Questions about Emergency Medicine? AMA!

[Blueprint Med School]

Hello there! I am an Emergency Medicine senior resident and like the title says, if you have any questions about EM, are considering EM, or are just interested in knowing the goods and bads of the best (obvs biased) specialty in all the land as it relates, drop them below!


David D, MD - USMLE and MCAT Tutor Med School Tutors

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[gyngyn]

What do you think about workforce projections?

 

[Blueprint Med School]

What do you think about workforce projections?

really good topical Q!

I actually went to the ACEP Leadership and Advocacy Conf in DC this year where the guy who authored the big study that shook the entire field spoke. Right now we have a good mix of docs but too many are working in cities and too few are rural, so midlevels are taking rural spots by necessity but they are starting to squeeze docs out. By 2030 we will have too many docs 'probably' but he showed several different curves based on:

1) growth of new residencies (more = overflow = bad)
2) turnover (which will probably jump because of pandemic burnout)
3) midlevel scope of practice expansion and impingement (the defining issue of our generation)

and depending on how those factors play out, we could either have 'about as many docs as we need but good luck getting a job in a major city' to 'crisis level oversupply and salary deflation'.

So if you are reading this, please get involved with AMA and the state/specialty groups where you end up (ACEP for ER for example) because they will be fighting the long necessary war over #3.

David D, MD - USMLE and MCAT Tutor Med School Tutors

 

[mdog31415]

Non-trad paramedic here and hoping to get accepted this cycle 🤞. With Step 1 going P/F, is there anything we should be doing in addition to rocking our exams, doing well on Step 2 CK, and doing well on rotations? Is research important when it comes to matching into a good EM residency? Are there certain non-EM rotations where the grades and preceptor assessments mean a lot when applying to residency? I’m going in with an open mind (Family Med, internal med, peds, surgery, anesthesiology), but I’d be lying to you if I said EM wasn’t the #1 seed rn.

 

[Blueprint Med School]

Non-trad paramedic here and hoping to get accepted this cycle 🤞. With Step 1 going P/F, is there anything we should be doing in addition to rocking our exams, doing well on Step 2 CK, and doing well on rotations? Is research important when it comes to matching into a good EM residency? Are there certain non-EM rotations where the grades and preceptor assessments mean a lot when applying to residency? I’m going in with an open mind (Family Med, internal med, peds, surgery, anesthesiology), but I’d be lying to you if I said EM wasn’t the #1 seed rn.

Research is only really important to those big-city research programs, your average EM program isn't super hung up on it. Be solid on QI projects because they are super applicable to both residency and real life.

EM programs take such a heavy emphasis on the 4th year AI grades. So do as much time in the ER as a 3rd year (that is conceivable) so you know how to take a basic focused H&P and management. If your school has an elective 3rd year, I would recommend it. If not, do a couple shadow shifts and try and see a few chest pains, belly pains, shortness of breath workups. There are only a dozen or so archetypal chief complaints but it just takes doing them a bunch of times to start developing these skills.

For Q2, it is hard since EM makes up a little of everything. But getting good grades on Med and Surg will take you far since they are the most like bread and butter emergency medicine.

I am super excited that you are looking at joining EM. If you have any questions now or later, feel free to DM me and ask for Dave.

David D, MD - USMLE and MCAT Tutor Med School Tutors

 

[Apothecary Aquinas]

Hope it's okay if I ask you a couple questions here given that this is the premed forum.

For context, I'm an M4 almost done with interview season and will be ranking my EM programs soon. I'm interested in fellowship and have had pretty decent luck getting some good hybrid and academic programs.

With that being said, any advice on ranking? More specifically, what are some things you've come to realize throughout residency that may have changed how you ranked programs if you could go back?

Any red or green flags that aren't so obvious that I should be more aware of or may not be knowledgable about at this stage?

Thanks, I really apprecaite it!

 

[Blueprint Med School]

Hope it's okay if I ask you a couple questions here given that this is the premed forum.

For context, I'm an M4 almost done with interview season and will be ranking my EM programs soon. I'm interested in fellowship and have had pretty decent luck getting some good hybrid and academic programs.

With that being said, any advice on ranking? More specifically, what are some things you've come to realize throughout residency that may have changed how you ranked programs if you could go back?

Any red or green flags that aren't so obvious that I should be more aware of or may not be knowledgable about at this stage?

Thanks, I really apprecaite it!

Of course it is! And my best advise is to write yourself a couple of rules of things that are important to you. That will help you largely put your list into tiers.

For me, my rules were:

1) 3-year programs over 4-year programs.
2) Northeastern over other regions.
3) NJ/PA over other northeastern.

I ended up ranking 17 places and that immediately helped get me 80% of the way. After that gave me my initial list, I then moved programs up and down based off my experience with them and other things that were important but not as important (benefits, scheduling, volume, etc).

You are more than welcome to DM me if you want some more individualized thoughts on the process. Would love to help.

David D, MD - USMLE and MCAT Tutor Med School Tutors

 

[voxveritatisetlucis]

Of course it is! And my best advise is to write yourself a couple of rules of things that are important to you. That will help you largely put your list into tiers.

For me, my rules were:

1) 3-year programs over 4-year programs.
2) Northeastern over other regions.
3) NJ/PA over other northeastern.

I ended up ranking 17 places and that immediately helped get me 80% of the way. After that gave me my initial list, I then moved programs up and down based off my experience with them and other things that were important but not as important (benefits, scheduling, volume, etc).

You are more than welcome to DM me if you want some more individualized thoughts on the process. Would love to help.

David D, MD - USMLE and MCAT Tutor Med School Tutors

Hi, thank you for offering to answer questions. I am just wondering if you could explain what opportunities are available to an attending who was trained at a “strong” residency program vs. a lesser/unknown program. Obviously, I can see why it may be important in derm/ortho/plastics (especially in private practice if one can tell patients they were trained at MGH or Cleveland clinic.) but why is it important for specialities like EM/IM/neurology etc. thanks in advance

 

[Blueprint Med School]

Hi, thank you for offering to answer questions. I am just wondering if you could explain what opportunities are available to an attending who was trained at a “strong” residency program vs. a lesser/unknown program. Obviously, I can see why it may be important in derm/ortho/plastics (especially in private practice if one can tell patients they were trained at MGH or Cleveland clinic.) but why is it important for specialities like EM/IM/neurology etc. thanks in advance

That really applies mostly to research. But even that doesn't follow 'traditional' rules because the biggest research name in EM that I can think of is probably Scott Weingart and he is at Stony Brook, NY. 'So much of EM tends to be regional. I live an hour away from Philly and the programs there tend to hire from the Philly residencies. So many choose to do a residency in the general area they want to live.

Are you interested in fellowship? That may change the game.

David D, MD - USMLE and MCAT Tutor Med School Tutors