Emergency Medicine

[relentless11]

I'm just curious about Emergency Medicine. How long is the residency, and what is involved? The only info i have gotten about it is from TV(Trauma Life in the ER). But its sorta confusing, so do they do surgery too? Or what?

Thanks in advance!

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[pcl]

There is a thread about this in rotations & residencies.

It is a 3 or 4 year residency, depends on the program.
http://www.studentdoctor.net/cgi-bin/ubbcgi/ultimatebb.cgi?ubb=get_topic&f=11&t=000494

 

[Firebird]

EM residencies are three to four years long, depending on the program (but most are three). I suppose that trauma surgery might be included as a "rotation" in EM, but EM doctors don't do surgery routinely.

To be in trauma surgery, I think you go through a few years of general surgery and then do a fellowship in trauma surgery. You wouldn't start out in EM.

EM is a great field. You don't have to worry with your own practice, the hospital generally covers your malpractice insurance, you have other great benefits, there's no call, hours are somewhat flexible, and you're well compensated.

However, many of the patients are drug-seekers, self destructive, etc. You see a lot of the same thing from day to day, I would expect. It's not nearly as fast-paced as "ER" or "Trauma: Life in the ER" portrays. I shadowed the other day in the ER and one of the med students said that she had been there for two or three weeks on her rotation and she had only seen two major resucitations (sp?) the entire time.

But I would say that would be different in a residency. Most residency programs I would assume would be in large trauma centers (as opposed to the semi-rural ER I shadowed in) and therefore would have a larger patient load and more acute cases. For example, I was looking at UofL's EM residency and their website's movie said they had one major resucitation every day.

Hope this helps...

 

[RockOn]

The ER can be slow but, a downtown Detroit hospital is not boring for long. I've been a research assistant in the ER for about 3 1/2yrs and I've seen a lot. Yes it gets busy and ugly and yes it gets slow and boring also.

I really enjoy the ER and the fast pace of a lot of it. Remember, though, that the whole ER is not teeming with critical trauma. Many people come there for primary care of subacute illnesses. These people, at least in a large urban setting, come her b/c they have no insurance and/or no money. Some can pay but have no primary care physician or basic medical support. Small or midsize problems get worse with time and need to be treated here. We have Category one for most severe cases. It's like a mini ICU. Cat 2 and Cat 3 are for less severe. We also have a GYN area and a Peds Category. Lots to do, lots of people to see, not all life or death.

As for residency, it's 3 yrs here but you can do a combined EM/IM in 5 yrs.

 

[relentless11]

Interesting. Is there actually an ER doc who deals with specifically Pediatrics? I'm doing an internship at UC Davis Med Ctr Peds ER this summer. I'm very excited since its the only level 1 trauma center north of San Francisco.

Lastly, i'm just wondering about the lifestyle for emergency medicine. I've met one of the professors of vascular surgery here at UCDMC, he pretty much goes from 6am-6pm on average. So i'm wondering like if i have to rotate through night shifts..etc.

 

[Winged Scapula]

I'll move this over to Rotations and Residencies for ya!

 

[Firebird]

Originally posted by relentless11:
•Interesting. Is there actually an ER doc who deals with specifically Pediatrics? •

Not for sure about this, but Doug Ross on ER was a Pediatric Fellow in the Emergency Dept. So maybe in real life there is such a thing as a Peds EM physician.

I think I have heard that lifestyle for EM docs is pretty good...like I said, no call, all shift work. Not too shabby.

Hmmm...UC Davis...pretty good school. I have a friend who just graduated there, I think...in the education dept.

 

[RBorhani]

Try http://www.saem.org/ They have pretty much all the info you need.... You can do EM/PEDS or EM/IM... EM/IM is not a fellowship but an actual 5 years of residency... EM/Peds can be done either by way of fellowship or a 5 year residency.. If you do just a Peds residency you can do EM fellowship for 3 years and become EM/PEDS or you can do EM residency and then do a Peds fellowship for 2 years and become EM/Peds.. http://www.saem.org/services/fellowsh.htm
is a list of all the fellowships you can do after EM...

 

[relentless11]

Thank you very much, the information have been very very helpful!

 

[pcl]

Originally posted by relentless11:
•Interesting. Is there actually an ER doc who deals with specifically Pediatrics? I'm doing an internship at UC Davis Med Ctr Peds ER this summer. I'm very excited since its the only level 1 trauma center north of San Francisco.

Lastly, i'm just wondering about the lifestyle for emergency medicine. I've met one of the professors of vascular surgery here at UCDMC, he pretty much goes from 6am-6pm on average. So i'm wondering like if i have to rotate through night shifts..etc.•

JulieR & I work at the same hospital (hello Julie!). Total visits are about 90K per year, with Peds ER seeing about 14. We have a seperate ER area staffed with Board Certified Pediatricians who also did a Peds ER fellowship. Pediatric residency first, then fellowship in PEM.

If you are interested in pediatric emergency medicine, you might check out seperate pediatric hospitals for what residency/fellowship options they have available. I don't think it is as common to have a peds ER fellowship (we only have 1 position per year) in a general tertiary center.

Yes, you will have to rotate through night shifts. As one ER physician reminded me "40% of all holidays, weekends, etc, you will have to work. This is not a normal lifestyle you are choosing, and sometimes that can wear on you. Make sure you love the work before you choose this field."

 

[RBorhani]

As one ER physician reminded me "40% of all holidays, weekends, etc, you will have to work. This is not a normal lifestyle you are choosing, and sometimes that can wear on you. Make sure you love the work before you choose this field."

I think by far as an Emergency Physician you will have one of the best lifestyles among all the docs (that's why EM is becoming so competitive)... You are never on call...never have to answer pages from home...you know your schedule way in advance and can easily plan vacations...When you work, you will work your behind off but when you are off...you are off....I have friends that have just finished their ED residency and one got a job that is 10 shifts per month...10 hour shifts…and gets paid $120/hr…..and 30% of the annual salary is matched for retirement by the group (i.e. does not cost the doctor anything) as a bonus incentive if the doc stays with the group for so many years.. You do the math…and you have 20 days left in the month to either work more if you want the cash or relax (if your loans are paid off and you dont want the cash)

Rez B.
PGY-II, Emergency Medicine
Univ of IL-College of Meidine

 

[mcwmark]

Rez-

Would you happen to know what the lifestyle/pay is like for academic EM physicians? And the pay differential between, say, the midwest and the west?

And what do you think about 3 year vs. 4 year programs--is there any advantage to spending an extra year with the "100k mistake"?

Thanks.

 

[relentless11]

Speaking of academic physician's. How would i make myself more competative for even that...at some point.

Yea yea, most importantly getting into med school is important right now. But i'm just curious, would it be more advantageous to be an MD, Phd; or MD, MPH for example to get into a position as a professr and a physician?

I have spoken to an MD about that, but he seemed to be one of those extraordinary people in the world. Ya know, MD from some well known institution, then like residency at UCLA, some fellowship at Harvard.

I am interested in teaching too, so thats something to wonder about.

 

[pcl]

Originally posted by RBorhani:
•
I think by far as an Emergency Physician you will have one of the best lifestyles among all the docs (that's why EM is becoming so competitive)... You are never on call...never have to answer pages from home...you know your schedule way in advance and can easily plan vacations...When you work, you will work your behind off but when you are off...you are off....•

And I would agree, but there's not much call in ENT either once you are out of residency. That was the point, taken from a senior staff physican who has been practicing 14 years. That it's great at first, but missing every other Christmas with your kids can get tough. The point was, the shift work gets exhausting if it's not the right type of position for you, so don't go into it just because it is shift work.

 

[rdennisjr]

mcw:

This is second hand info, but a buddy of mine just finished his residency (3 year) at a midwest school and starts work next week at a midwest teaching hospital in the ED. 14-9 hour shifts a month, 260+k a year. He has the choice after two years to head more instructional or treatment but will always have some mix. Hope that helps

 

[modemduck]

http://www.saem.org/inform/career.htm

This link gives a good comprehensive of EM

late,
modemduck

 

[modemduck]

ehh

Emergency Medicine