The EM Personality

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kupo

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Though I'm a long ways off from being in a position to choose a medical specialty, I like to fantasize. :) I'm aware of the stereotypical surgeon personality; do you all think there's something similar for EP's? If there is a stereotype, have you guys found it to be true?

The main reason I ask is, EM appeals to me in that a well-rounded broad knowledge of medicine is required and one gets to perform procedures that draw from many different disciplines. However, I'm worried that with the crazy pace and the constantly in-the-red stress levels, more sensitive souls such as myself would quickly become overwhelmed and broken. Thoughts?

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having worked with over 100 em docs over the yrs I have noticed the following in many( not all) of them:
1. in their personal lives they tend to enjoy more extreme types of pursuits such as big mtn climbimg, parachuting, scuba diving, white water kayaking, etc
2. these are folks who like to do things as opposed to sitting around or talking about doing things. standing in the o.r. for 6 hrs drives them nuts as does endless rounding.
3.they all are very calm under pressure, in fact they get a buzz off it.
long shifts, lots of sick pts:BRING IT ON! IS THAT THE BEST YOU CAN DO? .
an em provider who gets flustered easily doesn't stay in em for long
4. they are control freaks and linear thinkers who multitask well.10 new critical pts presenting at the same time? no problem. do that to an internist and they soil themselves.
they like to improvise.
one of the docs I work with has a license plate frame, "emergency medicine-order from chaos".
 
I always like to say there are truth in stereotypes, but only some truth. emedpa gives a nice summary. Although I would argue that scuba diving isn't high risk, but perhaps thats because I have been doing it for 20 years. :D (I am NOT that old, I just started early)

I never knew I was EM personality.. never considered it in med school till I was done with my 3rd year. I was planning on peds rheum. :D

You do have to like to multitask. and you do have to like sick patients. However, it is not always nonstop sick sick sick. You also have stubbed toes, sore throats, etc. In fact, I am sitting in the middle of a relatively slow ED (for us)- twenty five pts
 
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Thick skin.
 
I always like to say there are truth in stereotypes, but only some truth. emedpa gives a nice summary. Although I would argue that scuba diving isn't high risk, but perhaps thats because I have been doing it for 20 years. :D (I am NOT that old, I just started early)

I never knew I was EM personality.. never considered it in med school till I was done with my 3rd year. I was planning on peds rheum. :D

You do have to like to multitask. and you do have to like sick patients. However, it is not always nonstop sick sick sick. You also have stubbed toes, sore throats, etc. In fact, I am sitting in the middle of a relatively slow ED (for us)- twenty five pts

Red,

Probably more people die in scuba diving accidents than any other sport. Mostly newbies panicing and heading for the surface. No way to know the denominator in order to get a rate though.

BKN
 
Red,

Probably more people die in scuba diving accidents than any other sport. Mostly newbies panicing and heading for the surface. No way to know the denominator in order to get a rate though.

BKN

agree- I've been diving for about 17 yrs. am certified in nitrox/rescue/dry suit. 1 class away from master diver.

of the maybe 100 em docs I know 3 have attempted to climb everest or k2.
if you add in "lesser peaks" like hood, rainier, adams, etc that # is about 50.
I'm guessing you won't find 50 mountaineers in a random group of 100 internists.

the other thing I didn't add about the em personality is the love of instant gratification:
displaced fx or dislocation: reduced
vfib:converted
nasty facial lac: repaired
no peripheral access: IO
aloc: narcan/d50
 
having worked with over 100 em docs over the yrs I have noticed the following in many( not all) of them:
1. in their personal lives they tend to enjoy more extreme types of pursuits such as big mtn climbimg, parachuting, scuba diving, white water kayaking, etc".

don't forget Shark-fishing!
 
Red,

Probably more people die in scuba diving accidents than any other sport. Mostly newbies panicing and heading for the surface. No way to know the denominator in order to get a rate though.

BKN



That's what happens when you let amateurs in. ;)


It is definately potentially dangerous, if you don't know what you are doing. However, you could argue that untrained drivers are killers also... :D

But again... I said I was biased because I am a diver.
 
3.they all are very calm under pressure, in fact they get a buzz off it.
long shifts, lots of sick pts:BRING IT ON! IS THAT THE BEST YOU CAN DO? .
an em provider who gets flustered easily doesn't stay in em for long
4. they are control freaks and linear thinkers who multitask well.10 new critical pts presenting at the same time? no problem. do that to an internist and they soil themselves.
they like to improvise.
one of the docs I work with has a license plate frame, "emergency medicine-order from chaos".

How much of this do you think is their personality and how much is the training they recieved? Do medical students really have a grasp on whether they are able to handle multiple patients sick patients and multitask well and then select IM or EM (or whatever) based on their personality? Or does their training tend to make the EM ones able to mult-task and the IM ones not?
 
How much of this do you think is their personality and how much is the training they recieved? Do medical students really have a grasp on whether they are able to handle multiple patients sick patients and multitask well and then select IM or EM (or whatever) based on their personality? Or does their training tend to make the EM ones able to mult-task and the IM ones not?

it's the basic personality. competitive. uninhibited.
it's why a lot of em docs were paramedics and/or search and rescue guys 1st.....
folks without the right personality get crushed when they do an em rotation and try to stay as far away from the ed as possible for the rest of their lives. folks who like em do a rotation there and it is like a breath of fresh air. they have found a home and finally medicine can be fun.
 
I think that you can tell... but the best way is to get in an ED and see if you like it or not. There is definately a subgroup who were paramedics/emts, however, at least 70% of the ones I know never had any exposure prior to med school.

if you are early in med school, try finding an emp to shadow with. And then do a rotation.

Most people can tell right away if you like it or not. People rarely are in the middle about em. they love it or hate it.
 
"Most people can tell right away if you like it or not. People rarely are in the middle about em. they love it or hate it."

agree- you're either an em guy/gal or you're not.
what's funny is watching folks who aren't trying to make it in em. we have a med-peds doc who took an em job only because that was what was available at the time/place she needed. she gets flustered very easily and is less productive than anyone else in the dept. she calls consults faster than anyone else, and often for things the rest of us treat and street(corneal abrasions, pyelo, epistaxis etc) we keep piling more and more admin duties on her to decrease her clinical time. it's working.....she's down to 50% clinical/50% admin now.....
 
Very interesting stuff. Lots to think about...One of my main exposures to medicine growing up was my dad's practice which is pediatric oncology -- lots of long term patient relationships (almost 50 yrs for him now). That's why I think I'm gravitating towards something of an opposite specialty, but I suppose rotations are ultimately what helps make decisions like this, not ivory tower daydreaming :)
 
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while in med school the ones going into EM were the health freaks who were into outdoor activities: e.g. mountain biking, surfing, etc etc. i didn't quite fit in. in the end, unexpectedly i ended up in EM and can say the attributes above may have high specificity but very low sensitivity. those that like to multi-task, prefer instant gratification, and enjoy diversity in all respects seem to encompass most of the people that i've seen in the field so far. in other words, these traits are more sensitive. you don't have to scuba dive or love to party to be in EM.
 
"you don't have to scuba dive or love to party to be in EM."

couldn't hurt though :)
and you're right about the health freak part. I only know 1 obese em doc(probably 275 at 6 ft, used to be 180 right out of residency) and he's really working on getting back down to fighting weight-running every day, white water rafting, ice climbing, etc
 
folks who like em do a rotation there and it is like a breath of fresh air. they have found a home and finally medicine can be fun.

Hurray, hurray! :D That's how I felt! I LOVE being able to see another patient while waiting on the test results of another (I never got how FM docs could stand waiting days for those) and them pelvizing a 3rd, etc, etc, etc. Even when there aren't TONS of patients (ie during football games) there are some seriously cool kats to kick it with. IM residents get pissed when they have to take a new patient - EM residents GRAB for them. And the instant gratification is fabulous - you will either fix it or send them away.

I have always been a multi-tasker b/c I get bored with doing any one thing at a time, always looking for the next new thing. However, I haven't experienced the joys of scuba diving. :(

However, I'm worried that with the crazy pace and the constantly in-the-red stress levels, more sensitive souls such as myself would quickly become overwhelmed and broken. Thoughts?

I would argue that the pace is not "crazy", just non-stop, which is a good thing, right? The stress levels similarly bob up and down since most patients are not on the brink of death. EM is GOOD for the sensitive soul b/c you can help people from all walks of life and get a social work consult to help them afford their meds and healthcare. However, this sensitive soul would have to have a good sense of humor.... :smuggrin:
 
I would agree start with thick skin or grow some.

With respect to "love it or hate it" I certainly agree but make sure you rotate in an ED where you will get the opportunity to immerse yourself in the specialty (see patients of varying acuity, procedures, etc).
 
Scuba Diving - Check
Sky Diving - after Step I
Do things vs. talking - (worked construction for a few years) so...check
Calm under pressure - so far so good
Like to improvise - (construction) check
Love to party - went to college for 8 years, double CHECK

I'm seriously considering EM, though I'm only an M2.5 right now. My preceptor is an EP and I'm definitely clicking when I'm down there.
 
EM docs are very much like surgeons... except with shorter attention spans. ER docs are also goal-oriented rather than process-oriented. At the end of the day, you can hold up what you did and say "I did this for the patient" (eg. reduced their fx, stabilized their AMI, treated their overdose, etc), instead of endlessly tweaking BP meds.

There is also at least a small adrenaline-loving streak in all ER docs, no question about it. Some of us can admit it... the others are not being honest with themselves.

One does develop a very thick skin in EM. It's absolutely mandatory if you want to survive the abusive patients, the abusive families, and the abusive consultants.

However, one had better have some sensitivity as an ER doc. I'd make the argument that you need it more in EM than other specialties, since we sometimes box up more people in a single shift than other specialities do in a year. If you hold back the human side of yourself from your patients, you're being selfish, and you're cheating them terribly... sometimes even cruelly. Don't throw up cynicism as a shield; compassion is damned important, and sometimes that means hugging and crying with the mother who just lost her baby to SIDS or an MVA-vs-pedestrian. Don't hold it back... pain shared is pain divided.

Everyone have a merry Christmas.
 
I don't think there's a certain personality type. There's a good representation of different personality types in all of the EM docs where I work. Some can be overbearing, some are kinda passive, some are loud, some are quiet, some are "my way or the highway" types, others need to be babysat a little, some don't have much of a sense of humor, some you could say have too much...

The one thing that seems to be similar between them all is that lately, going to China is "the thing" with vacations. :confused:
 
The personalities in EM are really diverse. I think its one of the most diverse groups of people out there. For every mountain climber, you have about 10 couch sitters. For every scuba diver, you have about 5 beach loafers & 5 who've never been to the beach. For every adrenaline junky, you have 2 who are cerebral and into the academic aspects, 2 who could care less, and 2 who would rather do something else.

Again, I think the generalized characterizations misrepresent the whole.
 
The personalities in EM are really diverse. I think its one of the most diverse groups of people out there. For every mountain climber, you have about 10 couch sitters. For every scuba diver, you have about 5 beach loafers & 5 who've never been to the beach. For every adrenaline junky, you have 2 who are cerebral and into the academic aspects, 2 who could care less, and 2 who would rather do something else. Again, I think the generalized characterizations misrepresent the whole.
 
it's the basic personality. competitive. uninhibited.
it's why a lot of em docs were paramedics and/or search and rescue guys

This is definitly true one of my mentors in the ed used to be a field medic in the service and a parmedic. He now is the medical director for an ambulance service and an attending at the hospital I work at. Starting off on an ambulance and now working as a tech, ive worked in other departments but I can never see myself leaving the ed permenantly. I love the rush that you get while juggling a full board and triage. Not sitting down for more than 15 min in a 12 hour shift does wonders for my figure:D
 
:D :laugh:
And we're not a$$holes:D during consults especialy on borderline surgical cases or when a resident gets pulled out of a sexy surgery because the appy patient blew because they weren't answering their pages

We?? I thought you were a Freshman in undergrad.

No offence, but unless you are actually an EM resident or attending posting semi-inflammatory comments about surgeons (or any other doctor for that matter) is bad form.

For gods sake man, at least wait to you're actually in medical school before you start to rip on the surgeons.:laugh:
 

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We?? I thought you were a Freshman in undergrad.

No offence, but unless you are actually an EM resident or attending posting semi-inflammatory comments about surgeons (or any other doctor for that matter) is bad form.

For gods sake man, at least wait to you're actually in medical school before you start to rip on the surgeons.
Sorry if i ruffled any feathers just trying to keep amused on a boring christmas day. The doctors I get to work with in the er are very talented. I'm actually a sophmore.
 
"Most people can tell right away if you like it or not. People rarely are in the middle about em. they love it or hate it."

agree- you're either an em guy/gal or you're not.
what's funny is watching folks who aren't trying to make it in em. we have a med-peds doc who took an em job only because that was what was available at the time/place she needed. she gets flustered very easily and is less productive than anyone else in the dept. she calls consults faster than anyone else, and often for things the rest of us treat and street(corneal abrasions, pyelo, epistaxis etc) we keep piling more and more admin duties on her to decrease her clinical time. it's working.....she's down to 50% clinical/50% admin now.....

You aren't in Ohio, are you? If not, I know her twin!
 
In my postbac year, we started with an intense, ugly Summer term. The only other students on campus were writers, from a low-residency MFA program. A lot of them were career-changers or writers-on-the-side. Over beers at the campus pub, a few of us met one such writer, who's an internist in daily life. We got to talking about doctoring and specialties, and he pegged me as an EM person before I said a word about the subject.

On the question of the stereotypical hard-charging EM personality and how well it overlaps with the stereotype of other specialties, I'm not sure 'competitive' is the right word, though. It's more like, I enjoy the game, no matter what the outcome. I don't have to win all the time, and in a sense this is the secret weapon that allows me to play so hard and (sometimes) so well.

I know Orthopods who are quiet and bookish, surgeons who are laid-back and mellow, and internists who are smokin' hot, so stereotypes will only get you so far. But EM does seem to be something of a special category, where a person's outlook and personal approach seem to make a huge difference not only in how patients respond to them, but in how well they can get through a shift, a rotation, or a year.
 
at least from my perspective, we're generally high-yield ppl and we like to _do_ something - procedural, planning dispo. some would say the ed is a haven for those with adhd -- we understand pathophys and zebra diseases are important, but the medicine docs are around for a reason.

we're looking for what could be really really bad and what's at the top of the to-do list. once the patient's tucked in, it's time take on the next case. contrary to what you might expect, em docs aren't necessarily the biggest fan of inpatient medicine-- most find the floors to be way too slow, too much 'well, we could consider this on the differential, but...'

it's also very practical specialty -- almost like primary care but that moves a lot quicker. my dad's a neurologist, and if i have some generic pain, the response i usu get is it 'cut it off.' the point is -- you'll never be so specialized to the point you're just not practical about the common things.

finally, em docs are generally happy ppl. (the converse would probably be grumpy general surgeons who are probably wonderful ppl worked a little too hard) it's just nice being around positive, respectful, active ppl :)

but again just my two cents...
 
Sky Diving - after Step I

While I like adventure, I'm going to avoid Sky Diving. I'm kind of accident prone when it comes to sports and it's like they say:

"If at first you don't succeed, skydiving is not for you."
 
One thing that I did not see mentioned is that EM people like to have fun at work, yet at the same time they will click to all seriousness at the drop of a hat.

I rarely see little practical jokes, or attendings showing residents some funny email they were sent (or a youtube video!), etc outside of the Emergency Department... and to see these groups of people joking and laughing one minute, but jump to the trauma, code, or next chart with compassion, seriousness, and respectfullness the next....
 
One thing that I did not see mentioned is that EM people like to have fun at work, yet at the same time they will click to all seriousness at the drop of a hat.
The other day, a student was presenting a case and then the dean of my medical school asked what the most likely diagnosis was. It was one of those no-brainers that you feel stupid for answering and you could tell no one wanted to say it. After a few moments of pause I finally responded with "aliens" (even though I new it was RA)... it didn't go over too well.
 
The other day, one of our attendings came back from a patient room and announced, "well, whatever else is wrong with him, I can be confident about part of that guy's diagnosis: he's a tool."

The residents, RNs, and techs laughed; the visiting med student had to look first to make sure it was okay.
 
I rarely see little practical jokes, or attendings showing residents some funny email they were sent (or a youtube video!), etc outside of the Emergency Department...

True, true. I have yet to see a hospitalist prank call one of his interns. And yet, it happens with relative regularity in the ED. Or at least, when people are away at conferences.
 
having worked with over 100 em docs over the yrs I have noticed the following in many( not all) of them:
1. in their personal lives they tend to enjoy more extreme types of pursuits such as big mtn climbimg, parachuting, scuba diving, white water kayaking, etc
2. these are folks who like to do things as opposed to sitting around or talking about doing things. standing in the o.r. for 6 hrs drives them nuts as does endless rounding.
3.they all are very calm under pressure, in fact they get a buzz off it.
long shifts, lots of sick pts:BRING IT ON! IS THAT THE BEST YOU CAN DO? .
an em provider who gets flustered easily doesn't stay in em for long
4. they are control freaks and linear thinkers who multitask well.10 new critical pts presenting at the same time? no problem. do that to an internist and they soil themselves.
they like to improvise.
one of the docs I work with has a license plate frame, "emergency medicine-order from chaos".

As someone who's interested in EM, it's reassuring to hear that many, but not all, of these apply to me.
 
I'd just like to stress that med students reading this shouldn't feel discouraged if they feel like they don't "fit" the "EM personality." My residency program runs the gamut from the "let's go do some x-treme sports" types to quiet, bookish, soft-spoken people.

I have never noticed any particular correlation between "personality" and skill in the ED with one exception: if you are unable to assert yourself you probably will not be succesful in EM. Then again any field may be hard for you.

But fitting the classic, EM stereotype is extremely unimportant. If you like the medicine, go for it.
 
The adrenaline high is better than crack cocaine (or so I've heard).

I love being able to drop everything and take care of a REAL emergency when one comes crashing through the door. Unstable GI Bleeder, STEMI, critical trauma, SVT will really get your juices flowing. The critical patients are also when your teamwork is at its best, and the nurses, radiology techs, and clerks pull together to get things done.

If I don't get at least one of these per shift it feels like I haven't accomplished anything when I go home.
 
The adrenaline high is better than crack cocaine (or so I've heard).

I love being able to drop everything and take care of a REAL emergency when one comes crashing through the door. Unstable GI Bleeder, STEMI, critical trauma, SVT will really get your juices flowing. The critical patients are also when your teamwork is at its best, and the nurses, radiology techs, and clerks pull together to get things done.

If I don't get at least one of these per shift it feels like I haven't accomplished anything when I go home.

Originally Posted by emedpa
having worked with over 100 em docs over the yrs I have noticed the following in many( not all) of them:
1. in their personal lives they tend to enjoy more extreme types of pursuits such as big mtn climbimg, parachuting, scuba diving, white water kayaking, etc
2. these are folks who like to do things as opposed to sitting around or talking about doing things. standing in the o.r. for 6 hrs drives them nuts as does endless rounding.
3.they all are very calm under pressure, in fact they get a buzz off it.
long shifts, lots of sick pts:BRING IT ON! IS THAT THE BEST YOU CAN DO? .
an em provider who gets flustered easily doesn't stay in em for long
4. they are control freaks and linear thinkers who multitask well.10 new critical pts presenting at the same time? no problem. do that to an internist and they soil themselves.
they like to improvise.
one of the docs I work with has a license plate frame, "emergency medicine-order from chaos".

I know I'm really late to this and as a pre-med student it's ridiculous to try and determine my specialty but I can't say how relieved I am to find the EM spec. :love: I'm a huge adrenaline rush junkie and I'd rather be slammed with issues or have 1000+1 things going on at one time than have 25+ things. This is also why I chose being a flight medic for the air force. In the air in a huge C-130, going skydiving later and maybe even some barrel racing later on in the day. Wow, you guys got me so amped for this.:thumbup:
 
How do the EM personality compare to the critical care/pulm personality?
 
I don't think I fit the stereotypical personality at all. I'm not into adventure sports, I'm not an adrenaline junky, and I like seeing psych patients. That last one alone makes me an atypical EM personality. :D

But seriously, I think there is room in EM for lots of different personalities. You have to know your own strengths and weaknesses and be prepared to learn how to compensate for them. I know that I tend to overthink things and am more likely to do nothing if I don't know what to do. That can be bad if immediate intervention is required. Some of my classmates are more stereotypical cowboy types, and they have the opposite problem where they might jump in too fast without thinking it through first. No matter which end of the spectrum we start on, all of us need to learn when to be decisive and jump in quickly, and when to be cautious and take a step back.
 
I don't think I fit the stereotypical personality at all. I'm not into adventure sports, I'm not an adrenaline junky, and I like seeing psych patients. That last one alone makes me an atypical EM personality. :D

But seriously, I think there is room in EM for lots of different personalities. You have to know your own strengths and weaknesses and be prepared to learn how to compensate for them. I know that I tend to overthink things and am more likely to do nothing if I don't know what to do. That can be bad if immediate intervention is required. Some of my classmates are more stereotypical cowboy types, and they have the opposite problem where they might jump in too fast without thinking it through first. No matter which end of the spectrum we start on, all of us need to learn when to be decisive and jump in quickly, and when to be cautious and take a step back.

You sound exactly like me. I'm more of a sleuth than I am a cowboy. I also like psychiatry, and I do tend to over analyze things. A lot of people say that EM burns you out if you work too much. I was wondering, is that only true for those laid back cowboy types, or does that apply to you as well?
 
I don't think I fit the stereotypical personality at all. I'm not into adventure sports, I'm not an adrenaline junky, and I like seeing psych patients. That last one alone makes me an atypical EM personality. :D

But seriously, I think there is room in EM for lots of different personalities. You have to know your own strengths and weaknesses and be prepared to learn how to compensate for them. I know that I tend to overthink things and am more likely to do nothing if I don't know what to do. That can be bad if immediate intervention is required. Some of my classmates are more stereotypical cowboy types, and they have the opposite problem where they might jump in too fast without thinking it through first. No matter which end of the spectrum we start on, all of us need to learn when to be decisive and jump in quickly, and when to be cautious and take a step back.

let me guess...EM/IM?
 
IT'S ALIVE!!!:beat:

Seriously, the original post on this thread was 5 years ago.

Anyway...carry on. :D
 
I'd just like to stress that med students reading this shouldn't feel discouraged if they feel like they don't "fit" the "EM personality." My residency program runs the gamut from the "let's go do some x-treme sports" types to quiet, bookish, soft-spoken people.

I have never noticed any particular correlation between "personality" and skill in the ED with one exception: if you are unable to assert yourself you probably will not be succesful in EM. Then again any field may be hard for you.

But fitting the classic, EM stereotype is extremely unimportant. If you like the medicine, go for it.

I second this emotion. I see no consistent trend with personalities. Other specialties are more diverse (IM, FP, peds) due to massive infusions of foreign medical graduates and atypical candidates. Any uniformity in ER is due to a lack of these applicants.
 
Are there any INTJ emergency medicine docs out there? If so, how do you differ from the stereotype "short attention span/mountain climbing" ones? Are INTJ EM docs better or worse when it comes to burnout?

If you don't know what INTJ is, no need to reply (its not worth explaining).
 
Are there any INTJ emergency medicine docs out there? If so, how do you differ from the stereotype "short attention span/mountain climbing" ones? Are INTJ EM docs better or worse when it comes to burnout?

If you don't know what INTJ is, no need to reply (its not worth explaining).

I don't understand how people invest so much into a personality test. It's like worrying that medical school might not be for you because you were better at Monopoly than Operation...
 
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