Is Emergency for me?

[Zweihander]

I've been interested in EM for several months now, and as I approach fourth year I'm really trying to figure out if this is the field for me to commit to.

- I'm interested in public policy/public health
- I will (if all goes according to plan) have an MPH by the time I graduate (and I'd like to be able to apply it)
- I hate long-term patient management
- I think I may want to be involved in research
- I'd like a field that allows me to teach
- I like doing procedural stuff
- I like patient contact
- I enjoy the process of diagnosing, and I would prefer that I see a wide array of clinical situations during the course of my career
- I have an interest in working with pediatric populations
- I love reading and interpreting radiographs
- I am task-oriented; I'm very energetic when I have things to do, but can't work well when I have vague or distant deadlines
- I'd like to be able to work with other doctors: that is, I'd like to be in an environment where I have colleagues who I can interact with, have fun with, and learn from on the job
- I have trouble focusing on one thing for too long

additionally, I have crappy basic science grades (passes only with a couple of exceptions) and strong board scores. Haven't gotten enough clinical grades to comment on those.

I'm not really looking for a "what are my chances" sort of a response, but really what I'd like to know is based on this description, do I sound like the sort of person that could be successful in and *enjoy* emergency medicine?


cheers, and thanks

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[DrQuinn]

it sounds like you'd be a decent fit, but the ONLY way to really know is to do a four week or one month rotation in EM. When you get down in "the pits" and really see what EM is like, you'll know pretty quickly if you love it or hate it. Just remember, that the "thinking" of EM is far different from the vast majority of your 3rd year rotations.

Q

 

[GeneralVeers]

it sounds like you'd be a decent fit, but the ONLY way to really know is to do a four week or one month rotation in EM. When you get down in "the pits" and really see what EM is like, you'll know pretty quickly if you love it or hate it. Just remember, that the "thinking" of EM is far different from the vast majority of your 3rd year rotations.

Q

I agree with your assessment. Most of medical school is centered on general internal medicine, with an emphasis on primary care. There's nothing wrong with that, however I often find students are completely overwhelmed when they hit the ED and can't do their 45 minute H&P, and can't address every primary care complaint the patient has. It's definitely a state of mind, and the approach is often completely opposite of what is taught in med school. Yes, I'm going to ignore the patient's toe fungus if he's here for acute MI.

 

[Zweihander]

Thanks for your tips guys. I'm actually doing a family rotation right now, so what you're saying definitely rings a bell -- I've literally had cases of incidentally discovered toe fungus that get treated just because I found something on physical exam, even though they have nothing to do with why the patient is there.

How much time does an emergency h+p take on average, for a walk-in patient without an emergent condition? Will you deviate from the norm of treating the big things if it is a slow day and you do happen to catch something non-emergent/urgent that isn't related to the chief complaint?

 

[USAF MD '05]

Most H and P's take 3-5 minutes or so. Do i focus on an incidental finding on a slow shift? Hell no! You just encourage abuse of the ED that way. You get one complaint per visit, unless 2 things happen to be killing you at the same time. Steve

 

[GeneralVeers]

It depends. If the patient is not on crack, and can carry on a decent conversation without rambling, then my history usually lasts 5 minutes. Physical is 1-5 minutes depending on the complaint.

Generally I'll treat "incidental" findings like Tinea, or conjunctivitis if it simply involves writing a prescription.

Thanks for your tips guys. I'm actually doing a family rotation right now, so what you're saying definitely rings a bell -- I've literally had cases of incidentally discovered toe fungus that get treated just because I found something on physical exam, even though they have nothing to do with why the patient is there.

How much time does an emergency h+p take on average, for a walk-in patient without an emergent condition? Will you deviate from the norm of treating the big things if it is a slow day and you do happen to catch something non-emergent/urgent that isn't related to the chief complaint?

 

[Dr.Evil1]

It sounds like you would fit into EM and it also sounds like you have half your personal statement written as well. Now all you need is a rotation in the ED in order to get a good story to fit into your personal statement. Or you could also steal one from SDN and that would work too.