This question is commonly posed in this forum, typically by a first or second year medical student, and sometimes by a third or even fourth year medical student. If in the early med school years, the asker is typically attempting to find their field early so they can have a muy bonito application. If asked later, the asker typically has done a few rotations and is feeling the pressure to decide on a specialty. To both types I say this: Take your time, and don't worry. You've got plenty of time to decide. That said, there are a few generalizations that can be made about people who seem to be happy going into EM. EM's strengths are important "categories" to them, and they do not mind EM's weaknesses. So compare yourself to the descriptions below to decide if EM is for you.
Strengths of EM:
1) The EP sees his profession as a job, not a calling. You will notice in your medical school class that there are those who live, eat, and sleep medicine. Those people typically do not go into EM. EPs typically have many outside interests, and are interested in a job that allows them to pursue those interests as well as medicine.
2) EPs love working up undifferentiated complaints. They got upset in their third year medicine rotations when they were told to go down to the ED and work up the guy with the COPD exacerbation. They wondered, "If I already know he has a COPD exacerbation, what's left to work up?"
3) EPs get bored easily. ADHD at its best. You can work something up as long as you like, and then when you get bored with it, you either admit it or refer it to be worked up as an outpatient.
4) EPs think a doctor-patient relationship is what you have when someone gives you a chart with a patient's name on it, not what happens after following someone's hypertension for 10 years.
5) EPs like to do procedures. They think sticking people with needles is fun. They know the truth of the statement, "There is no body cavity which can't be reached with an 18 gauge needle and a good strong arm."
6) EPs aren't afraid to make a decision on limited information.
7) EPs like to work as a team. They don't see nurses and techs as out to get them as you may see in other areas of the hospital. They know what their nurses do outside of the hospital, and nurses call them by their first names.
8) EPs like to multi-task. So many off-service residents never gain an appreciation for emergency medicine until they feel overwhelmed with 5 patients on the board for the first time, and then realize all the EM residents have 10. EPs prefer to work while they're at work.
9) EPs prefer a specialty of breadth to a specialty of depth. They enjoy learning practical information, and using common sense.
10) EPs enjoy being able to take care of people from all walks of life, rich, poor, old, young, smart, stupid, etc, without having to worry about whether they can pay you.
11) EPs typically enjoy a large percentage of their medical school rotations. They often complain about psych rotations, but all think Psychiatry is interesting, just not necessarily something they'd like to do all day. They enjoyed surgery, they enjoyed ICU, they may even have liked OB/GYN. They usually liked internal medicine, but detested rounding for hours and writing 10 page long notes.
12) EPs don't feel a sense of importance when paged to the hospital from their daughter's soccer game. (If you see this one as a weakness, you really don't belong in EM.)
Weaknesses of EM
1) EPs don't mind being criticized. They are the whipping-boy of the hospital because there is someone in the hospital who is better at nearly every individual thing that they do. Those are the people they admit their patients to. So of course those people are going to see their mistakes.
2) EPs don't mind treating drug addicts, street people, drug-seekers, uninsured patients, psychiatric patients, criminals, trauma victims, child abuse victims etc (sometimes all in the same person.) Many rotators in EM profess a dislike of treating these patients.
3) EPs don't mind working nights, weekends, and holidays when it means that they work three 4-day weeks a month.
4) EPs eat faster than any other specialty. I thought I was pretty good until I saw an attending inhale a sandwich while walking between the nursing station and the trauma bay.
5) EPs don't take it personally when they are sued. They realize it is about money, not ability.
6) EPs don't mind not being "the expert." They don't get tired of family and friends constantly asking, "I know you work in the ER, but what are you going to specialize in when you get burned out." They aren't intimidated by the fact that PAs and NPs work in EDs.
Hope this is helpful.
