This was my response:
joker-
You have gotten some great gas opinions here. The similarities are really superficial. I think you will find that most people either love or hate each field once you actually get into it. You need to do a shift or two in the ED to see if you like it. I have rarely met an individual that didn't either love it or hate it. Its rarely somewhere in the middle.
What do I love about EM (and I didn't pick it until the end of my third year... I was peds rheum all the way! 😉 ):
-diversity. I liked some of everything but not enough of anything to do it alone. I like gyn, fp, IM, critical care, ortho, surgery, intubations, trauma, peds.
-pace. I like multitasking. I never realized it but I hate sitting and contemplating for hours on end. The or only interested me when I had my hands in a belly or was putting a tube down a throat. You either love this or it drives you crazy.
-shift work. this has plusses and minuses. I worked today (memorial day) but I am off for 7 days in a row. this is nice. Many people I know iwll take a month of at a time. Very few fields allow this. Gas might (don't know...) Shifts are not as bad as you think. search it in the EM forum
-Longevity: the burn out issues is a dead issue (look in the EM thread and search). It came about from IM/FP/surgeons in the ED. The reason there aren't a ton of 'old EM docs' is that its a young field (25 years of board certification). We have plenty of 'senior docs' in EM. Just not as many as others because its younger.
-job security- there is a severe shortage of EM docs. its only getting worse. More and more hospitals are not wanting FP/IM docs in the ED for liability reasons. Also, we are somewhat 'protected' agains all the healthcare issues. Emtala ensures that we get to practice the way we want without considering overtly insurance status etc.
-acuity- I like sick patients. I don't want all sick patients but I like a mix. the level of acuity will vary where you train and practice. I work in an urban ED that sees 100K+ a year. We see tons of sick patients. We do see non-acute. doesn't bother me to much. Mostly because I make sure there is nothing life threatening and then send them to thier doc for follow up. Plus, while I didn't want to be an FP, I didn'tn hate it.
-interdisc. work- the level of consults again depends on where you are. I like dealing with consults. (find me a field of medicine that doesn't deal with it and you are working with dead people...) gas works with surgeons, surgeons work with gas, etc etc. My consults only did procedures I can't do: cath a patient, open thier belly, etc. Everything else, I did. Admitting privelages vary but I don't ask for admissions. I have direct admitting privelages. This will vary where you go.....
Regarding respect, etc: your sense of respect shouldn't be garnered from other fields. Your respect will come from you knowing you are doing what is right and being well trained. EM docs are experts at dealing with acute issues. Fields shift. Where I am, the surgeons are horrible at acute abdominal pain because they don't see it any more. They see our patients after they are diagnosed and are ready for the OR. Are cards people don't see ACS. They see acute ST elevation MI's. As an EM doc, you are an expert at dealing with Emergency medicine. You stabilize, treat and manage acutely ill patients. It is VERY different. If you haven't spent much time in the ED, its hard to get. But watch a senior IM resident in the ED. You must think quickly and act. The best advice is to get int here and see if you like it.
/ramble.
