Help me decide: EM or Ortho

[Psai]

And those 40 hours are packed with dense decision-making, seeing 4-5 pts/hr, while trying to find room to admit.

Dude have you ever worked in the ED? 4-5 patients an hour LOL

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[Angry Birds]

Yeah but through Gen surg you can get into trauma, CT, plastics etc, which are all competitive/respected.

I used to think that way until I got into the wards and people started to compare each other based on what specialty they're going into. It gets very tiring to constantly get **** on when you go to work, especially if you're working 60+ hours a week.

Although I hate the attitude of surgeons (including general surgeons), I respect their field and appreciate the work they do. I certainly do not respect a field more just because it is paid more.

(FYI, per hour ER is very high on the scale--perhaps the highest on average. Perhaps.)

Dude have you ever worked in the ED? 4-5 patients an hour LOL

Kids...

 

[Osteoth]

Although I hate the attitude of surgeons (including general surgeons), I respect their field and appreciate the work they do. I certainly do not respect a field more just because it is paid more.

(FYI, per hour ER is very high on the scale--perhaps the highest on average. Perhaps.)

Kids...

No, but the general public does.

EM is probably the highest on a per-hour basis out of any medical field, but at the same point it is about mid-way in total compensation, with limited private practice options, limited autonomy, corporatization and EMTALA/Press Ganey question marks going forward.

Not saying its not on my big-board, but definitely some baggage.

 

[Angry Birds]

No, but the general public does.

Not really. Dermatology is highly paid and is not that well respected by the public: "Are you a real doctor??"

The public opinion is fickle. Don't decide based on that either.

EM is probably the highest on a per-hour basis out of any medical field, but at the same point it is about mid-way in total compensation, with limited private practice options, limited autonomy, corporatization and EMTALA/Press Ganey question marks going forward.

Not saying its not on my big-board, but definitely some baggage.

I don't think you'd be a good match for EM. Good luck with surgery.

 

[BJJVP]

And those 40 hours are packed with dense decision-making, seeing 4-5 pts/hr, while trying to find room to admit.

Dude have you ever worked in the ED? 4-5 patients an hour LOL

To be fair, I do notice that a lot of physicians will claim to see 4-5 pts/hr. And on some shifts, I actually will see that many. However, in the past, my average has been closer to approximately 3.75 pt/hr. That figure includes PAs' patients.

 

[Osteoth]

Not really. Dermatology is highly paid and is not that well respected by the public: "Are you a real doctor??"

The public opinion is fickle. Don't decide based on that either.



I don't think you'd be a good match for EM. Good luck with surgery.

I don't think the average person could differentiate between a dermatologist and a radiologist to be honest. I think the average person probably understands cut vs. don't cut, but outside of that it starts to get murkier.

And based on what do you make your second claim? Which one of the topics I mentioned earlier is not something to think about when deciding whether to spend 40 years of my life in emergency medicine?

 

[deleted547339]

Recent threads here:

Alternative sources of income
How common is it to get ripped on by surgeons
How much are you worth (read: how much are the mbas taking from you)

Recent threads in ortho:
How happy are you? (Most respond 10/10)
Switching into ortho.

 

[TheOther]

Again, false... most docs steadily see 2 - 2.5 pts/hr. lets not stretch hyperbole to ridiculous extent.

To be fair, I do notice that a lot of physicians will claim to see 4-5 pts/hr. And on some shifts, I actually will see that many. However, in the past, my average has been closer to approximately 3.75 pt/hr. That figure includes PAs' patients.

Yeah, I understand it isn't the norm. I have a handful of friends who are EM attendings, all in community settings -- some county, some rural, and one at Kaiser. Apart from Kaiser (1.5-2/hr), the others say it varies by shift between 3-5. Should have included: with PA oversight.

Didn't mean for it to offend anyone.

 

[Laufcra]

I continually hear people citing 'prestige' as an actual deciding factor arguing for ortho over EM.... am I alone in thinking that is a totally meaningless measure? I was in a similar position to this poster during my 3rd year trying to choose between EM and ortho (I have a degree in kines, seemed like the natural choice) as were many of my classmates with grades/scores plenty competitive enough for either specialty, and the vast majority of these folks ended up choosing EM over ortho. I found that the OR was like a prison. To many of us the OR is worse than watching paint dry or grass grow, so the hypercompetitive procedural fields are all out. People don't just choose EM because their step 1 score is in the 230s, and people don't choose ortho simply because their score is in the 250s, there's more to specialty choice than that.
So my question is, who exactly is putting these ortho folks up on this 'prestigious' pedestal? Their work is not more intellectually demanding than any other field of medicine as far as I can tell... far from it. And I'm not talking about the general public, they get a pass for their ignorance, I see this attitude in the hospital as well.

 

[Birdstrike]

I continually hear people citing 'prestige' as an actual deciding factor arguing for ortho over EM.... am I alone in thinking that is a totally meaningless measure? I was in a similar position to this poster during my 3rd year trying to choose between EM and ortho (I have a degree in kines, seemed like the natural choice) as were many of my classmates with grades/scores plenty competitive enough for either specialty, and the vast majority of these folks ended up choosing EM over ortho. I found that the OR was like a prison. To many of us the OR is worse than watching paint dry or grass grow, so the hypercompetitive procedural fields are all out. People don't just choose EM because their step 1 score is in the 230s, and people don't choose ortho simply because their score is in the 250s, there's more to specialty choice than that.
So my question is, who exactly is putting these ortho folks up on this 'prestigious' pedestal? Their work is not more intellectually demanding than any other field of medicine as far as I can tell... far from it. And I'm not talking about the general public, they get a pass for their ignorance, I see this attitude in the hospital as well.

You're correct that perceived 'prestige' is virtually meaningless in specialty selection. or at a minimum should be very low on the list. If anything, it has the effect of sometimes drawing people away from specialities that may be great for them. There are a lot of great sleeper specialties on the 'not so sexy' list.

If your at work, miserable on any given day, I guaran-f'ing-tee you, some external prestige held by someone that's not you, isn't going to do a damn thing to lift you out of your misery on that, or any other day.

What some people get very wrong, is that what's most 'prestigious' is to be happy, content, and fulfilled in a career that works great for you and your family, not what some pre-med focus group thinks is most 'prestigious.' There's a lot of very miserable people in so called more prestigious specialties that is never change places with. Take that to the bank.

I'm in a subspecialty (Interventional Pain, double boarded with EM) that many on this board sh ¡t on. Many of you think it's bottom of the prestige barrel. But it's worked out great for me and my family, and in fact much better than a specialty that's much more 'prestigious' amongst emergency physicians (that is emergency medicine itself). I'm happy doing it, and it's works out great for my family. That makes it prestigious to me, and to the people that matter the most.

 

[Jabbed]

I continually hear people citing 'prestige' as an actual deciding factor arguing for ortho over EM.... am I alone in thinking that is a totally meaningless measure? I was in a similar position to this poster during my 3rd year trying to choose between EM and ortho (I have a degree in kines, seemed like the natural choice) as were many of my classmates with grades/scores plenty competitive enough for either specialty, and the vast majority of these folks ended up choosing EM over ortho. I found that the OR was like a prison. To many of us the OR is worse than watching paint dry or grass grow, so the hypercompetitive procedural fields are all out. People don't just choose EM because their step 1 score is in the 230s, and people don't choose ortho simply because their score is in the 250s, there's more to specialty choice than that.
So my question is, who exactly is putting these ortho folks up on this 'prestigious' pedestal? Their work is not more intellectually demanding than any other field of medicine as far as I can tell... far from it. And I'm not talking about the general public, they get a pass for their ignorance, I see this attitude in the hospital as well.

I think that there's something special about devoting that many years to perfecting your surgical craft and occupying a niche that no one else can fill. Nobody thinks that they can play orthopod after a few months exposure, whereas everyone thinks that they can do the EP's job better than the EP.