Should this bother me?

[streetdoc]

I went to med school after several years of being a paramedic and am considering EM along with many other areas. I, like everyone else, go to all the various Interest Group meetings (FREE FOOD!) So after the surgery interest group, i overhear fellow classmates (who came in last year DIE HARD SURGERY!) say that they didn't want to work as hard as surgeons so they were DIE HARD EM now. I guess i don't like the fact that they see EM as easier and that's why they want to do it. They are gunners anyway and i don't like the idea of gunners in EM (pushing out others that truly WANT to practice EM). I'm probably way out of line...but does it upset anyone to hear people "pick" EM based on lifstyle. maybe they will find some other speciality along the way...i can hope.
streetdoc

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[docB]

Most of these yahoos run into big problems early in residency. Once they realize how much time EM really is and how tough the work is they either get really bitter and bail out or they get their attitudes changed for them. Nothing in medicine is easy and everyone works hard in residency. Looking for the greenest grass over every fence will just mess up your head.

For example I know a path resident when I was in med school and she felt that her 9-5 with 4-5 calls per month was just too much so she wanted to quit and go find an easier residency. Some people will just never be happy.

 

[WilcoWorld]

Those ex-barbers don't sound too DIE HARD to me, considering that they've already changed their tune.

My roommate (an aspiring cardiologist) ribs me about my having chosen a "lifestyle" specialty. At first I'd point out that I would be working nights, weekends, & holidays for the rest of my life, and make other arguments for why EM isn't as cush as he suggested, but then I wised-up. So long as I'm happy with my choice & my reasons for making it then others' opinions are unimportant. If you feel that you are choosing EM for good reasons then have confidence in yourself & ignore your classmates (f*ck the haters). You might as well start now, because a career in EM means a career of wisecracks from other docs (as well as a career of "Wow!"s from many, many more people outside the hospital), and if you can't handle that then you might not want to do EM.

As for your comment "They are gunners anyway and i don't like the idea of gunners in EM (pushing out others that truly WANT to practice EM)." I disagree. While I don't like prototypical gunners any more than the next guy or gal, medicine should be a meritocracy. If your classmates earn a spot in an EM residency, then they deserve it. Feeling that you want it more than, or more purely than they do does not entitle you to that spot. That being said, if they are lazy jerks who just happen to do well on tests, then they wont do well at all come time for interviews.

 

[Doczilla]

I don't think it's too unusual that these would-be surgeons would be attracted to EM. Surgery and EM share many characteristics (ducking the many dense objects hurled my way from both sides):
- Procedures, and getting your hands dirty
- Having to be decisive in tense situations
- Making decisions quickly on limited information and acting on them
- Critical care
- The need for a relatively wide set of knowledge and skills (though EM smokes surgery on this)
- Prestige as perceived by the general public
- A certain amount of unpredictability in the day, which can be exhilarating
- Wearing scrubs every day

The culture of EM is far more attractive than the culture of surgery. Perhaps these other students are realizing that now. Surgeons seem to want to do surgery in spite of being with a bunch of surgeons. EM docs seem to be a pretty cool bunch, which attracts other cool folks.

As far as the gunners are concerned, you'll find them at every step of this process. At every medical school there are those gunners who clearly shouldn't be doing anything remotely dealing with patient care, yet went into it because of the money, prestige, or challenge of it, pushing aside others who would make great and caring physicians if their spot wasn't taken by one of these jerks. I'm sure that every specialty has a similar problem with people who perhaps don't share the love for the specialty as much as they like to look at themselves in the mirror and say that they do it.

I welcome these deathbed EM converts. With luck, they will come to love the specialty for what it is and their colleagues in it. Otherwise, it gives me someone to torment with lasix in their mountain dew or lidocaine jelly around their coffee cup.


'zilla

 

[waterski232002]

It boggles my mind how people look down upon others for "chosing a specialty based on lifestyle". I mean, this IS what we are choosing to do for the rest of our LIVES and (believe it or not) our lifestyle is what we should be living for.

I feel very sorry for people who do not consider the specialty as a whole when choosing what field to enter. Those are the people who wake up at age 50 and realize that they busted their chops for prestige/respect/money or whatever, and they let their life just pass on by. If you want your life to be your profession, more power to you! Just make sure you realize that you are choosing that when you make your ultimate career choice. For those of us (like myself) who have considered the pros and cons of all the specialties and have found an excellent match, there is NO SHAME in considering lifestyle as a huge factor in that.

Do not be in denial about the difference in hours/call/financial reimbursement/respect/patient population/ and procedures conducted between each of the specialties. Find out what you like and chose accordingly. Make sure you like the work and make sure you like your life. If you try to pick a career without thinking about your future monetary and lifestyle situation will be, you will probably end up in regret later. Not to say that those are the only factor, but they are still factors.

For the people who ultimately choose EM, lifestyle is usually a factor, but it is rarely the only. If you were really only concerned with lifestyle and money, you would go into ENT, Ophtho, Rads, Anesth, Derm, etc. All of those make lots more money, get more respect/prestige, and still just as good of lifestyles if not better than EM. So, to say it's purely based on lifestyle is false... you've got to love the work down in the trenches and have an appreciation for disease and diagnosis too.

I think one of the most ironic situation is when IM or surgery residents get paged down to the ED in the middle of the night, and all they do is complain. The best is when they b!tch about how we have it sooo easy compared to them b/c we're a "lifestyle" specialty. "Too bad for you" I think to myself... They chose that lifestyle, so they can deal with it. If you are unhappy with the job you chose, then it's your own fault. No need to complain to me... I am happy with my choice.

 

[EctopicFetus]

Man you are so right. I couldnt have said it better myself.

Lifestyle obviously matters. It entered into my decision more so than $$$. I wanted to do EM prior to med school but I agreed to look at other fields because I want to make sure I make the right decision. Now that I am almost done with 3rd yr I am 100% EM.

Once I found out about the pay, it only reinforced the decision I already had made. EM is a great specialty but I would actually argue it is NOT a lifestlye specialty. My definition of lifestyle specialty is to be in the hospital/office after 7 and be gone by 4 EVERY day and have my weekends off. Take call from home and not have to come in. By my accounts that sounds like Derm, Radiology, ophtho.

Thats just my 2 cents.

 

[Febrifuge]

As far as the gunners are concerned, you'll find them at every step of this process. At every medical school there are those gunners who clearly shouldn't be doing anything remotely dealing with patient care, yet went into it because of the money, prestige, or challenge of it, pushing aside others who would make great and caring physicians if their spot wasn't taken by one of these jerks.

When I have nightmares, this is what they're about. Not "am I too old?" or "have I wasted my life up til now?" and not "can I become great at this, given the chance?" I'm not, I haven't, and yes I can. Rather my night sweats come from wondering "will I get through it without taking a shiv in the neck from some little junior Machiavelli daisy-licker who decides his/her agenda takes priority over my work?"

I welcome these deathbed EM converts. With luck, they will come to love the specialty for what it is and their colleagues in it. Otherwise, it gives me someone to torment with lasix in their mountain dew or lidocaine jelly around their coffee cup.

On the other hand, this is inspiring, and gives me cheer.

 

[sunnyjohn]

When I have nightmares, this is what they're about. Not "am I too old?" or "have I wasted my life up til now?" and not "can I become great at this, given the chance?" I'm not, I haven't, and yes I can. Rather my night sweats come from wondering "will I get through it without taking a shiv in the neck from some little junior Machiavelli daisy-licker who decides his/her agenda takes priority over my work?"
On the other hand, this is inspiring, and gives me cheer.

OH my! Febrifuge, this post made my day..... I have the same nightmares!

Maybe its 'cause I'm getting older, but many 20 somethings with med ambitions scare me!!! Actually most pre-meds of any age scare me...They are so intense....

 

[Febrifuge]

To be fair, some of 'em are really cool. As a tech, I see students rotate through the ED, and some are scary weasels who I hope choose a low-patient-contact specialty. Most, however, are ambitious but grounded and freakishly smart. The best of the best are the ones who are all that but also funny, genuine, and communicate well and easily with patients and staff. They're clearly on the way to being great doctors.

I notice that the hardcore gunners, no matter how wily, never seem to be able to evolve all the way to that last phase...

 

[The White Coat Investor]

It took me two years to realize this, but the best thing about EM is that you go home about the time it stops being fun, instead of working 8-24 more hours straight. Nothing is fun for more than 16 hours a day.

 

[Jeff698]

Rather my night sweats come from wondering "will I get through it without taking a shiv in the neck from some little junior Machiavelli daisy-licker who decides his/her agenda takes priority over my work?"

I was, shall we say, slightly more mature than my classmates. I was seriously worried about this when I started school. Fortunately, by the time I was halfway through first year, I quit worrying about it. Maybe it is just the school I went to (although I doubt it) but there wasn't as much of the "you're an old fart who's just stealing my oxygen" as I thought there would be.

While there may have been one or two jerks, the vast majority of my class was really mature and had low shiv potential. The minority were easy to spot.

Take care,
Jeff

 

[sunnyjohn]

While there may have been one or two jerks, the vast majority of my class was really mature and had low shiv potential. The minority were easy to spot.

Take care,
Jeff

low shiv potential... harhar