Personality fit question: I am a new 4th year and only decided to do EM a few months ago. Since then, I've only been able to shadow 2-3 shifts in the ED and this is what I'm basing my life decisions on...No previous ED experience either. I have EM AIs and aways set up for the summer (and a backup residency choice if I end up not liking EM) but my question is: what kind of qualities describe a good EM physician?
I understand its hectic and busy, and sometimes I feel that I will not fit in because I can get overwhelmed when there's too much going on. Is this ability to juggle an acquired skill, or do you find that most interns already have that personality trait?
The ability to juggle a ton of different patient care issues at once is certainly not something most interns start with. It takes years to be able to learn to to more effectively multitask in the ED. If you aren't overwhelmed as a resident at times, then you aren't pushing yourself hard enough. So I wouldn't worry about not being able to juggle a large number of clinical tasks at once as a starting intern. Most interns, if not all, can't do that when they start.
As for qualities that I think help make a good EM physician:
1. Ability to work with a team. Unlike other fields of medicine where the doctors are treated like gods by staff, you are just another member of the team in the ED. Nurses, techs, midlevels, docs... all are working toward a common goal. This team mentality clicks with many people that want to go into EM. But I've seen people who are on the more egotistical side struggle with it at times.
2. Adaptability. You may not be able to juggle a million clinical things when you start, that's not expected. But you have to be someone who can try and think on the fly, and remain flexible. If you always HAVE to be in bed by 10pm or else... you will hate EM.
3. Intrigue vs fear of the unknown. This is perhaps, in my opinion, what attracts many to EM, and is terrifying to those that hate it. So many consultants hate the undifferentiated patient without a firm diagnosis. Once a diagnosis is made, they can go about working it up further, but the patient that presents undifferentiated with no tests... that's what separates us from them. Alternatively, the average EM doc hates the idea of rounding every day on a patient that's already been worked up and figured out. We love the intrigue and the mystery of figuring it all out. Very different mentality than most fields I've found.
4. Sense of humor. Look, we deal with some of the worst segments of society, and see some of the most horrific things many specialties will never see. Having a way to balance the stress of the job by being able to laugh at times with your colleagues and team members really is important.
5. People person. Half of what we do sometimes is talking people down from the ledge, convincing the drug seeker to leave without narcotics, calming the drunk guy down without having to sedate them, getting the hospitalist to admit a weak 90 year old with ambulatory dysfunction but with normal labs, and convincing the mom of the 3 year old with a temp of 99 and a runny nose they don't need abx. You can be the smartest guy/girl in the room, but if you don't relate well to the patients, families, and consultants, you won't be efficient. Being efficient means getting the patients/families/consultants to buy into the plan you set for them.
6. Comfort with procedures. No one expects you as a student to go put in a chest tube. But you need to be comfortable doing simple procedures on people, because you are going to get called to do much more dangerous stuff to people in the future. So its really helpful to know that you like/aren't afraid of doing procedures. If you are terrified just to suture someone as a student, or if you are frozen in fear by the idea of putting in a line or intubating someone as an intern, then its the wrong field for you.
7. Constant life long learner. I think this is true for all fields, but our field encompasses a little bit of every field of medicine so the shear daunting amount of information goes on and on and on...
8. Family/Spouse support. This doesn't apply to the single folks out there. But I can tell you I hear all the time that EM is a "lifestyle" field, and its not true. Shift work has significant physiologic effects on you, and will reek havic with your social life. Sure, you may have a day off, but if you slept until 5pm because you worked the night shift, then you are awake all night because you can't go back to sleep, your "day off" amounts to you being awake at 4am while your whole family sleeps. Dealing with shift work is way, way, way harder many realize, especially as you get older. How I felt doing shift work at age 25 was way different than at age 35. As you get older it just gets harder and harder to do. So those of you with spouses/families have to buy in to your career choice, and understand that this field is a major inconvenience to their lives and most certainly always will be assuming you are working a full time EM job.
I mean, those were the main things I could think of off the top of my head. I'm sure there is plenty more.
