EM - what do i need to do?

[pre-doc]

I apologize if this has been asked before (i am quite confident that it has been in some form or the other), but what does one need to do to look competitive enough for EM residencies. I know that this field has been hot as of late, but isn't it truly that competitive? It isn't like ortho is it?

Thanks in advance!

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[Mr. happy clown guy]

go to the following sites

<a href="http://www.emra.org" target="_blank">www.emra.org</a>
<a href="http://www.saem.org" target="_blank">www.saem.org</a>

these will help!

 

[rastelli]

EM is nothing like ortho...Nor like ophtho, derm, ENT, etc. EM residencies are a dime a dozen. Just look around. EM has gotten a huge boost from all the TV shows on the subject, from NBC's pseudo-ER to TLC's programming.

EM residencies are as plentiful as gen. surgery, pediatrics, medicine, etc. Like all of these disciplines, there are "better" programs, but EM is not that difficult to find a spot.

Good programs are: Charity Hospital, New Orleans; LA County, LA; Parkland, Dallas; Grady, Atlanta; Cooke Co., Chicago.

 

[rastelli]

As far as making yourself more marketable, I'd recommend some research (hyperbaric medicine is an up and coming field), decent grades, and a board score at/above the mean. You'll have plenty of opportunities with such a profile.

Remember the majority of EM in the real world is merely primary care. In New Orleans, the majority of our patients are simply people that don't have a regular primary care doc. You'd be surprised how long people will wait in the ED just to have you work up typical low back pain. The majority of your patients will not be as exciting as TV has made EM out to be.

 

[roadie]

are you telling me that every patient isn't a penetrating trauma? :wink:

 

[Freeeedom!]

EM is extremely challenging to get into, and as for "dime a dozen", that has the sound of insulting sarcasm.

Since I am doing my residency in EM, I don't think I would say residencies are as "plentiful" as PEDS or IM.
There are roughly 340 IM programs, 148 Orthopedic Surg programs,189 peds programs, and 118 EM programs, etc etc.
EM certainly has an aspect of Primary Care (this is NOT a bad word), but has huge aspects of IM, cardiology, psych, OB, peds, and Ortho. It is alot of fun, and one of the main reasons it is so popular, is that there is no call (makes residency much more tolerable) and each shift holds remarkable diversity.
The EM docs I have worked with have been the most intelligent and most fun people I have been around! Hell, the residents actually have a social life!

As for the best programs.
There is NO FORMAL LIST, but generally the most respected/oldest/best established are found in the following list:

U. of Cincy
U of Michigan
Indiana U.
Hennenpin County
Carolinas
Maricopa Med Center
MetroHealth (Cleveland)
Pittsburg
Christ Hospital
U. of Chicago
USC-LAC
Louisville
Vandy
Orlando

These programs consistantly work on research, maintain high visability within the field (SAEM, ACEP, AAEM) and lobby for standards and the rights of EM physicians.

 

[rastelli]

Hey Dr. Carter, oops I mean Freeedommm....relax dog. No one's poking fun at your chosen profession. However, I feel some clarification is in order.

If the term "dime a dozen" insults you, toughen up. Don't be such a sissy. EM residencies are the fastest growing in the field. Sure, there are approx. 148 ortho residencies around the country. I'm willing to accept that as fact. That number has undoubtedly remained the same for years. As of this year, there are 124 EM residencies. Just six years ago there were 108 residencies. In '85 there were 63 residencies in the US. That's almost double in less than twenty years. No other field is opening up like that.

I love how primary care docs always get defensive when one uses the terms "primary care." EM is mainly primary care. Sure, the occasional MVC can interupt a night of suturing grandma's cut finger, but that's not how the ED generally works. Most of the patients that enter the ED of a given hospital, do so on their own two feet. Most of them are quite content hanging out in the waiting room until the next nebulizer is ready for their asthma treatment.

If you like EM, great. I think ED docs are crucial. However, don't go making it out to be something it simply isn't. You end up making an ass of yourself. If you had a tough time finding a residency that's your beef.

 

[bobo]

Where is the Captain Freedom of old when we need him? Somebody please blast this clown back to where he came from!

I am so glad that EM residencies are a dime a dozen. I am so relieved that I am assured of a good residency spot now since they are SO plentiful.

 

[Freeeedom!]

Dog? Sorry, Snoop, didn't realize we would be "speekin street" tough guy.

Rastelli, the reason I answered in such a way is so that people could actually get some reliable information, rather than *****ic comments from some premed or 1st or 2nd year.

Oh, yes this is captain freedom! Some days I choose to be helpful though.

 

[rastelli]

Freeedommm...we meet again. I do not claim to be omniscient, however, as a 3rd year in a school known for it's EM program I thought a bit of realism should be injected into the forum to counter your rhetoric.

When I entered med. school I wanted to go into EM. Many aspects of the discipline still appeal to me. However, my conversations with faculty, attendance at national conferences (last fall in Atlanta), and personal experience in the ED has pushed me away from EM. Many of the ill feelings conveyed by the physicians who have practiced in the real world(not residents like yourself) regarding poor job satisfaction, poor relations with other physicians within an institution, and lack of respect drove me to seek a different profession.

 

[Mr. happy clown guy]

Rastelli,
After seeing that you are in New Orleans, I can understand...EM is different in areas where there has not been strong departmental status, especially in the south. But listen up, people talk trash about EVERY department!
You know the jokes
"How do you hide a stethoscope from an Orthopod...put it in the chart"
"How do you hide a stethoscope from FP, put it in a research article"
The battle cry of the typical knuckles-on-the ground orthopod is "BROKE BONE...ME FIX!!"
Hell, EM guys constantly make fun of IM, cardio, radiology, etc! If you are worried that other professionals will second guess you are talk trash...then maybe you should choose something else to do.
My advice, hold your tongue till you get to the end of your 4th year...and you have seen a bit more.

 

[rastelli]

Thanks for the advise Obi Wan....but I'm pretty comfortable with my understanding of how things work. I understand that EM residents have a chip on their shoulder for god know what reason. Perhaps frustrated that other physicians think of them as merely high-tech first aid artists, I don't know. I also understand that EM residents have tons of time on their hands to perpetuate this topic. Shouldn't you guys be attending to patient care?

And please, don't give me the "South is slow" line. It's tired and obsolete. I used to live up north and know things aren't as peachy as Yanks love to preach. If that were the case, how would you explain the tremendous influx of Yanks to cities like Atlanta, Dallas, New Orleans, DC, Charlotte, etc.? Or are you one of those Long Islanders or Jersey boys stuck in the 19th century? Speaking of which: What exit you live off of?

 

[rastelli]

What is an orthopod's definition of the heart?

That thing that pumps Ancef to the bones.

 

[hankhill]

What specialty are you thinking of pursueing rastelli? And why?

Thanks

 

[windsurfr]

Pre-Doc
The worst thing you could do to yourself at this time is listen to/worry about some of the above remarks. Read Iserson's 'getting into a medical residency'. Wonderful book with many stats to back up opinions.
Also hit up any local ED's web sites and email a doc or two. Chances are they will let you tag along. Then see for yourself. The talk about North/South, Primary Care/Specialty sounds like a pre adolescent argument. Find out for yourself.