Any regrets?

[Erek94]

For those of you who were fortunate enough to perform well on test day and acheive that 250+ Step 1 & step 2 and chose EM do you ever find yourself thinking "ehh maybee I shoulda done X,Y or Z competitive specialty."

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[winkleweizen]

For those of you who were fortunate enough to perform well on test day and acheive that 250+ Step 1 & step 2 and chose EM do you ever find yourself thinking "ehh maybee I shoulda done X,Y or Z competitive specialty."

Nope, BC xy and z are boring.

 

[The White Coat Investor]

Plus x,y,z don't give me as much time off or pay me as well per hour.

Seriously, your question presupposes that people "settled for" EM rather than chose it over derm, ophtho, ortho or whatever specialty you think super high test scorers go into. That's absolutely not true.

The highest of my Step exams (number 2, because I actually studied for it because I had to have it for the military match) was 269, and the other two were also above 250 (I think...my memory on Step 3 is getting really blurry). Could I have matched into derm? Probably. Do I regret not doing it? Never have and suspect I never will.

Sometimes I think about getting out of EM, but it certainly isn't to go practice another specialty.

 

[SoCuteMD]

Every so often, when I'm having a bad day or am particularly cranky I'll think "I should have gone into x!" Truth is, I never wanted to go into anything other than emergency medicine. Usually those times are close to my next vacation or after a long stretch. Then I get to spend the next morning shopping, taking care of errands when it's not crowded, or sleeping late and going to my favorite exercise class.

I love my job. I have a great boss. I work at a hospital that takes pride in the care it provides. I have good coworkers and work a minimal number of true overnight shifts. And I make more money than I need to pay my expenses. I literally pinch myself several times a week to make sure it's real.

 

[tima]

Basically, everything in medicine becomes boring after awhile. It's one thing to be a Johnny-on-the-spot kick butt intern or resident when you're in your 20's, but when you're in your 50's and having to drag your *ss out of bed to see some latest victim of the knife and gun club because your group covers the trauma call at the community hospital or grandma fell out of bed and broke her hip, etc, etc, etc...it gets old.

So, yes, you should do what you love, follow your bliss, and all the other good stuff that is written on motivational greeting cards. But, remember, after it becomes boring all you'll be left with is the lifestyle.

Saw this in an older thread. Basically, you have to pick something that you truly enjoy and not primarily based on factors like competitiveness, salary, lifestyle, etc.

 

[deleted547339]

Every once in a while I miss surgery. Really loved the OR in med school and considered it a lot in med school. At the end of the day I realize I made the right choice and it's a "grass-is-greener" thing.

 

[Birdstrike]

I literally pinch myself several times a week to make sure it's real.

You literally grab a very sensitive portion of your body and pinch? Several times per week?

 

[Birdstrike]

Sometimes I think about getting out of EM, but it certainly isn't to go practice another specialty.

What do you dream about doing? For me, it's hitting the powerball, and doing nothing, except buying lots of hot cars and goofing around lots, doing everything but any kind of work.

 

[GeneralVeers]

We make more per hour than almost any other specialty, so no. If we did 80 hour work weeks like they did, that would be 320 hours/month which would be $768,000 per year. That's assuming an "average" IC salary of $200/hour.

 

[Birdstrike]

We make more per hour than almost any other specialty, so no. If we did 80 hour work weeks like they did, that would be 320 hours/month which would be $768,000 per year. That's assuming an "average" IC salary of $200/hour.

Might make more per hour, but not necessarily per wRVU.

 

[Robinson EM]

You have to do what you enjoy. Forget prestige and other people's opinions.

The question comes down to, "I feel very talented, am I too good for EM?"

Believe me, there are doctors who are much better than you will ever become in EM (and every other field). It's difficult to be too good for something that you enjoy doing.

For those of you who were fortunate enough to perform well on test day and acheive that 250+ Step 1 & step 2 and chose EM do you ever find yourself thinking "ehh maybee I shoulda done X,Y or Z competitive specialty."

I like how you mentioned "competitive" instead of just another specialty which shows where your head is. Competitiveness is all based on prestige, money and lifestyle.

 

[Erek94]

Thank you all for the responses. Im half way through MS3 and about to make that decision to "sell out" for EM by pretty much scheduling most of my aways in EM. Just wanted to hear some input from those who have walked a similar path im about to walk that were in my situation. As a third year my ER exposure has been limited to whatever time ive been able get out of staying later after other rotations and sneaking into the ER and finding a resident or attending willing to take me on. Its hard for me to determine a life choice based on literally maybee 100 hrs of ER exposure over the past 6 months and not even having had an official EM rotation untill 4th year.

 

[sylvanthus]

I say choose another specialty personally. The fact that you are focused on "competitive" specialties and somehow feel you would "sell out" by going EM, makes me think you're more into the prestige factor than anything. I don't think you would make a good fit for EM. Congrats on doing well on the boards, but remember there are several of us who did just as well and still did EM.

 

[Lysinee]

We make more per hour than almost any other specialty, so no. If we did 80 hour work weeks like they did, that would be 320 hours/month which would be $768,000 per year. That's assuming an "average" IC salary of $200/hour.

Work 320 hours for a couple of months and the Dr might end up as an EM patient soon.

 

[Lysinee]

I say choose another specialty personally. The fact that you are focused on "competitive" specialties and somehow feel you would "sell out" by going EM, makes me think you're more into the prestige factor than anything. I don't think you would make a good fit for EM. Congrats on doing well on the boards, but remember there are several of us who did just as well and still did EM.

That's pretty cool how you can judge someone's personality over the internet and over 1 post. Please teach me some of your secrets.

 

[Erek94]

I think you missunderstood what I meant by "sell out". I mean go all in, put all my eggs in one basket whatever you wanna insert there for what Im trying to say. Not meant to mean settle..but I can see how that would be confused. The prestige thing doesnt matter to me as much as it appears through my inital comment but I cant help but wonder if anyone has any regrets, hence the entire point of my thread. Thanks

 

[Erek94]

I say choose another specialty personally. The fact that you are focused on "competitive" specialties and somehow feel you would "sell out" by going EM, makes me think you're more into the prestige factor than anything. I don't think you would make a good fit for EM. Congrats on doing well on the boards, but remember there are several of us who did just as well and still did EM.

I think you missunderstood what I meant by "sell out". I mean go all in, put all my eggs in one basket whatever you wanna insert there for what Im trying to say. Not meant to mean settle..but I can see how that would be confused. The prestige thing doesnt matter to me as much as it appears through my inital comment but I cant help but wonder if anyone has any regrets, hence the entire point of my thread. Thanks

 

[swamprat]

I sometimes think maybe I should have tried for derm since I had pretty high scores and was AOA and all that nonsense, but then I realize I actually do enjoy EM and look forward to going in to shifts even though sometimes it can be draining especially when you have a shift with a lot of BS complaints. Also, something to think about is night shifts. Before starting residency I kinda blew that off because I've done them as a med student every once in a while and they weren't that bad - but as a resident it def throws you for a loop because you do them way more often, and the way my program is set up we rotate between days and nights in a block. I would say the weird schedule of EM is the one negative thing I didn't consider too much before joining the field but overall I'd say I'm very happy with my choice thus far. That being said, I'm only an intern so take that for what its worth.

 

[The White Coat Investor]

What do you dream about doing? For me, it's hitting the powerball, and doing nothing, except buying lots of hot cars and goofing around lots, doing everything but any kind of work.

That sounds good until you do it for a while. After about a week off, I want to get back to working. Don't get me wrong. Two weeks later I want to take another week off. But just play 24/7/365? Nope, not interested. I'd feel purposeless, and without work, play starts feeling like work.

I have a bit of an advantage. I have another, non-medical job. So I can compare one to the other with ease. In lots of ways the medical job is way better. Sometimes we just suffer from the grass is greener syndrome. If things are really starting to look good outside of medicine, hop the fence and see what it's like. You may find yourself coming back A LOT more satisfied with your medical job.

 

[sylvanthus]

That's pretty cool how you can judge someone's personality over the internet and over 1 post. Please teach me some of your secrets.

 

[Birdstrike]

...I cant help but wonder if anyone has any regrets, hence the entire point of my thread...

Many of us blew the boards out of the water and had our choice of any specialty. Specialty choice is very personal, and specialties don't have a hierarchy despite some thinking their specialty choice elevates them, and reduces others. There's many, many "regret" threads, but I don't think the regrets have much if anything to do with people's board scores. I can't imagine there's a single regret or frustration not posted already somewhere on here. I'm paraphrasing by memory, so forgive me if I'm off on the exact titles, but some of the many "regret" threads are,

"12 reasons not to go into EM"

"Negatives of EM as a specialty"

"Medicine sucks"

"EM burnout"

"Too smart for EM, Fantasies of EM vs. the Reality: Common Misconceptions of EM Hopefuls"

"Why I used to love EM and now I don't (6 years out)"

"Is burnout real or a myth? If real, how do you avoid it?"

"When good is not good enough"

Many are are the stickies/FAQ and others can be searched.

 

[Birdstrike]

Many of us did extremely well on the boards and had our choice of any specialty. Specialty choice is very personal, and specialties don't have a hierarchy despite some thinking their specialty choice elevates them, and reduces others. There's many, many "regret" threads, but I don't think the regrets have much if anything to do with people's board scores. I can't imagine there's a single regret or frustration not posted already somewhere on here, and repeated ad nauseum. I'm paraphrasing by memory, so forgive me if I'm off on the exact titles, but some of the many "regret" threads are,

"12 reasons not to go into EM"

"Negatives of EM as a specialty"

"Medicine sucks"

"EM burnout"

"Too smart for EM, Fantasies of EM vs. the Reality: Common Misconceptions of EM Hopefuls"

"Why I used to love EM and now I don't (6 years out)"

"Is burnout real or a myth? If real, how do you avoid it?"

"When good is not good enough"

Many are are the stickies/FAQ and others can be searched.

 

[DocRGR]

Highest Step score 269, top of my medical school class, AOA, yada yada, no one has cared since medical school. Upper level EM resident now, still show up to shifts thinking how much there is too know in EM and frequently find myself thinking how I could "finesse" my approach for this or that circumstance/presentation to benefit the patient. I'm relatively involved with med student interviews and selection, frankly board scores are a small portion of what many of us care about. I want to work with someone who is driven enough to see patients quickly, do right by that person and dispo them in a timely manner. Some of the hardest working EM guys I know didn't 'crush' the boards by any means, but are my favorite people to see show up based solely on work ethic and having enough pride to care about doing a good job.

 

[deleted547339]

Highest Step score 269, top of my medical school class, AOA, yada yada, no one has cared since medical school. Upper level EM resident now, still show up to shifts thinking how much there is too know in EM and frequently find myself thinking how I could "finesse" my approach for this or that circumstance/presentation to benefit the patient. I'm relatively involved with med student interviews and selection, frankly board scores are a small portion of what many of us care about. I want to work with someone who is driven enough to see patients quickly, do right by that person and dispo them in a timely manner. Some of the hardest working EM guys I know didn't 'crush' the boards by any means, but are my favorite people to see show up based solely on work ethic and having enough pride to care about doing a good job.

Exactly.

 

[throckmortonDO]

I hear ya OP, I get where you are coming from.

Like you, I did really well on steps, top of the class, research, blah blah..
I thought..well, I did well, I opened all the doors..now what do I want to do?
Had mentors say 'man you should do ortho, or derm or interventional rads!" etc etc.
So I did some rotations in some of that stuff, but found that it just didn't gravitate to me as easily as EM. I didnt leave everyday from that ortho rotation feeling like I looked forward going to work the next day.
In EM, I liked the humor, the staff, the nurses and techs, the irony, the drama, the rectal foreign bodies, the psych patients, the stories they told..etc etc. you get the point.

Every specialty has its ups and downs. Certainly for some, EM's downs are not for them.
EM certainly does not have the prestige factor amongst medical peers. We get berated for everything as by the time we send patients to subspecialists, they can look down their retrospectoscope on us. every EM shift has emotional swings, some days boring, some days miserable, some days elational. If prestige is what you had in mind, you may not find it in EM. if patient admiration is what you had in mind, you likely won't find it in EM. if making that ortho salary is what you had in mind, you wont find it in EM. if lifestyle is what you had in mind, think derm or rad onc, you wont find it in EM. if you had career longevity in mind think diagnostic radiology or FM, its harder to work till you are 70 as a pit doc in EM.. some of the above have caveats, yes I acknowledge that.

Take a minute to examine your personality and think about what you find important.
I was somewhat of a diverse and dynamic person prior to med school, I found that being a 'jack of all trades' suited me better than being a specialist in one specific area, repeating the same procedures and treating the same conditions day in day out. I found that I actually liked the idea of not knowing what each day brings, for others that may cause a great deal of anxiety. lastly, I found that the pace of EM, and the knowledge base came easier to me than other things, such as focused neurology, or cancer drugs and tumor staging, etc etc etc.

in your 3rd year you have a short amount of time to make a decision, and it is not easy, after all, many residents switch fields. if you have the chance, spend time outside of rotations or use vacation to go an pull some shifts in some fields you might find interesting if you dont have enough electives to explore everything. go scrub some ENT cases, or go hang out in the ED. Whatever floats your boat. but try to make your decision with your eyes open, and not with the idea of "well I got a 250, guess that means I should do derm" or let others expectations goad you into doing something you may not like.

YMMV.

best of luck

Throckmorton

 

[Arcan57]

I think you missunderstood what I meant by "sell out". I mean go all in, put all my eggs in one basket whatever you wanna insert there for what Im trying to say. Not meant to mean settle..but I can see how that would be confused. The prestige thing doesnt matter to me as much as it appears through my inital comment but I cant help but wonder if anyone has any regrets, hence the entire point of my thread. Thanks

"I'm not selling out, I'm buying in"

 

[alpinism]

I hear ya OP, I get where you are coming from.

Like you, I did really well on steps, top of the class, research, blah blah..
I thought..well, I did well, I opened all the doors..now what do I want to do?
Had mentors say 'man you should do ortho, or derm or interventional rads!" etc etc.
So I did some rotations in some of that stuff, but found that it just didn't gravitate to me as easily as EM. I didnt leave everyday from that ortho rotation feeling like I looked forward going to work the next day.
In EM, I liked the humor, the staff, the nurses and techs, the irony, the drama, the rectal foreign bodies, the psych patients, the stories they told..etc etc. you get the point.

Every specialty has its ups and downs. Certainly for some, EM's downs are not for them.
EM certainly does not have the prestige factor amongst medical peers. We get berated for everything as by the time we send patients to subspecialists, they can look down their retrospectoscope on us. every EM shift has emotional swings, some days boring, some days miserable, some days elational. If prestige is what you had in mind, you may not find it in EM. if patient admiration is what you had in mind, you likely won't find it in EM. if making that ortho salary is what you had in mind, you wont find it in EM. if lifestyle is what you had in mind, think derm or rad onc, you wont find it in EM. if you had career longevity in mind think diagnostic radiology or FM, its harder to work till you are 70 as a pit doc in EM.. some of the above have caveats, yes I acknowledge that.

Take a minute to examine your personality and think about what you find important.
I was somewhat of a diverse and dynamic person prior to med school, I found that being a 'jack of all trades' suited me better than being a specialist in one specific area, repeating the same procedures and treating the same conditions day in day out. I found that I actually liked the idea of not knowing what each day brings, for others that may cause a great deal of anxiety. lastly, I found that the pace of EM, and the knowledge base came easier to me than other things, such as focused neurology, or cancer drugs and tumor staging, etc etc etc.

in your 3rd year you have a short amount of time to make a decision, and it is not easy, after all, many residents switch fields. if you have the chance, spend time outside of rotations or use vacation to go an pull some shifts in some fields you might find interesting if you dont have enough electives to explore everything. go scrub some ENT cases, or go hang out in the ED. Whatever floats your boat. but try to make your decision with your eyes open, and not with the idea of "well I got a 250, guess that means I should do derm" or let others expectations goad you into doing something you may not like.

YMMV.

best of luck

Throckmorton

Agreed. Especially the bolded.

If you're not sure about EM, do whatever you can to work some EM shifts before scheduling aways. Come in on off days, weekends, holidays, etc...
Even 2-3 full shifts can make a huge difference. Night shifts as well.

Then you have to do some soul searching and introspection and figure out if its the right choice for you personally.

Do you look foreword to working the next shift?

Do you like seeing all types of patients of all ages and not knowing who you'll see next?

Do you like the pace, the people, the atmosphere?

 

[tednus]

Wow this thread has been really insightful. I'm in 3rd year and I have been getting pressured by fellow peers (and some physicians) to look into something more competitive because of my score. My internal medicine rotation hasn't been very interesting (aka I'm bored) so I began to start to second guess EM. I came into medschool mainly for EM, and after reading this thread I'm more confident in staying the EM course.