FM Boarded to EM

[ActionFigure]

so as my residency is coming to an end, I am strongly considering to apply for EM residency. Right now I have two options to pursue this.

I can start moonlighting in the local ERs, get my skills up and apply through ERAS for this coming year.
or
I can moonlight, apply for an EM fellowship out of FM, get strong LORs and then apply for EM residency.

If I apply this coming year, I'm not sure I would have any strong LORs, which is why I'm considering to do the fellowship.

I'm not sure which path would be most efficient. Unless you guys can tell me of any other way to pursue this? Do you guys think this is a good idea?

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[USCDiver]

Just so I have this straight. One of your options is to do a EM Fellowship, and then apply for EM Residencies?

 

[Makati2008]

so as my residency is coming to an end, I am strongly considering to apply for EM residency. Right now I have two options to pursue this.

I can start moonlighting in the local ERs, get my skills up and apply through ERAS for this coming year.
or
I can moonlight, apply for an EM fellowship out of FM, get strong LORs and then apply for EM residency.

If I apply this coming year, I'm not sure I would have any strong LORs, which is why I'm considering to do the fellowship.

I'm not sure which path would be most efficient. Unless you guys can tell me of any other way to pursue this? Do you guys think this is a good idea?

Why the switch right after finishing residency? Why not work in rural ers(which some pay pretty well) instead of sacrificing more of your life as a resident?

 

[USCDiver]

Right, I'm not seeing the value in the Fellowship at all if your end goal is to be board certified in EM. Presumably you have done your 200 or whatever hours in the ED at your home program and can get a SLOR from there. Talk to your PD and try to get an elective month during your third year where you could do an away rotation somewhere else for another. Is there an ED program at the hospital you are working at now? If they like you enough, they may overlook some of the SLOR requirements in your application.

 

[ActionFigure]

an EM fellowship doesn't allow you to work in level 1 trauma centers or even sit for the ABEM. I'm from the east coast and I'd like to eventually move back there. The EM fellowship is mainly to increase your skills in EM. I don't necessarily have to do it if I just want to work in rural ERs. But like I said, I want to eventually move back to the east coast.

There isn't an EM program at the hospital we work at but there is am EM fellowship for FM grads, which is what I'd be applying to.
I wish I could do an away rotation at an EM program but our program does not allow that because it interferes with required clinic days per week. We need to have 2 full days of clinic a week.

 

[Makati2008]

an EM fellowship doesn't allow you to work in level 1 trauma centers or even sit for the ABEM. I'm from the east coast and I'd like to eventually move back there. The EM fellowship is mainly to increase your skills in EM. I don't necessarily have to do it if I just want to work in rural ERs. But like I said, I want to eventually move back to the east coast.

There isn't an EM program at the hospital we work at but there is am EM fellowship for FM grads, which is what I'd be applying to.
I wish I could do an away rotation at an EM program but our program does not allow that because it interferes with required clinic days per week. We need to have 2 full days of clinic a week.

So I assume you are wanting to work in a metro area? What made you change your mind now?

 

[ActionFigure]

So I assume you are wanting to work in a metro area? What made you change your mind now?

This is derailing from the original post

 

[Doctor Bob]

This is derailing from the original post

No, it's actually quite germane.
More back story is necessary.

Why FM in the first place? Why did you change to want to do EM? How do you know you won't change your mind into another specialty?

If you were always interested in EM, but didn't match in it and did FM instead, we'd say you need to show an ability to work in the environment so take the "work in a rural ED" track.
If you used to be interested in FM, but then changed your mind and now want to do EM, you should do the fellowship, if only to demonstrate that you aren't going to go chasing the next shiny thing that comes along.

Often these "what should I do" question threads take 20-30 posts before we can actually give useful information, while we dig and dig to get enough of the backstory info to be able to give useful advice.

 

[Makati2008]

This is derailing from the original post

Not in the least. Read Doctor Bob post who it hit on the head. If you failed to match it's nothing to be ashamed of just realize the competition is even more fierce now than 3years ago. If you changed your mind in the middle of residency some will question your commitment......

Edit: I noticed you previously wanted to switch into Ob/gyn residency. I'm confused. If you are attempting to go into EM for money you will be miserable.

 

[ActionFigure]

I'm finishing my FM residency this year...there is no leaving in the middle or anything, or even switching... I want to do something in my career that I will enjoy where I plan on going. The country grammar life is not for me.

I was never interested in EM until I did FM. I really enjoyed working in the ER during my EM rotations and I'm not a big fan of only outpatient clinic all day everyday which is what most of my job prospects look like in a more metropolitan area. If I wanted to settle in a rural area then FM would be great, I get a little bit of everything: hospital rounding, see patients in clinic, and pick up a few ER shifts here and there, scopes, house calls, maybe even deliver babies if I so pleased. But I want to eventually go back to my more bustling hometown. And out of all the things in residency I liked EM and inpatient medicine the most. I could apply for hospitalist jobs in the city, but even that is hard to find if you're not an internist. Plus I like EM a little more and I'd like further training in it.

If you are attempting to go into EM for money you will be miserable.

If I was going into EM for money, then like you said so yourself, I could just moonlight in the rural EDs here and make a pretty penny without having to do any further training. Just ship everyone that the facility isn't capable of taking care of.

 

[zero0]

I would look into the following options.

http://www.abpsus.org/family-physicians-in-emergency-medicine

 

[DeadCactus]

Check with people in the FM forum but to me the FM emergency medicine fellowship is basically a scam designed to sucker you into indentured labor for another year. The places that will higher an FP don't care and the places insisting on an EP won't recognize it. It's not like Sports Medicine where you get into a recognized subspecialty or OB where you need procedures for credentialing but run your own practice...