Cucumbers

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What's the deal with all the recent pgy-2 vacancy spots on SAEM.org? Hennepin, Maricopa, Harvard-- all in the past 2 weeks or so... is this typical turnover for EM-residency spots?
 

waterski232002

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If you're going to bail... you're going to do it during your intern year. Thus, the opening becomes available as a PGY-2 spot.
 

EctopicFetus

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It does seem like a lot though. Who knows.. perhaps people didnt realize what it really entails.. good luck to em all!
 

corpsmanUP

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I think early on in EM residencies there are way too many offservice rotations. 3 years is so short, and I truly believe we burn out some of our best people by sending them off to the trenches for extended periods of time. Not to hijack the thread, but I hope the RRC considers ways in the future to allow for more offservice rotations within the department. I think the dream program would come up with a way to train completely within the ED with mechanisms for being the "ortho residents", the "cards resident", or "Peds resident" for that month. It can be depressing as all hec to leave your department for 5-6 months at a time. ICU is the one exception in my mind to really needing to leave the department, but virtually everything else can be gained in the department.
 

dmitrinyr

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I don't wish them luck. They kept me from getting a job last year. They're dead to me.
I agree, just not with such a harsh tone. I say that if you realize that you would like to do something else after only one year of your EM residency, then EM was never really for you and you probably shouldn't have applied for it. I know that people realize that they don't like something and some poeple just change their mind but I don't think that residency is the right time for you to be "trying things out and see if they fit". Residency training should be training doctors who want to have a career at that particular specialty not doctors who don't know what they want to do. As Dr. McNinja said, it's these type of people that take spots from others who want nothing more than to be an EM physician. Same thing applies for surgery residents. I don't understand how you can get a categorical surgery residency (hence assuming that you have proven your love and dedication to a career in surgery to prospective programs) and then less than one year into residency you realize that it's not for you or it's too hard or now you realize that you want kids and a life and a family. Do these residents spend their clinical years in a fairytale land? How are you applying for surgery and not know that intern year (as well as the rest of your residency) will be pure hell of 100 hour weeks and you will really not have anything resembling a life for a few years? Don't these people do Sub-I's or electives in their future career? Sorry about the venting but this just hits a nerve.
 

Arcan57

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Medical student experience varies greatly from program to program. The "shoot the breeze with the cool ED attending and carry one patient at a time" are very differents experience from programs where MSIVs are carrying 4-5 pts and learn by doing because the supervisors are too busy to hand-hold.

I think EM residency comes as a shock to people who are very bright and excelled at the first experience but are not good multitaskers. They go from being praised as medical students to being behind the curve as interns and seeing a career that does not play to their strengths looming in front of them.

It is painful to supervise an MS carrying multiple patients when you have too little time and too many patients but we need to let medical students understand the cognitive issues with EM.
 

GeneralVeers

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A lot of it has to do with people going into EM for the wrong reasons. I've seen interns come in with no skills, but great enthusiasm for the profession and they do well. Likewise I've seen people with prior residencies (like FP or IM) start EM thinking that they'll have more family time, have a better salary, or just an easier schedule. These people who clearly have no interest often crash and burn.
 

JackBauERfan

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A lot of it has to do with people going into EM for the wrong reasons. I've seen interns come in with no skills, but great enthusiasm for the profession and they do well. Likewise I've seen people with prior residencies (like FP or IM) start EM thinking that they'll have more family time, have a better salary, or just an easier schedule. These people who clearly have no interest often crash and burn.
i agree people who are really interested EM do generally better, just like any field, if you put my in GYN i'd be a slacker, not enthusiastic, and pretty much a pain to everyone around me!

But there are also folk that pretty much hate every day but are still good, but its less often that happens.

I think people leave residencies for a lot of reasons and its not like they just leave without thinking about it, I mean its a pretty big decision in their life and even though a year of anything (besides ob/gyn) is never a waste...you still have to really not like EM to not continue for 2 more years and be done with it.

another point brought up was the multitasking...its really different than in med school, i did 3 rotations and on all of them was never pressured to see more patients, most of it was just see what you can, if you need to spend 2 hours doing that lac, its ok...all things like that. Even now not necessarily pressured, but any resident will start thinking/projecting themselves a few years down the road as an attending and think 'will i be able to handle it' like the person they are working with. Some of these attendings are supervising like 3-4 residents, some pas, seeing some patients by themselve, signing off on ekgs, dealing with abusive patients...and you know when youre an attending you're gonna have to be able to manage the 'whole ED' or whateve part is your responsiblity. And you can't spend 2 hours doing a lac, and in general have to be very good at time management...

ok i think thats enough of nothing
 

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A lot of it has to do with people going into EM for the wrong reasons. I've seen interns come in with no skills, but great enthusiasm for the profession and they do well. Likewise I've seen people with prior residencies (like FP or IM) start EM thinking that they'll have more family time, have a better salary, or just an easier schedule. These people who clearly have no interest often crash and burn.
But I gotta' say it, I just negotiated a contract for my first job that is for much, much more than I would have made if I had stayed in the Specialty That Dare Not Speak Its Name. And I do have a better schedule (more days off in residency, I mean) than if I had stayed at a place I'm just going to call "Earl" to avoid riling up its many fanatical defenders.
 

Apollyon

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Specialty That Dare Not Speak Its Name.
Family Medicine

a place I'm just going to call "Earl" to avoid riling up its many fanatical defenders.
Duke

This is just a small primer to bring newer folks up to speed on the jargon that is beyond a beaten dead horse - it's more now like that blood streak you see on the interstate.
 

jbar

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wait, the family medicine doctor of the Duke of Earl was beating horses on the interstate?

I'm confused.
 

AmoryBlaine

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wait, the family medicine doctor of the Duke of Earl was beating horses on the interstate?

I'm confused.
Is that why there are so many PGY-2 vacancies?
 

hurricanemd

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I wonder how many of these vacancies are due to people who matched into EM because it was their "backup plan." At my school we had a huge number of people match into EM, but I know for a fact that a few of them aspired to anesthesia or derm. If someone starts off like this, having been disappointed already by not matching into their dream specialty, I would think that the negatives of EM as a field would catch up even faster.
 

AmoryBlaine

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I wonder how many of these vacancies are due to people who matched into EM because it was their "backup plan." At my school we had a huge number of people match into EM, but I know for a fact that a few of them aspired to anesthesia or derm. If someone starts off like this, having been disappointed already by not matching into their dream specialty, I would think that the negatives of EM as a field would catch up even faster.
I'm going to start telling people I ranked Ortho as a back up.
 

Dr.McNinja

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Seriously, EM as a backup to Gas? Based on recent data, that's like saying you applied to Peds as a backup to IM. Marginally more competitive, but completely different.
 

wook

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wait, the family medicine doctor of the Duke of Earl was beating horses on the interstate?

I'm confused.
No, no, no, no. The Duke of Earl's Family Medicine Doctor was beating dead horses outside of the interstate, while using a truck (Mack I believe). You hadn't heard?



Wook
 

SoCuteMD

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Seriously, EM as a backup to Gas? Based on recent data, that's like saying you applied to Peds as a backup to IM. Marginally more competitive, but completely different.
I'm never quite sure where people get the "Gas is more competitive than EM" thing.

According to the data I found (the 2007 match), they are pretty equivalent with EM coming out just a little bit more competitive than gas on most fronts.

EM avg board score: 221
Gas avg: 220

EM positions/#US grads applying to EM 1.17:1
Gas positions/# US grads applying to gas 1.2:1