After being out for a few years, I went back and did a Pain fellowship. I'm happy I did. There's a whole thread on it that you might find informative.
CC is the best if you want to do an EM fellowship and still have to work nights, weekends and holidays the next 30 years.
Weekends and holidays sure. As for nights, a lot of icus these days don’t have the doc in house at night, but a mid level.
Will it stay that way? Is Medicine trending towards being a 24-hr service or the opposite?
If that is the trend, that's great for ICU docs. But it seems to me that's a house of cards. It seems to me liability concerns plus patient demand/patient satisfaction would apply pressure for 24-hr physician coverage, and win out in the long run. I could be wrong.
How comfortable are you with your midlevel managing critical patients while you watch....virtually
I don't see how being ultrasound trained benefits a group unless it's academic and you have residents that need teaching
Do you still practice EM at all or are you all Pain now? What's that lifestyle like?
All Pain.
It's only an n of 1, but a guy I did residency did a hyperbarics fellowship. It's allowed him to do hyperbarics and run a hyperbarics fellowship, while reducing his general EM shifts down to 2 per month. The last time I talked to him, he was hella happy with the decision. We were both in agreement about how much happier we were since our fellowships.
I get maybe 1 after hours call every 6 months (maybe?) I've never had a call after 8 pm. I've never had a procedural complication that couldn't be dealt with by saying, "Show up at the office 8am tomorrow and we'll take a look."
I know a guy that did an Undersea/Hyperbarics fellowship, and he does wound care now with it. I guess, when you dive a decubitus at 3 ATM, it gets better!
I can confirm this, I'm not sure what the market wit large looks like, but the main application for hyperbarics in the community is wound care. I live in Texas (hundreds of miles from diving/ocean in any direction) and our community hospital has a hyperbarics program for wound care management (no oceans, but we do have a lot of obese/diabetics/vasculopaths with chronic wounds). As far as I know we have never used our chambers to treat a decompression sickness. It seems safe to assume given the epidemiology of this country, chronic wounds are going to continue to proliferate in my career span and treatment of them may be a growing clinical area.
As another poster pointed out in another thread, the ICU is one place where the interests of the doctor, hospital and CMG can align. It is resource intensive, and keeping people in there for futile care is bad for everyone's bottom line, and the hospital/CMG will be more willing to do what it takes to get people out that don't need to be there.
Good post. I agree.
Which skill in particular lend themselves to which non-clinical professions? It seems that most recommendations on websites (ie side hustles, alt income ideas, etc.) seem to point towards something medically adjacent with examples being grant writing, healthcare utilization, or hospital admin to name a few. Is there anything that you had in mind which is non-clinical AND non-healthcare related which employs either clinical or non-clinical EM skills?
Agree with your post. A lot of the skills you develop as an EP have nothing to do with sheer emergency medical knowledge or procedural ability. You’d think that would easily translate to a non-medical field. There isn’t another environment like the ED though where I can visualIze this combination of skills mattering. The best example I can think of is a restaurant server. However, it’s usually a one way direction from that to an EP. What non-medical type of job benefits from this skill set that has some degree of prestige, compensation and satisfaction? (Forewarning, you may not want to tell us as there is a looming oversupply of EPs who might compete with you for these jobs.)
www.businessinsider.com
Good luck getting a non-entry level job with those "skills"
This is very true. It's hard to see when you're on the inside. But from the outside, it's very obvious. There's a perception that "if you can handle being an Emergency Physician, you can handle anything." There's a lot of truth to that perception.
My ED job was so painful, my fellowship year felt like a vacation. But it sounds like you have a good plan that will work well for you.
I feel you. I've gotten somewhat numb to the ED at this point and the thought of re-training to do anything else just exhausts me. Luckily, I'm not one of the types that needs a formal job to find meaning in retirement. I'd be perfectly happy as a full time investor. I'm not quite there yet but hope to be in a few years.
