I don't see how this is so controversial to you and a few other people. Family Medicine has a much broader knowledge than IM, Peds or OB/Gyn individually. Nobody would argue that a family physician is as much of an expert in each of those 3 fields as someone that pursued a residency in a specific field, and conversely, nobody would expect a peds doctor to have as much knowledge on OB/Gyn as a family physician does. There's nothing wrong with wanting to be an ED physician or having a knowledge base that's broad. Some people prefer to be experts in a narrow range of a field than have the broad base knowledge. Now if you want to believe that being an ED physician means you'll know how to diagnose neurological conditions as well as a neurologist or allergies as an allergist, be my guest, but you're wrong.
I think that this is a key point. I am very interested in EM, but anyone considering the field should understand that, when dealing with a specialist in their area of expertise, the majority of the time the specialist will likely know more, at least regarding that particular area of medicine (there are times where this isn't the case, but these are exceptions. Rare ones.). That being said, as an EP you will be trained to manage the acute presentations that might occur in a broad variety of specialties. So while the specialist in the ED might very well be the best doctor for whatever patient they happen to be consulting on, they might very well have no idea have to treat the febrile peds patient next door, the pregnant vaginal bleeder across the hall, or the actively-trying-to-die trauma patient down the way - and would be absolutely lost trying to handle them all at once.
This is the place of the EP. If you take the knowledge base of an EP in a particular field and compare it the knowledge base of a specialist in that field, the specialist will almost always win out. I think that's where a bit of disdain for emergency medicine as a whole comes from. Where the EP wins is when their practical knowledge base regarding medicine as a whole is taken into consideration, as well as their ability to manage the flow of a busy, overcrowded emergency department. While a specialist is really good at their particular area of medicine that they deal with day in and day out, EPs must be ready to manage any acute problem at any time. There is a trade-off, of course - specialists are in fact "smarter" in their area of expertise, but EPs must learn and retain a broader, practical knowledge of medicine as a whole. Not necessarily in depth, mind you, but in depth enough to manage a case and in many cases begin treatment.
Each cog has it's place in the machine. Those of us interested in specializing must realize that by delving deeply into a limited field of medicine we forgo the opportunity to practice the rest. A urologist, for example, will not help you with your chest pain or unilateral weakness. A CT surgeon will not help you with your DKA. On the other hand, those of us interested in a field like EM must realize that the residency does not teach you the deepest secrets of each specialty, but will make you comfortably able to handle a wide variety of emergent (and nonemergent) issues. I've heard it said that EPs only know about 70% of any given specialist's knowledge base - it's that 30% that makes them a specialist. Whether or not you agree with the exact percentage, the idea remains the same. Everyone plays a different role. Some will want to be really good at a small number of things, while others want to be competent at a large number of things. Each has it's place, and whichever option you choose, there's no need to justify your choice by dissing the other guys, whomever they may be.
