Any surgical type fellowships after ER?

[sshashid87]

I was wondering if there were any surgical-esque fellowships that one can do after EM residency? I know that without a Gen. Surg. residency, EM physicians can't actually do any major surgeries, but do any fellowships allow them to assist in such cases? Also, what exactly do EM Trauma fellows do? Does this allow them to work in Level 1/2 facilities as opposed to 3/4? I kind of thought after EM residency you were allowed to handle trauma calls, but this fellowship seems like you have to pass it on to EM trauma fellows. Does anyone know what a Trauma specialty allows you to do that an EM physician can't? Also, does anyone know the statistics for getting into Trauma, Sports Medicine fellowships? I've looked at SAEM, but I can only find the names of programs. Thanks!

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[pseudoknot]

If you want to be a surgeon, you need to do a surgical residency. EPs don't work in the OR.

EPs do work in all levels of trauma centers, and are involved to varying degrees in the initial resuscitation of trauma patients. However, definitive management of serious trauma will be in the OR (by surgeons) or the ICU (by surgeons or other critical care doctors, which may include IM, anesthesia, or EM after fellowship).

I don't know what an "EM trauma" fellowship is but I don't think it's common. All EM residencies prepare you to handle the initial workup of trauma patients, as described above.

 

[deleted109597]

If you do an EM trauma fellowship (likely just a critical care fellowship), then you get the privilege of covering the unit while your surgery buddies operate.
If you do EM, you can do a few surgeries. Only in the bay for traumas though.

 

[sshashid87]

Dr. McNinja, I take it that the "privilege" of covering is not really a privilege at all? I found EM Trauma fellowships on random school/hospital websites, so I do believe it's an actual fellowship, but I really had no idea what they did differently. Thanks for all the info, I still got 5 yrs before I enter residency, so yeah, I have some time...and this is not really so important, but as far as EM hours are concerned, do people work like 4 straight days and then take 2-3 days off, or is the schedule random, such as night/day, random calls, etc?

 

[177983]

Though I'm pre-med myself (going post-bac style), I can tell you that EM docs don't take call. There's always a doctor there in the hospital, so when you're working, you're working and when you're off, you're off. I also don't think many work 4 straight days and then have 3 off. However, it's not like you'll work 7AM-7PM on Monday, then work Wednesday from 7PM - 7AM. You'll likely work two weeks of days, then a week of nights or some such arrangement. Every other or everything 1/3 weekend is likely as well.

 

[SoCuteMD]

Though I'm pre-med myself (going post-bac style), I can tell you that EM docs don't take call. There's always a doctor there in the hospital, so when you're working, you're working and when you're off, you're off. I also don't think many work 4 straight days and then have 3 off. However, it's not like you'll work 7AM-7PM on Monday, then work Wednesday from 7PM - 7AM. You'll likely work two weeks of days, then a week of nights or some such arrangement. Every other or everything 1/3 weekend is likely as well.

It's entirely possible that you'll work a day shift Monday and a night shift Wednesday. Most of my attendings have worked funky schedules with frequent switching between days/nights. This is probably more pronounced at places where attendings work 12 hour shifts - when they work 8s or 9s there are more swing shifts to make the transition less harsh. Sometimes you'll end up with a string of nights (2-3 nights). I'm working an attending schedule this month and I worked last night overnight, am working day shift Monday and one later in the week. Next week I work 4 consecutive overnights and then go back to days.

 

[Apollyon]

I've worked Saturday and Sunday day and Monday overnight, then 4 days off, for years.

 

[deuist]

Though I'm pre-med myself (going post-bac style), I can tell you that EM docs don't take call. There's always a doctor there in the hospital, so when you're working, you're working and when you're off, you're off. I also don't think many work 4 straight days and then have 3 off. However, it's not like you'll work 7AM-7PM on Monday, then work Wednesday from 7PM - 7AM. You'll likely work two weeks of days, then a week of nights or some such arrangement. Every other or everything 1/3 weekend is likely as well.

EP's do take call in some locations. If things get really hairy in the ED, another physician can be called in. It's a rare occurrence overall. Further, you might indeed get swapped from days to nights to days relatively quickly without going for weeks at a time in the same time slot. I'm on externship and have done all manner of hours with little regard to any "arrangement" that you speak of.

 

[GeneralVeers]

EP's do take call in some locations. If things get really hairy in the ED, another physician can be called in. It's a rare occurrence overall. Further, you might indeed get swapped from days to nights to days relatively quickly without going for weeks at a time in the same time slot. I'm on externship and have done all manner of hours with little regard to any "arrangement" that you speak of.

Very rare. Usually the "on-call" day is built into the schedule so that it's sandwiched with days off. Getting called in is a pretty rare occasion. It's rare enough to say that EM doctors do not take call.

 

[sshashid87]

For all your ER physicians, who are in residency or in practice, do you have any qualms about your decision to go into ER? I've heard the some other specialties may not respect all ER physicians because IM/OB-GYN/Surg/etc all feel like they know more than you in their various fields. Now obviously, they have spent years learning about their respective fields and ER phys. have to know something about everything, so I understand that, but what I'm getting at is if you had to pick a specialty over again, with family in mind, would you pick anything else? I am pre-med, and I like ER best out of the 7-8 types of physicians I've shadowed for a good amount of time (I know it's nothing like actually working but still...) but I want to have time to do other things (time with family, sports, travel...I have a ridiculous amount of small hobbies)...I know this forum will be biased but I guess I'm looking for reassurance...

 

[EMCC]

If you do an EM trauma fellowship (likely just a critical care fellowship), then you get the privilege of covering the unit while your surgery buddies operate.
If you do EM, you can do a few surgeries. Only in the bay for traumas though.

I am currently a fellow in a Trauma & Critical Care Fellowship. Yes, it is true that a majority of the fellowship (one year!) is critical care. After all, not every hospital is a level 1/2 trauma center, but every hospital has a ICU, and most are short-staffed.

1/3 of my fellowship consists of being the trauma leader. So, while the trauma is in the bay (at a level I center), I am the one running it. The trauma surgeon is there (since I am just a fellow) in case I need them. Our other graduates from the program (and have gotten jobs a few different trauma centers) run traumas (and trauma bay procedures) all by themselves. The only time the surgeon gets involved is when a patient needs definitive operative treatment.

I personally love trauma, but I also realize that until the current guidelines change, there will be a need for a trauma surgeon to sign off on trauma bay activities. So, my main drive is to become a well-versed critical care doc. After all, critical care has become more emergency medicine than emergency medicine has (my personal opinion). My goal is to work 1/2 time in the ED, and 1/2 time in the ICU.

And, yes, I have gotten several job offers that would allow me to do this. So, at least in my region of the country, the fellowship has not been a "waste of a year"--yet.

 

[Apollyon]

Very rare. Usually the "on-call" day is built into the schedule so that it's sandwiched with days off. Getting called in is a pretty rare occasion. It's rare enough to say that EM doctors do not take call.

You really have to stop speaking with such authority when you're not aware of how things are nationwide - I mean, I'm just saying.

Our group has one on-call day every month. Average call-in for busy/high-census is one in 4. Have never had a call-in for sick since I've been here.