Hey you guys, thanks so far for your help, I'll be sure to get in touch with the Karolinska Institute and this "el duderino" dude.
Dutch Doc, I was gonna send you an email about Emergency Medicine, but I figured I'd put it up here in case anyone else may be interested. If you're thinking about doing EM in the US, this may (or may not) be useful.
Most urban EM prorgams (or ER programs, same thing) are either at a Level 1 Trauma Center, or are affiliated with such a center. What this means is that at some point in your residency you'll be exposed to pretty much every kind of trauma under the sun--gunshots, stabbings, MVA (motor vehicle accidents), burns, falls, jumpers, etc. (My favorite is the guy who jumped off a 13-story building and landed on his head, and was actually alive when the ambulance brought him in--the CAT scan of his head was pretty cool.) The number of trauma patients across the country has decreased since the crack wars of the 80's, but it's still something I think every ER doc should be able to deal with efficiently. Apart from the trauma you deal with the more medical stuff like the chest pains, abdominal pains, headaches, vaginal bleeders, back pain, all that stuff. You also have to deal with the less appealing clientele, like the alcoholics and homeless people and the "my left toe has been hurting me for the past 6 years so I decided to come into the ER at 3 in the morning on your shift and make your life a little more difficult" patient. Ancillary services in most urban ER's are virtually nonexistent, so you're drawing most of the bloods, wheeling the patients to XRay, screaming at the XRay tech, etc. It's chaotic and hectic and exhausting, but you walk away with some incredible stories.
Now, if you're interested in doing Emergency Medicine in the US, here are a couple of things to think about. EM was the 6th hardest residency to get into when I applied back in 1999, I don't know if it's gone up or down since then. Unfortunately it's even more difficult for FMG's. There are 3 or 4 FMG's in my program (averaging one per class), but all of them transferred into Emergency Medicine either halfway through or after finishing a Surgery or Internal Medicine residency. I definitely did NOT rock my Boards, but as an FMG you'd probably need to.
Don't let the numbers discourage you though. I didn't think I had a chance in a million of matching, and I came through with my first choice. So if you're still thinking about Emergency Medicine when it's time for you to make your decision, this is what I suggest you do (I don't know if it works for everyone, but it worked for me):
Try to do TWO away electives, one at a top-tier program and one at a medium-tier program. (If you're interested in EM in the New York City area, email me and I'll let you know which ones are considered top-notch and which ones aren't). Do the elective at the medium-tier program first; this way you'll have time to get used to ER environment, learn the terminology that gets tossed around, become good at what's expected of you as a student, and so on. Then when you go to the top-tier program you'll be ready to rock their world. Get to know the Attendings, show them that you're 1) enthusiastic, 2) curious, and 3) a nice person. Do NOT kiss @$$, most of us can see that from a mile away. You don't even need to be that smart (I know I wasn't when I was a med student). As long as you present yourself as being the kind of person they would want to work next to for the next 3 or 4 years, you're way ahead of most other med students.
Anyway, hope this helps. Email me if you have any other questions,
sudeesh
