Combined Anesthesia/EM Residency

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DeadCactus

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Looks like some people are working on establishing a combined EM/Anesthesia residency.

http://www.theaba.org/PDFs/Emergency-Medicine/ABA-ABEM-Combined-Training-Guidelines

http://link.springer.com/article/10.1007/s40140-015-0130-9
http://journals.lww.com/em-news/Fulltext/2015/02000/After_the_Match__An_Emergency.6.aspx


Thoughts?
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Waste. Of. Time.

The ONLY thing I see it being useful for would be advanced pain control methods (nerve blocks and what not).
 
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I would say the date they chose to make the guidelines effective doesn't bode well for the specialty.
 
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canigetawhatwhat said:
Waste. Of. Time.

The ONLY thing I see it being useful for would be advanced pain control methods (nerve blocks and what not).
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EM can already do a pain management fellowship if you want to do this stuff too.


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You can yell at yourself during the intubation also. "What do you see, what do you see? Cords? Cords yet?!?" "Let me take over!"
 
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Anesthesia critical care sounds nice. 5 ED shifts/mo and 5 anesthesia shifts/mo for 50% more pay? Nice mix to the daily grind too.
 
sylvanthus said:
You can already do an anesthesia critical care fellowship from EM.
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I realize that. My point was that a combined anesthesia + EM would be a sweet gig. ICU work is a whole different animal
 
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fahimaz7 said:
I realize that. My point was that a combined anesthesia + EM would be a sweet gig. ICU work is a whole different animal
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hmmm...interesting. I think it would be a sweet gig. I know one guy that did both residencies. he says it's a nice way to decompress from the multi mental trauma of the ED. I almost leaned toward anesthesia when deciding on residency choices. I like all the physiology/pharmacology but It drove me nuts sitting in the OR all day listening to beep-beep-beep on long cases but gave you some down time.
they didn't have either fellowships when I started but if they did.......
 
They try to bill this as a ED to OR to ICU resuscitator which is a nice idea but I have a hard time imagining the logistics of hiring someone to follow patients that longitudinally.

I do see it as a nice option for someone who just wants to do both and develop a niche as the airway and sedation guy in an EM program. They could do QI, education, research, etc related to those topics. Like most of the other combined programs, there's no need for a massive influx of those people but they could serve some useful niches...
 
I'm applying for medical school right now, so my knowledge on this stuff is limited. However, I would love to hear an opinion on this for rural medicine. I have read that most of these combined residencies are used predominantly in academic environments, but I feel like something like this or EM/IM would be a great gig for someone in a rural area. Would love to hear any of your opinions for future reference!
 
one of my partners is EM/CCM and we work in the outskirts of the suburbs. I personally know another guy that does this in a very rural setting. he's contracted with emcare for a number of shifts, then contracts for another group filling in at times doing gas. you can do whatever you want as long as you're willing to put in the residency time. go backwards, figure out what you think you want to do in the end then draw backwards at what residency/fellowship path will take you there
 
One of the leaders in our field had a great racist quote.

The only time I want anesthesia in my department is if I need a Korean translator.
 
MSmentor018 said:
one of my partners is EM/CCM and we work in the outskirts of the suburbs. I personally know another guy that does this in a very rural setting. he's contracted with emcare for a number of shifts, then contracts for another group filling in at times doing gas. you can do whatever you want as long as you're willing to put in the residency time. go backwards, figure out what you think you want to do in the end then draw backwards at what residency/fellowship path will take you there
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Is that pretty normal for outside the city as far as working for multiple groups? Or is there a possibility of working both positions, say gas and ED shifts, for the same group? It seems as if you could partner up with a Gen surg you trust with traumas that you guys are willing to take in and both feed off of each other fairly well. Throw in a few NPs or PAs and have a pretty nice gig. I'm sure it's much more complicated than that, but I'm just trying to wrap my mind around being dual certified and making the most of it outside of the academic world.
 
YoungDoc25 said:
I'm applying for medical school right now, so my knowledge on this stuff is limited. However, I would love to hear an opinion on this for rural medicine. I have read that most of these combined residencies are used predominantly in academic environments, but I feel like something like this or EM/IM would be a great gig for someone in a rural area. Would love to hear any of your opinions for future reference!
Click to expand...
No, it wouldn't work for a rural area. The ED needs staffing and the OR needs staffing. In a small hospital there's only going to be one of each on at a time. As a general rule of thumb, the more specialized you are the larger the system required to support you. Very few hospitals are going to have the bandwidth to support an ED based resuscitationist. There's a reason Weingardt practices in NYC and not Madison, IN.
 
Arcan57 said:
No, it wouldn't work for a rural area. The ED needs staffing and the OR needs staffing. In a small hospital there's only going to be one of each on at a time. As a general rule of thumb, the more specialized you are the larger the system required to support you. Very few hospitals are going to have the bandwidth to support an ED based resuscitationist. There's a reason Weingardt practices in NYC and not Madison, IN.
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That makes sense. You'd be needed in two places at once and the hospital would suffer, as opposed to hiring an EM and gas physician separately. In that case, you would be forced to, like the above poster, be contracted at different rural or suburban hospitals in the area in order to get a use out of both specialties then, right? Or work in a larger city at a hospital that can support such a position like you said.
 
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YoungDoc25 said:
That makes sense. You'd be needed in two places at once and the hospital would suffer, as opposed to hiring an EM and gas physician separately. In that case, you would be forced to, like the above poster, be contracted at different rural or suburban hospitals in the area in order to get a use out of both specialties then, right? Or work in a larger city at a hospital that can support such a position like you said.
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You could do both at same place (theoretically). You couldn't do both during same shift.
 
Arcan57 said:
You could do both at same place (theoretically). You couldn't do both during same shift.
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This is like those threads of old where people wanted to know why they couldn't just have acute care surgeons in the ED who then take patients to the OR for appys, etc. Because the zombie hoard at the door doesn't stop coming in just because you go upstairs. This is the biggest problem I have with responding to codes upstairs. Sometimes they take an hour of your time or more. And the ED doesn't quit.
 
Not sure why anyone would want to do this. Can I assume this will be a 6 yr residency? If so, crazy. If its 5, then I can see doing 1 more year for the flexibility.

If its for the money, I don't see how you make more. I believe EM makes as much or more per hour. I rather work my odd hour schedule than come in at 6am for cases.
 
Arcan57 said:
No, it wouldn't work for a rural area. The ED needs staffing and the OR needs staffing. In a small hospital there's only going to be one of each on at a time. As a general rule of thumb, the more specialized you are the larger the system required to support you. Very few hospitals are going to have the bandwidth to support an ED based resuscitationist. There's a reason Weingardt practices in NYC and not Madison, IN.
Click to expand...

Weingart practices in stony brook which is definitely not NYC. I guess you wouldn't consider it quite a rural area but it's not exactly urban.
 
Dr.McNinja said:
This is like those threads of old where people wanted to know why they couldn't just have acute care surgeons in the ED who then take patients to the OR for appys, etc. Because the zombie hoard at the door doesn't stop coming in just because you go upstairs. This is the biggest problem I have with responding to codes upstairs. Sometimes they take an hour of your time or more. And the ED doesn't quit.
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Comparing ED patients to "hoards of zombies"?
Excuse me?!

This is a tremendous insult to hoarding zombies. I demand an apology now.
 
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Psai said:
Weingart practices in stony brook which is definitely not NYC. I guess you wouldn't consider it quite a rural area but it's not exactly urban.
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He left Stony Brook for Sinai some time ago.
 
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