Hey everyone, I am a PGY-2 EM resident interested in critical care. I know there are a handful of EM-CCM trained docs on this forum, and I was hoping to garner some insight. I have found that I really enjoy my time in the ICU, particularly as an intern but even more so this year as a PGY-2, where I was basically treated as a senior resident. I did the majority of the procedures myself and ran the codes, supervised the interns. I was given a lot of autonomy by the critical care fellows. I began comparing it to my EM shifts. I find that CC is more cerebral, there is time to actually sit down and review old consultation notes, old cultures, prior echos, and to make more informed decisions. I also found that I had much more meaningful discussions with families, because the pace was just different compared to the ER. I didn't feel like a cog in a wheel, churning through patients like I do in the ED. It is getting around the time where I need to decide if I should apply for fellowship. My residency program has a pure CC fellowship that is open to EM, and I have already met with the PD who knows me well (I worked with him several weeks on the unit). He encouraged me to apply and basically told me I would be a good fit. My decision to apply is purely because I enjoy critical care and think that it adds career longevity to my career. It would do nothing for me in terms of salary. Unfortunately, several of my attendings and one of my mentors discouraged me from doing it. They sited that it is very difficult to work as both an EM doc and an intensivist, and that no community hospital would hire me for 7 on/7 off schedule for two week of the month AND give me shifts in the ED, and furthermore, they asked me if I even wanted to work that much clinically coming out of residency. They told me that the only way to really swing both is to work somewhere academic, where one week out of the month I could work as an intensivist, and then work 8 or so ED shifts. I was also told that since the job will be an academic position, the salary will be significantly reduced when compared to working in a community setting. My question is, is it possible to work as an intensivist for 1 week out of the month in the community, and to then work 8 or so ED shifts a month? How many of you guys have a set up like this? Do you even get the benefits (health insurance, 401K, etc. ) since you technically are not a full time intensivist or a full time ED doc? I am interested in being a nocturnist so, would it be possible to get a gig where I work 1 week of nights as ICU doc and then have the remainder of my shifts scheduled in the ED? Would love to hear any other general advice from those who are currently EM-CC trained and working. TIA.