2 problems I see with wanting to practice IM AND EM.
1. We need good, solid PCPs, who are available to their patients. You are doing noone a favor by only having clinic for 1-2 days a week and then working random ER shifts, and recovering from night shifts the rest of the time. The only way that is useful to anyone is if they happen to get sick or have a question on that 1 or 2 days where you are available. Or are you going to be fielding out-patient calls all day while you work the ER, or recover from a night shift?
2. ER has such an incredibly broad base of knowledge, that every hour spent practicing IM, and studying IM is an hour away from peds, ophtho, trauma, surgery, Ob-gyn, etc. I believe that the best ER doctor is a person who spends the majority of their time training and practicing in the ER.
I have a co-worker who did IM/EM. He is undoubtedly a great doc. Hhe has more IM knowledge than I do. However, he doesn't practice out-patient or in-patient medicine, so what was the point of spending an extra 1-2 years on pure internal medicine rotations?
My bias is that he would have learned more had he got out of residency and practiced ER on his own for that period, making good money, rather than making crap pay in residency and still having his hand held by attendings.
