Med-Peds and EM

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

yobabydoc

Member
15+ Year Member
Joined
Aug 18, 2004
Messages
96
Reaction score
4
How likely is it that a med-peds trained physician can work in the ER? Is it better to just train in EM where you will get to see everyone or train in med-peds with indepth knowledge and work int he ER without doing a fellowship or anything like that?
 
If you're wanting to do EM, I don't see why you wouldn't just to an EM residency in the first place. If you really wanted you could do a combined EM/IM program.
 
I don't think you can work in the ED if you are only med-peds trained. I think you would have to do a fellowship, and I know that there have been med-peds trained folks who've gone on to peds EM. I don't think there is anything available for medicine, however, except maybe sports medicine.

If you are seriously considering EM, talk to your advisor or dean. Especially since you've already applied to med-peds, you should try to figure out what your options are. I know some EM residencies are 4 years with a prelim year, so that might be an option for you.

Take care, and good luck!
 
yobabydoc said:
How likely is it that a med-peds trained physician can work in the ER? Is it better to just train in EM where you will get to see everyone or train in med-peds with indepth knowledge and work int he ER without doing a fellowship or anything like that?

Well, I've seen a peds nephrologist run the local VA's "emergency department" at night... Boy was he glad when the medicine team showed up to see a couple patients that were going down fast!

My understanding is that as far as "moonlighting", if you have a license to practice medicine (unrestricted? i'm not sure the exact terms), then it's just up to the particular community ED to see if they want to hire you part-time...
 
Being one who has completed a med-peds residency and now training in emergency medicine, I found the job market in most cities is tight for non-EM trained physicians. Many non-EM boarded physicians are not being hired anymore, and as a result, they have limited job opportunities other than their current employer. Indeed, you'll find the med-peds training superb for 90% of the EM patients. However, for the other 10% of the time you're working in EM, you'll find yourself inadequately trained for such situations as airway management and trauma. Due to the lack of training in EM, your susceptibility to malpractice and your malpractice insurance itself are significantly increased over the EM trained physician. Studies have shown that training in EM lowers your malpractice substantially.

After speaking with several chairs in EM, they advised me that a peds EM fellowship training is less marketable than EM training. The number of jobs is less, and the salary for peds EM is substantially less than general EM. A peds EM fellowship is merely 1 year of additional clinical training with 2 years of research as is the case with all pediatric fellowships. By doing an EM residency now, I will gain about 6 months of peds EM training which will provide enough knowledge and experience to care for most sick children.

If you know you want to do EM, do a residency in emergency medicine as it'll shorten your training by 4 years. Clearly, the medicicine and peds training is helpful, but it's not necessary to be an excellent EM physician. For someone such as myself who is pursuing an academic career in adult and pediatric EM, the unusual path in which I took (not intentially) will hopefully prove beneficial.

I'd be happy to speak in more detail about this discussion if anyone has any questions. Have a good week.
 
On the interview trail for med-peds, I have seen that a fair number can go into EM if they want. One place said that about 10% of their residents do go into ER. You can devote some of your elective time to more trauma type months to gain more experience in that area if it is something you are really interested in doing. And Med-peds is versatile enough that if you decide that ER isn't what you want to do during residency, you can pretty much pursue whatever else you want to do instead!
 
yobabydoc said:
How likely is it that a med-peds trained physician can work in the ER? Is it better to just train in EM where you will get to see everyone or train in med-peds with indepth knowledge and work int he ER without doing a fellowship or anything like that?

Speaking as an EM PD who has lived through the entire EM era. The number of positions in EM for nontrained physicians is getting ever smaller and that is appropriate. If you want to be an EP take the correct training. It may be possible to get a job now with other training, but you won't be able to do it for a 35 year career. Going back to your trained specialty will be difficult also after ten years in the ED.
 
virginiaemdoc said:
Being one who has completed a med-peds residency and now training in emergency medicine, I found the job market in most cities is tight for non-EM trained physicians. Many non-EM boarded physicians are not being hired anymore, and as a result, they have limited job opportunities other than their current employer. Indeed, you'll find the med-peds training superb for 90% of the EM patients. However, for the other 10% of the time you're working in EM, you'll find yourself inadequately trained for such situations as airway management and trauma. Due to the lack of training in EM, your susceptibility to malpractice and your malpractice insurance itself are significantly increased over the EM trained physician. Studies have shown that training in EM lowers your malpractice substantially.

After speaking with several chairs in EM, they advised me that a peds EM fellowship training is less marketable than EM training. The number of jobs is less, and the salary for peds EM is substantially less than general EM. A peds EM fellowship is merely 1 year of additional clinical training with 2 years of research as is the case with all pediatric fellowships. By doing an EM residency now, I will gain about 6 months of peds EM training which will provide enough knowledge and experience to care for most sick children.

If you know you want to do EM, do a residency in emergency medicine as it'll shorten your training by 4 years. Clearly, the medicicine and peds training is helpful, but it's not necessary to be an excellent EM physician. For someone such as myself who is pursuing an academic career in adult and pediatric EM, the unusual path in which I took (not intentially) will hopefully prove beneficial.

I'd be happy to speak in more detail about this discussion if anyone has any questions. Have a good week.

Wow thank you all for wonderful insightful responses. Several heads are always better than one.
 
Top