How to decide if EM is right for you?

[dkwyler94]

I am about to start my third year rotations. I have had a lot of experience working in hospitals before medical school and have spent a fair amount of time getting hands on experience in school. I am fairly sure I want to do either surgery or emergency medicine, however I don't want to commit on anything until I have done a rotation in it.

My question is, my third year I don't have any electives and it appears most ERs don't let third year students rotate. I understand most of the fourth year audition rotations need to be set up several months in advance.

Would I need to decide before my fourth year what I want to specialize in so I can set up rotations. If so, how do you decide if EM is right for you.

A second question for you still reading. I am from the west and would ideally like to do my residency in the west as that is where I plan on practicing. I am a DO student from KCOM. Of course all the DO residencies are in the midwest or east. Does anyone know of any ACGME DO friendly EM programs in the west?

Thanks

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[edinOH]

First off, the nice thing about third year is that you have plenty of time to experience most fields of medicine before you start feeling the pressure to commit to something. While now you may think that you will either do EM or surgery, it is still quite possible you will find yourself attracted to an entirely different field. It is perfectly fine of course to think that you now know which two fields you have it narrowed down to, just be sure you give yourself an honest opportunity to judge all the other specialties with an open mind. You might surprise yourself.

As far as the fourth year audition roations are concerned, it would be wise to start gathering preliminary information now about a handful of programs you might wish to rotate at. It would be a good idea to have a list of 5 or 6 that you would like to rotate at by around Christmas if possible but definitely no later than March. This way you can start to contact programs in late winter early spring about setting up your rotations. For most people two rotations in your specialty are all that are needed and often times allowed. I am of the opinion that you should do your audition rotations in July, August, or September at the latest because this will allow you to request and receive letters in plenty of time for early submission to ERAS as well as leave you with enough time to investigate another specialty should you change your mind.

I would say that a solid 50% of all allopathic EM residencies are receptive of DO students. What I mean is that they have no reservations about interviewing and ranking DO students on a level playing field with MDs. There are still plenty others that will interview DOs but may have some reservations about ranking them above MDs. And a few others that won't interview DOs at all. But you wouldn't want to go to any of those anyway! Not to say that this is fair or correct just that it has been my impression that some programs operate this way. Ultimately, if you are a competitive candidate it won't matter if you are an MD or DO.

I interviewed in the midwest and east so I can't really offer any insight into programs out west.

 

[DrQuinn]

My future colleague edinOH gives excellent advice, heed it well. Like, read it every day before you go to your hospital rotations.

Seriously, though. As a DO student, EM is a wide open field. Like edinOH said, some are receptive, some are not. I applied to 40+ programs and received about 20+ interviews. Some places didn't even bother to reject me, ERAS jsut took my $ and left.

Midwest/east are the most DO friendly EM residencies. The west (from what I gather from this site) is much more competitive for EM residencies anyways. I'm sure you'll find some DOs out in the MD residencies there, but much less than the midwest or east.

Just so you know, 8% of all allopathic EM residents are DOs, which is a significant # considering the relative competitiveness of Emergency Medicine.

Even though you may not be doing an EM rotation, try to spend as much time as you can down there. I'm sure on your surgery rotation or IM rotation, you'll be called down there for admits or consults. Tell the EM attending or the Dept Head that you are interested in EM, and if you can pull some night shifts or something for him.

They'll likely take you in under their wing.

Q

 

[sweetfynesse]

As Quinn mentioned, it is very plausible for you to spend time in the ED during some of your clinical rotations. I didn't decide until April of my third year that I wanted to do emergency med. I didn't even consider it until March, after a month of trauma surgery. Until then, I thought people were nuts for doing it. However, I found myself hanging out in the ED many IM call nights, just waiting for something exciting (ie, worthy of being awakened while on call) to hit the door so I'd have a heads up on my residents. (I know, it sounds a bit gunnerish...farther from the truth, you see, our residents didn't tell us we had new patients until they had been on the floor for hours, and by this time they didn't want to be subjected to yet another H&P from the lowly med students after they had been worked up by a $h!& load of people already).

Oops, I digress. If you want to experience the ED, just go and hang around. Most people would love to show you around and answer quesitons, if you seem interested. And, always, always, keep an open mind. Otherwise, you'll find yourself hating every rotation you're on because it's not surgery or emed. Best of luck to you...

 

[dkwyler94]

Thanks for your replies. I don't mind working hard, so I will look into working some nights or weekends in the ER once I start rotations. I am still keeping an open mind. I have a few specilties at the top of my list, a few I would never consider (people really want to be Dermatologists?), but everything else is fair game.

Thanks again for the responses.

David

 

[DrQuinn]

I think if you are curious about EM, one resource you can use is www.emra.org and www.saem.org.

I think both sites have pages dedicated to "Why EM?" and "Is EM for you?"

They may be helpful.

Q

 

[DOrk]

Kern Medical Center (Bakersfield, CA) has at least two DO's in each class. It seems like a cool place. It's only a level 2, but it's the only hospital for about 100 miles in any direction so they see everything (at least according to the website The program is PGY 2-3-4

 

[jashanley]

What I don't understand is why more people as first and second year medical students don't consider shadowing EM docs.
My medical school had an EM interest group and an outside elective in EM for first years where we had some basic lectures and had to shadow attendings for 8 or 9 shifts. It was great it was an early exposure to the lifestyle and pace of the ED, plus I got to do some simple procedures as 1st year. It really helped me figure out what I wanted to do.
Med students don't realize that in your preclinical years you can get exposure through shadowing. Find a surgeon, EM doc or an internest to work with an find out what you like and don't like.
I have trouble believing that after a month or two of a single rotation in your third and fourth years you can decide what you want to do for the rest of your working life.
Plus if you want to learn more about a field. Find an attending to work with and start an interest group.
At UConn, we had an interest group that met once a month to present patient cases, learn about topics, discuss applying to residency and practice skills. It led to the development of an annual emergency medicine symposium run by the students for medical students throughout the northeast and which brought in speakers such as Mike Carius, former or soon to be former ACEP president (i forget which.....cut me some slack I'm an intern). The interest group also put together an annual 2 day wildnerness medicine retreat.
Because of the interest group, we on average have 10+% of our graduating class entering into EM, and in popular programs and locales: Boston, New York, Chicago, San Francisco, San Diego, and the beautiful city of Hartford (CT for those geographically challenged). Good luck to all those starting their Intern year....July 1st is just around the corner. It isn't that bad....I have to say......you could be going into Surgery or Ob/gyn where they have have become Vit D deficient and will remain so for 3-4 more years.