EM/Rads: can it work??

[cpb80]

---

Members do not see this ad.

Hi M4 applying to EM...
I recently realized that I also like radiology, and I was wondering if any of you thought that it was feasible to do both. I have played with the idea of applying to a three year EM program and then doing rads for four years (assuming that radiology programs would allow me to skip a transitional year?) What's my reason? Well aside from enjoying radiology, I think it would make me a better EM physician (not to mention that I was already planning on doing a fellowhip in US). I am also a bit worried about burnout down the road, & I have been playing with the idea of working fewer shifts as I get older and supplementing my income with diagnostic reads on the side. I understand that pursuing both may seem unrealistic, but I had to ask.
Any feedback would be much appreciated.
Thanks!

 

[Monica Lewinsky]

Why don't you just do a year of ultrasonography that some EM programs have for residents who have finished the standard training? Its still radiology oriented, but you aren't dropping your ER work.

 

[yaah]

If you want to be an ER physician then do ER. The only reason to do a full radiology residency is if you want to be a radiologist. I don't understand all these questions from people who want to do multiple residencies as if that will somehow make them a better doctor. Your rationale is frankly a little bizarre. You're worried about potential burnout down the road, so your solution is to do another 4 years of residency (high time commitment and low pay) early in your career?

Other interests are why you have electives.

 

[cpb80]

If you want to be an ER physician then do ER. The only reason to do a full radiology residency is if you want to be a radiologist. I don't understand all these questions from people who want to do multiple residencies as if that will somehow make them a better doctor. Your rationale is frankly a little bizarre. You're worried about potential burnout down the road, so your solution is to do another 4 years of residency (high time commitment and low pay) early in your career?

Other interests are why you have electives.

Don't get your panties in a bunch. I don't think it's such a ridiculous idea to forego 4 years of higher pay etc. (which is relatively short term) to pursue something I would enjoy and which would potentially supplement my income in the future, when I might not want to work overnights as much. Yes, it would be a long time, but I find it "bizarre" that you can't relate to extra time in training ... does it say fellow under your avatar?

 

[unoriginal]

Don't get your panties in a bunch. I don't think it's such a ridiculous idea to forego 4 years of higher pay etc. (which is relatively short term) to pursue something I would enjoy and which would potentially supplement my income in the future, when I might not want to work overnights as much. Yes, it would be a long time, but I find it "bizarre" that you can't relate to extra time in training ... does it say fellow under your avatar?

i think funding issues would prevent u from being able to do both residencies????

 

[yaah]

Don't get your panties in a bunch. I don't think it's such a ridiculous idea to forego 4 years of higher pay etc. (which is relatively short term) to pursue something I would enjoy and which would potentially supplement my income in the future, when I might not want to work overnights as much. Yes, it would be a long time, but I find it "bizarre" that you can't relate to extra time in training ... does it say fellow under your avatar?

There is a big difference between one year of fellowship and four extra years of residency. In addition, pathology is a different world than ER - everyone (well, 90%) do at least one fellowship, some even do more, because of the way our field is. But that's irrelevant. The simple fact of three extra years not in residency will give you hundreds of thousands of dollars in income EARLY in your career. Basically the extra income you would be supplementing would be going towards paying back this virtual loan that you have taken out.

My panties are not in a bunch. I have no personal concern whether you take this path or not. I just frankly cannot understand why you would go through this extra four years (plus an extra board exam, plus more interviews, plus lots of other stuff) for the potential to supplement your income in the future. There are many many ways for a good ER physician to adjust their schedule and live a very nice lifestyle. And what makes you think you are going to be able to carve out a niche supplementing your income when you are primarily an ER physician? You may have done a radiology residency years ago but wouldn't someone rather use a full time radiologist for this work? If your interests in radiology are primarily personal interest or supplementing your ER knowledge/education, that is what electives are for.

 

[freddydpt]

look into a TY program with lots of ER or lots of electives so you can do a bunch of ER months.

 

[cgscribe]

It'll be tough to swing getting into a rads program directly after EM because of funding and the fact that it's a little weird. ER docs do benefit from some radiology training, but they see a very limited scope, and the important stuff is taught during EM residency. If you really like both, you could do rads and then emergency fellowship, or do interventional rads focusing on the acute stuff. Good luck in whatever happens.

 

[Taurus]

I can't see how you can do both and do them well. It's like being a jack of all trades but master of none. Pick your pony and go with it.

 

[Ratchet]

It's like being a jack of all trades but master of none.

Ha...isn't that essentially what EM is? 😉

 

[Taurus]

Ha...isn't that essentially what EM is? 😉

It's also essentially what primary care is too.

Because you're shallow in so many areas, guess which group is claiming it can provide the same level of care as physicians in primary care setting and even in the ED?

Let me give you a hint: it starts with an N and ends with a P.

 

[cgscribe]

If it's true that NP's are trying to move in on territory, and say that, that's interesting. I worked in an ED a while where NP's staffed the low acuity area, and they did great work...but they always had the MD's looking over them for help when needed or when something goes wrong (as tends to happen in the ED).

 

[Vince]

As a paramedic working in EMS for 8 years prior to medical school, I thought I wanted to be an ER physician for the longest time. It wasn't until about 3rd year during clinical rotations that I had to really look at Emergency Medicine as a career long term, and I decided that I would probably get burnt out fairly quickly and wouldn't want to be working all night long in the ED when I was 50 years old. I liked the diversity of pathologies that presented to the ED, but ER physicians have limited time to spend with their patients and because of contraints on the health care system, they seem to do a lot of "primary" care and protocol oriented care. I think you need to decide which one you want to do more and weigh the pluses and the minuses. I chose radiology and definitely made the right choice, especially when the ED calls me for reads on CT scans and they never really seem to know much clinical history. I think its a combination of overcrowding and being too busy, getting too used to seeing the same things again and again, or not doing a thorough exam/hx. I have a little more time to think about the patient and I am an expert with respect to imaging, whereas the ER doc often has to get consults from other physicians, wait on lab results, wait on imaging studies, and I just didn't want to be waiting on others before I could do my job. With respect to ultrasound, I have met very few er docs who are proficient at ultrasound. All I see is misuse of ultrasound in the ER. I believe it was first introduced for "FAST" scans, but now I get requests for multiple imaging studies based on what the ER thinks they see on the US. I'm not sure it changes care that much and sometimes I think it is just wasting time, although I have asked a friend who works in the ED and he said it does help them make managment decisions. Many times when I get requests for something the ER thinks they see on U/S, they are right 50% of the time....so I call their US machine the most expensive coin flip in the world. Bottom line is you have to decide which specialty you want to do. If you want to do a ER US fellowship after residency, then so be it....it may prove very useful, but hopefully it will be good quality US training and that should include some time in the radiology department. I don't see the benefit in doing another 4 years of radiology residency after 3 years of ER residency.