Needs some serious advice

[UHSDOMBA]

Hey fellow colleagues in emergency medicine,
I am almost done with my internship year of EM at a pretty good program in the Midwest. For some reason, I still feel really uncomfortable in terms of managing patients in the emergency department, to the point where I would rather do another off-service rotation. I am considering switching over to family medicine since the acuity is less and pace seems to be a lot slower. Is this a common feeling among EM residents? I love EM but just get really nervous when I am back into the ED. I did well on my inservice so I am learning the stuff, just the high anxiety and low comfort level that bothers me most. Does this get better as I become a second year/third year? Please give me any advice. Thanks ahead of time.

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[whasupmd2]

It's a bit difficult to say since I haven't seen you work, etc. Having said that, your feelings are fairly common. You are not expected to feel totally comfortable in the ED, and there is often a certain level of anxiety. I would encourage you (if you really do enjoy EM) to try to relax a little, focus on trying to learn what you can (while you're not out in the real world and are expected to move the meat and "know everything").

Hey fellow colleagues in emergency medicine,
I am almost done with my internship year of EM at a pretty good program in the Midwest. For some reason, I still feel really uncomfortable in terms of managing patients in the emergency department, to the point where I would rather do another off-service rotation. I am considering switching over to family medicine since the acuity is less and pace seems to be a lot slower. Is this a common feeling among EM residents? I love EM but just get really nervous when I am back into the ED. I did well on my inservice so I am learning the stuff, just the high anxiety and low comfort level that bothers me most. Does this get better as I become a second year/third year? Please give me any advice. Thanks ahead of time.

 

[8744]

...I am considering switching over to family medicine...

Jesus Christ.

 

[Pelivar]

Hey fellow colleagues in emergency medicine,
I am almost done with my internship year of EM at a pretty good program in the Midwest. For some reason, I still feel really uncomfortable in terms of managing patients in the emergency department, to the point where I would rather do another off-service rotation.

I think what you are feeling is completely normal. Most residents try to pretend that they are never scared or nervous but once you get to know them, most people admit to it. Part of the problem for most interns is that you don't spend a ton of time in the ED and just 1-2 months out of the department will make you feel rusty and slow all over again. I remember feeling nervous driving into the ED at times during intern year, especially when you had a rough shift the previous day (missed procedure, impossible dispos, etc.). For me, there was a time in second year where I had worked in the ED for a few months straight that I started getting comfortable with the chaos and unpredictability.

Unless you really do not like EM, I would stick it out and not switch. The anxiety will get better with time as you become more comfortable with the ED. Good Luck.

Pelivar

 

[12R34Y]

I worry about this as well (NOT LEAVING EM RESIDENCY!!), but the fact that I'll be out of the ED for so many months in the first year does concern me a little.

I do 2 months in the fall and then one month in january (one month in may in pediatric ED) then no more ED for 6 months!!

So the beginning of 2nd year I'll be like starting over? oh, well. Tried and true ancient program so I guess many others have been there before me and have succeeded so I guess I shouldn't worry.

later

 

[corpsmanUP]

Jesus Christ.

Never a dull moment with the spotted bear! Understanding your statement, I believe you are simply nervous. I am just getting ready to start my intern year so I have about as much to offer you as I have to offer a crumping septic 96 year old!

But one thing is interesting about your case. I personally find that I thrive on being overwhelmed. When I was a medic, I actually liked being somewhat overwhelmed and deep down I lived for mayhem. I think most people in this profession also feel this way somewhere deep in their loins. You know, we are the same people that always need at least one major worry or else we feel like is too quiet.

FM will assuredly give you boring, low acuity stuff and if you can deal with that, then maybe EM is not for you. I paid back over a hundred grand to the feds for my NHSC scholarship because in the end I could not stomach FM. I had done it for several years as a PA.

You did well on the inservice, so just stick it out and see if maybe its just all in your mind. I would not think your PD would allow you to continue in the program if you were having all that much difficulty. But good luck and do what you feel is right in your heart.

 

[8744]

Never a dull moment with the spotted bear! Understanding your statement, I believe you are simply nervous. I am just getting ready to start my intern year so I have about as much to offer you as I have to offer a crumping septic 96 year old!

But one thing is interesting about your case. I personally find that I thrive on being overwhelmed. When I was a medic, I actually liked being somewhat overwhelmed and deep down I lived for mayhem. I think most people in this profession also feel this way somewhere deep in their loins. You know, we are the same people that always need at least one major worry or else we feel like is too quiet.

FM will assuredly give you boring, low acuity stuff and if you can deal with that, then maybe EM is not for you. I paid back over a hundred grand to the feds for my NHSC scholarship because in the end I could not stomach FM. I had done it for several years as a PA.

You did well on the inservice, so just stick it out and see if maybe its just all in your mind. I would not think your PD would allow you to continue in the program if you were having all that much difficulty. But good luck and do what you feel is right in your heart.

Man. If anyone thinks the Specialty That Dare Not Speak Its Name affords a realxed atmosphere then they have never talked to one of the Keepers of the Sacred Flame. Those guys work hard. The typical KOTSF might see 30 to 40 patients a day. Sure, most of it is low acuity stuff but it is still a grind and on top of all that work you have to keep all of their long-term health maintenance squared away. In the future, your pay will depend on it.

EM physicians work pretty hard to but you might have a slow night or you might take a job at a rural ED which is not all that busy. In my hometown they are advertising for an EM Physician to run the ED there and I know they have many, many, slow nights where the guy working there can sleep a little. (And the salary they're offering is outrageous).

This is never the case with the KOTSF. They always have a full panel. You will probably spend more time with your patients in EM than the typical KOTSF does simply because you are juggling him with your other patients and the little slivers of time you give him will add up.

If the OP will PM me I will give him some advice.