Considering the possible harmful effects of having medical students working in an emergency department alone, all activities developed must be under supervision, what help their practical training process that will never be achieved only by books.[5, 9] Nevertheless, replacing curricular activities by extra-curricular ones shall be always discouraged. Not only but also, many Universities unfortunately do not offer a good enough plan of activities for their medical students, making regular lectures not a priority in their schedules (an issue that shall be addressed in a different paper). Despite the better

quality of medical care that can be offered by dedicated doctors compared to medical students, in Brazilian busy public emergency rooms most of the time it is impossible to dedicate the appropriate Akt inhibitor time on consultations to each patient (what may be the reality in most of the countries worldwide). Then, a team of committed medical students can be extremely helpful on patient care. Even being

non-licensed not-fully-trained, if properly supervised, they can play an important role in this environment. Tutors must be always aware of eventual medical errors that if not promptly approached will be under their legal responsibility as well as a threat to patients’ safety. Since it is a surgical clerkship, it is expected LY3039478 price that the vast majority of students aim to follow a surgical career beforehand (70.6%). However, data concerning the influence of the extra-curricular activity in their decision should be analyzed carefully. Most of the students that do not have interest Amobarbital on a surgical career and find the practical activities a bad influence for them may abandon it before its completion (500 hours), or even before 200 hours, and would not participate in the present study. Conclusions Our data suggests that 200 hours seems to be a suitable threshold in medical students’ learning surgical manual dexterity in an Emergency Department clerkship, even in the

absence of objective parameters to further evaluate this theory. Last but not least, maturity and quality of medical care significantly improved proportional to the number of hours served in the ED clerkship. Therefore the practice of leaving before 200 hours should be actively discouraged. Further comparative studies with objective criteria to evaluate students and residents’ manual dexterity and their own perception of their abilities should be performed in order to assess our initial findings. Acknowledgements We thank Iwan Augusto Collaço, MD, PhD, TCBC, for his substantial academic contributions in the field of Trauma, and for his efforts by which this study was made possible. We also thank Kenneth Stahl, MD, FACS, for his contribution with the discussion of this study. This article has been published as part of World Journal of Emergency Surgery Volume 7 Supplement 1, 2012: Proceedings of the World Trauma Congress 2012.