EM docs crossing over into CC realm

[futureemdoc1]

Anyone see this where EM docs work in the CC either with or without CC fellowship?

---

Members don't see this ad.

 

[psychbender]

Yeah, there are several EM/CCM trained docs on this forum. It's becoming increasingly common to see EM residents applying. I think almost half the residents I met for pre-interview dinner last year were from EM.

Sent from my SM-G930V using SDN mobile

 

[RandomChaos]

YES! EM is the newish kid on the block and quickly filling the large intensivist work gap. Many Medicine and Anesthesia programs are starting to create tracts specific for EM.

 

[K31]

Yeah, there are several of us on the forum.

 

[SpacemanSpifff]

Anyone see this where EM docs work in the CC either with or without CC fellowship?

EM-trained physicians are not staffing ICUs without completing a fellowship.

 

[tartesos]

They are a welcome addition tbh.



Sent from my iPhone using SDN

 

[MTGas2B]

My co-fellow, in 2010, was an EM doc. Went on to full time ICU practice.


Sent from my iPhone using SDN

 

[Blanky]

Hmm I'm curious why the drive to switch? Isn't the salaries relatively close? I work in the ED but enjoy working with the CC physicians and certainly can see there is some difference in training.

 

[Dr.CCM]

Hmm I'm curious why the drive to switch? Isn't the salaries relatively close? I work in the ED but enjoy working with the CC physicians and certainly can see there is some difference in training.

It’s kind of what you actually want to do as an ER doc outside of academics. You actually have time and are incentivized to properly resuscitate people. You do a lot more critical care than dealing with urgent care/level 3 ESI complaints and don’t have to worry about moving the meat.

Now academic ER guys have a cool gig imo with all the resuscitative medicine they get to do. Still lots of BS.

 

[deleted547339]

I do both. There’s not many of us (a couple hundred) that trained in both, fewer that actually practice both. It’s a fun gig, plain and simple.

Pay is similar, but the stressors of the jobs are different, which is nice.

 

[chocomorsel]

We need intensivists. Where I trained there were no Anesthesia ICU attendings, but there were ER and Surgical attending. Back in the day Shock trauma was one of the few places that let them in. But now, there are lots of programs. My program lets them in and my friend is an ER with over 20 years experience who came back for fellowship.

 

[engineeredout]

Hmm I'm curious why the drive to switch? Isn't the salaries relatively close? I work in the ED but enjoy working with the CC physicians and certainly can see there is some difference in training.

Cause you want to do critical care. Has nothing to do with the money.

 

[Blanky]

Cause you want to do critical care. Has nothing to do with the money.

Seems like that is the correct answer. Strange to fellow and lose salary to enter another specialty with high burnout.

 

[Dr.CCM]

Pay is better as an ER doc on hourly average. Same reason IM people do endocrine/ID/Rheum. You gotta like it even though it’s more training for less or similar pay.

 

[deleted547339]

Seems like that is the correct answer. Strange to fellow and lose salary to enter another specialty with high burnout.

It’s not strange if it makes you happier, gives you an academic niche, makes you a stronger EP and allows you to work fewer nights.

 

[AdmiralChz]

Cause you want to do critical care. Has nothing to do with the money.

Unfortunately, this is also true for the CCM route taken by Anesthesiologists and surgeons - the extra training is sought due to an interest, not financial factors. It's also why it's minimally competitive to land a fellowship, even at top notch programs. Not so much IM who can pair with pulmonology.

 

[engineeredout]

Seems like that is the correct answer. Strange to fellow and lose salary to enter another specialty with high burnout.

The burnout is not additive. On the contrary, the freedom to move between different fields/environments reduces burnout.

 

[deleted547339]

The burnout is not additive. On the contrary, the freedom to move between different fields/environments reduces burnout.

I hope you’re right.

 

[wickedskillz]

Trained with some badass em docs. I think ER training leaves them well equipped to Deal with acute critical care problems. Like anesthesiologists, we both need to work on chronic care and seeing the same patient every day

Sent from my SM-G950U using Tapatalk

 

[jdh71]

The burnout is not additive. On the contrary, the freedom to move between different fields/environments reduces burnout.

This is why pairing with Pulm out of IM gives longevity.

 

[jdh71]

Trained with some badass em docs. I think ER training leaves them well equipped to Deal with acute critical care problems. Like anesthesiologists, we both need to work on chronic care and seeing the same patient every day

Sent from my SM-G950U using Tapatalk

Thus the year of two of bedside fellowship

 

[Laryngophed]

Trained with some badass em docs. I think ER training leaves them well equipped to Deal with acute critical care problems. Like anesthesiologists, we both need to work on chronic care and seeing the same patient every day

Sent from my SM-G950U using Tapatalk

I'm currently at a place with EM docs, anesthesiologists, and surgeons all in the same "fellow" pool. A fellow is a fellow here. We all start in different places, but the expectation set by our faculty is that we will all end in the same place and we will all share our different skill sets and tips and tricks with one another. Hell, when the pulm/ccm fellows are on our services they are just one of us and vice versa. Same expectations. Frankly, I love the multidisciplinary approach. I learn so much from other specialties, I know I would hate being a program with only gas or only surgery or only IM.

And the last point, I think is probably spot on. I think Anes, surgery, and EM start off with a mindset that fits well with the bulk of care provided in CT and SICUs. High acuity with a relatively predictable throughput model and our IM colleagues seem more adapted to "this person has been in the unit for the last 13 weeks" and having a clear thought about where to go next.

But I don't buy that only IM docs can staff a MICU, or only EM/surg/Anes can staff a CT or SICU. Our strengths may initially align better with patients/pathologies/work flows but any sufficiently trained and motivated intensivist can learn to function anywhere, IMHO.

 

[wickedskillz]

I'm currently at a place with EM docs, anesthesiologists, and surgeons all in the same "fellow" pool. A fellow is a fellow here. We all start in different places, but the expectation set by our faculty is that we will all end in the same place and we will all share our different skill sets and tips and tricks with one another. Hell, when the pulm/ccm fellows are on our services they are just one of us and vice versa. Same expectations. Frankly, I love the multidisciplinary approach. I learn so much from other specialties, I know I would hate being a program with only gas or only surgery or only IM.

And the last point, I think is probably spot on. I think Anes, surgery, and EM start off with a mindset that fits well with the bulk of care provided in CT and SICUs. High acuity with a relatively predictable throughput model and our IM colleagues seem more adapted to "this person has been in the unit for the last 13 weeks" and having a clear thought about where to go next.

But I don't buy that only IM docs can staff a MICU, or only EM/surg/Anes can staff a CT or SICU. Our strengths may initially align better with patients/pathologies/work flows but any sufficiently trained and motivated intensivist can learn to function anywhere, IMHO.

Agreed, had a similar set up and loved the multidisciplinary approach. Learned a lot from my co fellows.

Sent from my SM-G950U using Tapatalk

 

[jdh71]

I'm currently at a place with EM docs, anesthesiologists, and surgeons all in the same "fellow" pool. A fellow is a fellow here. We all start in different places, but the expectation set by our faculty is that we will all end in the same place and we will all share our different skill sets and tips and tricks with one another. Hell, when the pulm/ccm fellows are on our services they are just one of us and vice versa. Same expectations. Frankly, I love the multidisciplinary approach. I learn so much from other specialties, I know I would hate being a program with only gas or only surgery or only IM.

And the last point, I think is probably spot on. I think Anes, surgery, and EM start off with a mindset that fits well with the bulk of care provided in CT and SICUs. High acuity with a relatively predictable throughput model and our IM colleagues seem more adapted to "this person has been in the unit for the last 13 weeks" and having a clear thought about where to go next.

But I don't buy that only IM docs can staff a MICU, or only EM/surg/Anes can staff a CT or SICU. Our strengths may initially align better with patients/pathologies/work flows but any sufficiently trained and motivated intensivist can learn to function anywhere, IMHO.

You will adapt to the practice environment when you start working regardless. Fellowship is just something that gives you a toolbox you carry with you. You will use what you need wether it's buffing then turfing gomers or titrating drips post op in the CVICU.

 

[leviathan]

Very common for EM/CCM dual training in Canada.

 

[jdh71]

Very common for EM/CCM dual training in Canada.

so are ketchup potato chips in Canada

don't make it right

 

[MedicineZ0Z]

so are ketchup potato chips in Canada

don't make it right

You'll never ever see an NP running even a tiny community ICU during nights in Canada. USA? Everywhere.

 

[jdh71]

You'll never ever see an NP running even a tiny community ICU during nights in Canada. USA? Everywhere.

Was that supposed to be a burn? Did you get hurt in the feelz?

It was a joke. Ffs.

 

[chocomorsel]

You'll never ever see an NP running even a tiny community ICU during nights in Canada. USA? Everywhere.

I need to live in Canada. If only it was warm....

 

[jdh71]

I need to live in Canada. If only it was warm....

We simply don't have the physician numbers to cover our US population yet. Maybe never? Canada has a much lower population and a "stingy" use of resources relatively speaking. Basically all of their ICUs are real ICUs located more regional type of centers to consolidate experience and expertise. In the US lots of hospitals have "ICUs". They staff as needed. Most of those "ICUs" . . . Aren't.

 

[Doc Doc Doc Goose]

I'm currently at a place with EM docs, anesthesiologists, and surgeons all in the same "fellow" pool. A fellow is a fellow here. We all start in different places, but the expectation set by our faculty is that we will all end in the same place and we will all share our different skill sets and tips and tricks with one another. Hell, when the pulm/ccm fellows are on our services they are just one of us and vice versa. Same expectations. Frankly, I love the multidisciplinary approach. I learn so much from other specialties, I know I would hate being a program with only gas or only surgery or only IM.

And the last point, I think is probably spot on. I think Anes, surgery, and EM start off with a mindset that fits well with the bulk of care provided in CT and SICUs. High acuity with a relatively predictable throughput model and our IM colleagues seem more adapted to "this person has been in the unit for the last 13 weeks" and having a clear thought about where to go next.

But I don't buy that only IM docs can staff a MICU, or only EM/surg/Anes can staff a CT or SICU. Our strengths may initially align better with patients/pathologies/work flows but any sufficiently trained and motivated intensivist can learn to function anywhere, IMHO.

I think I’m falling in love with you.

 

[Doc Doc Doc Goose]

Agreed, had a similar set up and loved the multidisciplinary approach. Learned a lot from my co fellows.

Sent from my SM-G950U using Tapatalk

What program is this? Cause I want to go there!

 

[leviathan]

I need to live in Canada. If only it was warm....

I assume you live in the southern US?

 

[sylvanthus]

We hired 3 EM/CC guys last year and just recently hired another. Were now majority EM/CC or EM/IM/CC.

 

[Tipsy McStagger]

We hired 3 EM/CC guys last year and just recently hired another. Were now majority EM/CC or EM/IM/CC.

Same here. Our PCCM colleauges are now a significant minority, which is too bad because I really like their perspective. I think a good shop has a nice balance of backgrounds. There remains much to learn from each other. I wonder if this EM/CCM trend will continue,

 

[chocomorsel]

I assume you live in the southern US?

Yup. But not for long. Right now all over America, North, South, East, West, it is boiling.

 

[leviathan]

Yup. But not for long. Right now all over America, North, South, East, West, it is boiling.

It's been in the mid 80F all month where I live. Last summer it hit 121F in Lytton BC. We don't all live in igloos up here. But my igloo is pretty nice.