EM vs Radiology

[Fundamentals]

Recently finished my EM rotation, have been mostly for radiology throughout medical school but having second thoughts after doing some EM.

What I value most:
- Variety in pathology (find the two actually pretty similar in a lot of ways making this a tough decision right now. I get very bored, very quickly and both EM and Rads offer probably the widest coverage of pathology in medicine.)

- Lifestyle (In terms of lifestyle, I guess being in my 20s, the EM lifestyle is amazing. 30 hours a week, a couple nights/weekends, shifts in urgent care and still make 325 K. Rads is getting busier, but its still around 50 hrs a week, nights on call but you can listen to music, have the game on, eat while working, work from home etc. I'm not sure which one drains you more as I find it hard to anticipate how i'm going to feel 10 years down the road. Rads say they have to focus throughout the majority of the shift and EM does too but 90% is non-emergent stuff and it can get pretty auto-pilot which is kinda lax)

- Personalities of those I work with (EM docs win here, probably the chillest people I've seen at the hospital. Nothing phases them. If I were to do rads, i'd definitely be an extroverted one. Though, this specialty is more likely to attract those who want to be alone all day, and i'm not sure how chill these guys really are, any insight here?)

I dont thirst for patient contact, i'm indifferent about it, but I do like talking to my physician colleagues and nursing staff. Not a fan of big egos. Just trying to have fun, work hard, have plenty of time to chill out, all while making a good income - which specialty lends itself to this the most? Thanks everyone!

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[shoal007]

EM is not a lifestyle speciality. you will work half evenings and nights and half weekends. ohh and half of the holidays. yes, you work less hours but part of that is lost due to changing shifts. you also dont get vacation. your days that you do not work are your vacation. so 50 hr= 30 hr depending on schedule and vacation package.
As for mundane basic cases, small variations can make these very difficult and not slam dunks. Worried well and sick patients are typically the easiest. the middle grey zone is difficult. PAs and NPs are pulling off the easy patients more and more leaving EPs only with difficult patients and this may cause you to leave work feeling like youve been run over by a truck.

I think the difference is primarily in patient contact between these 2 specialities and if you like the dark. I considered rads for a little while until my rotation where i fell asleep everytime in the reading rooms.


good luck

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[AdmiralChz]

I think the difference is primarily in patient contact between these 2 specialities and if you like the dark. I considered rads for a little while until my rotation where i fell asleep everytime in the reading rooms.

This is the huge, HUGE difference between EM and Rads. You literally see many patients on an emergent basis or you literally see none (except IR, which is quickly becoming a separate field entirely).

You need to do some more thinking about your specialty - you will likely be able to take jobs where you won't have to work a huge amount of time in any specialty (meaning large groups, primarily) but lifestyle is in the eye of the beholder. Check out the EM forum sometime to see what they say about their lifestyle. While EM docs certainly work less hours, those hours are absolutely jam-packed with work - they have some of the highest rates of burnout of all physicians. As far as personalities, in both you will be dealing with consultants (surgery, medicine) but in a very different way.

You'll see plenty of pathology in just about any residency in an academic center, as community hospitals often lack the infrastructure and the specialists to deal with it. So just about any specialty would fit that requirement. You are certainly right about ER not knowing what's coming in the door.

I guess I'm a little confused - what are you really looking for in a specialty?

 

[BoardingDoc]

If you like EM, do EM. If you think you like EM because of the hours and the money... do anything besides EM. You will very rapidly find that your "awesome schedule and hours" sucks the life right out of you if you don't like your job. I definitely understand weighing how many hours you're going to work into the equation, however, at the end of the day you really need to decide which job you think you will be happy in. And I don't mean, which job will allow you to be happy. I mean which job doing the day to day routine stuff will you like?

 

[qwerty89]

The thing about EM is that shifts are based on patient volume. So you may need double coverage for busy late afternoons through late evenings/mornings (think 2am) but only single coverage during the coveted 6am-2pm shift.

In other words a disproportionate amount of your shifts will extend late into the evening/overnight. Not to mention weekends/holidays.

 

[qwerty89]

I think the difference is primarily in patient contact between these 2 specialities and if you like the dark. I considered rads for a little while until my rotation where i fell asleep everytime in the reading rooms.

I always fell asleep on my radiology rotations as a med student and as a TY intern. As a current R1 I can assure you that reading studies is completely different.

 

[EBKame]

EM academic attending here three years out of residency. LOVE EM. Wouldn't want it any other way. I couldn't even imagine nor did I consider radiology as a medical student. It's tough as an MS-3, MS-4. You really get so little exposure to EM/rads. Do you have a good advisor that knows you well? In EM there's a lot of variability. You can be in academics and do mostly teaching and research with occasional clinical medicine. You can become a sub specialist and do hyperbaric or sports medicine in a 9-5 type way. OR you can do what most do in EM and work at a community hospital. Those who work in the community do work 2/3 of their shifts in the evening or overnight. You're frequently paid by your ability to see volume and by patient satisfaction. In academics, most shifts are still evenings and overnights, but shifts are broken up with resident teaching, you work far less of them, and you're not compensated mostly by volume.