Working in an Australian ED has been one of the most valuable learning experiences of my career so far. Every shift is different and every patient teaches you something new. As a resident doctor, you are usually the first doctor to assess the patient, formulate a differential diagnosis, organise investigations, and discuss the case with your registrar or consultant.
One thing that quickly became apparent was the sheer variety of presentations. During a single shift, you can see patients from every age group with completely different complaints, making emergency medicine one of the best environments to build clinical confidence.
Common Presentations
As resident doctors, we usually assess patients triaged as Category 2 to Category 5. Patients in Category 1 are primarily managed by the registrar and consultant, although we often assist when required.
Respiratory
- COPD exacerbation
- Asthma exacerbation
- Pneumonia
- Viral respiratory infections
- Shortness of breath
Cardiovascular
- Chest pain
- ACS workups
- Serial troponins
- Palpitations
- Syncope
- Heart failure
Gastroenterology and General Surgery
- Abdominal pain
- Appendicitis
- Gallbladder disease
- Gastroenteritis
- Constipation
- Bowel obstruction
- Surgical referrals
Geriatrics
- Falls
- Delirium
- Functional decline
- Confusion
- Urinary tract infections
Paediatrics
- Fever
- Reduced oral intake
- Vomiting
- Diarrhoea
- Viral illnesses
- Neonates who are not feeding well
Procedures
- IV cannulation
- Difficult IV access
- Blood collection
- ECGs
- Blood gas sampling
Mental Health and Toxicology
- Alcohol withdrawal
- Drug withdrawal
- Medication related presentations
- Overdose assessments
Why ED Is Such a Great Place to Learn
The biggest advantage of working in ED is the diversity of patients. Every shift exposes you to new presentations and forces you to think systematically.
As a resident doctor, you develop confidence in taking focused histories, performing examinations, ordering appropriate investigations, interpreting results, and presenting cases to senior doctors. You also learn when to escalate concerns and when patients require urgent review.
No two shifts are ever the same, which makes every day an opportunity to improve.
The Resources I Used Every Day
Two resources became essential during my time in ED.
The first was ETG. Almost every doctor in the department uses it regularly. It is an excellent resource for investigations, medications, antibiotic choices, and management plans. Whenever I was unsure about a treatment plan or medication dose, ETG was usually my first reference.
The second was the RCH Clinical Practice Guidelines. These are incredibly useful when managing paediatric patients. Whether it was fever, bronchiolitis, gastroenteritis, asthma, or neonatal feeding concerns, the guidelines were practical, easy to follow, and evidence based.
Learning Practical Skills
Another major part of working in ED is developing procedural skills.
One skill I found particularly rewarding was ultrasound guided IV cannulation. Many patients have difficult veins, and being able to use ultrasound can make a significant difference.
Learning bedside ultrasound is another valuable skill that every junior doctor should consider. Becoming familiar with EFAST and other common emergency applications makes you much more confident when assessing patients.
What I Will Cover Next
In my next post I will share the resources that helped me learn ultrasound guided IV cannulation and bedside ultrasound. I will also discuss how I practised these skills, how beginners can improve their success rate, and the learning resources I found most helpful.
If you are planning to work in an Australian ED, I hope this series gives you a realistic idea of what to expect. It is a busy environment, but it is also one of the best places to grow as a junior doctor.
Leave a Reply