Entering EM as an older graduate

[MrEmjay417]

Do forgive. I tried a search, but if this has been asked before then I apologize.

I'm a non traditional student. Currently 27, will probably apply at 30 (prereqs), which puts me at 34 when I graduate. I am primarily interested Emergency Medicine. I'd like to do computer science and machine learning research with emergency medicine on my off hours (I am currently a software developer with a focus in webdev/artificial intelligence).

Will it be significantly harder for me to get an EM residency as a graduate at age 34? I believe many ED's require EM physicians to retire at 65, so I am worried about being discriminated against as an older physician.

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[TheComebacKid]

I have never heard of any EM job "requiring" anyone to retire at any given age. Maybe it does exist but I have yet to see it. Instead, many people in EM would rather prefer to retire earlier if possible, given the demanding nature of the work, burnout, and other interests.

But my understanding is that if you can do the work, and still do it well without showing signs of negligence, you can practice for however long you want. I have a handful of attendings in their 70s that are still going strong.

I would say that if medicine is what you want to do and you can't imagine doing anything else, then go for it. I would also say that if you think you want to do EM now, there is a very good chance you will change once in medical school. Don't make any decisions to go or not go into medical school based on your current perceived notion of EM at this time.

 

[Willzyk]

If anything you have a leg up with more life experience and being able to relate others more. I think you can easily spin it as a positive. Plus I don't think 34 is old for entering residency.

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[theseeker4]

Do forgive. I tried a search, but if this has been asked before then I apologize.

I'm a non traditional student. Currently 27, will probably apply at 30 (prereqs), which puts me at 34 when I graduate. I am primarily interested Emergency Medicine. I'd like to do computer science and machine learning research with emergency medicine on my off hours (I am currently a software developer with a focus in webdev/artificial intelligence).

Will it be significantly harder for me to get an EM residency as a graduate at age 34? I believe many ED's require EM physicians to retire at 65, so I am worried about being discriminated against as an older physician.

You are fine, and there is no requirement for someone to retire, unless you are in the military. Doing so would risk an age discrimination lawsuit. I am 34 currently as a second year EM resident, and there is someone in my residency class who is ten years older than I am. Age will not be an obstacle. You will have to be comfortable with switching from mornings to evenings to overnights, randomly, pretty much for the rest of your career. You are not really all that old compared to some who start medical school at the age of 40 or even older. Just make sure medicine is what you really want to do before you blow up your life. I am personally very glad I pursued this, but there are some who were not so thrilled with their decision I knew in medical school, and it definitely has been a lot of sacrifices.

 

[surely]

Do forgive. I tried a search, but if this has been asked before then I apologize.

I'm a non traditional student. Currently 27, will probably apply at 30 (prereqs), which puts me at 34 when I graduate. I am primarily interested Emergency Medicine. I'd like to do computer science and machine learning research with emergency medicine on my off hours (I am currently a software developer with a focus in webdev/artificial intelligence).

Will it be significantly harder for me to get an EM residency as a graduate at age 34? I believe many ED's require EM physicians to retire at 65, so I am worried about being discriminated against as an older physician.

n=1 but, as an MS4 going into EM, I know someone in your age bracket currently applying with a ton of success. I wouldn't be concerned about your ability to match solely because of your age.

 

[MrEmjay417]

n=1 but, as an MS4 going into EM, I know someone in your age bracket currently applying with a ton of success. I wouldn't be concerned about your ability to match solely because of your age.

I have never heard of any EM job "requiring" anyone to retire at any given age. Maybe it does exist but I have yet to see it. Instead, many people in EM would rather prefer to retire earlier if possible, given the demanding nature of the work, burnout, and other interests.

But my understanding is that if you can do the work, and still do it well without showing signs of negligence, you can practice for however long you want. I have a handful of attendings in their 70s that are still going strong.

I would say that if medicine is what you want to do and you can't imagine doing anything else, then go for it. I would also say that if you think you want to do EM now, there is a very good chance you will change once in medical school. Don't make any decisions to go or not go into medical school based on your current perceived notion of EM at this time.

This is awesome advice and advice I've been given many, many times.

 

[MrEmjay417]

If anything you have a leg up with more life experience and being able to relate others more. I think you can easily spin it as a positive. Plus I don't think 34 is old for entering residency.

I definitely think I have some good life experience that would be beneficial to EM. I used to be a jail guard when I was young and I worked all three shifts

 

[whatisthisstuff]

You're not old and it won't be a problem.

That said I would reconsider investing all this time/money/effort into med school and EM to do it as a side gig...atleast that what I gathered from your psot.

 

[carbonizedeyesockets]

A friend of mine matched into one of the most prestigious residencies for EM when he was 38. Older residents are everywhere in EM. Worry about Med school for now.

 

[MrEmjay417]

You're not old and it won't be a problem.

That said I would reconsider investing all this time/money/effort into med school and EM to do it as a side gig...atleast that what I gathered from your psot.

I definitely won't do it as a side hustle. I would actually do research on the side. I really want to clinical work.

 

[Groove]

Do forgive. I tried a search, but if this has been asked before then I apologize.

I'm a non traditional student. Currently 27, will probably apply at 30 (prereqs), which puts me at 34 when I graduate. I am primarily interested Emergency Medicine. I'd like to do computer science and machine learning research with emergency medicine on my off hours (I am currently a software developer with a focus in webdev/artificial intelligence).

Will it be significantly harder for me to get an EM residency as a graduate at age 34? I believe many ED's require EM physicians to retire at 65, so I am worried about being discriminated against as an older physician.

I was also a developer and worked in IT for several years prior to medicine (MS in MIS). I turned 30 during my first semester of med school. The age shouldn't deter you, especially if you "think" you want to pursue EM which may or may not change as you do your 3rd and 4th year rotations.

After residency, finding positions that allow you to utilize your prior skillset while building on your newly minted EM skills are difficult to find. (And I searched very hard...) In my experience, those positions are largely either academic or involved specifically in medical informatics. You, like myself, probably would be looking into whether a medical informatics fellowship would be beneficial or not. I had a long discussion with a PD of one of those programs and ultimately we both came to the conclusion that I was overqualified and the 1-2 years or fellowship would be largely wasted, especially when factoring in time and money lost. So, that leaves you trying to find "MIS" related positions at your local hospital or being the "IT" guy within your practice group. Again, the positions are tough to find in private practice unless you are looking to take on a more MIS related career role semi full time. "CMIO, etc.."

Finally, after some soul searching I came to the conclusion that it is not only difficult, but next to impossible to balance both career arms and be great at both. The more time you sacrifice from clinical medicine, the bigger a disservice it's going to be to your patients and your colleages/employer who more than likely will be less interested in what "IT" skills you have and much more interested in whether you can work in a clinical FT capacity, and do it with competence, efficiency and finesse.

In the end, I made the decision to devote 100% of myself to EM and I just dabble at this point in the technology side of things. (I made that decision several years ago and have never regretted it if that makes you feel any better.) Personal enjoyment aside, it's really a much more financially practical solution also when you think of the time and lost income you will give up sacrificing almost a decade of your thirties. Nothing is impossible, but just keep in mind...If you decide to try to pursue an informatics position while working in medicine/EM part-time, you will sacrifice a tremendous amount of compensation. Good luck and feel free to PM me if you want to discuss more details.

 

[The White Coat Investor]

Do forgive. I tried a search, but if this has been asked before then I apologize.

I'm a non traditional student. Currently 27, will probably apply at 30 (prereqs), which puts me at 34 when I graduate. I am primarily interested Emergency Medicine. I'd like to do computer science and machine learning research with emergency medicine on my off hours (I am currently a software developer with a focus in webdev/artificial intelligence).

Will it be significantly harder for me to get an EM residency as a graduate at age 34? I believe many ED's require EM physicians to retire at 65, so I am worried about being discriminated against as an older physician.

Seriously? Is 34 even non-traditional? I mean, I was 31 when I left residency. How different can that be from 34? I assure you they didn't feel very different.

 

[Vandalia]

Seriously? Is 34 even non-traditional? I mean, I was 31 when I left residency. How different can that be from 34? I assure you they didn't feel very different.

Exactly. When I saw the thread I thought it would be someone who was 50 and starting medical school. 34 and starting a residency is not unusual at all. There is a big difference between age 55 and age 65; there is not much between 25 and 35.

 

[TheTruckGuy]

I had several med school classmates that ranged in age between 34-40 at the time of graduation, and I think a couple were in their mid-late 40's but didn't tell anyone how old they were. And I have several fellow residents in our program that will finish residency between the ages of 38-44.

I do believe some other specialties are a little tougher on the ages they "allow" in. It's unofficial, of course, because they can't discriminate on age. But these specialties are also known for being pretentious d-bags as well, so you probably wouldn't want to be one anyways.

 

[ScoutQ4]

My class has a woman who is 41 going into emergency medicine. Just a number, my friend.

 

[The White Coat Investor]

Seriously? Is 34 even non-traditional? I mean, I was 31 when I left residency. How different can that be from 34? I assure you they didn't feel very different.

Oh, I think I misread. You'll be 34 when you start EM residency. Okay, I guess that's non-traditional. Still not a huge deal. Eight years behind someone who went straight through, which most of us didn't. I don't think you'll have an issue matching or having a career as long as you want it to be. If you really hustled you could probably even retire at 50 if you wanted to. You'll just have to manage your money well. So if they boot you out at 65, no big deal. I mean, that'll give you 28 years to save for retirement. That's plenty on an EM salary. FWIW- Our group doesn't boot anyone out at 65, but they almost all retire before then!

 

[Jlaw]

I will be 38 when I finish residency next year and don't think it is a big deal. There are others in my program my age and plenty who are only a few years younger. If anything I think its a benefit, the younger residents seem to be the ones who have issues with professionalism, who don't choose to moonlight because its too much work, and who end up doing useless fellowships, etc. The older ones I have seen have for the most part avoided any issues in residency, maximized their skills, gotten great moonlighting gigs and obtained the best jobs after graduation. I have no idea about age caps but I would venture to guess that unless you have early onset alzheimers most places will keep you around past 65. By the time we are 65 retirement age is likely to be older anyway. They might take you off nights or reduce your clinical schedule a bit but if you still want to work there will be opportunities. If you have a good work ethic and any semblance of money management skills you should be able to retire much earlier though. Feel free to PM with any specific questions.

 

[Angry Birds]

Do forgive. I tried a search, but if this has been asked before then I apologize.

I'm a non traditional student. Currently 27, will probably apply at 30 (prereqs), which puts me at 34 when I graduate. I am primarily interested Emergency Medicine. I'd like to do computer science and machine learning research with emergency medicine on my off hours (I am currently a software developer with a focus in webdev/artificial intelligence).

Will it be significantly harder for me to get an EM residency as a graduate at age 34? I believe many ED's require EM physicians to retire at 65, so I am worried about being discriminated against as an older physician.

As everyone else mentioned, I wouldn't worry about your age when it comes to doing emergency medicine. If anything, a shorter residency makes sense.

On the other hand, I'd make sure you want to go to medical school at all... especially when you are older and have a cool job as a software developer in webdev/AI. Why not just move to the Bay Area and work for Google?

I say this as a person who regrets going into medicine... Having said that, I'm no longer miserable as I once was, due to finding an EM job I can even sometimes enjoy, especially when I get compensated so well. But, if I could get the lost decade back, I'd do it in a heartbeat. I could have invested that decade into my true calling...

 

[Gray Fox]

As everyone else mentioned, I wouldn't worry about your age when it comes to doing emergency medicine. If anything, a shorter residency makes sense.

On the other hand, I'd make sure you want to go to medical school at all... especially when you are older and have a cool job as a software developer in webdev/AI. Why not just move to the Bay Area and work for Google?

I say this as a person who regrets going into medicine... Having said that, I'm no longer miserable as I once was, due to finding an EM job I can even sometimes enjoy, especially when I get compensated so well. But, if I could get the lost decade back, I'd do it in a heartbeat. I could have invested that decade into my true calling...

What is your true calling?

 

[MrEmjay417]

As everyone else mentioned, I wouldn't worry about your age when it comes to doing emergency medicine. If anything, a shorter residency makes sense.

On the other hand, I'd make sure you want to go to medical school at all... especially when you are older and have a cool job as a software developer in webdev/AI. Why not just move to the Bay Area and work for Google?

I say this as a person who regrets going into medicine... Having said that, I'm no longer miserable as I once was, due to finding an EM job I can even sometimes enjoy, especially when I get compensated so well. But, if I could get the lost decade back, I'd do it in a heartbeat. I could have invested that decade into my true calling...

You know... It's all theory at this point, so I'm definitely going to develop relationships with docs and see what their day to day is like. The itch to go into to medicine actually began when I started doing consulting for a medical practice in the rural Midwest (in addition to a mystery Illness that also, mysteriously went away). I'm mostly making sure they don't get ripped off by the IBM's and HP's or startups run by some senator's son (read: HIPPA really keeps you from innovating).

Everyone says this, but I do like to help people. I worked in law enforcement before getting into webdev, but left because I couldn't afford rent. And honestly staying CS would also be very wise. My salary now is approaching some of the lower paying medicine specialities and I've moved up very quickly in the webdev world, but the clinical work really interests me.

As an aside, I live in the low cost Midwest. One of the things that makes me nervous about working for a Google or a Facebook is the cost of living in the areas there in. I see salaries for $150K (offers I'm getting now), but I also see stories of devs living in their cars because they can't afford the Bay Area.

 

[Groove]

You know... It's all theory at this point, so I'm definitely going to develop relationships with docs and see what their day to day is like. The itch to go into to medicine actually began when I started doing consulting for a medical practice in the rural Midwest (in addition to a mystery Illness that also, mysteriously went away). I'm mostly making sure they don't get ripped off by the IBM's and HP's or startups run by some senator's son (read: HIPPA really keeps you from innovating).

Everyone says this, but I do like to help people. I worked in law enforcement before getting into webdev, but left because I couldn't afford rent. And honestly staying CS would also be very wise. My salary now is approaching some of the lower paying medicine specialities and I've moved up very quickly in the webdev world, but the clinical work really interests me.

As an aside, I live in the low cost Midwest. One of the things that makes me nervous about working for a Google or a Facebook is the cost of living in the areas there in. I see salaries for $150K (offers I'm getting now), but I also see stories of devs living in their cars because they can't afford the Bay Area.

Don't do anything impulsive. Although my dad was a surgeon, and medicine wasn't unfamiliar to me, I still volunteered in a local trauma ER for close to a year (while finishing my masters) on the weekends before I fully made my mind up. I would advise against doing it for the money, or because of perceived job security. I think anybody that enjoys their career and is passionate about it, will ultimately succeed. If you are getting offers for $150k, that's a lot to turn down for the long and arduous journey that will be a career in medicine. If you want something "medical" with good money, low stress and good job security... go be a dentist.

 

[hundreddaysoff]

I was also a developer and worked in IT for several years prior to medicine (MS in MIS). I turned 30 during my first semester of med school. The age shouldn't deter you, especially if you "think" you want to pursue EM which may or may not change as you do your 3rd and 4th year rotations.

After residency, finding positions that allow you to utilize your prior skillset while building on your newly minted EM skills are difficult to find. (And I searched very hard...) In my experience, those positions are largely either academic or involved specifically in medical informatics. You, like myself, probably would be looking into whether a medical informatics fellowship would be beneficial or not. I had a long discussion with a PD of one of those programs and ultimately we both came to the conclusion that I was overqualified and the 1-2 years or fellowship would be largely wasted, especially when factoring in time and money lost. So, that leaves you trying to find "MIS" related positions at your local hospital or being the "IT" guy within your practice group. Again, the positions are tough to find in private practice unless you are looking to take on a more MIS related career role semi full time. "CMIO, etc.."

Finally, after some soul searching I came to the conclusion that it is not only difficult, but next to impossible to balance both career arms and be great at both. The more time you sacrifice from clinical medicine, the bigger a disservice it's going to be to your patients and your colleages/employer who more than likely will be less interested in what "IT" skills you have and much more interested in whether you can work in a clinical FT capacity, and do it with competence, efficiency and finesse.

In the end, I made the decision to devote 100% of myself to EM and I just dabble at this point in the technology side of things. (I made that decision several years ago and have never regretted it if that makes you feel any better.) Personal enjoyment aside, it's really a much more financially practical solution also when you think of the time and lost income you will give up sacrificing almost a decade of your thirties. Nothing is impossible, but just keep in mind...If you decide to try to pursue an informatics position while working in medicine/EM part-time, you will sacrifice a tremendous amount of compensation. Good luck and feel free to PM me if you want to discuss more details.

Agree w/ all of this. I have a similar background. About to finish EM residency at 37, have experienced no age-related obstacles. One reason I went to med school was to study workflows so I could make an EHR that sucks less. Maybe I'll get back into that someday.

Informatics fellowship is a waste of 2 years if you have an IT background. CMIO is the way to go if you want to stay w/ IT stuff outside of academia. My buddy finished residency a year before me and has taken this route. I think it'd probably be possible to contribute both clinically and with the IT stuff if family were less important to me.

Another obstacle to EM informatics research in the community *and* most academic places is that most EHRs are incredibly opaque. AFAICT there are no APIs, so they're impossible to extend, and even just getting the user manual is like pulling teeth. One of the most popular ones (Meditech; no coincidence it's also the cheapest) was written in the 80s and is still DOS-based. You can't just convert all the clinical data to CSV or whatever like you can with lots of other software. And you don't get to choose which EHR your hospital uses since your hospital is probably owned by HCA or another big evil company who already bought the equivalent of IBM for all its hospitals. Maybe if you become CMIO there's some super-secret switch you can flip to enable hackability... I dunno.

As of 2015, one exception was Beth Israel Deaconess in Boston (Harvard affiliated), where I did my sub-I. Great custom ED EHR with very active hacker docs who extended it in all kinds of crazy ways. Not sure if management has converted them to Meditech yet

 

[MrEmjay417]

Agree w/ all of this. I have a similar background. About to finish EM residency at 37, have experienced no age-related obstacles. One reason I went to med school was to study workflows so I could make an EHR that sucks less. Maybe I'll get back into that someday.

Informatics fellowship is a waste of 2 years if you have an IT background. CMIO is the way to go if you want to stay w/ IT stuff outside of academia. My buddy finished residency a year before me and has taken this route. I think it'd probably be possible to contribute both clinically and with the IT stuff if family were less important to me.

Another obstacle to EM informatics research in the community *and* most academic places is that most EHRs are incredibly opaque. AFAICT there are no APIs, so they're impossible to extend, and even just getting the user manual is like pulling teeth. One of the most popular ones (Meditech; no coincidence it's also the cheapest) was written in the 80s and is still DOS-based. You can't just convert all the clinical data to CSV or whatever like you can with lots of other software. And you don't get to choose which EHR your hospital uses since your hospital is probably owned by HCA or another big evil company who already bought the equivalent of IBM for all its hospitals. Maybe if you become CMIO there's some super-secret switch you can flip to enable hackability... I dunno.

As of 2015, one exception was Beth Israel Deaconess in Boston (Harvard affiliated), where I did my sub-I. Great custom ED EHR with very active hacker docs who extended it in all kinds of crazy ways. Not sure if management has converted them to Meditech yet

Hey! You're speaking my language!

I've been a volunteer/consultant for a small family practice and we've noticed this. I was going to use NLP to help with their email billing and get their staff doing more reception work. It is pretty damn impossible.

What I more thinking of was doing primary research and collecting data first-hand. I don't know if that's even possible now that you mention it.

 

[gman33]

The age is not a factor.

Wanting to do something else and doing EM on the side seems like a waste of time.

 

[MrEmjay417]

The age is not a factor.

Wanting to do something else and doing EM on the side seems like a waste of time.

My writing above wasn't clear. My intention was to do EM primarily and do research secondarily. Honestly, what is attracting me to medicine is the clinical aspect. To do research for the medical community with computer science doesn't necessarily require me to get a MD/DO. I would be able to get into a MS program that would qualify me for a lot of research projects. I am seriously considering that path, but I'm going to explore the clinical path while taking classes.

 

[gman33]

My writing above wasn't clear. My intention was to do EM primarily and do research secondarily. Honestly, what is attracting me to medicine is the clinical aspect. To do research for the medical community with computer science doesn't necessarily require me to get a MD/DO. I would be able to get into a MS program that would qualify me for a lot of research projects. I am seriously considering that path, but I'm going to explore the clinical path while taking classes.

that makes more sense

 

[Groove]

Trying to "balance" EM and/or clinical medicine with a separate and alternate non-health related career just seems like a colossal waste of time, energy and money. No offense. Again, it's how much value you place on "getting your geek rocks off". I'm of the opinion that once you commit to med school/residency with ~8yrs of limited income and delayed retirement savings, any sacrifice in clinical time becomes financial suicide and really questions why a person went into medicine in the first place. Med school shouldn't be necessary to develop for an EMR company or work with a local hospital in some clinical informatics capacity. Get a masters in health policy and focus on the tech side of things if that's the end goal. Sure, sacrificing 1/3rd or half of your clinical shifts while working within something IT related might be satisfying on an intellectual level, but you would easily be sacrificing at least 200+K/yr.

 

[doster112]

I concur with many posters that have already commented. As someone who entered medicine late, I was able to match into my number EM program at age 34 and doing fine. Everyone of your peers will have their strength and weaknesses, but being a tad bit older is not going to hurt your chances. Do well in med school and get into whatever you like...GOOD LUCK

 

[enalli]

Trying to "balance" EM and/or clinical medicine with a separate and alternate non-health related career just seems like a colossal waste of time, energy and money. No offense. Again, it's how much value you place on "getting your geek rocks off". I'm of the opinion that once you commit to med school/residency with ~8yrs of limited income and delayed retirement savings, any sacrifice in clinical time becomes financial suicide and really questions why a person went into medicine in the first place. Med school shouldn't be necessary to develop for an EMR company or work with a local hospital in some clinical informatics capacity. Get a masters in health policy and focus on the tech side of things if that's the end goal. Sure, sacrificing 1/3rd or half of your clinical shifts while working within something IT related might be satisfying on an intellectual level, but you would easily be sacrificing at least 200+K/yr.

Unless you are personally logging 2,600 hours a year of pure locums work in Podunk, East Dakota and Nowheresville, North Alaska at $600 per hour then you too are doing the same thing. Everyone leaves some money on the table. Maybe doing some IT stuff on the side will significantly improve his happiness more than an extra $200k per year will--in that scenario he is still making $200k per year, which is plenty for anyone to pay off their loans and live comfortably.

The answer to your bolded point is "not for the money."

 

[Groove]

Unless you are personally logging 2,600 hours a year of pure locums work in Podunk, East Dakota and Nowheresville, North Alaska at $600 per hour then you too are doing the same thing. Everyone leaves some money on the table. Maybe doing some IT stuff on the side will significantly improve his happiness more than an extra $200k per year will--in that scenario he is still making $200k per year, which is plenty for anyone to pay off their loans and live comfortably.

The answer to your bolded point is "not for the money."

200K invested at ~8% return a year = roughly 2.8-3.3 million over 10 years.

Hey, it's your money, your life and your retirement planning. Personally, I'd rather retire 10 years early but to each their own.

 

[enalli]

200K invested at ~8% return a year = roughly 2.8-3.3 million over 10 years.

Hey, it's your money, your life and your retirement planning. Personally, I'd rather retire 10 years early but to each their own.

Right, I completely agree; it's a big financial hit.

I think about this often. It sounds really awesome to be financially independent after 10-15 years of work, but I don't think that strategy is for me. I would burn out quickly and might not even make it to 10-15 years. If I do make it, I probably would actually retire immediately. I think I would rather take a salary hit that would allow me to extend my career. Sure, I would have to work for 20-25 years, but I might not mind it as much. Who knows, I may enjoy it more and choose to keep working after achieving financial independence rather than rage-quitting medicine once I hit a certain number in my retirement account.