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Tired of being discouraged! (a rant)

Discussion in 'Emergency Medicine' started by Hard24Get, May 9, 2007.

  1. Hard24Get

    Hard24Get The black sleepymed 7+ Year Member

    I am so sick and tired of people trying to discourage me away from EM that I want to scream. So many arrogant medicine attendings that think they are the only ones who know anything, and force me to justify myself unless I am going into their field. I try to smile and act polite but it just grates on my nerves. A few examples: "Can I pay you a compliment? Go into something more intellectually challenging than ER". "Someone as excited about pathophysiology as you are doesn't belong in the ER". "How are you going to fit in ER with your interest in research?".... and on and on. They are trying to make me think I'm crazy, but it ain't working! I would wilt away and die on the floors in IM, and I love the pace and variety of the ED. Don't they see that?

    Anyone else having this problem? I feel like as application season approaches, people are taking recruitment to the jugular.... :(
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  3. SolidGold

    SolidGold Florida winters are the best! 10+ Year Member

    Jan 8, 2002
    Tampa, FL
    I'm surprised I didn't get any of this. The IM docs that I worked with said it's a better lifestyle, and even some IM residents say they wished they chose EM because of the reasons you listed above for being interested in EM. Just keep being polite. You'll show them when you're an EP doing research that matters and all while knowing the pathophysiology behind you're patients' conditions. Honestly, what is more intellectually challenging than being an EP trying to figure out what is wrong with a patient when they are critically ill? Sure, there are those old EP's that stabilize and turf, but EM has evolved and matured to the point that most programs make sure their residents make a diagnosis in the ED, or at least have a strong idea about their patients' condition. It's going to take time for EM to gain the respect it deserves in all circles, remember that EM is an infant compared to IM and Surgery.
  4. raidermedic

    raidermedic MS IV 5+ Year Member

    May 29, 2005
    I'm trying to narrow down my career options right now and it is a close call between FM and EM with Gas coming in third (although the order seems to change daily). Needless to say I get endless flack from surgeons and shameful looks from internists. A lot of the old school docs don't even bother to ask me what field I want to go into, limiting their questioning to simply "So are you going into Medicine or Surgery?" Apparently those are the two noble fields with the rest of us being the bastard children of medicine :rolleyes:

    Whats worse is your fellow class mates. You can see them developing into these arrogant attendings who think their field is the greatest and everyone else is an idiot or incompetent.
  5. Dr.McNinja

    Dr.McNinja Nobel War Prize Winner Moderator Physician Faculty 10+ Year Member

    Aug 2, 2006
    Yeah, the only worse thing than that is having to face all of those people at graduation telling you "See, I told you ER wasn't right for you. Come to field XXXXXX." I love it when other people know what I want to do more than me.
  6. Louisville04

    Louisville04 Junior Member 10+ Year Member

    Oct 8, 2005
    EM is so mucher harder to get into than IM. It is a lot easier to switch into IM than you can always switch later :rolleyes:
  7. sleepymed

    sleepymed The white Hard24Get 7+ Year Member

    Jun 24, 2005

    I feel exactly the same way. I try to go for polite, if that doesn't work I comment on one of my patients... "EM is a field with the shortest half life." "hmm, really. I wanted to ask your opinion about the patient in 435, her blood sugar is through the roof, what do you think is cooking?"

    Distract, distract, distract
  8. Universe_Explorer

    Universe_Explorer Junior Member 7+ Year Member

    Aug 8, 2005
    City Beautiful
    That's interesting - no one has ever tried to talk me out of EM (although I have gotten some questions about how my research interests fit the specialty). On the contrary, a lot of the surgeons and internists I have worked with have actually said "good choice". Only one really grilled me about it, and after I explained my reasons he was all for it (even let me spend some more time in the ED). Maybe none of them thought I was up to par for anything more "intellectually challenging"! :)
  9. bulgethetwine

    bulgethetwine Banned Banned 10+ Year Member

    Jan 4, 2005

    Totally institutionally dependent, fortunately.

    Go to a big, ivory tower place with status quo, old and aging, stodgy IM, and that's what you get. Don't worry, there will be lots of places that you'll see on the interview trail where EM is respected more than what sounds like at your hospital. You won't be the little dog worth kicking everywhere. And, even if you are, you're the only one who has to be satisfied at the end of the day. We're all in on the joke, the IMers don't even know they're the butt!
  10. Hard24Get

    Hard24Get The black sleepymed 7+ Year Member

    You got me there. That is probably most of the problem.

    I'm cool with all of this as long as I don't get disparaged by the folks at SAEM next week! THEN I will feel I might have made a mistake :eek:

    Thanks for all the replies, it makes me feel less alone.
  11. FoughtFyr

    FoughtFyr SDN Lifetime Donor Lifetime Donor Classifieds Approved 10+ Year Member

    Mar 19, 2003
    Just remember,

    You are good enough,
    you are smart enough,
    and gosh darnit, people like you!

    - H
  12. southerndoc

    southerndoc life is good Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Jun 6, 2002
    Unless you live in a van down by the river!
  13. JackBauERfan

    JackBauERfan CTU Field Agent 10+ Year Member

    Dec 24, 2002
    I get mixed remarks all the time too, the main thing that gets me is when they say 'why did they order the abdominal ct'....

    I mean, they (meaning IM/surgery/peds) are not dumb, they must know that a lot of abdominal pains get sent home and the percentage of abdominal pains that get admitted must have looked sick enough to warrant a ct. then all the little residents/interns laugh along is another thing that gets me haha. they are all my friends, but sometimes they can be very degrading to EM folks. I just sit there and take it...can't wait til i'm in EM next year haha.

    oh and then as the conversation resumes 'what is the next step you would take?' everyone and their momma say they would get a abdominal ct!
  14. AmoryBlaine

    AmoryBlaine the last tycoon 7+ Year Member

    May 1, 2006
    On my first night of Surgery call, the night-float resident (PGY-2) told me that "all the ER docs are f------ idiots" and that "she had to yell at them alot b/c they were so stupid." I was then treated to 2 months of barely controlled disaster when it came to patient care. Whenever I brought up a problem with one of my patients (including a really screwy, almost pericarditis-looking EKG) I was told something to the effect of "we're surgery, we don't care about stuff like that."

    Similarly, I just got to watch 7 Medicine residents stumble their way through a code. 2 of them were PGY-3. 1 of those starting Pulm/CC this summer. Total chaos, everyone with thumbs up arses. My favorite was when the PGY-2 who was ostensibly "running the show" said, "hmm, should we be doing chest compressions?"

    Anyway, not trying to hijack the thread, just venting.

    I think the greatest irony of the anti-EM bias in the hospital is that when you are doing your IM/Surg/Peds rotations you are never making a freaking DDx. Why? B/c the "f------ idiot EP" dx'ed the patient before they came upstairs.
  15. Mighty Mouse

    Mighty Mouse One Nation Under a Groove 10+ Year Member

    Feb 25, 2007
    during my rotations, i found that all the specialities talk smack about each other. during surgical grand rounds once, an attending said that "surviving a trauma in this ER is as much luck as it is skill." plenty of times they diss ER docs. at the same time though, the ER docs dog the surgeons for this, and the IM residents for that. its part of the fun of being doctors....always thinking you're right and know what the best course of action is, and all the other docs don't know it as well as you do.

    new EM PGY-1
  16. Hard24Get

    Hard24Get The black sleepymed 7+ Year Member

    Hijack? - this is exactly what this thread is about! Not just the personal discouragement, but it is also irritating to hear people rag on my chosen field. I was on GI the other day, and the ED did a CT and caught a large abscess in the lining of someone's stomach. The first thing my attending says is, "Bah - if he came in with a little stomach pain and constipation, why did they do a CT?" (Me: Um, because they suspected something like THIS). Then, "Oh Lord, why did they give antibiotics! Why? Why don't they leave it to the people who will be taking care of the patients to give antibiotics? I bet they didn't even take blood cultures!" (Yes, they did take clx, and they probably gave the antibiotics because he had an ABSCESS and THEY were taking care of him at the time).

    I accept the whole whipping boy thing, especially if it makes other people feel smart because, once the EP makes the initial diagnosis and starts the treatment and resuscitation, they can afford to sit around doing special studies for days just so they can usually confirm the working diagnosis in the ED. They even occasionally cough up some additional diagnoses or a variation on the original theme. Anyone notice the diagnoses we do get to make on the floors are usually of untreatable things or of things that should be managed the same way as the original diagnosis?

    No one appreciates that EPs run circles around medicine docs on surgery, and circles around surgery docs on medicine, while thumping everyone on resuscitation, as AmoryBlaine reports.

    AND - I'm bored with them! I do appreciate what they do, but the down time kills me (are you sure you want to do a 2nd consult? Aren't you tired? NO - bored!). Surgery is not as slow, of course, but I do lose interest during a long case...

    Considering all of the above, I just want to laugh in the IM and/or Surgery attending's face when they suggest I do what they do for the rest of my life.

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