Em/im

[MeeraDO]

I'm starting EM/IM in July, and was wondering if anyone has any input as to what most docs do when they get both degrees? I know most go into EM, but is practicing IM also a little crazy? What about doing EM shifts and having your own practice? Just wanted some input. Thanks.

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[bulgethetwine]

I'm starting EM/IM in July, and was wondering if anyone has any input as to what most docs do when they get both degrees? I know most go into EM, but is practicing IM also a little crazy? What about doing EM shifts and having your own practice? Just wanted some input. Thanks.

Uh..... you're actually STARTING in July, or you're thinking of EM/IM?

I would have thought if you were starting in July, you would have thought this through. I'm not trying to give you a hard time, just wondering. Anyway, if you are starting, let's forget for a minute that you're late for the dance, and embrace the fact you arrived at all.

I know three people that did combined. One went into purely clinical research. A second works as a hospitalist but moonlights in an ER. I think he moonlights as time/financial incentive permits. The third alternates months at a major medical center as an attending in General Medicine and Emergency Medicine. He seems to enjoy it, but admits that the demands of each are different and the first couple of days after the switch (typically q2 months) he says it takes a little bit of time to adjust. He is particularly adept at negotiating the inevitable Medicine vs. ED squabbles, however.

 

[NinerNiner999]

Two words for you - "Stress Testing." You will see a TON of chest pain r/o MI in the ED and will most likely admit patients overnight for rule-out. If you have the ability get IM privledges at the same hospital in which you practice EM, admit these patients yourself (or to your group) and stress them in the morning after they rule out. I suppose this is possible, but it may not be. Otherwise, I suppose you could open up your own practice and follow the patients you discharge. There is also the possibility of clinic medicine...

 

[MeeraDO]

Yes I am starting EM/IM in july, and yes I did think this through. Just seems that there are endless possibilities as to what someone can do after finishing the program. Just wondering what people in the past have done who have completed the residency, or what people in the combined residency are plannin on doing.

 

[Dr.Evil1]

Two words for you - "Stress Testing." You will see a TON of chest pain r/o MI in the ED and will most likely admit patients overnight for rule-out. If you have the ability get IM privledges at the same hospital in which you practice EM, admit these patients yourself (or to your group) and stress them in the morning after they rule out. I suppose this is possible, but it may not be. Otherwise, I suppose you could open up your own practice and follow the patients you discharge. There is also the possibility of clinic medicine...

I don't think that you can admit patients to yourself from the ER. This is one of the reasons that emergency medicine as a speciality independent of IM or surgery came into existence. I think that you walk a very thin ethical line if you do this.

I think that as a dual boarded EM/IM physician you set your self up perfectly to do administration or education. I doubt that you could reliably practice both for any length of time (years). Good luck on your residency.

 

[turtle md]

We have 3 EM/IM's per year. Of the three from this year, one is doing a nephro fellowship, one is doing outpt medicine and clinical research, and one is doing straight EM (though he may pick up a few moonlighting hospitalist shifts eventually.) Of next years, one wants to do EM, one wants a pulm/CC fellowship, and the third I don't know.