EM/IM grads

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For all you EM/IM grads... do most of the hospitals in the US cater to your needs of doing both IM (hospitalist, clinic, etc) & EM work? The couple of residents I've spoken with have said that it may be little difficult finding places that would cater to splitting the schedule between the two. That being said, I should mention that these were EM residents (non EM/IM).

How competitive are the programs??? I know there are ~ 10 programs with 2 spots per program. But are there a lot of people applying to these programs?

Aside from doing all the recommended things getting into EM, what additional things would you recommend for getting into the combined program?

Jason
 
And what is the upside, besides being the guy/gal everyone wants to be stranded on a desert island with? Is there better pay/more fun at work/greater intellectual challenge -- what's the deal?

I'm attracted to it in a weird way -- I'd love to have that all-around skill set. A doc for all seasons. But with two extra years of residency and God knows what other hoops, I'm hoping there's some "secondary gain."
 
I highly doubt there is better pay, from what I understand the programs are less competetive than straight EM. Ill let the "experts" weigh in on this one..
 
We have EM/IM's at Christiana. From my limited experience I've seen that they usually choose either EM or IM at the end. One explained to me that he did it b/c he wants to do academic EM, and that the IM part would be his special niche - what would set up apart from just straight EM. Of course, you could do academics with EM and a special interest, and don't need the other two years, but that's what he told me.

I don't know anything about competitiveness.
 
We have two EM/IM attendings - one runs the evaluation unit (it's not just a chest pain unit, although that's the majority) and is EM staff, and the other alternates months as EM attending and service IM attending.

There's a guy at Columbia that is IM/EM/Pulm/CC quad-boarded - he works alternate months in the ED and the unit.
 
We have an EM-trained/CC fellowship-trained attending who does time as a MICU and SICU attending. So, theoretically, it's possible to find a department that will let you do both.

The problem with joint appointments is the research requirements that one must keep in order to maintain status within the department.
 
Southerndoc...

Where did he do is EM residency? Where did he do his fellowship? I am assuming he did not do any other residencies (IM/anes/gsurg)... right?
 
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