Jun 27, 2017
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Hello everyone I was wondering about thoughts on going from emergency medicine to primary care. I'm not even sure if I'm in the right place to ask this. I'm pre med and I know I shouldn't be thinking about specialties and all that but I still have to ask. I would really love to do EM but I hear so much about the quick burn out. I was wondering if burn out does occur would it be "easy" to transition over to primary care? The amount extra of training doesn't bother me, it's all time that's going to pass anyways. If you could share thoughts or advise on this I'd appreciate it. Thanks
 

Mad Jack

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You'd have to complete a second residency. Not impossible to do, but a lot of departments aren't going to take you due to funding issues. That being said, a second residency shouldn't be impossible, and would require a full 3 years in FM or IM if you did a 3-year EM program, or as low as 2 years if you did a 4-year EM program that has an intern year that is diverse enough to meet the requirements of a FM or IM intern year (whether your new program will take these months is entirely up to them, however).

Your other option would be just going straight to urgent care, which is an outpatient, 9-5ish job that gets you a lot of the stuff primary care sees with zero extra training.
 
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djtallahassee

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What about the other way around? FM to EM. A doctor I shadowed said it used to be more common and was only like an extra year.


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Mad Jack

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What about the other way around? FM to EM. A doctor I shadowed said it used to be more common and was only like an extra year.


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There are FM fellowships in EM, but they are pretty much going to restrict you to the same sort of stuff a non-fellowship trained FM doc can do- rural and community ERs far away from civilization. These days you have to fully retrain in EM, which is going to run you 3 years more often than not.
 

darkjedi

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In most places you do not need to be board certified (by ABIM for Internal Medicine or ABFM for Family) in order to practice independently. You just need a full license, which depending on the state, still requires one to several years of post-graduate training.

If you decided to practice independently without a family medicine or internal medicine board certification, you just can't legally list yourself as being board certified as those. That has the potential to limit the patients that want to go to you, especially in an area with many physicians. Most hospitals will also not hire physicians without board certification, but if you run your own practice, this isn't as much of an issue. You may also run into some reimbursement issues with insurance companies if you are not properly board certified. You may also run into some snags enrolling in malpractice insurance since your rates vastly differ depending on your specialty. None the less it is possible.
 
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Planes2Doc

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90% of EM is primary care.
 
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Jun 27, 2017
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90% of EM is primary care.
I have read this aswell. I'm talking more about "transferring" out of the EM environment to a primary care setting like in a Family practice. I know they each come with their own stressors. I was just wondering if it was possible to go from one to the other if/when EM did become a burnout situation.
 

Planes2Doc

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I have read this aswell. I'm talking more about "transferring" out of the EM environment to a primary care setting like in a Family practice. I know they each come with their own stressors. I was just wondering if it was possible to go from one to the other if/when EM did become a burnout situation.
You need to first see whether you like clinic or not. You will find that out in medical school.

If you hate clinic, then you will likely hate primary care. Emergency medicine is similar to clinic except you don't see the same people unless it's frequent fliers. I'm not a fan of clinic, and a one month family medicine rotation with 40-50 patients a day was enough to burn me out for the month. On the other hand, some people love that setting. That's why primary care is ultimately one of the most polarizing aspects of medicine.
 

Tenk

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You can transition to urgent care or a less busy hospital if you feel burn out but you won't be a family doctor by any means. Also if you look at those medscape burn out chart things, everyone is burning out. The difference between EM and other specialties is not that high.
 
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