Things I Messed Up So You Don't Have To: Lessons from a 5-Year Residency

It happens overnight: You go from being a trainee to working as an attending – and the senior-level confidence you felt just 24 hours earlier can't even be spotted with the donut of truth. What's a new attending to do?  In her final episode as an EMRA*Cast fellow, host Blythe Fiscella, MD, shares a hodgepodge of actionable advice from EM attendings as she transitions from residency to starting as an attending at the same institution.

A seemingly routine pediatric nosebleed quickly became one of the most frightening cases of my career when a five-year-old with undiagnosed immune thrombocytopenia (ITP) developed life-threatening epistaxis. In this episode, we walk through the case and explore why dissolvable hemostatic agents may be an underutilized first-line option, incorporating insights from ENT that may change your practice the next time pressure, Afrin, and traditional packing fail.

In this solo episode, Dr. Blythe Fiscella shares 11 hard-won lessons from the emergency department — covering everything from procedures and airway management to communication and clinical uncertainty. Whether you're a resident or a seasoned clinician, there's something here for everyone.

In this mini episode of our "Bridging Health and Humanity" series on EMRA*Cast, Dr. Natalie Hernandez speaks with EM:RAP's Dr. Matt Delaney about patient vulnerability during transitions of care, focusing on what clinicians should do when receiving sign-out.

The opioid epidemic has become supercharged in the past 10-15 years, first with the widespread replacement of heroin by the more potent fentanyl and more recently with the introduction of alpha agonists such as xylazine and medetomidine into the drug supply. Peter Lorenz, MD, sits down with EM/tox/addiction medicine-trained Rachel Haroz, MD, to discuss this ever-changing landscape and how to best provide lifesaving care to some of our most vulnerable patients in the emergency department.

Hand injuries may look minor, but missed diagnoses can mean permanent disability. In this episode, EMRA*Cast host Maiya Smith, MD, is joined by PGY-3 Orthopedic Surgery resident Dr. Tyler Thorne to break down the high-yield hand exam and walk through can't-miss cases like Seymour fractures, central slip injuries, and perilunate dislocations.

This episode of EMRA*Cast delves into the making of "MicroSkills: Small Actions, Big Impact," a powerful book by Drs. Adaira Landry and Resa Lewiss. Much like the book itself, the conversation breaks down a big topic (how to be successful at life) into snackable stories. Join host D'Monte Farley to learn some premium life tips.

In this EMRA*Cast episode of Bridging Health and Humanity, host Natalie Hernandez speaks with Dr. Maya Yiadom, MD, MPH, MSCI, an associate professor and director of Precision Analytics and Data Integration in Emergency Medicine at Stanford, about how artificial intelligence is reshaping emergency care.  They discuss practical AI already in use (predictive analytics and ambient AI scribes), how AI can be designed from clinical workflows to improve detection and timeliness (for example, speeding recognition of STEMI), and the promise of tools that reduce documentation burden and support decision-making.  Dr. Yiadom also grapples with real risks — biased training data, subgroup performance, privacy and cloud constraints — and emphasizes protecting trainee learning while teaching residents how to use AI responsibly. She closes on an optimistic note: AI as a fail-safe that augments clinicians' judgment rather than replaces the human art of medicine.  

This week on EMRA*Cast, Dr. Jay Kaplan shares compelling insights on the evolution of emergency medicine and the art of being a 'people doctor.' Join host Blythe Fiscella, MD, for a heartfelt conversation that's sure to inspire! Get tips on overcoming moral injury, finding your fit in medicine, and running a marathon instead of a sprint.

Dr. Sean Nordt is an emergency physician, toxicologist, pharmacist, and educator with deep expertise at the intersection of clinical toxicology, addiction medicine, and frontline emergency care. As a former Poison Center director, he brings a wealth of insight to a discussion with host Dr. Lauren Rosenfeld. Let's get into it! Tune in as Dr. Nordt explains an increasingly common—and often misunderstood—ED presentation: kratom.