- Joined
- Aug 20, 2019
- Messages
- 88
- Reaction score
- 15
I apologize for the length of this post in advance.
Currently, I am a PGY-1 in emergency medicine. Being an IMG, I was told to have a parallel plan/backup when applying for residency being that I applied to a competitive specialty such as EM and there would be a good chance I would not match. My backup was psych. I got interviews in both psych and EM. When match day came I knew something was wrong when I wasn't super excited about matching into my #1 choice of EM at an academic center. I realize it has only been 2 months into internship year, and trust me I knew well in advance just how hard this year would be, regardless of what specialty I went into; but, being miserable doesn't even being to describe how I feel. Day after day, I LOATHE going into work. Just about everyone is great and helpful and easy to work with, but I can't even begin to imagine how I will do this for the rest of my life. Hard work is not something that is foreign to me and I don't mind it one bit, but it's the type of work that I do which is so unappealing to me in this field. Seeing an enormous volume of patients makes me worry about the whole quality vs. quantity issue and I don't feel like I'm really getting to know any of my patients. Juggling multiple things at once ALL the time makes me feel like I am being spread too thin which will affect my patient care one way or another. That's just the reality of this specialty. And the scary thing is that as interns we're not even expected to see that much volume and I'm already beyond overwhelmed. I'm rushing around like a chicken with my head head cut off and also trying to finish notes (which I never can) only to have to stay up an extra few hours to finish them or ruining the following day spending hours doing so. Notes are problematic in every field but especially in EM where the likelihood of being sued is high enough that doctors have to aggressively document, which is time-consuming...and scribes are not everywhere. Perhaps things are a little different in a community hospital in terms of volume (which makes me hopeful), but I think many of those issues are present in this field regardless of the hospital setting.
I don't have a minute to eat nor does anyone else and if they do, it consists of shoving food down their throats so fast I'm amazed they don't choke. Is this how EM doctors are supposed to function?? As a result, I feel incredibly foggy not able to think straight so my performance inevitably reflects this. Because of the incredibly fast-paced nature, I feel like I'm learning nothing. I spend more time sitting and staring at a computer screen, calling consults and constantly getting interrupted, etc. rather than doing what attracted me to medicine in the first place: caring for people. The allure of doing procedures has worn off already; I get anxiety looking at EKG's and avoid them at all costs; I can't stand calling consults; I'm horrible with radiology and despise looking at anything that is more complicated than a 5 yo could figure out; and I run away when anyone even mentions doing an US. I look at how hard the seniors work and how insane their workload is and I and cannot imagine ever making it to that level given how I feel right now. I also feel like this is a specialty where you are taking care of problems that are ironically non-emergent (and could have easily been managed at home or outpatient) and/or dealing with someone else's train wreck the majority of the time. The really interesting stuff ends up being managed by other services.
As you read this, you must wonder why in the heck I went into this specialty in the first place. I ask myself the same thing. I do think that doing a rotation as a med student doesn't always necessarily reflect what it would be like to do it as a career. I am a person who really needs time to think things through and because of that, I don't know if my learning style is well-suited for this field.
I compare my life now to what it would have been like if I had just gone into psych in the first place. I can't help feeling like I would've been so much happier if I had just done that. I find myself wanting to see those patients more than any others in the ED b/c that's where I feel like I can be the most helpful and what I enjoy. I don't have to worry about following up on 100 labs or taking the time to do procedures or calling a million consults or rushing through with each patient bc I have 10 others I have to go and see. I would get to spend time with my patient bc that is the foundation of psychiatry.
When I was making my rank list as a 4th year med student, I ranked psych lower because technically it was my backup anyways, but it was also because I listened to everyone around me say that psych would be "boring" or "it's not real medicine" or any of the other stereotypical things that people unfortunately say about the field. It was around this time I also began having second thoughts about choosing EM as my top choice. But in the end, I essentially I ignored my gut.
I realize that some of the complaints I just listed will go away once I become an attending or they are issues that every specialty faces; however, many are unique to the field of EM. Right now Im just feeling like I made the wrong decision. I know that I'm obligated to give this more of a chance before I start seriously considering a switch. After all, I chose EM for a reason and want to be 110% sure before I decide to throw in the towel. So...if I decide to make the transition, any advice on how to go about doing this? From reading other posts, I know talking to the PD is basically the first step. But how long do I give it before approaching them? I certainly don't want to jump the gun before I give it a real chance but I also don't want to wait until the end of my PGY-2 to make a switch and then have to basically redo several years of residency.
As a side note, I actually interviewed with the psych program at the same hospital where I'm currently doing my EM residency. Maybe this would work against me? Maybe not.
Sorry for the long-winded rant. Any advice would be greatly appreciated 🙂
Currently, I am a PGY-1 in emergency medicine. Being an IMG, I was told to have a parallel plan/backup when applying for residency being that I applied to a competitive specialty such as EM and there would be a good chance I would not match. My backup was psych. I got interviews in both psych and EM. When match day came I knew something was wrong when I wasn't super excited about matching into my #1 choice of EM at an academic center. I realize it has only been 2 months into internship year, and trust me I knew well in advance just how hard this year would be, regardless of what specialty I went into; but, being miserable doesn't even being to describe how I feel. Day after day, I LOATHE going into work. Just about everyone is great and helpful and easy to work with, but I can't even begin to imagine how I will do this for the rest of my life. Hard work is not something that is foreign to me and I don't mind it one bit, but it's the type of work that I do which is so unappealing to me in this field. Seeing an enormous volume of patients makes me worry about the whole quality vs. quantity issue and I don't feel like I'm really getting to know any of my patients. Juggling multiple things at once ALL the time makes me feel like I am being spread too thin which will affect my patient care one way or another. That's just the reality of this specialty. And the scary thing is that as interns we're not even expected to see that much volume and I'm already beyond overwhelmed. I'm rushing around like a chicken with my head head cut off and also trying to finish notes (which I never can) only to have to stay up an extra few hours to finish them or ruining the following day spending hours doing so. Notes are problematic in every field but especially in EM where the likelihood of being sued is high enough that doctors have to aggressively document, which is time-consuming...and scribes are not everywhere. Perhaps things are a little different in a community hospital in terms of volume (which makes me hopeful), but I think many of those issues are present in this field regardless of the hospital setting.
I don't have a minute to eat nor does anyone else and if they do, it consists of shoving food down their throats so fast I'm amazed they don't choke. Is this how EM doctors are supposed to function?? As a result, I feel incredibly foggy not able to think straight so my performance inevitably reflects this. Because of the incredibly fast-paced nature, I feel like I'm learning nothing. I spend more time sitting and staring at a computer screen, calling consults and constantly getting interrupted, etc. rather than doing what attracted me to medicine in the first place: caring for people. The allure of doing procedures has worn off already; I get anxiety looking at EKG's and avoid them at all costs; I can't stand calling consults; I'm horrible with radiology and despise looking at anything that is more complicated than a 5 yo could figure out; and I run away when anyone even mentions doing an US. I look at how hard the seniors work and how insane their workload is and I and cannot imagine ever making it to that level given how I feel right now. I also feel like this is a specialty where you are taking care of problems that are ironically non-emergent (and could have easily been managed at home or outpatient) and/or dealing with someone else's train wreck the majority of the time. The really interesting stuff ends up being managed by other services.
As you read this, you must wonder why in the heck I went into this specialty in the first place. I ask myself the same thing. I do think that doing a rotation as a med student doesn't always necessarily reflect what it would be like to do it as a career. I am a person who really needs time to think things through and because of that, I don't know if my learning style is well-suited for this field.
I compare my life now to what it would have been like if I had just gone into psych in the first place. I can't help feeling like I would've been so much happier if I had just done that. I find myself wanting to see those patients more than any others in the ED b/c that's where I feel like I can be the most helpful and what I enjoy. I don't have to worry about following up on 100 labs or taking the time to do procedures or calling a million consults or rushing through with each patient bc I have 10 others I have to go and see. I would get to spend time with my patient bc that is the foundation of psychiatry.
When I was making my rank list as a 4th year med student, I ranked psych lower because technically it was my backup anyways, but it was also because I listened to everyone around me say that psych would be "boring" or "it's not real medicine" or any of the other stereotypical things that people unfortunately say about the field. It was around this time I also began having second thoughts about choosing EM as my top choice. But in the end, I essentially I ignored my gut.
I realize that some of the complaints I just listed will go away once I become an attending or they are issues that every specialty faces; however, many are unique to the field of EM. Right now Im just feeling like I made the wrong decision. I know that I'm obligated to give this more of a chance before I start seriously considering a switch. After all, I chose EM for a reason and want to be 110% sure before I decide to throw in the towel. So...if I decide to make the transition, any advice on how to go about doing this? From reading other posts, I know talking to the PD is basically the first step. But how long do I give it before approaching them? I certainly don't want to jump the gun before I give it a real chance but I also don't want to wait until the end of my PGY-2 to make a switch and then have to basically redo several years of residency.
As a side note, I actually interviewed with the psych program at the same hospital where I'm currently doing my EM residency. Maybe this would work against me? Maybe not.
Sorry for the long-winded rant. Any advice would be greatly appreciated 🙂
