Doubts entering residency

[DDAVP123]

Hi all,

4th year medical student here, recently matched at a great EM program but having recurring doubts entering residency and whether or not I chose the right the right path. I think I am the type of person that could be happy in a number of other fields in medicine and I can still picture myself in those fields unlike my other classmates who vomit at the thought of say primary care. Though I love medicine, I really envy PA/NP's flexibility to just switch fields at any given moment if they so desire.

Is it normal to have these doubts/cold feet upon entering residency? What makes you or anyone so 100% sure EM was the right choice 10-20 years down the line?

---

Members don't see this ad.

 

[Fox800]

Stay the course. Give it a year, and see how things go. These feelings are normal.

It's a good sign that there are way more docs trying to transfer from XYZ specialty (FM, IM, etc) into EM than the other way around...

 

[Bouddha]

Hi all,

4th year medical student here, recently matched at a great EM program but having recurring doubts entering residency and whether or not I chose the right the right path. I think I am the type of person that could be happy in a number of other fields in medicine and I can still picture myself in those fields unlike my other classmates who vomit at the thought of say primary care. Though I love medicine, I really envy PA/NP's flexibility to just switch fields at any given moment if they so desire.

Is it normal to have these doubts/cold feet upon entering residency? What makes you or anyone so 100% sure EM was the right choice 10-20 years down the line?

Hey there, didn't want to leave you hanging. I've been there, although I wasn't willing to admit my own 2nd thoughts to myself going into my surgery residency. I started to acknowledge them by Aug/Sept and in November I made the decision to switch to EM. It was the best decision I ever made.

At this point, you have to give it a go because of rules regarding the match. What I can say is I don't know of any specialty that offers the flexibility of EM. Residency is tough, and will kick your ass. But after residency (at least that's what I keep telling myself), the sky is the limit. Last year there were 15k vacancies in EM, and only 5k ED docs in the market to fill them. You can go anywhere you want. Read the thread here: What's a good way to earn extra cash or get out the game?. The White Coat Investor has some sage advice on the flexibility of EM.

Finally, at the end of the day, you have to trust yourself. If you're 3 months in and you're still having significant doubts, sit down and talk with your PD. Part of their job is helping you succeed, whether that means switching to another specialty or staying in EM. Honor yourself first by giving it 100% first though. EM really is amazing.

 

[deleted547339]

I would even go so far as to say you may want to give it a while. Internship is tough. Makes you feel dumb. And you work a ton.

A good mentor is the best thing you can do for yourself.

 

[Venko]

As someone else who has switched specialties before....try it out but if you know in your heart something isn't right then try and switch in the next match.

The reasons:
- funding will allow more residencies to take switchers if only one year has passed
- other residencies will not worry that you've been out of medical school for too long and may be out of touch with their specialty (less of an issue when leaving EM than for psych for example)

It will be important to distinguish between joy and hatred for the hours and workload vs the specialty. The hours and workload change or are changeable after residency.

As for wanting to hop around like a PA/NP...there probably isn't any medical specialty that will offer that. EM does have quite diverse fellowships and work styles / environments...more so than many other if not all other specialties.

Best wishes


Sent from my iPhone using SDN mobile

 

[Bouddha]

I would even go so far as to say you may want to give it a while. Internship is tough. Makes you feel dumb. And you work a ton.

A good mentor is the best thing you can do for yourself.

Agreed. I said 3 months above, but that's only based on my experience of switching to EM and having to do the match a second time. The reality is that switching from EM to IM/FM is significantly easier (and specialties relatively harder), but you wouldn't necessarily have to go into the match to switch out. Giving it a longer go (9+ mo) would give enough time to get into the swing of EM and at the same time leave to switch if you wanted.

 

[engineeredout]

Finally, at the end of the day, you have to trust yourself. If you're 3 months in and you're still having significant doubts, sit down and talk with your PD. Part of their job is helping you succeed, whether that means switching to another specialty or staying in EM. Honor yourself first by giving it 100% first though. EM really is amazing.

Problems with only giving it three months are:

#1) Huge transition from med student to resident - there's growing pains for at least the first few months no matter what specialty you're in.

#2) Depending on your schedule you could easily have very little time in the ED to start off. Few months of trauma/ICU/surgery/medicine in a row may make you hate what you're doing, but it's not your chosen field.


Trust your instincts. There is something that drew you into emergency medicine. It is an amazing field, your life is comparably better than other specialties (even in residency), and it's fun. Plus it does open up for a variety of different practice environments. You can work in a small rural hospital, large academic center, you could subspecialize in sports med and work in an office, you can do urgent care and get your fill of primary care type stuff etc... Tons of possibilities and more flexible than others.

I don't think you can ever be 100% sure about whether or not the field was correct that you chose. That is not limited to medicine. I originally went to college to become an engineer (hence the username); people burn out whether it's medicine or an office job somewhere crunching numbers.

You've cleared the hurdle of matching into a very difficult to match specialty. Take these next few months and enjoy them. Residency is coming whether you worry about it or not, so might as well lay in the sun with a drink in your hands until then

 

[swamprat]

I will play it from the other side. I'm EM doing a fellowship that will get me out of the ER forever if I want (which I may right and well do). My thoughts of EM were great like most other applicants until starting intern year. I absolutely hate shift work. With a passion. Now when I did my rotations as a student one rotation was pretty light so I got a taste of shift work and I remember thinking hmm.. this is weird, my gf is going in and I am hanging out till 3PM to start work on this Friday. Whatever. And then my second away audition was packed with so much learning/fluff I was always going in at 7-8AM regardless just some days I'd stay late to do a shift so I didn't really get a taste of shift work. Anyway as my days are numbered in residency I will say I still hate it with a passion. I much prefer to be off when people are off, not struggle several days post night shift to get my circadian rhythm back in order etc. I do like the work, excitement etc.. most of the time at least. I also enjoy the variety, procedures. So it's not all bad. But when I was an intern I made it my job to figure a way out. Thankfully that was a fellowship rather than another specialty because honestly I didn't really like anything in med school. And to add to all this one of our interns is switching out to do another field with EM counting as a prelim for her. So yeah it goes both ways. See how it is but if you don't love it realize there are a lot of outs.


Sent from my iPhone using SDN mobile

 

[deleted547339]

I will play it from the other side. I'm EM doing a fellowship that will get me out of the ER forever if I want (which I may right and well do). My thoughts of EM were great like most other applicants until starting intern year. I absolutely hate shift work. With a passion. Now when I did my rotations as a student one rotation was pretty light so I got a taste of shift work and I remember thinking hmm.. this is weird, my gf is going in and I am hanging out till 3PM to start work on this Friday. Whatever. And then my second away audition was packed with so much learning/fluff I was always going in at 7-8AM regardless just some days I'd stay late to do a shift so I didn't really get a taste of shift work. Anyway as my days are numbered in residency I will say I still hate it with a passion. I much prefer to be off when people are off, not struggle several days post night shift to get my circadian rhythm back in order etc. I do like the work, excitement etc.. most of the time at least. I also enjoy the variety, procedures. So it's not all bad. But when I was an intern I made it my job to figure a way out. Thankfully that was a fellowship rather than another specialty because honestly I didn't really like anything in med school. And to add to all this one of our interns is switching out to do another field with EM counting as a prelim for her. So yeah it goes both ways. See how it is but if you don't love it realize there are a lot of outs.


Sent from my iPhone using SDN mobile

Way to be vague about fellowship, birdstrike.

 

[pandahunter]

I will play it from the other side. I'm EM doing a fellowship that will get me out of the ER forever if I want (which I may right and well do). My thoughts of EM were great like most other applicants until starting intern year. I absolutely hate shift work. With a passion. Now when I did my rotations as a student one rotation was pretty light so I got a taste of shift work and I remember thinking hmm.. this is weird, my gf is going in and I am hanging out till 3PM to start work on this Friday. Whatever. And then my second away audition was packed with so much learning/fluff I was always going in at 7-8AM regardless just some days I'd stay late to do a shift so I didn't really get a taste of shift work. Anyway as my days are numbered in residency I will say I still hate it with a passion. I much prefer to be off when people are off, not struggle several days post night shift to get my circadian rhythm back in order etc. I do like the work, excitement etc.. most of the time at least. I also enjoy the variety, procedures. So it's not all bad. But when I was an intern I made it my job to figure a way out. Thankfully that was a fellowship rather than another specialty because honestly I didn't really like anything in med school. And to add to all this one of our interns is switching out to do another field with EM counting as a prelim for her. So yeah it goes both ways. See how it is but if you don't love it realize there are a lot of outs.


Sent from my iPhone using SDN mobile

which fellowship are you doing? I'm trying to get out of EM as well as I near the end of my time in residency

 

[TrailRun]

Hi all,

4th year medical student here, recently matched at a great EM program but having recurring doubts entering residency and whether or not I chose the right the right path. I think I am the type of person that could be happy in a number of other fields in medicine and I can still picture myself in those fields unlike my other classmates who vomit at the thought of say primary care. Though I love medicine, I really envy PA/NP's flexibility to just switch fields at any given moment if they so desire.

Is it normal to have these doubts/cold feet upon entering residency? What makes you or anyone so 100% sure EM was the right choice 10-20 years down the line?

I'm with you OP... although I matched gen surg and am highly questioning whether I should have applied EM. For me, the fears of lifestyle and lack of undifferentiated patients in surgery are my key concerns. I also really liked every EM resident I ever worked with. EM also has such a cool 'support network' full of podcasts, etc, even if the fantasy (saving lives every day!) of the job doesn't always match the reality.

Ultimately, I felt like gen surg was a way to do OR/procedures stuff while also practicing medicine, thinking it was a way to 'not give up anything' (i.e. the OR). But ultimately it seems true that every specialty ends up giving up something (like undifferentiated patients, scheduling flexibility as compared to EM, etc). I definitely envy my classmates who are 100% certain of their choice. I'd say I'm at 50%. And, as has been stated, the challenge with switching during your first year is that you only get 3 months to experience it before you have to reapply for a switch. I'm pretty confident I'll know after a full first year, but then I'll have to do my 2nd year and reapply and by that point I could finish surgery in the same time as doing another residency.

Best of luck with whatever you decide, but know that those of us heading into surgery and other fields are in the same boat I think EM is a safer choice though, for the schedule flexibility and scalability, and diversity of fellowships (CC).

 

[bananasinpijamas]

.

 

[gamerEMdoc]

I'm with you OP... although I matched gen surg and am highly questioning whether I should have applied EM. For me, the fears of lifestyle and lack of undifferentiated patients in surgery are my key concerns. I also really liked every EM resident I ever worked with. EM also has such a cool 'support network' full of podcasts, etc, even if the fantasy (saving lives every day!) of the job doesn't always match the reality.

Ultimately, I felt like gen surg was a way to do OR/procedures stuff while also practicing medicine, thinking it was a way to 'not give up anything' (i.e. the OR). But ultimately it seems true that every specialty ends up giving up something (like undifferentiated patients, scheduling flexibility as compared to EM, etc). I definitely envy my classmates who are 100% certain of their choice. I'd say I'm at 50%. And, as has been stated, the challenge with switching during your first year is that you only get 3 months to experience it before you have to reapply for a switch. I'm pretty confident I'll know after a full first year, but then I'll have to do my 2nd year and reapply and by that point I could finish surgery in the same time as doing another residency.

Best of luck with whatever you decide, but know that those of us heading into surgery and other fields are in the same boat I think EM is a safer choice though, for the schedule flexibility and scalability, and diversity of fellowships (CC).

Former surgery residents make GREAT EM residents. Just saying, if you ever decide to change your mind! But best of luck, Gen Surg is a grind, but next to EM residents (obviously) they are always my favorite to talk to and deal with clinically.

 

[throckmortonDO]

If you are flexible enough to see yourself in multiple fields and had a hard time deciding, EM sounds like a decent fit, we deal with almost every aspect of medicine in some way. You don't sound like you have much of an Ego so that's good as well for EM. Sure, you could have gone to B school or been a lawyer, but you didn't, and you matched EM. Stop having doubts. put your regrets aside. put your nose to the grindstone, butt up, shut up, head down. Be the best EM doc you can be. Life is good on the other side of residency. Explore your interests. hell, go back and get an MBA later or something if you really want to. If you hate EM in a decade go back and do a fellowship, several on here have.

You'll be fine.