Cody1MD
I considered EM-IM heavily. EM-IM is a 5yr residency that was started to fill the "Intensivist" role, where a physician could be trained in a residency to see the critical patients at the door and in the units (a little history).
There are many reasons to do or not to do EM/IM.
EM/IM graduates have historically entered EM only positions. However, the oportunity to sit for both boards can offer many avenues after graduation. For example and in no particular order - IM serves as a fall back career, combined EM shifts with unit coverage, EM and Hospitalist, diversified EM physician, improved marketability and those who can't make a final decision for a career choice. These are a few of the avenues that I observed among residents and attendings.
Most EM docs you will encounter will ask "why would you torture yourself?" That being said, all the EM/IM physicians I encountered were incredible EM clinicians, diagnosticians and freqeuntly consulted by their department collegues.
Residents have said that it is difficult for the first few years to integrate the two philosophies of medicine. They often felt like a stepchild of both departments because they divided their time between both and therefore were often educationally behind the residents of each field. When the third year arrives and both residencies (em and im) are graduating, the remaining two years are frequently described as a struggle. But, in those final years the resident's skills begin to culminate and sync. All the 4th and 5th year resident's I observed, worked as functional attendings.
The EM/IM training, in my opinion, does not cheat you out of a quality education or experience when compared to the individual specialties, it just cost 2 more years.
As neutropeniaboy mentioned, you should consider what you endpoint will be, EM, EM/IM, or IM. Talk to EM/IM residents and faculty.
Got alot long winded. Hope this helped.