Age cutoff for EM?

[CaptainObvious]

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So I'm interested in EM. It's where I've had the majority of my medical experience as a long-time medic.

I'm sure my interests will change as I gain exposure to other fields, but the field of EM in general has always floated my boat.

Now, I'm no spring chicken. I'm 40 now and am shooting for acceptance by 44-45. Graduate at 48-49. 3 years of EM residency puts me at 51-52. So really, I'm looking at 8-9 years of Attending practice by the time I'm 60.

I have a hard time seeing my self running around a busy ED, working night shifts, and keeping up with the young-uns much past that age.

I also have an interest in anesthesia and the more gas docs I speak with, the more I like what they do. I've been reading A LOT about it. It seems like I may have a chance for more career longevity in gas vs EM. I would also consider a faculty teaching position in my later years in either specialty as I do enjoy teaching.

Just looking for some healthy dialogue here.

Thanks!

 

[DrMidlife]

Well, this raises the general issue of how you're predicting that it'll be worth it to finish med school at 50 (as will I). I personally wouldn't want to do 10 years of training to get less than 10 years in practice, or to have a sitting job on the other side.

Medicine's only worth the entry cost to me if I can reasonably expect to act and feel like a peer to my younger colleagues, and keep up with (or preferably stay ahead of) them. What I've looked at is the health of my older relatives, and their ages at retirement. My mom's side has most folks working into their 80's. Good eyes, good knees, good backs, sharp and engaged all the time, no arthritis or Parkinson's or early Alzheimers. My dad's side, well, I have to fight obesity and nastiness, but they do live a long time.

I'm curious to know what my fellow over-40 premeds have done to predict their viability after med school, and what makes the investment as realistic as possible. What's your checklist?

Best of luck to you.

 

[Nasrudin]

Cool thread. Even if it's just the three of us interested. I hope DrMidlife doesn't mind if I chime in. Cause I'll only be 44-46 when I enter practice. I promise to not to stare at a device while pumping my rebecca black jams during this conversation.

I worked in the ED as an assistant. And love the overall culture. Am still holding out an interest in it despite many of the concerns the OP indicated. I remember this doctor I worked with. Dude was one out of shape sob. And on top of that was like ready to blow at any moment. Stressed, so tense you just felt uneasy being around the cat. That's a recipe for physiosocial disaster.

what I'm getting at is, yes. There is a lot more physically at stake in medicine than people seem willing to recognize. And though age may be a real consideration. I think physical condition is a better measure. Aging being very individual. If you're a 60 y/o triathelete with a mind like a whip. You're better off than a 25 y/o marshmellow-bodied slob.

With me, the concern with EM is that I struggle with MSK pain. That is well managed by constant exercise. But all of the bending, twisting, hoisting of the procedures is daunting. Secondly I don't think I like to be doing 15 things at once all the time. And I'm not sure about the high stress nature of an ED shift. Which doesn't bode well for pain management.

I need a focused meditative sort of practice. One that has the flexibility to enable daily exercise.

This is the way you should look at it. Individually. Focusing on the endgame scenarios contemplatively as you go forward. Measuring your own personality and natural gifts against them.

ED is attractive to many. Will still be sought for residency by less. And is actually a good match as a career for less than that. It's increasing popularity as a field is not necessarily good for it or it's applicants in my opinion. For instance does derm benefit from being aggressively competed over by lifestyle oriented applicants. I'm not sure that it does.

 

[vc7777]

Cool thread. Even if it's just the three of us interested. I hope DrMidlife doesn't mind if I chime in. Cause I'll only be 44-46 when I enter practice. I promise to not to stare at a device while pumping my rebecca black jams during this conversation.

I worked in the ED as an assistant. And love the overall culture. Am still holding out an interest in it despite many of the concerns the OP indicated. I remember this doctor I worked with. Dude was one out of shape sob. And on top of that was like ready to blow at any moment. Stressed, so tense you just felt uneasy being around the cat. That's a recipe for physiosocial disaster.

what I'm getting at is, yes. There is a lot more physically at stake in medicine than people seem willing to recognize. And though age may be a real consideration. I think physical condition is a better measure. Aging being very individual. If you're a 60 y/o triathelete with a mind like a whip. You're better off than a 25 y/o marshmellow-bodied slob.

With me, the concern with EM is that I struggle with MSK pain. That is well managed by constant exercise. But all of the bending, twisting, hoisting of the procedures is daunting. Secondly I don't think I like to be doing 15 things at once all the time. And I'm not sure about the high stress nature of an ED shift. Which doesn't bode well for pain management.

I need a focused meditative sort of practice. One that has the flexibility to enable daily exercise.

This is the way you should look at it. Individually. Focusing on the endgame scenarios contemplatively as you go forward. Measuring your own personality and natural gifts against them.

ED is attractive to many. Will still be sought for residency by less. And is actually a good match as a career for less than that. It's increasing popularity as a field is not necessarily good for it or it's applicants in my opinion. For instance does derm benefit from being aggressively competed over by lifestyle oriented applicants. I'm not sure that it does.

Hey Nas, haven't seen you in a while? Maybe I'm checking the dark side of the forum while you are more sunny side up? Maybe I've got that backwards. Ne'er the two shall meet?

I agree with what you said, I'm out of warranty myself (both miles and years). Made in detroit, none the less. But the way I figure, I'm not getting any younger, and the problems will be there regardless of my specialty.

Thinking a lot about EM too, but I've got years still left to decide. That's the one up side of this long journey.

Sent from my Android phone using Tapatalk

 

[Nasrudin]

Hey Nas, haven't seen you in a while? Maybe I'm checking the dark side of the forum while you are more sunny side up? Maybe I've got that backwards. Ne'er the two shall meet?

I agree with what you said, I'm out of warranty myself (both miles and years). Made in detroit, none the less. But the way I figure, I'm not getting any younger, and the problems will be there regardless of my specialty.

Thinking a lot about EM too, but I've got years still left to decide. That's the one up side of this long journey.

Sent from my Android phone using Tapatalk

Wassup Rocket Scientist. How's the space race. Yeah. Good point. Mileage is there irregardless. Or is it regardless? Still I'm not taking Unlce Jesse's 73 F-150 as my get away car to make the county line in time. (Damn. I even surprise myself sometimes with deft references. Given I'm vintage 1973.)

I mean. One pan of eggs. Two pieces of toast and I'm alright. ****-talk texting my buddy in cali. But 5 pots, gas on high, 8 kids darting around the kitchen and all of sudden my BP threatens that weak blood vessel in my brain.

So that's probably what I'm really worried about. I just like low and slow these days. And could give a **** about being a hero.

I just find ED interestees have lot's of lemming amongst them heading for the cliff at breakneck speed.

 

[MDOnlyWillDo]

I have a hard time seeing my self running around a busy ED, working night shifts, and keeping up with the young-uns much past that age.

I work swing shift with an ED doc in his late 50's. He's been working the overnight shift for 20+ years and holds his own just fine with the young'uns. I bet you'll have no problem too.

I'll be at least 45 during the thick of my residency and I plan on going into surgery at this point. So I've given this topic a lot of thought and I can't come up with a decent reason not to go for it. I've decided that I'd rather be 50 and a doctor, because I'll be 50 regardless. So my checklist has one question- do I want to be a doctor? Yeah. So regardless of age, I press on. Even if I get only 10 good years of practice, that's 10 years I never would have had at all. Better to have loved and lost, and all that.

 

[LifeTake2]

I should be practicing around 46. I'm very intersted in gas work, and one of the reasons is that if at 60-65 I decide I'm getting too old to stand in an OR for hours; there is the option of pain management as a more office-based practice w/ maybe some outpatient procedures to keep the blood pumping.

Guess we will see how it works out; but that is my plan at the moment.

 

[CaptainObvious]

I can certainly see where the "coolness" factor of EM can wear off pretty quickly as much as I like the atmosphere. I worked as a medic in the ED as well, and the the "weak and dizzy all over" pt's and the drunk A-holes that need 143 sutures while they slur and breathe all over you can really get old fast.

All I keep thinking about is that PBS special that followed a bunch of Harvard Med graduates through their careers. The EM doc was a train wreck. His life really beat him about the head and shoulders (and the rest of him).

I don't know much about derm, but what I've experienced from my own derm guy doesn't look like it'd be my bag. Other than the money and the bankers hours, I don't really see the draw. 😴

I may already have some miles on me, but there's no sense running out the miles I have left in the red. Good thing I've got a long way to go to make this decision.

 

[DrMidlife]

The EM doc was a train wreck. His life really beat him about the head and shoulders (and the rest of him).

Tom Tartar. I think about that guy a lot. I bet EM was a symptom, not the problem in his case.

Maybe another nontrad metric should be something like: have you been previously successful at integrating into a heavily regulated, political, administratively burdensome environment where the percentage of time you get to actually be in charge of what you're doing is about 10% on a good day?

 

[Nasrudin]

Tom Tartar. I think about that guy a lot. I bet EM was a symptom, not the problem in his case.

Maybe another nontrad metric should be something like: have you been previously successful at integrating into a heavily regulated, political, administratively burdensome environment where the percentage of time you get to actually be in charge of what you're doing is about 10% on a good day?

That's a great point. I agree. But as much as I hear different angles of this perception, I'm curious to know what you guys think about the relative degree of autonomous activity exists as a doc. Maybe I've been a puppet too long. But how much autonomy does anyone have in the corporate landscape? And how does that compare to medicine?

 

[Nervous Ned]

I don't ever post but I'm an EM resident that will finish when I'm 41. I'm the oldest resident in my class and also the whole program. What can I say, residency is hard on you mentally and physically too. but it's everybody who feels that way, not just me. No matter what you go into, you will be stressed as an intern and if you aren't, then it's not a good program. I mean stressed to a point. We work hard at my shop but EM is respected and they take good care of us. I know I am getting good training and will be well prepared when I get out, but it's not easy sometimes while you're going through it

The pre meds should shadow in EDs but also otehr specialties too. try to shadow as many specialties as you can. As med students, if you want to do EM then you need to rotate in a few hospitals, because community EM is nothing like working in a university hospital or a county hospital. You want to see all three kinds. Also try to go on away rotations and see what the program or hospital you think you want to go to is like. if the residents don't seem happy and you have a bad gut feeling when you work there or interview, don't ignore it.

Sorry this is kind of rambling but my brain is tired and I suck at typing. If you have a question, post and I will try to answer it.

 

[NightGod]

http://docsontheweb.blogspot.com/
Excellent blog for people who are interested in working in EM

 

[spiderpete]

Well, this raises the general issue of how you're predicting that it'll be worth it to finish med school at 50 (as will I). I personally wouldn't want to do 10 years of training to get less than 10 years in practice, or to have a sitting job on the other side.

Medicine's only worth the entry cost to me if I can reasonably expect to act and feel like a peer to my younger colleagues, and keep up with (or preferably stay ahead of) them. What I've looked at is the health of my older relatives, and their ages at retirement. My mom's side has most folks working into their 80's. Good eyes, good knees, good backs, sharp and engaged all the time, no arthritis or Parkinson's or early Alzheimers. My dad's side, well, I have to fight obesity and nastiness, but they do live a long time.

I'm curious to know what my fellow over-40 premeds have done to predict their viability after med school, and what makes the investment as realistic as possible. What's your checklist?

Best of luck to you.

How long we live and how we choose to live those years is at the root of this whole adventure that is midlife entree to medicine.

It may be trite to say every day is precious, but we still live in a time when life is fragile. If you are over 40, you probably know someone dead or dying who is of an age with you. I believe you really must be doing what you love now, even if it is the 'just' training. The journey is at least as important as the destination.

So I may be dead tomorrow, but more realistically I have 40-50 years. Dad is 90 and in good health; dont smoke; eat right; exercise; even keeled re stress, etc. Mom died at 50 but she had 12 babies and smoked. So, if I take good care maybe I will live into my 90s too. And medical technology is getting better, right?

I will finish school at 53, residency at 56, then hopefully practice for 20+ more. Thats the goal at least. EM docs who are friends are in there 50s and have colleagues in their 60s. If they can do it, so can we!

I say enjoy the ride, change what you dont like if you can, and make the most of it. Whatever we each have left, this is our one best shot.