Never. If you want to boarded in EM, then either do the dual cert program or do an EM residency. The dual program wasn't available when I started so I'm doing a second residency in EM. Best decision I ever made. There is no substitute for the EM training you get in an EM program. There is no way you can be adequately trained for EM in FP given that you get one month in R-1 and one month in R-3 in most FP programs, especially in any of the smaller rural FP programs. That's not to imply that you won't find a job being FP boarded. There will never be enough EM boarded physicians to cover all of the smaller ER's, but you just won't get the volume or the training by EM boarded attendings that you need to have the skills and confidence to go out and work by yourself - in many cases, in rural ED's.