Interesting. My experience in EM in MS4 and intern year (I am in neither EM or IM) was very different. Never truly "diagnosed" anything in the ED. The main job was to stabilize and dispo - admit vs discharge. Once stable, whatever work-up needed to diagnose went to IM or whatever other specialty necessary.
Did you not get at least 1 zebra every few days on inpatient Medicine?
My two cents from a fellow M4 who flirted with EM but ultimately decided against it: I think most med students who truly enjoy medicine like being in the ER. Its one of the only places i truly felt useful and like a “real” doctor. Theres a reason its so popular amongst med students now. After speaking with many attendings, though, it became clear to me that EM is just so much more appealing from the perspective of a single 27 year old than a married 35 year old with a family. For various reasons, I came to the conclusion that its a short-sighted decision to go into EM and decided to pursue a specialty where even 60 year old attendings rave about their jobs. To me, the only way to make such tremendous life decisions is by looking at those who have made it already.
Current 35yo, married with a family M4 going into EM. Please don't generalize. I know plenty of 60 year old attendings who still love EM, but also realize that as a speciality, many of those weren't residency trained EM docs. EM is shift work, with no call. Yes, it's grueling when you're on, but I'm not dealing with prior authorizations, dispo issues with case management, etc. Also, there are a ton of fellowships that break up the monotony or the grind - you can do tox and work poison control, EMS and be a medical director or do admin and have a c-suite, all while still doing 0.25-0.5 FTE and working 1-2 times a week in the department. I don't mean to try and change OPs mind, but the discussion here seemed negative towards EM and only one person here in the field commenting.
In other words, your advice to the OP, who by the way has already applied into IM and would require significant time and effort to make a field switch at this juncture, is to pursue a specialty that is “monotonous” and “a grind” because, well, OP can just do a fellowship and/or take a desk job in 10 years when they almost invariably will get sick of doing the job they were trained to do. Meanwhile, in the field the OP has already chosen and will be hopefully matching into in a short time, the fellowship opportunities are vastly superior and carry job satisfaction rates that are worlds ahead of the field he is pondering over.
Ophtho
I’m not sure what this is about. All the ED is is diagnose, resuscitate, repeat.
Pretty sure you'd want the "resuscitate" part to come first in that order.
