Does EM get reflexive after you've been doing it for awhile?

[DeadCactus]

Does EM eventually wind down into coming into work, seeing the same old same old that you've dealt with countless times before, and once every so often getting a rarer case that actually challenges you intellectually?

If so, are there things that EPs do to keep the intellectual challenge in their careers?

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[The White Coat Investor]

Does EM eventually wind down into coming into work, seeing the same old same old that you've dealt with countless times before, and once every so often getting a rarer case that actually challenges you intellectually?

If so, are there things that EPs do to keep the intellectual challenge in their careers?

Yes, many cases become routine/reflexive. I think this is the case with every specialty. I think EM has as many (or more) opportunities for the "rare" intellectual cases as any other field.

 

[Hawk22]

Does EM eventually wind down into coming into work, seeing the same old same old that you've dealt with countless times before, and once every so often getting a rarer case that actually challenges you intellectually?

If so, are there things that EPs do to keep the intellectual challenge in their careers?

I think pretty much all medical specialties probably fit your first description.

The difference in EM is that we clinically see all ages and all comers, so we have even more variety than other folks.

If you want to be really challenged intellectually in a different way, you can always specialize or go into research to help answer the questions we're all asking on a daily basis.

 

[DeadCactus]

What kind of research do EPs do?

 

[leviathan]

What kind of research do EPs do?

Read the Annals or other periodicals for an idea.
http://www.annemergmed.com/

 

[Dr.Evil1]

Does EM eventually wind down into coming into work, seeing the same old same old that you've dealt with countless times before, and once every so often getting a rarer case that actually challenges you intellectually?

If so, are there things that EPs do to keep the intellectual challenge in their careers?

What you are describing...being able to pattern recognize and treat without having to use higher thought processes is actually thought of as a GOOD thing in EM. As opposed to IM or some of the more hypothetical deductive type specialties we need to act based on limited information in a timely manner.

What I think you are alluding to, though, is whether EM keeps you mentally challenged after you get the hang of it. I think that the answer is yes, but I am just a resident. I think that if you practice in an academic center and train residents you will always be challenged to teach and mentor (my plan). Others find research more fulfilling. There is tons of research going on in EM, and the great part is that it can center on almost any area of medicine, neurology, gyn etc that you are interested in.

 

[Febrifuge]

I can give you the Tech's-eye view on this. The thing is, even as someone who has only just scratched the surface of medical understanding, I can see that lots of stuff becomes routine. I stand at the patient's head and hand swabs to the docs during pelvic exams; their part of the choreography is not a great deal more complex than mine. But little things can jump out and surprise you.

We had a guy who got drunk, slipped and fell on ice, and dislocated his shoulder. Based on his xray and his clinical presentation, the docs thought he might have a rare inferior dislocation. The staff doc couldn't quite remember the Latin term "luxatio erecta," so I found it on the Internet... and got to dazzle everybody with my newfound knowledge. 0.5% of dislocations are actually this type; cool! The doc did know quite a lot about how to manage these and what to look out for, even if the Latin name wasn't on the tip of his brain.

Then the drunk guy moved his arm, apparently with great effort and pain, though for no good reason, and he now had a boring anterior dislocation.

People are an endless source of amusement, wisdom, and general surprise for me, and the thing about EM is, we try to see a boatload of people each shift. So yeah, there is a lot of autopilot engaged. But as was said above, that just means you can direct your attention to the stuff that stands out.