Hello all,
Three questions about Emergency Medicine:
Does anyone have a vibe on the kind of hours an ER resident puts in? I’ve heard that it can be a managable life because its basically shift work; you leave and someone takes over, as opposed to being on call all the time.
How bout after finished with residency and when you finally start working?
Finally, what are the chances of doing EM part time, or are there only f/t jobs out there?
Just wondering what my future would look like.
My best
Sam
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Does anyone have a vibe on the kind of hours an ER resident puts in? I’ve heard that it can be a managable life because its basically shift work; you leave and someone takes over, as opposed to being on call all the time.
EM Resident life is not any worse than any other residencies. When you are doing months in the ED itself, it is basically shift work. However, a considerable portion of your residency is spent doing “off-service” rotations (OB, surgery, peds, ICU, medicine, etc) and those hours are not as happy. All residencies are now limited by the 80 hour work week limit.
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How bout after finished with residency and when you finally start working?
ED is mostly shift work. No call when you leave after shift. But - you will have to do your fair share of nights, weekends, and holidays - especially as a new attending. Shifts vary from 8 - 12 hours. Many smaller ED’s run 1 physician coverage with 7a - 7p and 7p - 7a shifts. They rotate nights and weekends, even the docs that have been there forever.
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Finally, what are the chances of doing EM part time, or are there only f/t jobs out there?
There are lots of opportunities for part-time EM work.
I recommend you check out the Emergency Medicine forum on SDN. Read through the FAQ thread and some of the older posts that go back aways. Questions like yours have been addressed extensively on their, so you should be able to find quite a bit of info.
Good luck!!
Amy
I would like to add one caveat based on my extensive (tongue in cheek) experience (I’m doing an emergency medicine rotation). I’ve noticed that in most cases the ER physicians do NOT just “turn over a patient” that is being actively worked up. They usually stay to see their patients threw- either to discharge or admission. Of course there are some exceptions-- a simple case just waiting an X-ray result, or a patient that is just waiting for another physician to come admit the patient. Also, they frequently do not have time during the shift to do dictations, and they stay after to do these. Also, most of the physicians in the ER I’m in have extra duties-- such as doing quality reviews, teaching, etc. So, although in theory they are working 8 hour shifts, they are actually working a lot more than that. Also, they do a variety of shifts, rotating through the shifts, and this is hard on the circadian rhythms-- the first day off is often lost to sleep (or so I’ve seen and experienced). Not to say Emergency Medicine isn’t a great choice-- it’s one of two residencies I’m considering, but in my (admittedly limited) experience the simple “shift work” appearance is somewhat misleading.
Good points, epidoc. Being in EMS, I take for granted that people know that your shift doesn’t always end on time. In some cases, it rarely ends on time. My rule - if you have something scheduled/planned after your “shift” ends, you will end up staying over for at least an hour.
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I would like to add one caveat based on my extensive (tongue in cheek) experience (I’m doing an emergency medicine rotation). I’ve noticed that in most cases the ER physicians do NOT just “turn over a patient” that is being actively worked up. They usually stay to see their patients threw- either to discharge or admission. Of course there are some exceptions-- a simple case just waiting an X-ray result, or a patient that is just waiting for another physician to come admit the patient. Also, they frequently do not have time during the shift to do dictations, and they stay after to do these. Also, most of the physicians in the ER I’m in have extra duties-- such as doing quality reviews, teaching, etc. So, although in theory they are working 8 hour shifts, they are actually working a lot more than that. Also, they do a variety of shifts, rotating through the shifts, and this is hard on the circadian rhythms-- the first day off is often lost to sleep (or so I’ve seen and experienced). Not to say Emergency Medicine isn’t a great choice-- it’s one of two residencies I’m considering, but in my (admittedly limited) experience the simple “shift work” appearance is somewhat misleading.
The same could be stated for virtually all staff-level physicians. Even though the 80hr/week restriction has made residency much more humane, no such limitations exist for staff physicians. You are obligated to stay until your responsibilities are covered either by yourself or by someone else assuming their care. In reality, with a few expections, there is no such animal as ‘shift work’ in the world of physicians; however, some disciplines more closely approach what laypeople think of as ‘shift-work’. One of those is the ED Doc…others are Derm, Ophtho & Path.
The amount of off-service time/rotations varies with programs. We spend about 7/36 months off service in non-EM rotations. Other programs have fewer off-services months. A friend of mine is at a program where they only do EM and 4 ICU months. I know other programs where over 12/36 months are off-service. Then there are the PGY2-4 programs where you do a prelim medicine or surgery year.
The pain of off-service months also varies with the rotation. I’m on anesthesiology right now and am having a blast, have no call and have great hours. On the other hand, one of my fellow residents just came off Ortho and he looked like hell.
In addition to the 80 hour limitations, the EM RRC (residency review committee…the accreditation body) has even stricter requirements. The only time I ever have to worry about coming even close to the 80 hours (as opposed to the almost weekly questioning) is on off-service months.
Life after residency has been pretty well addressed above (plus, as a resident, I obviously have no experience with it). I’m just hopeful that there IS life after residency.
I’ve heard of lots of part time EM faculty.
BTW, EM is CLEARLY the best specialty. Of course, I might be a tad biased. 
Take care,
Jeff
Nice reply, Jeff. Really helpful.
BTW, what are “12/36 months” and “off service months”? Some of us aren’t familiar with this kind of jargon.
Thanks
Sam
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Nice reply, Jeff. Really helpful.
BTW, what are “12/36 months” and “off service months”? Some of us aren’t familiar with this kind of jargon.
Thanks
Sam
36 months total residency (3 years). 7 of those not spent specifically in the ER, but on other services (Internal medicine, OB/GYN, whatever) to flesh out your experiences that will help you function in the ER.