To Keep an Incessant Watch


  • No financial support was received for the preparation of this manuscript, and no conflict of interest has been identified in this work.

  • Supervising Editor: Carey Chisholm, MD.

  • A related commentary appears on page 549.

Kurt A. Smith, MD; e-mail: Reprints will not be available.


ACADEMIC EMERGENCY MEDICINE 2011; 18:545–548 © 2011 by the Society for Academic Emergency Medicine


Medical residency is an educational enterprise directed toward producing clinicians who recognize and correctly manage disease. While formal graduate medical education provides didactics and bedside teaching to improve knowledge, individual learning efforts are essential to the educational experience. Keeping track of patient outcomes after disposition from the emergency department (ED) is a useful exercise in reviewing gaps in knowledge of the individual and deficiencies in systems-based care. In reviewing the agreement between admission and discharge diagnoses of a single resident over 4 years of residency, significant improvement in diagnostic accuracy was observed. This method of self-correction has potential to supplement formal residency education in emergency medicine.