Emergency Medicine Resident - Ask me anything!!!

[DocMcStuffandThings]

Current EM resident in southeast US. Ask me anything.
Cheers 🍻
- DocMcStuffandThings

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[shotgunlagoon]

What made you decide on EM?

 

[frosted2]

Any experience in healthcare before medical school?

Are you interested in pursuing any fellowships?

 

[doomer_md]

.... do you think you'll get a job?

 

[CyrilFiggis]

What made you decide on EM?

Not OP, but diverse pathology, procedure heavy, no clinic, no rounding, no on call.

.... do you think you'll get a job?

Yes, covid created a weird market, but jobs are coming back as pre-covid volumes return. At least in New England.

Any experience in healthcare before medical school?

Are you interested in pursuing any fellowships?

No, non-trad. Yes, I’ll be doing an ultrasound fellowship.

 

[frosted2]

Not OP, but diverse pathology, procedure heavy, no clinic, no rounding, no on call.

Yes, covid created a weird market, but jobs are coming back as pre-covid volumes return. At least in New England.

No, non-trad. Yes, I’ll be doing an ultrasound fellowship.

New England is my dream place to move and establish once I am done with school. Would love to do residency there!

 

[Tenk]

Can I have a work note?

 

[DocMcStuffandThings]

What made you decide on EM?

I got interested in medicine while I was in the military. EM was always the goal. I went into clinical with an open mind, but only ended up realizing why I live EM so much. Diverse pathology - you need to be the best resuscitator in the hospital and second best at every other specialty, you see everything. I wanted to be able to treat anyone, at any time, anywhere, and I didn’t want to even consider their ability to pay for it. It’s raw medicine. I love procedures, but I don’t like standing in an OR for hours on end. Good lifestyle. Good pay. Relatively short residency.

 

[DocMcStuffandThings]

Any experience in healthcare before medical school?

Are you interested in pursuing any fellowships?

I picked up my civilian EMT while in the military and worked with some of our docs and medics. It wasn’t my primary job, but it helped augment our team while in Iraq. Also, battlefield medicine training.
Unsure about fellowship right now. I’m leaning toward not doing one, but as the medicine game shifts toward mid level care, fellowships are sadly becoming more essential. Not sure what I would do it in though.

 

[DocMcStuffandThings]

.... do you think you'll get a job?

Great question! The market report from this past year does not look great for EM. First time in history, go figure! However, I think what will happen is we will see jobs fill up in cities, forcing new docs to take rural positions for a while. There are some ideas out there on how we can slow the production of new ER docs, but not any perfect ones that I have heard. I just went to a conference where this was discussed and let’s just say that I left a little disappointed in the ideas presented by our representatives. However, things change so fast, that nobody really knows what exactly will happen over the next 3-5 years. Short answer: yes, I think I will be able to find a job, just maybe not my ideal job right away. But, fingers crossed.

 

[DocMcStuffandThings]

Can I have a work note?

Of course, you may return to work tomorrow 😂

 

[Tenk]

Of course, you may return to work tomorrow 😂

I’m off for five. Thanks tho.

 

[Blueprint Med School]

Great question! The market report from this past year does not look great for EM. First time in history, go figure! However, I think what will happen is we will see jobs fill up in cities, forcing new docs to take rural positions for a while. There are some ideas out there on how we can slow the production of new ER docs, but not any perfect ones that I have heard. I just went to a conference where this was discussed and let’s just say that I left a little disappointed in the ideas presented by our representatives. However, things change so fast, that nobody really knows what exactly will happen over the next 3-5 years. Short answer: yes, I think I will be able to find a job, just maybe not my ideal job right away. But, fingers crossed.

Current EM resident here as well and generally concur with this. A couple months ago I was down in DC for an ACEP conference and they had the guy who wrote and published that big study that started freaking everyone out and he gave a great presentation and came generally to a similar conclusion: right now there are enough jobs but there is misalignment between too many people going for urban jobs and not enough going for rural jobs. There was a pretty robust discussion including several potential solutions such as making em a four-year residency across the board (something emra opposes but I support), figuring out how to combat scope of practice issues (which is going to be the defining fight of the next decade for ACEP and friends) and how to deal with too many residencies opening and flooding the market with new docs.

Long story short, if you're a city person it's going to be a bit of a struggle as the decade moves on because of basic supply and demand. If you're willing to go where the jobs are there will always be jobs. And many of these jobs are in absolutely beautiful places; both of the places I visited while interviewing for jobs are very much nature filled small towns with the nicest people who enjoy helping people, there are absolutely more hidden gems like these for sure. Emergency medicine burns through attendings at a pretty decent rate so there will always be turnover if your mind is open enough to look for them.

David D MD - USMLE and MCAT Tutor
Med School Tutors

 

[Princeton Medical Student]

Current EM resident here as well and generally concur with this. A couple months ago I was down in DC for an ACEP conference and they had the guy who wrote and published that big study that started freaking everyone out and he gave a great presentation and came generally to a similar conclusion: right now there are enough jobs but there is misalignment between too many people going for urban jobs and not enough going for rural jobs. There was a pretty robust discussion including several potential solutions such as making em a four-year residency across the board (something emra opposes but I support), figuring out how to combat scope of practice issues (which is going to be the defining fight of the next decade for ACEP and friends) and how to deal with too many residencies opening and flooding the market with new docs.

Long story short, if you're a city person it's going to be a bit of a struggle as the decade moves on because of basic supply and demand. If you're willing to go where the jobs are there will always be jobs. And many of these jobs are in absolutely beautiful places; both of the places I visited while interviewing for jobs are very much nature filled small towns with the nicest people who enjoy helping people, there are absolutely more hidden gems like these for sure. Emergency medicine burns through attendings at a pretty decent rate so there will always be turnover if your mind is open enough to look for them.

David D MD - USMLE and MCAT Tutor
Med School Tutors

How is the job market in the suburban areas for EM?

 

[CyrilFiggis]

Current EM resident here as well and generally concur with this. A couple months ago I was down in DC for an ACEP conference and they had the guy who wrote and published that big study that started freaking everyone out and he gave a great presentation and came generally to a similar conclusion: right now there are enough jobs but there is misalignment between too many people going for urban jobs and not enough going for rural jobs. There was a pretty robust discussion including several potential solutions such as making em a four-year residency across the board (something emra opposes but I support), figuring out how to combat scope of practice issues (which is going to be the defining fight of the next decade for ACEP and friends) and how to deal with too many residencies opening and flooding the market with new docs.

There is zero value in making residency 4 years. There is also zero data to support it. All you would do is delay the same number of residents from entering the market. If you want to fix demand, get rid of stupid for-profit hospitals starting programs. There is a bloat in the market that will only continue to be exacerbated by additional spots.

 

[RNtoPhysician]

I got interested in medicine while I was in the military. EM was always the goal. I went into clinical with an open mind, but only ended up realizing why I live EM so much. Diverse pathology - you need to be the best resuscitator in the hospital and second best at every other specialty, you see everything. I wanted to be able to treat anyone, at any time, anywhere, and I didn’t want to even consider their ability to pay for it. It’s raw medicine. I love procedures, but I don’t like standing in an OR for hours on end. Good lifestyle. Good pay. Relatively short residency.

Did you ever consider Anesthesia and/or critical care? They obviously don’t have the same raw medicine that EM has but they seem like procedure heavy fields too and great resuscitators.

 

[mcat_taker]

Current EM resident here as well and generally concur with this. A couple months ago I was down in DC for an ACEP conference and they had the guy who wrote and published that big study that started freaking everyone out and he gave a great presentation and came generally to a similar conclusion: right now there are enough jobs but there is misalignment between too many people going for urban jobs and not enough going for rural jobs. There was a pretty robust discussion including several potential solutions such as making em a four-year residency across the board (something emra opposes but I support), figuring out how to combat scope of practice issues (which is going to be the defining fight of the next decade for ACEP and friends) and how to deal with too many residencies opening and flooding the market with new docs.

Long story short, if you're a city person it's going to be a bit of a struggle as the decade moves on because of basic supply and demand. If you're willing to go where the jobs are there will always be jobs. And many of these jobs are in absolutely beautiful places; both of the places I visited while interviewing for jobs are very much nature filled small towns with the nicest people who enjoy helping people, there are absolutely more hidden gems like these for sure. Emergency medicine burns through attendings at a pretty decent rate so there will always be turnover if your mind is open enough to look for them.

David D MD - USMLE and MCAT Tutor
Med School Tutors

Out of curiosity what would be the rationale and benefit of making it a 4 year residency across the board ?

 

[Blueprint Med School]

Out of curiosity what would be the rationale and benefit of making it a 4 year residency across the board ?

They did a study a few years ago polling program directors on the optimal length of EM residency training, the average was ~42 months. Rising third years often have a slower practice pattern attainment as an attending then 4 our colleagues but many of the latter say having an entire extra year is too much. In a perfect world I suppose a three and a half year program might be a happy medium for many.

My other rationale for being in favor of 4-year programs in the long-term is the expanded scope of practice that emergency medicine can take advantage of in the 21st century. We can be the masters of telemedicine, can run things like Suboxone clinics, and have access and training to really cool things like different type of pain blocks and other procedures. EM docs often end up doing a lot of stuff with healthcare administration and advocacy as well. In a 3-year program you get maybe one niche, i e. You're the ultrasound guy or you're the EMS gal etc, but there's not enough time to do more than one niche.

So that is why it is my personal opinion and personal opinion only that we as a field should not only be playing defense on scope of practice issues but offense on scope of practice issues expanding our field.


David D MD - USMLE and MCAT Tutor
Med School Tutors

 

[CyrilFiggis]

They did a study a few years ago polling program directors on the optimal length of EM residency training, the average was ~42 months. Rising third years often have a slower practice pattern attainment as an attending then 4 our colleagues but many of the latter say having an entire extra year is too much. In a perfect world I suppose a three and a half year program might be a happy medium for many.

My other rationale for being in favor of 4-year programs in the long-term is the expanded scope of practice that emergency medicine can take advantage of in the 21st century. We can be the masters of telemedicine, can run things like Suboxone clinics, and have access and training to really cool things like different type of pain blocks and other procedures. EM docs often end up doing a lot of stuff with healthcare administration and advocacy as well. In a 3-year program you get maybe one niche, i e. You're the ultrasound guy or you're the EMS gal etc, but there's not enough time to do more than one niche.

So that is why it is my personal opinion and personal opinion only that we as a field should not only be playing defense on scope of practice issues but offense on scope of practice issues expanding our field.


David D MD - USMLE and MCAT Tutor
Med School Tutors

All those scope of practice things, Admin, US, EMS are all fellowships. 4 years is too long. Unless they show worse patient outcomes I find those other studies superficial.

 

[Princeton Medical Student]

I know there is a lot of talk about lack of urban jobs but how does the situation in the suburbs look like?