEDICINE 2011; 18:S36-S40 ª 2011 by the Society for Academic Emergency Medicine E mergency medicine (EM) educators have published several curricular guides designed for medical student rotations and experiences. [1][2][3][4] These guides have primarily provided brief overviews of opportunities to incorporate EM into all 4 years of the medical student curriculum, encompassing both the preclinical student years and the clinical rotations. In 2006, a task force of EM medical student educators published a curricular guide designed specifically for students participating in a fourth-year EM rotation.5 Recently, the Clerkship Directors in EM (CDEM) published a revision of this guide. 6 However, there are no published guidelines specific to third-year medical students rotating in EM.Twenty-six U.S. medical schools offer EM rotations for third-year students, each created independently without a standardized guide for the content and structure of the rotation.7 Educators currently developing a third-year EM rotation face a similar situation: create a curriculum de novo or default to using the fourth-year curricular guide. There currently is no literature that differentiates the benefits of doing an EM rotation during the third year compared to the fourth year of medical school, and there is very little information about what the difference is between educating a student in each of these clinical years.3 Exposure to basic EM principles, such as the approach to the undifferentiated patient and stabilization of the acutely ill or injured patient, the presence of faculty on site at all times, and the Liaison Committee on Medical Education (LCME)'s recommendation that ''educational opportunities must be available in multidisciplinary content areas, such as emergency medicine …'' all lend support to our specialty being included during medical school training, but these are not specific to any individual year. 8Creating a curriculum for a third-year student rotating in EM poses several challenges compared to the fourth-year curriculum. First, most EM rotations currently are offered during the fourth year and there is a paucity of models of a third-year curric...

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