Hi! I am a current 4th year, just a few weeks away from graduating. I also plan on doing ER and decided to pursue a private practice rotating internship (matched into my top choice this cycle woohoo!). I've had a few people ask why I didn't pursue an ER mentorship program if ER is my goal, and it's a totally valid question and debate to have for yourself! I don't necessarily think there is a "wrong" answer either way, but I can explain why I made the decision to pursue internship personally.
I learn far better from clinical cases versus didactic lectures, so clinical year has been a massive step for me & my growth as a (future) doctor. I wanted continued mentorship in this manner, but this time with more opportunity to make clinical decisions. This mentorship can be gotten from an ER program or an internship.
However, I strongly wanted to continue learning from boarded specialists in their fields, so that when I take in a case I can advise owners as to what to expect when I hospitalize / transfer or refer patients to them. The more time I spend with specialists, the more I can absorb from them and the better prepared I can be to triage and treat cases relative to their field. Most rotating internships also have interns spend significant time on emergency anyways, so you are still getting that exposure of working with/learning from emergency cases and clinicians just with the bonus of also getting to spend time rotating through specialty services. As an intern, these specialty rotations also allow you to form connections with boarded specialists that you can call with questions or refer cases to in the future as an ER doc.
Additionally, I have found that while many of the corporations have various ER mentorship programs, the quality of said programs is highly variable. One company in particular is notorious for having new grads mentoring even newer grads within an ER setting, and that was something I generally wanted to avoid. Even more established ER mentorship programs sometimes struggle to maintain mentors for their programs as ER departments often have such a high turnover rate. Some ER programs are also only 6 months of training, and I personally wanted something longer. To me, it felt more stable to pursue a well-established, year long rotating internship where I will be educated by boarded specialists and other clinicians from various departments with many years of experience under their belts.
Like I said, both ER mentorship programs and rotating internships can be incredibly helpful and I don't think there is necessarily a right or wrong answer for you. I think that as long as you thoroughly research/investigate a program, you can find one with good teachers and opportunity for you to grow. You won't make as much money in a year long rotating internship versus ER mentorship, but many private practice rotatings are paying 75-80k (I know all VCA and BP internship programs are in this range). I do agree with the above that if your goals are ER, you don't necessarily need to pursue an academic internship (low salary, residents get learning priority before interns, not necessarily always reflective of the caseload and case types you would see in real world ER), but a private practice one could certainly be a great option! I know multiple people who are going into rotating internships or are currently finishing rotating internships with plans to do ER or GP (or don't know yet what they want to do)- it's fairly common!
