How confident were ya'll when ya'll graduated? I just don't feel confident in my knowledge base or technical skills for independent practice. In a few months I will graduate (EM 1-3) and I haven't even looked for a job due to my insecurity. I would appreciate any ideas on the best way to proceed. Better to start with low acuity/volume with single coverage or higher volume with double coverage. Or possibly due a fellowship (although it is likely too late to apply). Thanks.
Question for graduates
- Thread starter drifter
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I'm going to have to agree somewhat with the previous poster in that I think something has gone wrong if you don't think you can hack it in the "real world." Among my classmates, we were all chafing at the bit by about halfway through our 3rd year, and some of us sooner. We all did at least some moonlighting.
Something about the situation isn't well. Several possibilities exist. Either your program hasn't prepared you adequately, you are a slow learner, or you have adequate training and skills but lack confidence. Most likely is the third option. So what to do from here?
Given your situation, you have few options. Fellowship would have been good, but as you said, it's too late to apply. You need to find a job soon. Unless you're independently wealthy with no student loan debt, you need to work when your loans enter repayment.
I'm going to suggest the same as I do to all new grads, and that is to find a fairly busy ER where you can get a lot of exposure. I think finding a place where you'll be double or triple covered at least most of the time is valuable. My first job out, we had a trauma surgeon in-house all day and most nights, which turned out to be invaluable at times when I just needed a "old hand" to run a case by. Judgment is something that comes with time and experience, and older docs have lots of both.
I think a single coverage situation is a bad idea for new grads. I think it's not that great for anybody really, because you have nobody to pick up the excess when things get busy. In that case, everybody suffers. The patients get worse care and wait longer, you get burned out and tired (and maybe sued), and the nurses have to deal with all that and get cranky as a result. Single coverage is a necessary evil in lots of places that don't have the volume to support a higher level of staffing, but I think it's best for docs that have been out a least a couple years. I was still doing a lot of learning on the job during my first 1-2 years out.
Something about the situation isn't well. Several possibilities exist. Either your program hasn't prepared you adequately, you are a slow learner, or you have adequate training and skills but lack confidence. Most likely is the third option. So what to do from here?
Given your situation, you have few options. Fellowship would have been good, but as you said, it's too late to apply. You need to find a job soon. Unless you're independently wealthy with no student loan debt, you need to work when your loans enter repayment.
I'm going to suggest the same as I do to all new grads, and that is to find a fairly busy ER where you can get a lot of exposure. I think finding a place where you'll be double or triple covered at least most of the time is valuable. My first job out, we had a trauma surgeon in-house all day and most nights, which turned out to be invaluable at times when I just needed a "old hand" to run a case by. Judgment is something that comes with time and experience, and older docs have lots of both.
I think a single coverage situation is a bad idea for new grads. I think it's not that great for anybody really, because you have nobody to pick up the excess when things get busy. In that case, everybody suffers. The patients get worse care and wait longer, you get burned out and tired (and maybe sued), and the nurses have to deal with all that and get cranky as a result. Single coverage is a necessary evil in lots of places that don't have the volume to support a higher level of staffing, but I think it's best for docs that have been out a least a couple years. I was still doing a lot of learning on the job during my first 1-2 years out.
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I am sure you may be hesitant to indicate what program you trained at, but it would be greatly appreciated if you might hint as to what state it is in.
As far as your concerns, I am sure that your problem is mostly a confidence issue more than a training one. The RRC appears to do a pretty decent job of ensuring that each program at least meets the minimum requirements of training. That being said, there is also a important self innitiative component to training as well. You should definitely try to moonlight a bunch of times before graduation to build your confidence a bit.
Good luck!
As far as your concerns, I am sure that your problem is mostly a confidence issue more than a training one. The RRC appears to do a pretty decent job of ensuring that each program at least meets the minimum requirements of training. That being said, there is also a important self innitiative component to training as well. You should definitely try to moonlight a bunch of times before graduation to build your confidence a bit.
Good luck!
Thanks for your input gentlemen (or ladies). You are all partially correct. I feel like I have been trained to run a walk-in clinic for the indigent more than anything else. Maybe that is the real world. I will start moonlighting soon, but that will be single coverage. As for the program... well this board is not as anonymous as one would think, but I will say it is in the southern US. Peace, out.
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I don't think you should feel obligated to even hint at the program you are at. You are asking a very important question that not a lot of people would have the cojones to ask, and thankfully SDN has come through and some of our veteran posters have helped. Keep it to yourself and good luck! Go SDN!drifter said:
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I disagree that your program must have sucked for you to feel this way. This may be more of a personality issue meaning that you have enough sense to be humble and uneasy about going out on your own. I'd say that makes you more likely to do a good job and less likely to make mistakes than someone who is a hot shot.
Here's my suggestion. Pick a place that serves a population like you are used to. Go somewhere with double coverage so you can bounce the trick stuff off the other guy. Be conservative until you get more comfortable.
The learning curve is high for everyone fresh out. Even the people who think they know it all.
Here's my suggestion. Pick a place that serves a population like you are used to. Go somewhere with double coverage so you can bounce the trick stuff off the other guy. Be conservative until you get more comfortable.
The learning curve is high for everyone fresh out. Even the people who think they know it all.
