How to Crush Your SLOE (Tips 26-30)

Tip #26

Update your attending when the nurse is having difficulty with your patient’s IV or drawing blood.

Tip #27

Get the urine sample from your patient (there is no greater delay in patient flow than waiting on urine)

Tip #28

Round on your patients and repeat your initial scripting.

  • “It’s Zack the medical student again”
  • “Anything I can do to make you more comfortable?”
  • “Do you have any questions?”
  • “I’m doing my best to keep things moving fast for you, here’s an update”
Tip #29

Perform one of the 4 most important reexamination protocols.

  • The ambulation trial
    • Best for patients with low oxygen on arrival or geriatric patients with weakness/dizziness/etc
  • The repeat physical exam
    • Best for patients with abdominal pain or respiratory complaints
  • The repeat vital signs
    • Best for patients with multiple abnormal vitals documented in triage, hypertension, fever, etc
  • The PO Challenge
    • Best for patients with nausea and vomiting or pediatric patients
Tip #30

Update your attending the MOMENT everything is back (and choose one of 3 dispositions)

  • Admit them
    • Best when you have confirmed a specific, bad diagnosis
  • Discharge them
    • If everything is normal, including your reexamination
    • Recommend follow up in 1-2 days
  • Observe them
    • Best for patients with concerning symptoms, risk factors, or red flags but reassuring testing or no clear diagnosis


  1. Jeremiah Velasco

    Hey Zack!

    Thank you for EM clerkship! I used it as my main tool to prepare me for my EM rotation. I am now hired as a PA in that same place where I did my rotation. I still find myself listening to your podcast on a daily basis, thank you for being a huge help!

    • Zack

      You’re welcome! Thank you for downloading.

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