Dang! I might want to be a EM physician.

[Packamylase]

Hey everybody!

I'm doing my required EM rotation this month and I really LOVE it! I've never had so much fun on a rotation. The faculty are encouraging and the cases are fun to work-up. I enjoy both the acuity and the diversity.

Having said that, I was leaning toward IM before this rotation (I'd like to be a hospitalist) and I have my Sept and Oct rotations scheduled already in IM subspecialties.

2 Questions:

1. Why should I be an EM physician? Please talk me into it.

2. How many LORs would I need to be competitive for EM? My numbers are not fantastic, I'm a team player and I get along well with my co-workers and faculty members.

Thanks for any guidance you can give me! I wished I didn't like EM so much!

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[dchristismi]

Ok, so why should you be an internist?

I presume you're now a 4th year - many of us had the same realization with that first EM rotation that yep, this was the place for me. Most had some inkling, but usually you don't really know until you do it.

You'll need at least one SLOR, but someone closer to the application cycle (God, I'm getting old) will be able to tell you better.

Bottom line: Kick ass, and make sure that your director knows it. (And if there's an EM program at your med school, so much the better)

 

[Packamylase]

Ok, so why should you be an internist?

I presume you're now a 4th year - many of us had the same realization with that first EM rotation that yep, this was the place for me. Most had some inkling, but usually you don't really know until you do it.

You'll need at least one SLOR, but someone closer to the application cycle (God, I'm getting old) will be able to tell you better.

Bottom line: Kick ass, and make sure that your director knows it. (And if there's an EM program at your med school, so much the better)

True! On paper, EM seemed really great. And that's why I scheduled EM so early my 4th year, because it was something that I really thought I would enjoy. I'm looking for programs in the midwest, primarily.

It would be a lot easier if I didn't like it, I guess.

I have researched IM programs much more - guess I need to start looking at some EM programs! Any great programs that you suggest I take a look at?

 

[deleted65604]

I really am being serious, not necessarily a jerk. If you need to be talked into ER, then you shouldn't do it. If it isn't crystal clear after doing a rotation, then you are going to be sorely disappointed in residency.

 

[tkim]

i really am being serious, not necessarily a jerk. If you need to be talked into er, then you shouldn't do it. If it isn't crystal clear after doing a rotation, then you are going to be sorely disappointed in residency.

+1

 

[gro2001]

I am only a fellow 4th year, so take what I say with a grain of salt... but here are some of the things that did it for me:

1) Can't beat the diversity. Apart from the "IM-like cases" that will make up a huge portion of your work load, you will see Ob, peds, ortho, etc.

2) For many people who like EM, the diagnosis and initial management is much more interesting than repleting potassium.

3) Procedures.

4) More interesting work environment (ED vs the ward). Some people like chaos, some people like order.

Most of the characteristics of EM can sound like either a plus or a minus depending on your character (broad>deep, shifts, chaos, no clinic time). Its mostly soul-searching between here and application time.

 

[KYTNOH]

Reasons why:
1. You will feel more comfortable with acutely decompensating patients earlier in your career than any other specialty. General Surgery would probably be #2.
2. No one has any broader experience with the various specialties of medicine than EM. You can sound semi-intelligent with every single specialty in the hospital with the exception of pathology. On the flip side, with the exception of resuscitation, you are usually only second best at whatever you do.
3. You can tailor your career and your hours however you like. If you want to work 7 days a week, you can. If you want to work 1 day a week, you can.
4. You will workup, diagnose, and start treatment on more illnesses every day than any other specialty. The flip side is you rarely provide definitive treatment.
5. The full spectrum of bedside procedures if yours: LPs, paracentesis, central lines, art lines, intubations, chest tubes, emergent thoracotomy, reductions, lac repairs, etc.
6. You can work in the smallest hospital you can imagine or the largest hospital in the country. Being a pediatric neurosurgeon really limits what type of hospital you will practice in.
7. The people in EM are generally laid back and easy to get along with. Significant arrogance is rare.

 

[Packamylase]

I really am being serious, not necessarily a jerk. If you need to be talked into ER, then you shouldn't do it. If it isn't crystal clear after doing a rotation, then you are going to be sorely disappointed in residency.

I have this problem - I want to go into every specialty that I'm currently on, except for Surgery and Peds. I've loved everything - OB, Psych, Medicine, Pathology. All are great and all offer something that I enjoy.

I think EM might offer a little bit of everything. I enjoy the wide variety of cases and the acuity. I've never met an EM physician that I didn't like and that wasn't happy (for the most part) with their jobs.

 

[KYTNOH]

My school basically did "lunch and learns" every few weeks with a panel of certain specialists. They would try to be honest about their careers. While the n was small, I distinctly remember the two happiest specialties were Pediatrics and Emergency Medicine. Pathology and PM&R also seemed very happy about their career choices. It was when the "high powered" specialties like neurosurgery or cardiology came that you could see the burnout on display. They all seemed to emphasize the negatives much more than the positives of their specialty. Without a doubt there are happy people in every specialty, but however hardcore someone is at first it's hard to maintain enthusiasm with q3 or q4 calls and 80 (or more) hour workweeks as an attending.