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Here’s my honest advice to you. And really listen and pay attention.
It actually sounds a little like you want ortho but don’t have the numbers. So EM is kind of like a second choice. It’s very hard to sustain a EM lifestyle especially if it’s your second pick. Yes, i get it, ortho is very very hard to get in.
You say you don’t like kids - 20 percent of ER visits is kids.
You also say you don’t like women’s health. 10 ish percent of ER visits are gynecology/obstetrics related.
So 30 percent of your job as an ER doctors, you already don’t like.
You say ‘no to psych’ - the reality is a lot of the patients we see are some degree of anxiety disorder, running to the ER at the simplest thing. Then obviously there’s all the depressed suicidal people you’ll see. Psych is probably another 5-10 percent of patients we see.
Now throw in the drunks, the drug seekers, the disrespectful, and the belligerent.
I mean you’re basically saying you already dont like 50 percent of what we do.
So i have no idea where your desire to pursue EM is coming from? Let’s be real…. Are you sure you don’t like the idea of making 400k working 36-40 hours a week? I fell for that trap since I’m very financially minded.
You say you like procedures - the reality is when you have a very busy ER, a procedure is the last thing you want to do. Central lines take so long! Sutures take so long!!! When it’s busy, you really really don’t want to do procedures.
I work 10 days a month. I still don’t have perfect work life balance. My wife works 12 days a month, she has better work life balance. She’s off on weekends, i still work quite a few of those. I work nights and don’t sleep in my bed plenty of nights, my body struggles to recover. If your circadian rhythm is flip flopping between days and nights - I’m sorry that’s not work life balance. If you miss a bunch of family events on the weekends, that’s just not work life balance.
Ill tell you what’s work life balance - my wife who goes into work for 4-5 hours a day for 3 days a week - Tuesday through Thursday. Is back from work at 2 pm everyday and still makes 250k as FM -_- that’s work life balance. Even on her work days she has time for life -_-
So….. you think EM is work life balance. It’s better than some, but it’s not derm, psych, allergy/immunology, rheum, pm&r and others. I mean yeah our work life balance is better than surgeons - but thats about all i can say for EM.
Think long and hard. You’re probably better off doing IM and getting a fellowship in something else.
I'd also add that outside of high acuity tertiary hospitals most EM docs rarely do invasive procedures on shifts.
Besides maybe suturing there really isn't a procedure that's usually done on average more than once when on shifts.
Critical Care procedures for example tubes and lines are extremely rare nowadays and the last study that was performed 10 years ago showed that most docs will do 10 a year on average based on a chart review from USACS sites across the United States. I wouldn't be shocked if it was lower now with more widespread usage of CPAP and BIPAP machines and probably closer to 5 a year for the average EM physician.