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I'm a USDO good board scores, low 240s Step 1, high 230s Step 2. No red flags.
Before medical school, I was a scribe at a community ED. I enjoyed it a lot. When I got to medical school, I told myself to keep an open mind, but EM was really my top choice. Starting clerkships, I never really hated or loved any one rotation outside maybe surgery. Anyways, I did an EM rotation at a community, non-residency site at a level III ED and walked away feeling that maybe I had found my specialty (18 busy shifts). The nights were tough, and I of course was not a huge fan of staying up until 4am to get ready for three nights in a row, but I thought it was tolerable. As an aside, other than EM, I had always considered PCCM. However, due to COVID my entire ICU exposure was only 1 week before getting pulled off rotations. Otherwise, I did an inpatient medicine rotation at the beginning of my clerkship that was mostly hands-off / shadowing. I walked away from the rotation enjoying it somewhat but I was not crazy about the workflow, but I chalked that up to not being terribly involved in the patient care.
I did my sub-i in EM at a county/community hospital. The residents said they see and do so much trauma that their PD was actually a bit worried they were not seeing enough bread and butter cases. So, I felt this place was representative of EM. At the end of the rotation, I said to myself I had enjoyed it (I certainly was not turned off to it) and said I would move forward pursuing the specialty. Even the PD said residents enjoyed working with me and that he said not to worry about matching. I ended up doing a sub-specialty rotation in ultrasound afterwards and I have a Peds EM rotation coming up too. So of my current SLOEs, all them are apparently strong which to me is an indication that I could succeed in EM.
Despite all this, I recently have been wondering if I have been getting a sanitized view of the specialty. I don't deal with consults directly. I mostly do H&P and discuss workups with my attendings sprinkled in with a few procedures and I have yet to really have a godawful terrible/rude/why-even-bother-doing-medicine type of patient interaction. I certainly don't get exposed to metrics or Press-Ganey BS.
All that being said, I still have some FOMO and will be applying to EM and IM programs since I think I have not been properly exposed to IM. Clearly, the one specialty I have had the most interaction with throughout my clinical years so far has been EM bar none. So, looking at my app you would think EM is a no brainer for me, but despite all this -- and especially with the doom & gloom of the field that seems to be many factors worse than in IM (or their respective sub-specialties) -- I feel like I never seriously exposed myself to the sub-specialties that were out there, like Cardiology, Heme-Onc, GI, or even PCCM with only 1 week really of seeing it. I plan on getting a MICU or Cardiology rotation after my Peds EM rotation.
Anyways, I know it's a long post and possibly a bit rambling, so thank you for reading this far. I don't really have any peers in a similar position so I appreciate any advice or thoughts coming my way. I think my worst case scenario is being like 37 years old and finding out EM was not the right fit for me when I decided as a 27 year old single guy at that time.
Edit: I am not sure if this will change anyone's response but I am extremely fortunate that I will be graduating with zero debt. So, I have the luxury of not thinking exclusively of the monetary goals.
Before medical school, I was a scribe at a community ED. I enjoyed it a lot. When I got to medical school, I told myself to keep an open mind, but EM was really my top choice. Starting clerkships, I never really hated or loved any one rotation outside maybe surgery. Anyways, I did an EM rotation at a community, non-residency site at a level III ED and walked away feeling that maybe I had found my specialty (18 busy shifts). The nights were tough, and I of course was not a huge fan of staying up until 4am to get ready for three nights in a row, but I thought it was tolerable. As an aside, other than EM, I had always considered PCCM. However, due to COVID my entire ICU exposure was only 1 week before getting pulled off rotations. Otherwise, I did an inpatient medicine rotation at the beginning of my clerkship that was mostly hands-off / shadowing. I walked away from the rotation enjoying it somewhat but I was not crazy about the workflow, but I chalked that up to not being terribly involved in the patient care.
I did my sub-i in EM at a county/community hospital. The residents said they see and do so much trauma that their PD was actually a bit worried they were not seeing enough bread and butter cases. So, I felt this place was representative of EM. At the end of the rotation, I said to myself I had enjoyed it (I certainly was not turned off to it) and said I would move forward pursuing the specialty. Even the PD said residents enjoyed working with me and that he said not to worry about matching. I ended up doing a sub-specialty rotation in ultrasound afterwards and I have a Peds EM rotation coming up too. So of my current SLOEs, all them are apparently strong which to me is an indication that I could succeed in EM.
Despite all this, I recently have been wondering if I have been getting a sanitized view of the specialty. I don't deal with consults directly. I mostly do H&P and discuss workups with my attendings sprinkled in with a few procedures and I have yet to really have a godawful terrible/rude/why-even-bother-doing-medicine type of patient interaction. I certainly don't get exposed to metrics or Press-Ganey BS.
All that being said, I still have some FOMO and will be applying to EM and IM programs since I think I have not been properly exposed to IM. Clearly, the one specialty I have had the most interaction with throughout my clinical years so far has been EM bar none. So, looking at my app you would think EM is a no brainer for me, but despite all this -- and especially with the doom & gloom of the field that seems to be many factors worse than in IM (or their respective sub-specialties) -- I feel like I never seriously exposed myself to the sub-specialties that were out there, like Cardiology, Heme-Onc, GI, or even PCCM with only 1 week really of seeing it. I plan on getting a MICU or Cardiology rotation after my Peds EM rotation.
Anyways, I know it's a long post and possibly a bit rambling, so thank you for reading this far. I don't really have any peers in a similar position so I appreciate any advice or thoughts coming my way. I think my worst case scenario is being like 37 years old and finding out EM was not the right fit for me when I decided as a 27 year old single guy at that time.
Edit: I am not sure if this will change anyone's response but I am extremely fortunate that I will be graduating with zero debt. So, I have the luxury of not thinking exclusively of the monetary goals.
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