The advantages:
-- Ability to practice both after finishing
-- Ability to enter into academics without doing a fellowship
-- The idea that knowledge of EM enhances one's internist skills, and knoweldge of IM enhances one's EM skills
Someone could start a private practice whenever, as long as they keep their IM certification up-to-date.
I imagine most in IM/EM aren't interested in doing so; we half-breeds oftentimes are not the biggest fans of clinic, and enjoy being in the hospital with sick patients. The majority go into strictly emergency medicine, with a smaller contigent going into both (IM as a hospitalist, however); few also will do a sixth year to obtain critical care training, and hence have the ability to practice three flavors (general, ICU, and ER).
Overall, in order to be happy being im/em, you really have to enjoy both specialties. (and be able to switch personalities from rounding all day to 1/2 hour sign-out rounds!)
