Long-term: ER residency vs. FP residency

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Lys Ile Glu Leu

Lys Ile Glu Leu

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Given that, at least in certain areas, FPs can work in ERs, is it worth it to go through the 4-year ER residency to work an ER, or should one pursue a 3-year FP residency toward the same end instead?

Yes, I am a pre-med. Yes, I realize that I am likely to change my mind during third year. Just seeking your opinions!

Thoughts?
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There are some 3 year EM residencies...
 
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As stated above, there are 3 year programs for EM.

Many EDs are switching to only EM trained physicians in all but the most rural areas. I think if you wanted to practice true emergency medicine and be the best doctor for your patients, you should be EM trained. Just like being the best family physician means being FM trained. You are strongest at what you do the most.

Seriously though, don't even think about that at this point. It is a worthless exercise.
 
Unless you're in a rural area that desperately needs to staff their ER, you will need to have EM GME training and be Board Certified/Board Eligible in EM to get the job. I'm all for the FP doctors staffing EDs, but the odds are stacked against them in larger cities.
 
HughMyron said:
There are some 3 year EM residencies...
Click to expand...

I overstated the importance of time. It's a factor, but one that's really important is the difference in training that's pertinent to becoming an effective ER physician. What would I be losing (I'm assuming there's some substantial difference) by going the FP route?
 
Even if all EM residencies were 4 years, it would make no sense to train in a completely different specialty in the hope of saving a year. Just train where you want to be...
 
Lysilegluleu said:
I overstated the importance of time. It's a factor, but one that's really important is the difference in training that's pertinent to becoming an effective ER physician. What would I be losing (I'm assuming there's some substantial difference) by going the FP route?
Click to expand...

Not trolling, but if the year isn't what's important, then why would you do a FM residency over an EM residency if you want to do emergency medicine?

I see no other upside to FM for someone who wants to do EM.
 
Lysilegluleu said:
I overstated the importance of time. It's a factor, but one that's really important is the difference in training that's pertinent to becoming an effective ER physician. What would I be losing (I'm assuming there's some substantial difference) by going the FP route?
Click to expand...

Are you interested in practicing FM in addition to EM?

Board certified EP's are greatly preferred to FM docs so you would have much more flexibility training in EM.
 
Ultimately, if I do end up going either route, I'm hoping year 3 settles this particular issue for me and I can happily pick one over the other. Just gathering some super-preliminary info, your opinions/knowledge in this case.

To restate more clearly: If I stick with my current inclination to choose the path that allows me to work both settings, will I be losing significant tools of the trade (ER)?
 
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How common is it for EM physicians to practice outside the ED/practice FP? I've always wondered this as I'm interested in EM also.
 
MedPR said:
If you want to do both wouldn't you have to do FM then?
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It's a thought, really. I'm more on the ER side of the fence. I'd do the FP route if I thought I could be as good an ER doc as I would be with an ER residency just to keep my career prospects a little bit more broad.

And yes, the idea would be to work in a rural setting.
 
CityLights said:
You could do a five year combined EM/FM program.
Click to expand...

I've not heard of that, but thanks for enlightening me. Something I may have to consider. I would have to do some thinking, but I could possibly see that extra year being worth it especially if I find later that it's an even harder choice for me.
 
GorillaPanic said:
How common is it for EM physicians to practice outside the ED/practice FP? I've always wondered this as I'm interested in EM also.
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Yeah, its been gaining traction recently. Its actually becoming more competitive than ever before.

And probably not common since I believe they make more practicing EM than FM.
 
GorillaPanic said:
How common is it for EM physicians to practice outside the ED/practice FP? I've always wondered this as I'm interested in EM also.
Click to expand...

Not very common.

There's not really a ton of overlap between EM residencies and FM residencies, besides the fact that we see all comers (kids, pregnant women, old people, young people, etc.) Not many EM physicians would feel comfortable seeing patients in an outpatient FM practice, nor do most of them want to.

The one real area of overlap is urgent care ("doc in a box," "Minute Clinics"). Either EM or FM could do those, although I hate urgent care and would never want to do it for a living.
 
MossPoh said:
Seriously though, don't even think about that at this point. It is a worthless exercise.
Click to expand...

Yea, I know. Just an indulgence of curiosity. I'm not in any way trying to seal my fate now. I'm still very open to experiencing other fields and I recognize the possibility of ultimately deciding otherwise.

I do see myself aiming for a broad scope specialty. Is that an unreasonable/preconceived notion?
 
Lysilegluleu said:
Yea, I know. Just an indulgence of curiosity. I'm not in any way trying to seal my fate now. I'm still very open to experiencing other fields and I recognize the possibility of ultimately deciding otherwise.

I do see myself aiming for a broad scope specialty. Is that an unreasonable/preconceived notion?
Click to expand...

Yes.
 
MedPR said:
Not trolling, but if the year isn't what's important, then why would you do a FM residency over an EM residency if you want to do emergency medicine?

I see no other upside to FM for someone who wants to do EM.
Click to expand...

The only potential upside I can think of is a less competitive match. Still, it doesn't really make sense to not shoot for an EM residency if that's what you're interested in doing.
 
From what I understand, and I have been wrong once before, the only FM docs that work EM do so in rural settings in weekend EDs. Even the larger rural hospitals in Iowa was EM trained physicians.
 
Lysilegluleu said:
Have you had such a huge fundamental switch in preconceived career goals yourself? Besides that, what kinda relatively extreme shifts have you seen/heard of with classmates?
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Yes. I would guess <25% of my classmates that came into school with an idea of what they wanted to do ended up going into that field for a number of reasons. Decide whether or not you want to be a doctor. If you do, go to med school. Have an open mind when you start third year and see what happens.

Saw the wood in front of you, don't try to skip steps.
 
FSU2013 said:
Yes. I would guess <25% of my classmates that came into school with an idea of what they wanted to do ended up going into that field for a number of reasons. Decide whether or not you want to be a doctor. If you do, go to med school. Have an open mind when you start third year and see what happens.

Saw the wood in front of you, don't try to skip steps.
Click to expand...

If it satisfies you and many others to read this, I will convert like a traitor to any specialty that is more to my liking come years 3 and 4 of med school. I know what I want as of right now, and I know that's highly likely to change. Just going with the flow in the mean time. Thanks for all of the pertinent info, thread participants. It's been informative. Lys out..
 
Why do premeds worry about this kind of crap? Worry about A. Getting accepted into med school, B. Doing well in med school, C. Passing step 1, D. Doing well on rotations, E .passing step 2.......F. then worry about this kind of crap. There is such a massive amount of stuff between you now and residency, that thinking about this now is a waste of time. Hell, in 3 or 4 years from now, you might not even want to do EM. EM really isnt for everyone. I am 100% applying EM in a few months and I still havent worried about the difference between programs etc.
 
willen101383 said:
Why do premeds worry about this kind of crap? Worry about A. Getting accepted into med school, B. Doing well in med school, C. Passing step 1, D. Doing well on rotations, E .passing step 2.......F. then worry about this kind of crap. There is such a massive amount of stuff between you now and residency, that thinking about this now is a waste of time. Hell, in 3 or 4 years from now, you might not even want to do EM. EM really isnt for everyone. I am 100% applying EM in a few months and I still havent worried about the difference between programs etc.
Click to expand...
I still can't even name 90% of the programs.... (Also applying EM).

To whomever asked about EM docs practicing outside of the ED. There are some. EM/Critical Care is apparently getting more popular. EM/IM exists. EM/Peds EM does too but thats just moving to an ED with more colorful walls.
 
willen101383 said:
Why do premeds worry about this kind of crap? Worry about A. Getting accepted into med school, B. Doing well in med school, C. Passing step 1, D. Doing well on rotations, E .passing step 2.......F. then worry about this kind of crap. There is such a massive amount of stuff between you now and residency, that thinking about this now is a waste of time. Hell, in 3 or 4 years from now, you might not even want to do EM. EM really isnt for everyone. I am 100% applying EM in a few months and I still havent worried about the difference between programs etc.
Click to expand...

Read more closely. Your point is well within my understanding, as I've clearly stated. As far as I can tell, you're ranting on general principle. Respond if you want, but I'm done beating a dead horse. G' day.
 
Caesar said:
I still can't even name 90% of the programs.... (Also applying EM).

To whomever asked about EM docs practicing outside of the ED. There are some. EM/Critical Care is apparently getting more popular. EM/IM exists. EM/Peds EM does too but thats just moving to an ED with more colorful walls.
Click to expand...

:thumbup:

http://musom.marshall.edu/tactical/overview.asp

Or this. Muhaha. I want to apply for tactical medicine after I finish residency. I love guns, law enforcement etc. Seems like an awesome side job.
 
Most of the people in my community if I came back home, lol. If I ultimately enjoy my EM rotation enough to pursue the field, I'll probably go that route. Thx.
 
Guero said:
+1

There are 12 options for EM/IM, something I've been seriously considering: https://services.aamc.org/eras/erasstats/par/display8.cfm?NAV_ROW=PAR&SPEC_CD=705
Click to expand...

I do recall there was someone in the residency forums, who was burnt out due to extensive workload in his/her EM/IM combined program, and was trying to ditch it. I couldn't find the actual thread to share with you here.

Although, EM/IM seems like a masterkey, thus might look pretty appealing, one might incur quite a lot of work during residency. I've no idea how marketable it's, either. Maybe, it's gonna be better to stick to either EM or IM, and run with it. Life's short..
 
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