With my newly formed “open mind” about speciality choices, I’m now VERY interested in EM.
It doesn’t seem too popular among OPMs and I’m sure I could guess why that is. But I’m wondering who else is at least considering this field of medicine.
Yup. That’s my first choice as of now. It’s what I’ve had the most exposure to and more closely matches the work environment I enjoy. I’m not closing the door to exploring the many different options out there though. My mindset may be different in 4-5 yrs.
Me! It’s one of the specialties I’d like to learn more about (still a year away from applying). In my old career, I got to learn a lot about a wide range of topics and I think EM speaks to that as well. I loved that aspect of my job. I think I’d like the hands on aspect, plus having immediate impact on patients.
But I also want to be very eyes wide open about possible drawbacks (not building relationships with patients, dealing with a lot of the same intractable problems like gun violence day after day, a less predictable schedule.)
Actually I think EM is one of the more popular choices amongst OPMers. In fact, one of our long-time members who will be presenting at this year’s conference is in her third year of a combined EM/IM residency.
“How to Get Into Medical School Despite Yourself: A Nontraditional Success”
Marcia Hoffheimer, DO, OGME-3
Emergency Medicine/Internal Medicine Program
St. Johns Hospital System, Detroit
(yes that was a totally shameless plug for the conference)
- gonnif Said:
Actually I think EM is one of the more popular choices amongst OPMers. In fact, one of our long-time members who will be presenting at this year's conference is in her third year of a combined EM/IM residency.....
Thanks for the shameless plug Gonnif, the combined EM/IM residency like it could be a perfect professional fit!
Me too! I’ve pretty much got my mind set on EM. I work in a local ED as a scribe a couple of days a month and I really look forward to my time there.
There are a host of things I like about the specialty, but here are a few. First, I like the fact that you treat everyone (with very few exceptions) that walks in the door, regardless of their status. Second, I like the fact that you don’t have to deal with issues over the long-term. I’m much better at accomplishing a series of short tasks versus long-term projects. Third, I like that it’s a combination of diagnostic and procedural medicine. You get to do hands-on things like reduce fractures, splint limbs, suture wounds, intubations, etc, and you also work on the diagnostic side of things. Fourth, I think it’s one of the more family-friendly specialties out there. Yes, you’re going to work nights and holidays, but your schedule is made out in advance, you don’t take call. Most of the docs in the ED I work in take about 12-15 shifts per month (varies between 8, 10 and 12 hour shifts), so there’s a lot of time off. Finally, it’s only a 3-year residency program, which is ideal for us OPMs who don’t want to tie up even more time in training.
Actually EM is popular among trads and OPMers. What many know about EM is summarized in the last two sentences of bennard’s post …so they are flocking to EM. Everyone thinks they can do shift work until they are doing shift work…everyone also thinks they can handle the extreme stress but not everyone can. Good friend cannot fathom why anyone would go into EM and I cannot fathom why he didn’t…turns out he hates the stress of the emergency that’s about to walk through the door and the stress of the emergency itself.
I don’t get the notion of family-friendly specialties. None are family-friendly nor unfriendly they just are what they are. I’ve spoken to plenty of EM docs who do not consider EM family friendly at all. Working nights, holidays, weekends, birthdays, anniversaries…does not sound family-friendly. It “could” be considered a lifestyle specialty but that again depends on how you define lifestyle. The same friend considers lifestyle as being at home with his wife & kids during nights, holidays, weekends, and birthdays…anniversaries optional. 
He’s in IM and doesn’t carry a pager. He’s an associate professor at a school and also works as a hospitalist and earns a very good salary (~$500k)…his is a lifestyle specialty or at least he made it into one. Yet many of his colleagues did not and work twice as hard for half as much and carry pagers. There is also a FM doc I know who is 100% locum tenems and makes $300k working 8 months a year, with the other 3 on vacation and uses 1 to go to conferences and what not.
So all that to say, go into the medical field you would love to do even if they didn’t pay you and then find a way to make it work to you and your family’s advantage without taking advantage of anyone. EM is great and I’m 90% sure I want EM but there are too many going into it for the wrong reasons and ER’s around the country are feeling it.
- croooz Said:
Actually EM is popular among trads and OPMers.
I knew EM was popular among trads (ER TV show residual I suppose) but I had NO idea this was the case for OPMers. Could it be that it's one of the few middle provider resistant fields around?
As for stress, I think it's all relative. When all you've done all your life is school (most trads), I don't think you're in a good position to really know what real stress looks like. Whereas me and "stress" have had an ongoing relationship for YEARS!!! Yeah I get it, ED stress is very different, but the same catecholamines are released!!
As for the schedule, not only would I sign up to work nights, I'd volunteer to work holidays too. But then my child-rearing days are behind me so I'm feeling free bird on Ritalin! And Locums is also an idea too!!
Before you go ahead and decide on EM, remember that most of the time it is not blood and gore. Trauma is a surgical disease and as such it would be the trauma surgeons that would do the thoracotomies and other procedures.
In today’s day, most of the ER visits are for things that can be handled by a PCP but either there is too long a wait or the patient has no PCP or no insurance that they come to the ED. A sore throat, a hurt toe or finger. Not to mention my favorites, the drug seekers.
But as an ED doctor you will also incur the wrath of many a hospitalist when anyone who comes in with a little pang of pain in their chest that clearly is not cardiac, is admitted by you for a chest pain rule out. Take the time to really look at what you are getting into before you venture.
- gabelerman Said:
Before you go ahead and decide on EM, remember that most of the time it is not blood and gore.
Point taken, I'm not anywhere close to "deciding" on a specialty yet. In fact, I think I'm split 50/50 between EM/IM and IM/Peds, emphasis on "IM".
Of course, tomorrow it could be something completely different!
The prescritption drug problem is one I've seen up close and personal through a family member, so I totally "get" that problem. And it seems that addicts are an EM docs WORSE nightmare!
- croooz Said:
So all that to say, go into the medical field you would love to do even if they didn't pay you....
Honestly Crooz, there's not a damn thing I'd do for free having worked for the last 30 years. The structure of the "new" work environment pretty much insures that for me.
Jobs/Work environments just aren't what they used to be..............I'd like to say that I'd do medicine even if I hit the lottery.
- carrieliz Said:
Check out the hospitalist realm too...I've been following a group for a semester, and I've also discussed with my friend who is the VP of physician recruiting for my old company...the trend is seriously bright in this domain across most of the US.
One of my mentors is a IM/Hospitalist and I regularly shadow him at the local county hospital.
While I think the field could work for me clinically, the interplay between the different specialties ie Neuro, Psych or maybe I should say the lack thereof (ie patient can't have an eval due to a lack of insurance) I think would be problematic in the long run. I "get" the you "do as much as you can for the patient" meme, but having my hands tied clinically on regular basis would be difficult for me.
It seems that in EM, you do what the patient needs irrespective of their ability to pay. However I imagine that will likely change, but in todays medical environment, who knows what that change will look like.
- pathdr2b Said:
- croooz Said:
So all that to say, go into the medical field you would love to do even if they didn't pay you....
Honestly Crooz, there's not a damn thing I'd do for free having worked for the last 30 years. The structure of the "new" work environment pretty much insures that for me.
Jobs/Work environments just aren't what they used to be..............I'd like to say that I'd do medicine even if I hit the lottery.
Context is king pretty lady...and you ripped my statement out of it.
You're lucky I like you. My point was/is work your hustle. Whatever your hustle (specialty) is, don't get locked into the automatic response of finishing residency and begging for a job. Go out there and work your hustle and get paid nicely. I know...I know...all the altruists among us read that and cringe because medicine is all about helping people and you would do it for free. Well...good luck with that. There's a reason med school tuition is so ridiculously high and residency pay is so ridiculously low...EM is my #1 choice with locust-m&m's hospitalist my #2.
The only issue I see on this side of the MD line is the Press-Ganey surveys inherent to EM. Hospital administrators use it as multipliers for your money and it can cost you...as well as the ER. It's really not a good system because its entirely subjective with a few objective questions thrown...some of which are ridiculous. Did Dr. So&So smile when they introduced themselves? I had the hospital call a few weeks ago to fill one out over the phone. Since I know they use these to rate & pay the docs I gave the physician flying colors. Even went so far as to have them add that she should be the example for all physicians to try to emulate, she was an extraordinary physician. Was she? Certainly! She had me for a patient!
EM offers the greatest flexibility but like you the thing I'm MOST attracted to is the personalities in EM. I love my boy, the IM hospitalist, but I never got the priapism he got from discussing creatinine levels for hours at a time...just not my bag baby. Treat 'em, and street 'em! YET...his schedule is soooooo sweet. 9 hours/day, Mon-Fri. 2 patients/hour with an hour for lunch, so a total of 16 patients/day. He's home before 5:30pm... His salary you ask? Well that's personal but I'll just say that those salary surveys you find online have NEVER reflected the salary of any of the physicians I know of.
- croooz Said:
Context is king pretty lady...and you ripped my statement out of it.
Hey Crooz, it's ALL good!
Right now, I'm caught up in a "legal situation" with a former "death pharma" employer, so I'm feeling some kinda way these days about working for folks in ANY field outside of medicine.
All fields have their pros and cons. Go in with an open mind…during your clerkship years keep a pro-con list…and try to find something you enjoy. If you get into a residency and it is malignant or not your thing…you can try to switch…but that is difficult and a last resort…but the point being is that nothing is permanent.