JustPlainBill

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So.... just thinking about this and wanted some realistic input. 2nd career, went FM as I didn't want to yank my 2 children out of the only school system house they had known for 14 years. They're about to be off in college and my time/location is my own. Shift work is no longer an issue. I loved the Parkland ER during residency -- the sheer organized chaos was outstanding. Only rotation during residency where I didn't come home griping and looked forward to going to work.

So, question is-' is this even feasible? If so, how does one go about applying, etc? Did UC for a year and have been offered to staff smaller, more rural ERs but I'd like more training.....

Any legit help/comments would be appreciated...
 
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Angry Birds

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I think you would get accepted to an EM residency. It is feasible. Some programs may stay clear of you but I think many programs would value your maturity, knowledge, skills, and dedication.

The question is only: do you want to go through all that? Only you can answer that question.
 

pencilcase

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Where I did an ER residency, there was a person who had matched to be in my class. He was FM trained and was just finishing up that year that he matched into my residency. He however, changed his mind after the match and we never met him. So people do second residencies or apply and then decide against it. You would have to go through the match for the best chance of matching and being in an okay location.
Also, when I was in med school, there was an IM resident who started EM residency the day after graduating IM residency. Again it happens.

EM and FM are very similar but most, if not all programs will require the full three years and will not give you credit for having done 2 years. Three years is a long time but if you make up your mind to do it, go for it.

Are you married? And what does the spouse think of your plans. Their support will be important...
 

Angry Birds

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. He was FM trained and was just finishing up that year that he matched into my residency. He however, changed his mind after the match and we never met him.
This is the reason that some programs will not take the chance on the OP. For example, Pencilcase's program won't ever take that chance again. But, I think other programs would, if the applicant convinces them of his dedication.
 

goodoldalky

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How old are you (serious question)? If you are still in the DFW area there are some surgical center ERs that staff with FM. The rates are not as good but better than what you would pull working urgent care. Not sure about FSEDs. You may be able to piece together enough shifts to make a career out of it. If you are young it may be worth it to go back and do a residency but mid career I'd probably pass.
 

Angry Birds

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OP - You can also consider the EM fellowship. Won't make you properly board certified, but if your main issue is that you want some additional training.
 
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JustPlainBill

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Thanks to everyone --

1) Age -- 53 and yes, married with 2 HS/College age children -- wife knows that I probably should have gone EM right off the bat --
2) Early in my career -- 3 years out of residency
3) I've really been considering the EM fellowship up in Tulsa --
4) I would really prefer to have a full blown ER residency behind me
5) I'm likely to never retire -- I just like working way too much -- gives me something to gripe about ;->
6) Still in DFW for the next 2 years (until my youngest gets out of HS)

How would I go about getting the LORs needed in terms of SLORs for EM at this point? I'm not a student so I have no access to that venue -- Obviously I'd need to contact my med school for the Dean's letter, transcripts, etc. --
 

pencilcase

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You will need to contact your med school for an ERAS token then you can start your application. Applications will start being looked at by residencies sometime in Sept/Oct so you don't have a lot of time. Confirm the dates/timeline on ERAS. You will need a personal statement and SLOR/SLOE (specific letter of rec for people applying to EM) so you need to arrange an ER rotation at a place with an ER residency so you can get this letter. Be resourceful and find a way to get on an ER rotation very soon. If you don't get a SLOR/SLOE, your application won't do well and some places won't even look at an application without it. So this is step #1.

It goes without saying but EM as a specialty has a lot of negatives and I hope you have thoroughly thought of the pros and cons before starting this journey.
 

gman33

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You need an em rotation and a sloe.
I assume you don't have that.

Without this, things will be tough.
So at best you need this and then apply next cycle.

I would think most programs would not want you. His sounds harsh, but they probably don't want to take a 55 year old intern.

Done at 58-59.

Em is not an old man's game.

And this is coming from a non-trad.

If you really want it, give it a go, but I think it's going to be a tough road.

I may be a minority, but I think fm and em have very little in common.
 
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JustPlainBill

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Appreciate everyone's honesty....still thinking it through...have a lot of friends in tactical medicine and enjoy helping them with training classes so that may be what's driving this....although it was a tough choice when selecting residency paths....
 

Angry Birds

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I've been thinking about your question and was thinking throughout the day about how medical school and residency robbed me of the best decade of my life. Do you really want to put yourself through residency again? It's not even good for your health. Why not use your free time to go to the gym, spend time with the wife, etc. I just don't feel that your reason to put yourself through all that is good enough. If you wanted to invest in your life dream, then that's something else. that's another story. But is this really that?
 
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shoal

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Id personally do the fellowship if I wanted to learn for learning sake. I.e. Feel more comfortable in the ED. Otherwise I'd just work in rural EDs pray read and be happy. Good luck


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Tenk

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The only way you will get into an EM residency is if you know a PD personally and they are willing to take you in. Not happening any other way as you are up against the best and the brightest nowadays.

I knew a guy who was about 10 years younger than you in a similar situation but the only reason he got in is because of the people he knew. Doesn't happen any other way really. Probably best to do a fellowship if you don't have an in.
 

DrYoda

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If your going to do EM unfortunately for you I think a full blown residency is necessary. We're in a shortage and it's true some old-timer people who already have their foot in the door can work at smaller Eds still work there. But the FM fellowships not to be rude are kind of a joke and my group who is in a rural area and has has multiple critical access hospitals on our account wont hire anyone that didn't do a formal ED residency. Maybe it's just my area of the country but I work in an undesirable area in a state that most people don't want to live in. but if your that dead set on changing jobs I would direct contact program directors. where I trained is well known for being very open to non-traditional applicants. I can't hook you up in any way but if your open to moving I can at least give you a good option. You can IM me on here I don't log in every do so don't expect a realy fast answer but I can be back with you in a few days or less.
 
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JustPlainBill

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So after reading everyone's answer, I think I figured out what's going on....I went to a really crappy FM residency that abused the heck out of the residents and really didn't provide any procedural training (or much of any other type of training for that matter). I'm wanting to get some more training in procedures and general trauma medicine working under someone who knows what they're doing just to fill a gap in what I want to know. Will I likely ever use it in my branch 9f medicine (FM) --likely not...but I'd rather have it and not need it than need it and not have it.....thanks again for the input, everyone...
 

goodoldalky

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So after reading everyone's answer, I think I figured out what's going on....I went to a really crappy FM residency that abused the heck out of the residents and really didn't provide any procedural training (or much of any other type of training for that matter). I'm wanting to get some more training in procedures and general trauma medicine working under someone who knows what they're doing just to fill a gap in what I want to know. Will I likely ever use it in my branch 9f medicine (FM) --likely not...but I'd rather have it and not need it than need it and not have it.....thanks again for the input, everyone...
What I would suggest is this, take ATLS, go to and participate in an EM conference with a critical procedures course, ultrasound course, sim lab, and do all of that. It may take more than one conference to get what you're looking for. It'll cost you $1500-$2000 instead of tens of thousands (by you going back to residency), and it'll cost you about 60 hours of time instead of 3 years. It will be pretty high yield. I don't think an EM residency is really what you need and I think you can get what you're looking for with 1/10000th the time and money investment on your end.
 
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Apollyon

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my group...wont hire anyone that didn't do a formal ED residency. Maybe it's just my area of the country but I work in an undesirable area in a state that most people don't want to live in.
What's not to love? I hope they pay you better than the 75th percentile, because, if not, my next question is: how do you recruit EM-trained ONLY folks? The old saw is "location, lifestyle, pay - pick 2", but, if you don't have even the "pay" prong, you hit into a triple play.
 
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DrYoda

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What's not to love? I hope they pay you better than the 75th percentile, because, if not, my next question is: how do you recruit EM-trained ONLY folks? The old saw is "location, lifestyle, pay - pick 2", but, if you don't have even the "pay" prong, you hit into a triple play.
Hey man I''m just being honest, granted it's N=1 but it's my experience. and yes we pay a lot to get only EM trained people.
 

cbrons

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If your going to do EM unfortunately for you I think a full blown residency is necessary. We're in a shortage and it's true some old-timer people who already have their foot in the door can work at smaller Eds still work there. But the FM fellowships not to be rude are kind of a joke and my group who is in a rural area and has has multiple critical access hospitals on our account wont hire anyone that didn't do a formal ED residency. Maybe it's just my area of the country but I work in an undesirable area in a state that most people don't want to live in. but if your that dead set on changing jobs I would direct contact program directors. where I trained is well known for being very open to non-traditional applicants. I can't hook you up in any way but if your open to moving I can at least give you a good option. You can IM me on here I don't log in every do so don't expect a realy fast answer but I can be back with you in a few days or less.
So will those same places hire a non-residency trained PA or NP to run them?
 

DrYoda

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So will those same places hire a non-residency trained PA or NP to run them?
I don't think to run them (at least not in my state, what midlevels can do is highly dependent on state legislation and to be honest according to our midlevels I work in a PA/NP unfriendly state) others may have different experiences depending on geography . Most EDs in this day and age have some sort of midlevel coverage unless they are a critical access hospital with close to no volume.
 
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TedStark

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The majority of physicians working in the ED are not board certified in EM. Just something to consider, especially at your age.
 

DrDuck2

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The majority of physicians working in the ED are not board certified in EM. Just something to consider, especially at your age.
Guess it depends where you are... Rural? Urban? Desirable location? Highly variable