Please humor the "interested in EM" guy

[fiznat]

Heya everyone. I dont post much here but I've been lurking for a long while since I became interested in medicine (specifically EM) a few years ago. I am 22 years old, graduated from Boston University in '04, and have been working as an EMT (soon to be paramedic) for the past 3 years. Currently I am taking my pre-med requirements (was a philosophy/psych major for my BA) so I can hopefully apply to medical school within about 2 years (it takes a while when your loans are due and you have to work full time...).

Anyways, as I am going through all of this work I have been constantly troubled by these questions that I think MUST be fairly common amongst you all who have been here before. I realise this is not a pre-med specific section, but I was hoping you guys might have some particurally helpful insight to my concerns given that my primary interest is in EM. So if a few of you dont mind, I would REALLY appreciate it:

How much of this science work is truly relevant to a career in EM? I hate chemistry, physics isnt bad although my math skills arent exactly the best, and while bio is sometimes interesting, I cant see myself doing this for any real length of time. Working with patients in the back of ambulances gives me a completely different (medical?) experience: working with patients, solving problems, learning procedures, thinking on my feet, etc. This science coursework is, by comparison, starkly academic... I guess what I am asking is - is this work a hoop that I have to jump through in order to take the next step with patients, or is it practice for what amounts to an academic career clothed in an exciting reputation?

Based on my experience and knowledge of myself, I feel like I would make a pretty god emergency physician, but that assessment is based on a concept of the profession that I'm not sure is entirely correct. It is amazing to me though, because I have thousands of patient contacts and tons of experiences working directly with hospital personel. I see most every day what it is that emergency physicians do, and yet I am not confident that I could accurately describe what skills it takes to do well preparing for, and working in, the job. Can any of you guys talk a little about what it takes to succeed in EM?



I apologise for the lengthy post, but I hope some of you can understand (and help me out with!) some of these questions that I cant seem to answer on my own.

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[BKN]

:

How much of this science work is truly relevant to a career in EM? I see most every day what it is that emergency physicians do, and yet I am not confident that I could accurately describe what skills it takes to do well preparing for, and working in, the job. Can any of you guys talk a little about what it takes to succeed in EM?
.

I've been at it for 30 years and have trained 150 E.P.s

Chemistry, biology, physics and math are important and are the building blocks of all that comes after. If you don't succeed at them, you are unlikely to succeed at EM. EM is mostly about thinking; procedures, IVs etc are secondary.

We can teach you the infromation and to multitask, but the dedication and brainpower are prerequisites.

 

[bartleby]

There are two components to pre-medical knowledge. The first aspect is indeed some component of hoop jumping in regard to proving that you're "worthy" of med school. Nobody has ever really figured out how to spot a good doctor in a pool of applicants, particularly a minimum of 7 years before you're going to be a full-fledged physician. And out of all the smart people applying to med school, organic chemistry is just another data point.

The second thought is that, to paraphrase the saying, most medical though stands on the shoulders of the basic science concepts which were learned first. In some ways, organic chemistry is like Shakespeare... you don't go quoting it every day, but you can't really consider yourself educated if you hasn't been part of your education at some point.

 

[trkd]

BKN definitely has more experience than me but I will just toss in my experience, strictly from a student's point of view. I found that the undergrad courses were necessary to understand some of the concepts taught in med school but it certainly was more interesting in med school than it was in undergrad.

Undergrad science seeming like learning chemistry/biology just to learn it, without much purpose. Med school helps you learn the applications of such knowledge. It definitely makes it all more interesting. I hope it helps. Good luck!

 

[USAF MD '05]

Just yesterday when multiple traumas came rolling through the door, we were trying to remember the different orbital levels of the electrons in these people. Also we were trying to remember the exact metabolism of cholesterol we learned in biochem. I felt like it was my fault they all died. Those electrons HAD to be jacked up with all that blood flowing everywhere!! If I could have just payed more attention in Organic....oh well, back to the books! Steve

 

[fiznat]

Med school helps you learn the applications of such knowledge. It definitely makes it all more interesting. I hope it helps.

It does, thank you. And thanks to everyone else who responded as well.

I dont have a doubt whether I have the personal ability to do well in these courses, my concern mostly comes from the fact that I dont particularly enjoy them all that much.

It is a harder question to answer, I know- but what I am really trying to figure out is if the day-to-day job of an E.P. is something I could enjoy doing, and if it is worth the work to get there. I asked about the relevance of science courses not because I dont think I can get through them, but because I am sometimes afraid that the E.P.'s work is more like textbook science than what I have experienced thus far working with patients. The two experiences differ quite a bit, so its hard for me to put a finger on where the E.P. profession lays between scientific academia and patient care. ...Or perhaps they are one and the same?


Again, thank you all for your help.

 

[bartleby]

I started having a much better and less stressful time of it in med school when I had the realization that there wasn't something wrong with me for not enjoying everything about the experience. This was a real shock to me after being an undergraduate English Lit. major, when the whole fun of it was being able to sit around and talk about how beautiful three lines of a sonnet were for half an hour. Medicine is a rough business, and its education is a matter of necessity and requirement rather than one of pleasure.

Mick Jagger hit the nail on the head when he sang, "You can't always get what you want/but when you try sometimes, you find/you get what you need."

...my concern mostly comes from the fact that I dont particularly enjoy them all that much.

The fact that modern medicine is, at its best, logical and evidence-based by definition makes all good physicians scientists. But where the rubber meets the road in medicine (and where the "art of medicine" comes in) is taking all of the black and white facts you've learned and applying them to the care of a living, breathing human being who is the fundimental gray area in the universe. This is why it's possible to be absolutely brilliant person who turns out to be an absolutely horrendous physician.

EM is the epitome of this challenge where you have to make some of the toughest decisions often with the least information. You don't get to sit around and ponder, or talk to all the family first. But it can be the coolest job in the world on a good day.

<QUOTE> I am sometimes afraid that the E.P.'s work is more like textbook science than what I have experienced thus far working with patients....E.P. profession lays between scientific academia and patient care. ...Or perhaps they are one and the same?</QUOTE>

 

[leviathan]

Just yesterday when multiple traumas came rolling through the door, we were trying to remember the different orbital levels of the electrons in these people.

Mostly all sp2 and sp3 hybridized.

 

[sparky5]

Mick Jagger hit the nail on the head when he sang, "You can always get what you want/but when you try sometimes, you find/you get what you need."

humm I always thought it was "You can't always get what you want......"

 

[Dr.Evil1]

It sounds like you will be well suited for a career in EM. EPs tend to be more patient focused and it sounds like that is what you enjoy about being a EMT. The thing is, though, that as a physician you have to be able to think at a higher level then the protocol driven practice that predominates your practice as an EMT. You have to know some biochem and bio in order to understand pharm and physiology. You need those in order to understand disease process and treatment. You definetly need to understand those in order to make people better, even in the ED.

 

[Snacker]

I'll toss in my two cents...

I'm a 4th yr med student now who actually had many of the same concerns you did when starting my premed classes. It's okay if the o-chem, physics, and even biology aren't very interesting. That can mean a number of things. It could mean that you've got crappy teachers, that you've got a poor text, that you have a tough time sitting through hours of lecture, etc. Or, it could mean that the subject is just not appealing to you.

On the other hand, if you like learning about disease and physiology, if you like working with people, if you like procedures, etc, then you will probably find something you like in medicine. It's even okay if you don't enjoy your first 2 yrs of med school. If I were you I'd get involved in a clinical research project, shadow in the ED or in a clinic somewhere, and if you like the environment, then go for it.