Late switch to EM

[Dr.SPAC3MAN]

---

Members don't see this ad.

Hey everyone,

I switched to EM late, decided it was the best fit for me. I’m very excited about my switch. My biggest concern is that I won’t have a residency SLOE until mid to late October. I will have a SLOE from a community ED doc by the time I submit applications.

Little about my EM app:

- step 2 265+
- one manuscript pub in EM journal
- 2nd quartile
- no red flags
- I’m a hard worker so I anticipate decent SLOEs (when I get them)

Any ideas to maximize my initial interview invites?

 

[Just D.O. it]

- step 2 265+

lol, you’ll be fine. EM residency is a buyer’s market right now. Even mediocre DOs and IMGs are comfortably getting spots. You’ll be getting your pick of the litter as a USMD with an awesome step.

 

[Dr.SPAC3MAN]

lol, you’ll be fine. EM residency is a buyer’s market right now. Even mediocre DOs and IMGs are comfortably getting spots. You’ll be getting your pick of the litter as a USMD with an awesome step.

Forgot to add that I’m USDO. COMLEX 670+

Mostly just worried about the SLOE situation.
Thanks

 

[Starbuxian]

Several DOs don't have SLOEs. A SLOE is not consistenly demanded by all programs. Also there are situations where the med school doesn't have a home IM program, so no dept. chair etc. who could write the SLOE. Such programs do send students to an adjacent place for IM rotations so can get a letter from that preceptor I suppose. I know a couple of folsk who did not sent a SLOE last cycle and both matched well.

 

[Dr.SPAC3MAN]

Several DOs don't have SLOEs. A SLOE is not consistenly demanded by all programs. Also there are situations where the med school doesn't have a home IM program, so no dept. chair etc. who could write the SLOE. Such programs do send students to an adjacent place for IM rotations so can get a letter from that preceptor I suppose. I know a couple of folsk who did not sent a SLOE last cycle and both matched well.

You mean for EM? I’ll have the eSLOEs, just in mid to late October

 

[EthylMethylMan]

What interests you about EM? Are you sure you wouldn’t be happy in some other specialty? I’m sure you’ve heard about the myriad issues facing the field right now. An applicant with scores as good as yours could probably match into a specialty with better long-term prospects.

 

[Starbuxian]

Sorry I misread. For EM you should be fine. As others have said, it's quite a bit easier to match into and especially with scores like yours.

 

[Dr.SPAC3MAN]

What interests you about EM? Are you sure you wouldn’t be happy in some other specialty? I’m sure you’ve heard about the myriad issues facing the field right now. An applicant with scores as good as yours could probably match into a specialty with better long-term prospects.

Originally interested in surgery, made it to my sub-i’s and realized it was not for me. Lifestyle is just too much for me at this point in my life. EM has pretty much always been neck and neck w/surg. Honestly haven’t found myself interested in any another specialty. I realize my scores are higher, but I have felt better about my decision to switch. Didn’t have much doubt I would go unmatched for surgery, just want to watch my kids grow up. I know surgery is super important, but just not for everyone.

My biggest worry is not getting a lot of initial interviews for lack of SLOE, but the consensus I’ve gathered is to try and submit eSLOE asap and update programs.

 

[medDaisuki]

I think getting SLOE by mid-oct is no problem. But the bigger questions is if you haven’t done an EM sub-I, how do you know EM is the right choice for you? EM can be pretty draining too. Best of luck!

 

[Dr.SPAC3MAN]

I think getting SLOE by mid-oct is no problem. But the bigger questions is if you haven’t done an EM sub-I, how do you know EM is the right choice for you? EM can be pretty draining too. Best of luck!

Very good point. At this point I just knew I needed to get out. I’ve done a lot of shadowing in the ED over the years so I have some idea, but I would rather deal with a draining job 50 hours per week in EM than working 80+ hours per week with surgery.

 

[DOVinciRobot]

Very good point. At this point I just knew I needed to get out. I’ve done a lot of shadowing in the ED over the years so I have some idea, but I would rather deal with a draining job 50 hours per week in EM than working 80+ hours per week with surgery.

Are you talking residency or attendinghood?

Most surgery attendings work 50-60 hrs…. Not 80

 

[Dr.SPAC3MAN]

Are you talking residency or attendinghood?

Most surgery attendings work 50-60 hrs…. Not 80

well a little of both. I have some young kids now that I would miss pretty much their entire childhood if I went surgery, so just pretty much at a point in my life where it’s just not there for me.

So yeah it may get better after residency but for me I’m not at a point where I can dedicate what’s needed for a surgery residency.

 

[PB2464]

Are you talking residency or attendinghood?

Most surgery attendings work 50-60 hrs…. Not 80

And most EM attendings work about 30 hours a week...not 50.

EM offers much more lifestyle flexibility especially if you plan to cut back at any time to part time or just not work for a couple months. Good call.

 

[DOVinciRobot]

And most EM attendings work about 30 hours a week...not 50.

EM offers much more lifestyle flexibility especially if you plan to cut back at any time to part time or just not work for a couple months. Good call.

Interesting enough, EM attendings have the higher burnout rate 🤔

 

[PB2464]

Interesting enough, EM attendings have the higher burnout rate 🤔

Medicine in general has a high burnout rate. So if that is your go to support then the question should be why even medicine at all?
When you have 55-60% reporting burnout in a field vs maybe 45-50%, is that statistically significant enough to say DONT DO IT? There are many other confounding factors.
But ok, trust the polls. Smart.
I am not burned out. I can fully control my schedule. Can you? 🤔
You're also a resident. How about some real world experience first?

 

[Splenda88]

Why do you want do EM when most US students are running away from it?

Do IM and then GI so you can pretty much have a money printing machine.

 

[PB2464]

Why do you want do EM when most US students are running away from it?

Do IM and then GI so you can pretty much have a money printing machine.

Oooooooh enticing. OP you gonna do it?!!!!

 

[EthylMethylMan]

Honestly OP, just read this thread, or at least the first post of it:

Why emergency medicine is a dying specialty- The thread all Med students should read

Ok med students - I'm going to make this easy for you guys and explain to you really the details of what you don't experience as a med student and why EM is just a terrible specialty. I'm 3.5 years out of training. I wish someone sat me down and slapped some sense into me 7-8 years ago. But here...

forums.studentdoctor.net

It has all the info you’ll need.

 

[DOVinciRobot]

Medicine in general has a high burnout rate. So if that is your go to support then the question should be why even medicine at all?
When you have 55-60% reporting burnout in a field vs maybe 45-50%, is that statistically significant enough to say DONT DO IT? There are many other confounding factors.
But ok, trust the polls. Smart.
I am not burned out. I can fully control my schedule. Can you? 🤔
You're also a resident. How about some real world experience first?

Yes I am a resident. Doesn’t really matter to this discussion, especially since I work more now than I will as an attending..

Instead of polls how about we just ask your own colleagues over in the EM forum? I wonder what they’ll say…

 

[PB2464]

Yes I am a resident. Doesn’t really matter to this discussion, especially since I work more now than I will as an attending..

Instead of polls how about we just ask your own colleagues over in the EM forum? I wonder what they’ll say…

Excuses excuses. Managing your attending's patients isn't like managing your own. So yes it does matter to the level you're actually mentally working.

Don't you realize that people on forums actually come to them to complain? It might not take a surgeon to understand that logic.

Plenty of my colleagues are very happy and made a sweet lifestyle out of EM with income producing side gigs, including one as a big RE investor. You'll never get to realize that buddy.

 

[Splenda88]

Excuses excuses. Managing your attending's patients isn't like managing your own. So yes it does matter to the level you're actually mentally working.

Don't you realize that people on forums actually come to them to complain? It might not take a surgeon to understand that logic.

Plenty of my colleagues are very happy and made a sweet lifestyle out of EM with income producing side gigs, including one as a big RE investor. You'll never get to realize that buddy.

I guess EM is different from IM in that sense. I have found that managing my own patients is a lot easier than having someone (an attending) to answer to.

 

[DOVinciRobot]

Plenty of my colleagues are very happy and made a sweet lifestyle out of EM with income producing side gigs, including one as a big RE investor. You'll never get to realize that buddy.

Lol if that’s what helps you sleep at night, sure we can pretend that’s true.

We can ignore the issues with EM, and the voices within the field shouting about them, all we want but it won’t make them any less real.

I’m not going to derail the thread further.

 

[PB2464]

I guess EM is different from IM in that sense. I have found that managing my own patients is a lot easier than having someone (an attending) to answer to.

Little more sense of liability falling on your shoulders when it's only your patient in EM. And it's much much much different than IM. You're not making stay or send home decisions multiple times a day when workups are not complete.
Literally felt zero stress on IM rotations regarding sick care.

 

[PB2464]

Lol if that’s what helps you sleep at night, sure we can pretend that’s true.

We can ignore the issues with EM, and the voices within the field shouting about them, all we want but it won’t make them any less real.

I’m not going to derail the thread further.

You keep saying the same thing in a different way.
Way to close the argument since you haven't really come up with anything substantial except "these guys over here". I'm literally in the field. Also for trying to tell me how I'm supposed to feel...the surgeon way I guess.

I don't complain on forums about it nor does anyone else I know. Honestly my peers would probably consider me quite the dweeb for posting on here.

 

[EthylMethylMan]

You keep saying the same thing in a different way.
Way to close the argument since you haven't really come up with anything substantial except "these guys over here". I'm literally in the field. Also for trying to tell me how I'm supposed to feel...the surgeon way I guess.

I don't complain on forums about it nor does anyone else I know. Honestly my peers would probably consider me quite the dweeb for posting on here.

I don’t think the “managing your own patients vs the attending’s patients” argument is super relevant here. That said, I’m glad you’re happy in EM. I’m sure everyone wants a healthy number of EM docs to be minted regularly. The general concern of the nay-sayers is that there are a lot of issues in EM that are not immediately obvious when you’re rotating as a student. Much of the time students just see the “sexy” stuff because the educators want the learners to learn a lot. Surely you know this comparing MS3/4 experience to residency and attending experiences. There are probably a good number of students who would reconsider their decision if they were acutely aware of said issues. There are also a good number of people like yourself who do well in that environment despite those issues. Personally, I just want those issues to be absolutely clear to students so only the right kind of people enter the specialty. I can only speak for myself of course, but I think most people on here come from a similar place as I do.

 

[PB2464]

I don’t think the “managing your own patients vs the attending’s patients” argument is super relevant here. That said, I’m glad you’re happy in EM. I’m sure everyone wants a healthy number of EM docs to be minted regularly. The general concern of the nay-sayers is that there are a lot of issues in EM that are not immediately obvious when you’re rotating as a student. Much of the time students just see the “sexy” stuff because the educators want the learners to learn a lot. Surely you know this comparing MS3/4 experience to residency and attending experiences. There are probably a good number of students who would reconsider their decision if they were acutely aware of said issues. There are also a good number of people like yourself who do well in that environment despite those issues. Personally, I just want those issues to be absolutely clear to students so only the right kind of people enter the specialty. I can only speak for myself of course, but I think most people on here come from a similar place as I do.

Ok fair enough. I'll name a positive. There is nothing more gratifying that seeing a patient, coming up with a short problem list, investigating said problem in a matter of 2-4 hours normally and often being able to come up with an answer due to the availability of a battery of tests that come back reasonably quick versus other specialties.
To top this off with the ability to work 20 hours a week if you wanted and still make a very hefty salary.
Win/win. So therefore I don't care what these stupid polls say nor what the burned out EM docs are doing. I can guarantee many of them are locked into FT jobs flipping around days and nights (mistake number one) and are over-spenders (mistake number 2). It's really simple.
A lot of the mess in EM applies to several other hospital based specialties, but in EM it's fairly simple to get around it.

 

[Splenda88]

Ok fair enough. I'll name a positive. There is nothing more gratifying that seeing a patient, coming up with a short problem list, investigating said problem in a matter of 2-4 hours normally and often being able to come up with an answer due to the availability of a battery of tests that come back reasonably quick versus other specialties.
To top this off with the ability to work 20 hours a week if you wanted and still make a very hefty salary.
Win/win. So therefore I don't care what these stupid polls say nor what the burned out EM docs are doing. I can guarantee many of them are locked into FT jobs flipping around days and nights (mistake number one) and are over-spenders (mistake number 2). It's really simple.
A lot of the mess in EM applies to several other hospital based specialties, but in EM it's fairly simple to get around it.

I guess it's a matter of perspective.

I worked with a female EM physician when I was in residency. She was working 8 nights/month and she described her job as the "best gig in the world."

She said salary was great and most importantly she able to raise her kids with no issues.

 

[EthylMethylMan]

Ok fair enough. I'll name a positive. There is nothing more gratifying that seeing a patient, coming up with a short problem list, investigating said problem in a matter of 2-4 hours normally and often being able to come up with an answer due to the availability of a battery of tests that come back reasonably quick versus other specialties.
To top this off with the ability to work 20 hours a week if you wanted and still make a very hefty salary.
Win/win. So therefore I don't care what these stupid polls say nor what the burned out EM docs are doing. I can guarantee many of them are locked into FT jobs flipping around days and nights (mistake number one) and are over-spenders (mistake number 2). It's really simple.
A lot of the mess in EM applies to several other hospital based specialties, but in EM it's fairly simple to get around it.

Yeah that’s absolutely true. I was EM for a short time and I agree that those are the best parts of the specialty. There are a good number of people who thrive on those great things despite the downsides. Obviously you and I (and each individual applicant) will have different calculus on whether or not that is worth it. I’ll bow out at this point but I am glad that the positives are being fairly represented. Everyone deserves a fair, fully informed decision on how they’ll spend the next 30+ years of their professional lives.

 

[PB2464]

Another thing, if you generally go to the EM forum there is a lot of whining. I mean where else do people go to complain? They certainly aren't going to administration (no one actually does since they are too terrified. The weak doctor way). So they go to the deepest parts of the internet and tell their sob stories thinking everyone thinks this way. It's not real life.
Go actually find a few cool people that have their lives together and shadow them. (Relationships? Kids? A life outside of medicine?) See how it's done.

Same unhappy people answer surveys. Yeah I guess you could say hey the unhappiest surgeons are also responding to surveys. But like I said before are these small statistical differences even relevant?
I'm not even on this forum much because I go about my life. Think about it.

 

[voxveritatisetlucis]

Why do you want do EM when most US students are running away from it?

Do IM and then GI so you can pretty much have a money printing machine.

Matching GI and cardio are tough and if you don’t you basically have to be a hospitalist or PCP which isn’t for everybody

 

[voxveritatisetlucis]

Plenty of my colleagues are very happy and made a sweet lifestyle out of EM with income producing side gigs, including one as a big RE investor. You'll never get to realize that buddy.

surgeons make more than EM doctors and are less likely to be replaced by AI in the next ten years so I’m assuming a current surgery resident would be more likely to realize it than a current EM resident

 

[PB2464]

surgeons make more than EM doctors and are less likely to be replaced by AI in the next ten years so I’m assuming a current surgery resident would be more likely to realize it than a current EM resident

Hahaha. What? I can assure you that surgeons don't make any more than EM docs when it comes to dollar/hr that you have to work.

Also AI in EM? You're out of your mind.

 

[Splenda88]

Matching GI and cardio are tough and if you don’t you basically have to be a hospitalist or PCP which isn’t for everybody

Better to take a chance on that than EM. EM is a dumpster fire now.

 

[voxveritatisetlucis]

Hahaha. What? I can assure you that surgeons don't make any more than EM docs when it comes to dollar/hr that you have to work.

Also AI in EM? You're out of your mind.

Also hours is apples to oranges. I’ve seen trauma surgery offers for 550 base + bonus and usually it’s 7 on 7 off. At least at my school’s hospital, these surgeons may operate once per shift on average. EM doctors spend their entire shift working

PAs with AI diagnostics

 

[PB2464]

Also hours is apples to oranges. I’ve seen trauma surgery offers for 550 base + bonus and usually it’s 7 on 7 off. At least at my school’s hospital, these surgeons may operate once per shift on average. EM doctors spend their entire shift working

PAs with AI diagnostics

No, it's hours of your time away from home. Not hours actually performing a task. Who cares when you aren't at home or able to live life.

550,000 divided by 300/hr= 1833 hours a year. Divide by 12= 152 hours a month.
35 hours a week. Do trauma surgeons work less than that? Highly doubtful.

Your information is fake news.

 

[voxveritatisetlucis]

No, it's hours of your time away from home. Not hours actually performing a task. Who cares when you aren't at home or able to live life.

550,000 divided by 300/hr= 1833 hours a year. Divide by 12= 152 hours a month.
35 hours a week. Do trauma surgeons work less than that? Highly doubtful.

Your information is fake news.

Most of them take home call so who knows. And even when they’re doing an ACS most of it is just rounding on patients (no notes since residents write them and they just cosign)

 

[sylvanthus]

Yes I am a resident. Doesn’t really matter to this discussion, especially since I work more now than I will as an attending..

Instead of polls how about we just ask your own colleagues over in the EM forum? I wonder what they’ll say…

Wed say dont do it. But then wed realize every med student thinks they are the exception and give up.

 

[Dr.SPAC3MAN]

Yeah I see from both sides. End of the day I gotta do what’s best for my current situation and my family. Thanks for everyone’s advice! Currently sitting on 10 EM interviews so looks like I’ll make it.

 

[Dr. Pineal Gland]

Good luck OP , keep us updated. Also, Lots of EM docs in real life refute what is said about the field on here. I don’t doubt some of the issues but people come on here to vent and **** on their field, especially the older generation that fixates on the good old days. When these docs look back they only remember the good things and not the bad.