The best thing about EM

[melvindo]

As a MSIII trying to decide what to go into, I was wondering what is the best thing for you about EM. Is it the lifestyle, the hours, no call, what?

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[DrQuinn]

As a MSIII trying to decide what to go into, I was wondering what is the best thing for you about EM. Is it the lifestyle, the hours, no call, what?

The best thing for ME is that... its the only specialty that I LOVE and can see myself doing for years. EM has its own personality traits for the vast # of residents and attendings... as you can see by the tone of our threads.

Oh yeah, and I absolutely hate rounding.

Q

 

[dlung]

chicks dig it

 

[bemused]

chicks dig it

Chicks DO it

 

[The White Coat Investor]

It's the fact that I can do as much as I want to work up a patient and then when I get bored with them, (and have assured myself they have no impending medical emergency) I can either send them to their primary doctor or admit them to someone else.

 

[Sessamoid]

Chicks DO it

More proof that chicks dig it.

 

[srlondon]

Many things:

No call (don't get bugged at home... a big deal now that I've done home call as a resident and learned how painful it is)

Plenty of time off and the flexibility to do fun stuff with it (hobbies, travelling, actually getting to see your family)

Predicable schedule

Reasonable work hours even as a resident, even better as an attg. (attendings are quite often <40hrs/wk on avg)

Ability to take a patient about to code and turn them around in a matter of hours.

Knowing that you provide the ultimate safety net for people on what's often the worst day of their lives (good > bad on this one)

Better than average job market and salary

Don't have to deal with the boredom and BS of office-based practice

And yes, chicks do dig it. : )

As a MSIII trying to decide what to go into, I was wondering what is the best thing for you about EM. Is it the lifestyle, the hours, no call, what?

 

[WilcoWorld]

1-Working in the ED is the most fun you can (legally) have in a hospital.
2-You get to treat the CEO in bed 4 the same way you treat the bum in bed 7 - With the best care medically waranted, and without having to kiss anyone's ass to keep him/her satisfied.
3-You can have a dramatic effect on your patients & watch them turn for the better (or worse) right before your eyes. This distinguishes it from many (but not all) other specialties where you'll manage chronic, self-induced conditions.
4- Then there are all the perks - good salary/no call/40 hour work week/etc...but if #'s 1-3 don't appeal to you more than the idea of a "lifestyle specialty" than i suggest you think long and hard before commiting to working nights, weekends, and holidays for the rest of your career.

 

[Jeff698]

You mean other than no rounding?

I like EM for: undifferentiated patients, EMS, procedures, lots of sick people that I don't have to deal with for more than a couple of hours (hopefully), no continuity of care, no pagers, lots of funny, smart ass people to work with, nice schedules, decent salary.

Oh, and no rounding. I really don't like rounding.

Take care,
Jeff

 

[Eme-RG-ency]

I am only an MSIII myself, but I spent 3 years working as a tech in a level 1 and level 2 trama center before medical school. What I liked most about my experiences in EM are: 1) the adrenaline rush of a trauma, stablized, and sent on their way to surgery 2) always having a story to tell (check the threads on here, from heart-wreching to histerically funny, you will always have a great story), and 3) I loved being there when someone truly needed help. Sure there are a lot of pts with general concerns in the ED that should be seen by FP, but you get to see emergency situations as well, where you are needed immediately. That is a great feeling.

I also like the TEAM atmosphere of the ED. You need everyone from the attendings down to the cleaning crew to keep things running efficiently. Realize now that you might end up cross training as a patient transporter, janitor, secretary or even a security guard. When the staff is busy, you just do whatever you have to do to keep things going. If your patient attacks somebody, everyone rushes to secure them... waiting for security is not always an option. Neither is waiting for your patient to be transported to X-ray to get a CT, or getting your orders placed in the computer, or having a room clean for the next patient to be brought back. I have watched ER attendings and residents have to do these tasks as well as manage their patient load when things are hectic in the ED.

The sense of humor in the ED is whole seperate topic. But lets just say, we know how to have fun and we definately know how to party. BTW, someone should start a "Tales from the ED Christmas Party" thread on here. Typically we are a rowdy crew.

 

[NinerNiner999]

TPC - Total Patient Care. Stabilization, diagnosis, treatment, referral, and sometimes chronic management (we all have those frequent flyers). Not to mention we do all of the above for every specialty in medicine - from the sick child to the pregnant mother, to the transplant recipient with MSOF. 12 hour shifts fly by through the day and the perks of the job can't be beat (high salary, no overhead, no managment)...

 

[Febrifuge]

The sense of humor in the ED is whole seperate topic. But lets just say, we know how to have fun and we definately know how to party. BTW, someone should start a "Tales from the ED Christmas Party" thread on here. Typically we are a rowdy crew.

Dude, what happens at the Christmas party stays at the Christmas party.

 

[Homunculus]

As a MSIII trying to decide what to go into, I was wondering what is the best thing for you about EM.

that most of the time they do an excellent job and keep me *out* of the ED as a consultant.

that when i write "if xxxxxx happens then go to the nearest ER" on my clinic notes, someone will be open to take them and keep them from dying until they can see me again

that most of them aren't interested in peds EM as a subspecialty, leaving it open to me if i decide i want to do it

that most of them know when to defer to us, and that most are quite willing and genuinely interested in learning more about the patients they are consulting us for (which hopefully will save us both time and energy in the future)

that they let you go home early sometimes when you are a peds intern on an adult ED rotation block (like this month)

--your friendly neighborhood friend of the ED caveman

 

[WilcoWorld]

MSOF?

In all seriousness, EM is a good choice because it's what all the cool kids are doing.

 

[dlung]

As the health care safety net in the US, I would argue that EM draws many more physicians than other specialties who really like the service aspect of medicine. Although I can see how people who wear that 'county badge of honor' might be kind of irritating/ridiculous sometimes--I really dig it... as an idealist at heart, it's hard not to want to be around other people who have the same values...

man... you see those general surgeons and ob/gyns totally burnt out and who don't really believe in anything anymore (other than negotiating reasonable fee scheduling with insurance companies)--it's just depressing...

 

[Dr. Rosenrose]

I am torn between ER and Radiology. The pro's seem to be the same but what about the con's.

 

[kungfufishing]

I am torn between ER and Radiology. The pro's seem to be the same but what about the con's.

Oh, youll see many more cons in the ED than back in radiology. EM all the way if that is all that is holding up your decision. I like it because it keeps me current on which "killer clowns with knives for teeth" tattoos are most popular. Ex cons, too.

 

[kungfufishing]

in all seriousness, pretty different specialties. There was a similar thread to this one a while back featuring an applicant torn between urology and EM. Do you really enjoy the two equally well?

 

[srlondon]

EM and Radiology are really quite different. Before you even start thinking about the PROs and CONs, you need to decide whether you want to primarily be a clinician or not. If you don't want to roll up your sleeves and get your hands dirty on a daily basis, you are not going to like EM. There is certainly something to be said for never having to do a rectal again, but then again, I think I'd probably only last three or four days as a radiologist before I completely lost it.

The CONs in EM are really quite similar to the PROs if you think about it. Late nights, shift work, weekends... go both ways depending on your inclination. Obviously, if you're the sort of person who needs to be in bed at 10pm and likes to have the same exact schedule day in and day out, EM is not for you.

So here's the CONS:

shiftwork

late nights, weekends

schedule variability

Sometimes feeling like you're the only doc who gives a crap about the sick patient you're taking care of (between the patients PMD and his three consultants... The Hot Potato Scenario)

Having to deal with patients with a sense of entitlement (hardly unique to EM)

I am torn between ER and Radiology. The pro's seem to be the same but what about the con's.

 

[Febrifuge]

EM and Radiology are really quite different ... If you don't want to roll up your sleeves and get your hands dirty on a daily basis, you are not going to like EM.

That's a pretty nifty way to compare, actually. Think of all the places an EP's hands might be, over the course of, say, 10 hours. And compare that to a day's travels for Radiologist hands.

(These are just the ones I can think of, mind you. And I don't know all that much.)

RADS: Steering wheel of car; coffee mug; radiographs; keyboard, mouse; office door; sandwich; dictaphone; pens and pencils; telephone; pager; measurement tools.

EM: All the above, plus casting materials; ultrasound probes; diagnostic equipment; suture supplies; rectums; mouths; extremities; holes in places there should not be holes; pretty much any body part known to humankind, and some that are questionable; cash for the delivery guy; and (thankfully) what seems like 1400 pairs of gloves.

So I think the issue is, what do your hands like to do all day?

 

[DocM]

That's a pretty nifty way to compare, actually. Think of all the places an EP's hands might be, over the course of, say, 10 hours. And compare that to a day's travels for Radiologist hands.

(These are just the ones I can think of, mind you. And I don't know all that much.)

RADS: Steering wheel of car; coffee mug; radiographs; keyboard, mouse; office door; sandwich; dictaphone; pens and pencils; telephone; pager; measurement tools.

EM: All the above, plus casting materials; ultrasound probes; diagnostic equipment; suture supplies; rectums; mouths; extremities; holes in places there should not be holes; pretty much any body part known to humankind, and some that are questionable; cash for the delivery guy; and (thankfully) what seems like 1400 pairs of gloves.

So I think the issue is, what do your hands like to do all day?

Clever and Insightful. Great Post

 

[nikoo]

I second that! I find it a great way to make that decision.

 

[Hornet871]

This distinguishes it from many (but not all) other specialties where you'll manage chronic, self-induced conditions.

Are you kidding? Half my life is spent treating patients with self-induced CHF/COPD exacerbations and alcohol/drug intoxication.

I don't know what kind of cool, acute-conditions-only ER you practice in.

But the coolest thing about ER*? Time off. Lots of it.


*Yeah, I call it ER. I'm an ER doc and I call it ER. (Try to stop me.) The thousands of you out there who feel that you'll be laughed at for not calling it EM or, more risibly, ED, are fools. Yes, you can yourself an EM doc, but you certainly won't be laughed at for calling yourself an ER doc, which all of my colleagues here in the Northeast do.

 

[Apollyon]

which all of my colleagues here in the Northeast do.

I thought you were in MN - which is NOT Northeast!

 

[aphistis]

Are you kidding? Half my life is spent treating patients with self-induced CHF/COPD exacerbations and alcohol/drug intoxication.

I don't know what kind of cool, acute-conditions-only ER you practice in.

But the coolest thing about ER*? Time off. Lots of it.


*Yeah, I call it ER. I'm an ER doc and I call it ER. (Try to stop me.) The thousands of you out there who feel that you'll be laughed at for not calling it EM or, more risibly, ED, are fools. Yes, you can yourself an EM doc, but you certainly won't be laughed at for calling yourself an ER doc, which all of my colleagues here in the Northeast do.

Geez, did someone accidentally switch the decaf and the regular in your break room this morning?

 

[aprilshyla]

im a ms0 already interested in EM due to a few shadowing experiences

out of curiousity, what is the typical workweek schedule of an EM doc?

i used to be interested in ob-gyn, until i realized that i like to make people better, and not fight with an insurance company in my spare time i really like the atmosphere of the ER and the network that goes on...i guess i have a few years to really decide, but you guys are a hoot and i like it already

 

[WakeMedHeel]

Easy...the people you work with. No other specialty has the interesting and cool peopel that EM does.

 

[daveshnave]

As someone fresh off the interview trail, allow me to retort...

I agree whole-heartedly with the above posters, but for me, also want to add this... I liked certain aspects (surprisingly for me) of all my third year rotations, and conversely disliked many aspects of actual day-to-day practicing of many of my third year rotations. The ER is nice because I get a smattering of each of the specialties in medicine, and hence am not confined to one specific area. Even internal med docs, supposedly generalists, have their limits (ie. no ob/gyn or peds, limited ent, ortho, optho, etc). Forgive the overused cliche, but it really is true that an ER doc is a "jack of all trades."

As for the above poster comparing EM and rads, I really don't see the comparison. Other than the fact that they are both supposedly "lifestyle" specialties, that is where the similarities end (and frankly I disagree with this... I think many rads attendings after residency work LONG hours; even if it is away from the hospital, reading films is still work even though it's at home). My $0.02...