Lifestyle of EM vs. FM

[han14tra]

I enjoyed my EM and FM rotations the most. I'm interested in rural medicine. Could someone give me more insight into the lifestyles of each?

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[winkleweizen]

8-5 m-f with holidays off in FM or a conglomeration of randomness in EM. The end

 

[han14tra]

I think there is a little more to it than that.

FM: call (not just for your own patients, but probably for your partners), less pay, more hours (most family docs work some evenings and weekends so they can see their patients that work 1st shift), ability to open a practice ANYWHERE on your own, more administrative issues to deal with, more autonomy, less procedures, easier to do when you are 60 (less physically demanding), would probably need to do some inpatient (I hated my medicine rotation so that's sort of a turn off), + long term relationships with patients, could do urgent care to fulfill my EM love.

EM: no call, + nights/weekends, higher pay, more physically demanding, opportunities to teach EMS and do medical command (which I have an interest in), treat more complex problems, faster pace, do more procedures (central lines, intubations), no continuity, need an ED to practice, opportunities to do urgent care if I want to slow down the pace a little

What did I miss?

 

[gutonc]

I think there is a little more to it than that.

FM: call (not just for your own patients, but probably for your partners), less pay, more hours (most family docs work some evenings and weekends so they can see their patients that work 1st shift), ability to open a practice ANYWHERE on your own, more administrative issues to deal with, more autonomy, less procedures, easier to do when you are 60 (less physically demanding), would probably need to do some inpatient (I hated my medicine rotation so that's sort of a turn off), + long term relationships with patients, could do urgent care to fulfill my EM love.

EM: no call, + nights/weekends, higher pay, more physically demanding, opportunities to teach EMS and do medical command (which I have an interest in), treat more complex problems, faster pace, do more procedures (central lines, intubations), no continuity, need an ED to practice, opportunities to do urgent care if I want to slow down the pace a little

What did I miss?

If you have already made up your mind, why did you bother to ask the question?

 

[han14tra]

If you have already made up your mind, why did you bother to ask the question?

I didn't make up my mind. I'm 50/50 between EM and FM.

 

[gutonc]

I didn't make up my mind. I'm 50/50 between EM and FM.

Based on your last post you seem more 90/10.

 

[Arcan57]

There are a ton of threads regarding EM lifestyle. I'm not sure many posters on this forum can give you a comprehensive look at FM lifestyle. The actual lifestyle varies significantly within the specialty as well as between specialties. Nothing is universal (there are posts from docs that know an EP that never works nights and a couple that claim they know people that only work weekdays). The closer your ideal work schedule fits the average in your chosen specialty the easier it is to find a job you enjoy. The average ED doc is going to work about 30% nights and is going to be working two weekends a month. If that sounds good then there are a ton of jobs that can get you that. If you want something significantly different then it's out there but you'll be sacrificing something else (usually job stability) to get it.

 

[EdibleEgg]

8-5 m-f with holidays off in FM or a conglomeration of randomness in EM. The end

mmmm... no

It's extremely variable. It depends on how you value stability, liability, income, location, etc.



FM: call (not just for your own patients, but probably for your partners) Variable, from no call with hospitalists to 24/7.

less pay. the average FM makes less than the average EM physician, but FM incomes are extremely diverse

more hours. you can work as much or as little as you like.

ability to open a practice ANYWHERE on your own. this is true

more administrative issues to deal with. yes, if you open your own practice, but employment opportunities are everywhere.

more autonomy, probably

less procedures, not really, that depends on how you set up your practice and what you learn to do.

easier to do when you are 60 (less physically demanding), again, depends on the practice. Full scope family medicine is more physically demanding than EM is more demanding that outpatient only FM.

would probably need to do some inpatient (I hated my medicine rotation so that's sort of a turn off) Inpatient medicine is not the same experience as an attending.....

long term relationships with patients. true, there are long term relationships in EM too, but its rarely a good thing

could do urgent care to fulfill my EM love. If you love EM, urgent care will not be fulfilling.

EM: no call, I often fantasize about different ways to destroy my pager.

+ nights/weekends, EM works MORE on the weekends, but there's flexibility either way
higher pay, generally true, but not across the board

more physically demanding, see above

opportunities to teach EMS and do medical command (which I have an interest in); small part of the job

treat more complex problems, NOT true
faster pace, not really.... depends on the job

do more procedures (central lines, intubations), more central lines and intubations, yes; more procedures, not really

no continuity, see above

need an ED to practice, there is not as much flexibility as FM, but there are lots of other opportunities for EM trained physicians

opportunities to do urgent care if I want to slow down the pace a little: urgent care = purgatory

 

[han14tra]

mmmm... no

It's extremely variable. It depends on how you value stability, liability, income, location, etc.

Thank you. That was helpful

 

[Groove]

Thank you. That was helpful

Just go with your gut if you're torn. I think med students these days overanalyze.

Overanalyzing got me on an anesthesia rotation as a med student, along with a neurology rotation where I though I'd fall asleep (no pun intended) and diagnose all types of cool stuff I could never cure, respectively. In the end, I just thought about where I had the most fun in the hospital (ED), what environment I enjoyed being in the most (ED), which docs I thought I got along with and had more in common with... (ED), where most of my cool stories that I'd tell friends and family about... (ED), you get the picture. Yea, I analyzed it and I'm sure had an excel spreadsheet or two, but it's like a dating website. The chick can look great on paper but once you meet her in a starbucks... you're thinking "get me the hell out of here".