critical care vs. emergency medicine

[sunset823]

Hi everyone,
I'm an M1 who has always had some level of interest in trauma care. I came in wanting to do emergency medicine, but I have recently read more about critical care and it sounds like a really good fit for me. I will be doing a preceptorship in the ICU this year, and am really looking forward to it.

However, I did want to ask, what do you feel are the major differences between emergency medicine and critical care? Also, I know you can go to critical care from different paths, either IM or anesthesia. I would consider going either route, but what are the advantages of going one route over the other?
Thanks.

---

Members don't see this ad.

 

[jdh71]

Hi everyone,
I'm an M1 who has always had some level of interest in trauma care. I came in wanting to do emergency medicine, but I have recently read more about critical care and it sounds like a really good fit for me. I will be doing a preceptorship in the ICU this year, and am really looking forward to it.

However, I did want to ask, what do you feel are the major differences between emergency medicine and critical care? Also, I know you can go to critical care from different paths, either IM or anesthesia. I would consider going either route, but what are the advantages of going one route over the other?
Thanks.

Emergency medicine, with regards to trauma or critical patients, is the recognition of said critical condition, then appropriate stabilization and initiatil management of these issues. Critical Care is the long term management of these patients after they leave the ED.

You can get to critical care fellowships from medicine, gas, surgery, or EM residencies (If you want the double certification pulmonary/critical care, that is a IM only track). So if you like EM and you like critical care, there is no reason why you cannot do an EM residency.

 

[howelljolly]

To oversimpify things...

EM gets the patient from 'almost dead' to 'in critical condition', by correcting immediate problems, and by looking for anything that will kill them in the next hour, and managing it.

CC takes the patient in critical condition and gets them into stable condition where they can be managed on the general medical floor. They do this by taking hold of certain physiologic parameters and tweaking them as needed. They also manage the life threatening conditions which take days, not hours, to treat.... sepsis, ARDS.... etc.

You can do both.... there are a few SDN regulars who have. But it is more difficult to get into a CC fellowship if you are not boarded in IM/Gas/Surg, because these are the services which put the CC fellowships in place.

 

[error404]

Also, EM treats everything that walks in the door. Sick, healthy, half-dead... until its triaged to the appropriate area-- out the door, medicine, surgery, ICU, OR.
ICU only treats the sick, and rarely does any discharging directly.

(I seem to have referred to patients as objects. Clearly, intern year is going well.)

 

[error404]

Oh, and you have a TON of time to learn the differences and explore your options during med school.

Don't stress now.

 

[psychbender]

ICU only treats the sick, and rarely does any discharging directly.

This, right here, is one of the reasons I enjoy CCM.

...and one of the reasons that I hate this month (the medicine wards...*shudder*).

 

[sunset823]

Thanks for the responses. I know I still have plenty of time, but it's nice to get some information early on, and I tend to be the uber-planning type. Once the time comes, I'll investigate some of the joint residency/fellowship options in different specialties.

And yes, the part of CCM of dealing with only sick people (and no discharges) is quite appealing to me as well.

 

[error404]

And yes, the part of CCM of dealing with only sick people (and no discharges) is quite appealing to me as well.

Of course, if you ask in the CCM forum... you get CCM answers.