Too late for EM?

[muchtolearn]

Hello all, I am a current MSIV who just began my 1st EM rotation. I had a blast. It was great to see all sorts of problems... everything from chest pain to traumas to intracranial hemorrhages... to see kids and adults, basically to see it all. Up until this point, I was all set to do IM. I have my letters ready, have met with the IM residency director at my institution, etc. I know it's late in the game now. Already 9/3. I have always thought that I would do IM and then later specialize. I don't LOVE IM persay, but I do love the close interactions with people and the sense of fulfillment involved with seeing patients start out very ill and then work there way back to health. I know that I do not want to practice general IM. However, there is no one specialty that I am "in love with" at this point. Basically, do you think it is worth it to just go ahead with IM and hope that I find a specialty that I like, or consider ER so that I can see everything, live a nice lifestyle, and make immediate differences in peoples lives? In med school, I enjoyed ALL of my rotations. Also, I know that it is late now, so to do EM I would have to overcome some odds in order to get letters, maybe do another rotation, etc. My application would obviously not be sent out with the majority of other people applying into EM either and so that might put me at a disadvantage. I don't want 8+ years of hard work to be undermined by a poor EM residency application. Any thoughts? I do realize that this is just my 1st EM rotation... but we are getting late in the game here...

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[quinsy]

That is a tough one, see, I think medical school does students a disservice with the way current curricula are set up because there is so little flexibility until your 4th year, and then you have to apply to a residency right away. It is no wonder that so many people end up in specialties they aren't excited about.

All I can say is that to me, if I had a chance of getting into EM which I love, I'd much rather jump at that than consider spending a year doing IM, ending up transferring. So one thing you could do (others may disagree with me) is put in some EM applications as well and apply to both EM and IM programs, and then if you still feel you will be happier in EM, you can rank any EM programs where you interview more highly and at least give it a try! You could submit ERAS for EM now and scramble for some letters to submit within the next few weeks. Just don't apply to 2 programs at the same hospital, that can backfire.

Then again to me, being happy in the career you are going to spend your life working on is the most important thing. So having to scramble around for the next few weeks certainly seems worth it if you think this could be 'your calling'!

 

[muchtolearn]

Thanks so much... good advice. Any thoughts on getting the same physicians to write letters of rec for 2 different fields? (ex - EM and IM) Probably not a good idea but tough at this point to find new letter-writers...

 

[La Fiera]

It's definately not too late to apply to EM. I was in a similar situation my 4th year of med school; I didn't figure out that I wanted to do EM until around Thanksgiving!! (My situation was complicated by having a scholarship to do primary care medicine) I didn't even apply until December 1st or 2nd. Luckily, they remembered me from my 3rd year EM rotation, and I did well in the clerkship, so I got some letters together last minute.
Because I missed so many application deadlines, I had to contact PD individually and explain my situation. To my great surprise, many PD's at some great programs were sympathetic and extended app deadlines. (By the way my board scores and grades were just average). I even had to turn down some interview offers because I could not fit them into my schedule.
I don't recommend following the same route that I did because interview slots fill quickly and you often only get the leftovers, (I spent a lot of money interviewing all over the country); and you won't get interviews at the top programs... BUT I would do it all over again, I am so much happier where I am than where I would have been in primary care. I still like the program I ended up at, a big inner city county hospital program.
If you have any questions PM me.

 

[Egon]

It's not too late. I decided in October after a Sept elective.

I would apply for both IM, EM and EM/IM if you like aspects of both and want to keep long term options open.