Just finished my em fellowship!

[Kach]

If anyone has questions please feel free to ask.

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[ddjamb]

DO you feel more comfortable working in busy ER?

 

[Kach]

Yes I do. In choosing my fellowship I purposely focus on the ones that were level 3 and above and saw 50,000 patients a year and above. I did this specifically to get used to seeing high-volume amount of patience.

 

[FalseVanilla]

Thanks for the AMA! What kind of job offers did you get and was there any pushback or denials for the jobs you applied to?

 

[Kach]

Well, how it worked for me was that my recruiter put my cv out there and I got several responses. Whereas prior to the fellowship I was being looked at by lower volume Ed's, 1000 to 20000 annual pt volume, I've received 2 offers by larger suburban hospitals,ie 50-100k and I graduated on the 1st, lol. To some extent and depending on the locale and the hospital's desparation larger volume can translate to increased pay .

 

[ddjamb]

Could you elaborate more on those offers you received after fellowship?

 

[Kach]

Sure. Offer 1- 50k volume a year. Level 3. East coast. 1 hour from major us city. No trauma. Has scribe.

Offer 2 - 70k pt per year. Level 2 trauma. 45 mins outside large but not major city. SouthEast .

All mid 200/hr wage. All double coverage plus midlevels.

 

[Sardonix]

This may be a silly question, but will you be doing just EM from now on or do you plan to also work in an outpatient setting?

 

[Splenda88]

Not trying to create a thread of FM-->EM fellowship vs EM here... I am an IM PGY2 doing my EM rotation now... I have come across a lot of threads here where EM docs are arguing against EM fellowship coming from FM. Of course, going straight to EM should be the gold standard, but I really don't understand the argument that an EM fellowship will not prepare an FM doc to practice safely in the ED... That is just B$!

 

[Kach]

Not trying to create a thread of FM-->EM fellowship vs EM here... I am an IM PGY2 doing my EM rotation now... I have come across a lot of threads here where EM docs are arguing against EM fellowship coming from FM. Of course, going straight to EM should be the gold standard, but I really don't understand the argument that an EM fellowship will not prepare an FM doc to practice safely in the ED... That is just B$!

Yes, the fellowship route is an alternative pathway that is available to pcps who want to enhance their em skills. Residency is the gold standard but if a pcp wants to staff an ed then a fellowship can give you greater confidence.

 

[Lexdiamondz]

Not trying to create a thread of FM-->EM fellowship vs EM here... I am an IM PGY2 doing my EM rotation now... I have come across a lot of threads here where EM docs are arguing against EM fellowship coming from FM. Of course, going straight to EM should be the gold standard, but I really don't understand the argument that an EM fellowship will not prepare an FM doc to practice safely in the ED... That is just B$!

LOL not this garbage again.

 

[Kach]

This may be a silly question, but will you be doing just EM from now on or do you plan to also work in an outpatient setting?

Not a silly question. I work 75% in the ed and 25% as a hospitalist. No outpatient work.

 

[MedicineZ0Z]

Not trying to create a thread of FM-->EM fellowship vs EM here... I am an IM PGY2 doing my EM rotation now... I have come across a lot of threads here where EM docs are arguing against EM fellowship coming from FM. Of course, going straight to EM should be the gold standard, but I really don't understand the argument that an EM fellowship will not prepare an FM doc to practice safely in the ED... That is just B$!

Some of their content/conferences are led by Canadian FM docs who have a 1 year fellowship. That's the irony of it. Its strictly job market protectionism which is totally fair - but you'd figure they'd focus that anti-fm energy on midlevels who are the true job market threat.

 

[Lexdiamondz]

Some of their content/conferences are led by Canadian FM docs who have a 1 year fellowship. That's the irony of it. Its strictly job market protectionism which is totally fair - but you'd figure they'd focus that anti-fm energy on midlevels who are the true job market threat.

That would make sense...except for the fact that we don't qualify for the same jobs.


I don't compete with FM trained physicians for jobs anywhere in the US, and FM training in EM (Including CCFP fellowship training) isn't recognised globally. There isn't a market anywhere where an FM trained doc is competing with a BCEM doc for EM jobs - you guys are going into rural areas >1h away from midsized cities to get work.

 

[KeikoTanaka]

I have a lot of questions:
How do you balance your time between Hospitalist and EM duties? Do you do them in the same hospital? Are you technically "full-time" at one hospital system, or are you like per diem/part time for both jobs? Do you regret not doing an IM/EM residency? Did you not know you wanted to do EM before residency? What does 200/hr equate to salary wise for you as a FM physician working the ED? What is the normal hourly rate for EM physicians? I probably have more I can think of but I'll just ask these for now.

 

[Splenda88]

Some of their content/conferences are led by Canadian FM docs who have a 1 year fellowship. That's the irony of it. Its strictly job market protectionism which is totally fair - but you'd figure they'd focus that anti-fm energy on midlevels who are the true job market threat.

Yeah... There is nothing inherent about ED than an FM doc can't learn with one-year fellowship.

These guys order all kind of stupid test for nothing anyway. The ED is a waste of $$$.

 

[Kach]

Some of their content/conferences are led by Canadian FM docs who have a 1 year fellowship. That's the irony of it. Its strictly job market protectionism which is totally fair - but you'd figure they'd focus that anti-fm energy on midlevels who are the true job market threat.

Great points my friend. And I agree. The motives of many medical societies include financial and political considerations. That said, I wanted to use this post to inform my family medicine colleagues about a real Ed Fellowship experience as opposed to misinformation and hearsay. Anyway, thanks for your post!

 

[Lexdiamondz]

Great points my friend. And I agree. The motives of many medical societies include financial and political considerations. That said, I wanted to use this post to inform my family medicine colleagues about a real Ed Fellowship experience as opposed to misinformation and hearsay. Anyway, thanks for your post!

You do realise you're using the same logical fallacy that midlevels use to come after your jobs, no?

 

[KeikoTanaka]

You do realise you're using the same logical fallacy that midlevels use to come after your jobs, no?

Absolutely 100% disagree. The Midlevels did not go through 4 years of medical school AND 4 years of post-graduate training. The FM physician did a 3 year FM Residency followed by a year long EM fellowship. The PA Did 4 years of undergrad and 2 years of PA school, or a 5 year combined UG-PA route.

5-6 years vs 12 years. The FM doctor with an EM fellowship is 100x more capable of critical thinking and correctly diagnosing things in the ED (Assuming both the midlevel and FM doc have had the same length of ED experience)

 

[Lexdiamondz]

Absolutely 100% disagree. The Midlevels did not go through 4 years of medical school AND 4 years of post-graduate training. The FM physician did a 3 year FM Residency followed by a year long EM fellowship. The PA Did 4 years of undergrad and 2 years of PA school, or a 5 year combined UG-PA route.

5-6 years vs 12 years. The FM doctor with an EM fellowship is 100x more capable of critical thinking and correctly diagnosing things in the ED (Assuming both the midlevel and FM doc have had the same length of ED experience)

This argument has been rehashed 1000000000x. Yes, they did 4 years of postgraduate training. That being said, most of that postgraduate training is in a completely different field.

Board certification in EM requires at least 24 months of dedicated EM time in an emergency department with sufficiently high acuity to allow consistent exposure to management of trauma resuscitation and acute medical resuscitation of otherwise undifferentiated patients, in addition to 4 months of dedicated Critical care time and one month of dedicated Trauma time. A 12 month fellowship in an ED that "maybe" meets that criteria is literally half the time required - and that doesn't even address the deficiencies in exposure to critical care.

You want to do an EM doc's job with half the training. An NP wants to do your job with half the training. What is the difference?

The value of residency goes beyond simple exposure to patients and procedures. There is an inherent value in having accredited individuals track and direct your longitudinal growth and ensure that you are hitting milestones appropriately. We acknowledge that value in every other specialty but for some reason when it comes to EM everyone seems to live at the peak of the Dunning-Kruger curve (aka the peak of mount stupid) and assume that it's easy after minimal exposure.

Emergency Medicine in the US was founded nearly 40 years ago by people not trained in Emergency Medicine. Nearly all of them would agree that in 2019 there is no such thing as a non-inferior substitute to an EM residency.

 

[KeikoTanaka]

This argument has been rehashed 1000000000x. Yes, they did 4 years of postgraduate training. That being said, most of that postgraduate training is in a completely different field.

Board certification in EM requires at least 24 months of dedicated EM time in an emergency department with sufficiently high acuity to allow consistent exposure to management of trauma resuscitation and acute medical resuscitation of otherwise undifferentiated patients, in addition to 4 months of dedicated Critical care time and one month of dedicated Trauma time. A 12 month fellowship in an ED that "maybe" meets that criteria is literally half the time required - and that doesn't even address the deficiencies in exposure to critical care.

You want to do an EM doc's job with half the training. An NP wants to do your job with half the training. What is the difference?

The value of residency goes beyond simple exposure to patients and procedures. There is an inherent value in having accredited individuals track and direct your longitudinal growth and ensure that you are hitting milestones appropriately. We acknowledge that value in every other specialty but for some reason when it comes to EM everyone seems to live at the peak of the Dunning-Kruger curve (aka the peak of mount stupid) and assume that it's easy after minimal exposure.

Emergency Medicine in the US was founded nearly 40 years ago by people not trained in Emergency Medicine. Nearly all of them would agree that in 2019 there is no such thing as a non-inferior substitute to an EM residency.

3 years of training in a completely different field, but, still in a field with a ton of overlap. It's not like an Ophthalmologist deciding to go into EM, it's someone who sees a lot of the same pathology, just on the flip side of the coin. Plus many EDs are filled with FM doctors who DIDNT go through an EM Fellowship. I'd argue someone who went through an EM Fellowship has shown sustained interest in the field and perhaps did extra electives in the ED, did a lot of reading outside of their required learning, and went above and beyond to gain skills. Obviously it is a person-by-person basis, and of course EM fellowship doesn't equate to an EM physician, but it's also not appropriate to say NP and FM physician both trained for EM in "half the time". You're making the gross assumption that every single thing learned in the FM residency was 100% a waste and could never have any overlap with emergency medicine, which just isn't true, especially given the horrible misuse of the ED for so many primary care complaints (Which could be treated better by a FM doc than a midlevel - Even thinking from a public health lens - A midlevel might just throw a certain antibiotic their way, worsening the antibiotic resistance threat while someone who has more pharmaceutical knowledge could provide a better alternative). I'm sure even if you're not learning the 100% procedural knowledge of what to do in an emergent case for X pathology in a FM residency, you still are learning the theoretical approach to what you would do - then you do the fellowship to iron out those details. The NP didn't have any of that. Just a theory class on how to make patients feel better, then they learn on the job.

Someone with a PhD in Zoology can pick up human anatomy much faster/better than a young person who is just taking their Personal Training class for the first time. The whole point of our medical degree is technically to give you unrestricted access to practice medicine - so as much as EM physicians and hospitals may not like FM doctors in the ED, I do think it is better/safer than a mid level in the ED, like I said, assuming they both had the same experience in the ED. I'd obviously want a PA with 15 years of experience overlooking my care than a FM doc who did their 3 year residency and is now just willy nilly walking into the ED. But if they both trained for 15 years in the ED, I'd say the FM has a higher ceiling of knowledge and skill at the end of the day.

 

[MedicineZ0Z]

Just stop.


Look, I intubate and sedate and place central lines and A lines nearly every shift. I've tubed difficult airways in hemodynamically unstable patients. Should I be allowed to walk into the OR and just be an anaesthesiologist?

I read literally hundreds of CXRs and extremity films, Head CTs and other imaging. Would it be advisable to take a job as a radiology attending?

I interpret literally hundreds of EKGs a week and manage dozens of cardiac complaints ranging from stable angina to STEMI to acute decompensated CHF with cardiogenic shock. I've pushed lytics in the middle of the night, I've done pericardiocentesis, cardioversions for refractory AFib and managed VT storm in patients with HOCM. Should I be a cardiologist?



Of course FM and EM have significant overlap. We're both generalists - by definition we have significant overlap with literally every field in medicine. That isn't enough to do someone else's job to anything greater than a mediocre level. Let's cut the bull**** here.

I think you didn't read what I said. Why do you have no problem with family docs+ a fellowship being leaders in your field? A lot of the academia in Canada which also head this way is led by younger family docs. And midlevels have a tiny fraction of the training, like <5-10%. Not half. You're fabricating things.

I fully agree with defending your job market, because that's 100.0% what this is about. Just saying that you're ignoring 98% of the problem (midlevels) and focusing on the 2% which are family docs.

 

[KeikoTanaka]

Just stop.


Look, I intubate and sedate and place central lines and A lines nearly every shift. I've tubed difficult airways in hemodynamically unstable patients. Should I be allowed to walk into the OR and just be an anaesthesiologist?

I read literally hundreds of CXRs and extremity films, Head CTs and other imaging. Would it be advisable to take a job as a radiology attending?

I interpret literally hundreds of EKGs a week and manage dozens of cardiac complaints ranging from stable angina to STEMI to acute decompensated CHF with cardiogenic shock. I've pushed lytics in the middle of the night, I've done pericardiocentesis, cardioversions for refractory AFib and managed VT storm in patients with HOCM. Should I be a cardiologist?



Of course FM and EM have significant overlap. We're both generalists - by definition we have significant overlap with literally every field in medicine. That isn't enough to do someone else's job to anything greater than a mediocre level. Let's cut the bull**** here.

View attachment 275806

Nobody said you should walk in and be a Cardiologist or an Anesthesiologist. But, if you did a 1 year Anesthesia fellowship, I'd trust you in an emergent scenario in the event an Anesthesiologist was not readily available (Like in the majority of this country where there are more cows than people)

 

[Splenda88]

Nobody said you should walk in and be a Cardiologist or an Anesthesiologist. But, if you did a 1 year Anesthesia fellowship, I'd trust you in an emergent scenario in the event an Anesthesiologist was not readily available (Like in the majority of this country where there are more cows than people)

Hence some fellowships (eg critical care) accept applicants from different specialties.

 

[Kach]

Hey all, this is an fm board and my intention was and is to disseminate my fellowship experience to other fms and or pcps because a lot of us have considered the fellowship. Also i wanted to stop some of the disinformation and hearsay. To anyone interested please message me.

Also, I hoped not to argue the validity of non residency trained providers practicing in the ed as clearly thousands of us (fm with and wo fellowship training, nps/pas , cardiologists, oncologists, surgeons etc) are already working in the ed and nothing said on these anonymous boards will change that.

Again all due respect to all my residency trained colleagues in all fields including both pcps and specialists.

If any one has any questions about the fellowship let me know

 

[Sardonix]

Dammit just ONCE I'd like there to be a normal, civil EM-FM conversation on this board without 1-2 people just blowing it up.

 

[DO2015CA]

Dammit just ONCE I'd like there to be a normal, civil EM-FM conversation on this board without 1-2 people just blowing it up.

But why would anyone click on that thread then?

 

[deleted87716]

Dammit just ONCE I'd like there to be a normal, civil EM-FM conversation on this board without 1-2 people just blowing it up.

Always the same people, too.

 

[deleted87716]

But why would anyone click on that thread then?

Some of us read everything here. And some people might want to read an FM-EM thread that didn't turn into a ****show.

 

[KeikoTanaka]

Hey all, this is an fm board and my intention was and is to disseminate my fellowship experience to other fms and or pcps because a lot of us have considered the fellowship. Also i wanted to stop some of the disinformation and hearsay. To anyone interested please message me.

Also, I hoped not to argue the validity of non residency trained providers practicing in the ed as clearly thousands of us (fm with and wo fellowship training, nps/pas , cardiologists, oncologists, surgeons etc) are already working in the ed and nothing said on these anonymous boards will change that.

Again all due respect to all my residency trained colleagues in all fields including both pcps and specialists.

If any one has any questions about the fellowship let me know

I'll bite. Where did you do your fellowship (You can be general about just which region of the country youre in)? What did you like about it, what didn't you like? What would you wish you had more training in? What did you feel really confident about going into from your FM residency background. How soon after your residency did you go back to do the fellowship? Do you plan on working outpatient ever as a PCP with EM shifts scattered throughout?

 

[Kach]

I'll bite. Where did you do your fellowship (You can be general about just which region of the country youre in)?

It was a large trauma Hospital in the south.


What did you like about it, what didn't you like?

I loved learning more skills. I hated not being completely independent. To some extent it still felt like being a resident.


What would you wish you had more training in?

I wish I did a few more thoracostomys. I also wish I did a few more lines. That said, I got a lot more experience with those things in Fellowship than in residency.


What did you feel really confident about going into from your FM residency background.

There's lots of primary care and the ER. It was really funny being asked by multiple attendings what anti glycemic or antihypertensive I should discharge the patient on. Also, I was not intimidated by Peds. There was an internal medicine fellow in my cohort who was uncomfortable with Peds at least at the beginning.


How soon after your residency did you go back to do the fellowship? 2yrs


Do you plan on working outpatient ever as a PCP with EM shifts scattered throughout?

No more outpatient for me! But to me, the Ed seems like a super Clinic. The difference is that instead of waiting two weeks I can get my CBC or ultrasound in 2 hours. I practice 75% ER and 25% hospitalist.

 

[KeikoTanaka]

I'll bite. Where did you do your fellowship (You can be general about just which region of the country youre in)?

It was a large trauma Hospital in the south.


What did you like about it, what didn't you like?

I loved learning more skills. I hated not being completely independent. To some extent it still felt like being a resident.


What would you wish you had more training in?

I wish I did a few more thoracostomys. I also wish I did a few more lines. That said, I got a lot more experience with those things in Fellowship than in residency.


What did you feel really confident about going into from your FM residency background.

There's lots of primary care and the ER. It was really funny being asked by multiple attendings what anti glycemic or antihypertensive I should discharge the patient on. Also, I was not intimidated by Peds. There was an internal medicine fellow in my cohort who was uncomfortable with Peds at least at the beginning.


How soon after your residency did you go back to do the fellowship? 2yrs


Do you plan on working outpatient ever as a PCP with EM shifts scattered throughout?

No more outpatient for me! But to me, the Ed seems like a super Clinic. The difference is that instead of waiting two weeks I can get my CBC or ultrasound in 2 hours. I practice 75% ER and 25% hospitalist.

Thank you for your insight. There aren't too many EM/IM residencies throughout the country, so I can imagine displacing your whole life just to pursue that can be difficult. I also imagine with there not being too many they are really competitive. Is this a route you wanted to do? Or did you not really know you wanted to do EM before doing your FM residency?

 

[Kach]

Thank you for your insight. There aren't too many EM/IM residencies throughout the country, so I can imagine displacing your whole life just to pursue that can be difficult. I also imagine with there not being too many they are really competitive. Is this a route you wanted to do? Or did you not really know you wanted to do EM before doing your FM residency?

Well, med school and residency already displaced me so it wasnt a life changing deal.
FM fellowships are not as competitive as , say, cardiology or pulmcrit. There's no tedious acgme stuff or online apps. It was a free paper application and a phone call with the director. A lot of FM fellowships are much less tedious to apply and get into.
I didn't know much about EM in med school. my electives were in nephrology, anethesia and Oral surgery, (not ENT), lol. I discovered EM as a resident.

 

[GonnaBeADoc2222]

Train for the job you want. The right way. Sure you can get certified and credentialed and what have you. But your training is inferior and you are putting patients at risk.

 

[Kach]

Train for the job you want. The right way. Sure you can get certified and credentialed and what have you. But your training is inferior and you are putting patients at risk.

Sure.

 

[VA Hopeful Dr]

Train for the job you want. The right way. Sure you can get certified and credentialed and what have you. But your training is inferior and you are putting patients at risk.

Not helpful.

Would you rather someone like the OP or someone like me (just plain ole FP) working in the ED?

If we had enough board-certified EPs to cover every ED in the country, this wouldn't be an issue. We don't. This seems a decent 2nd best option.

 

[KeikoTanaka]

If the fellowship was longer than a year, would EM Physicians be as skeptical about it? Would making it two years be better for linear-growth and monitoring?

 

[Sardonix]

If the fellowship was longer than a year, would EM Physicians be as skeptical about it? Would making it two years be better for linear-growth and monitoring?

It's still a political-financial decision, turf wise. It's still not going through the same ridiculous hoops EM residents currently have to so therefore there will be plenty of people skeptical/doubting it as not a true EM experience.

You're never gonna make everyone happy so the FM --> EM fellowship may as well just be whatever the hell is worth it to those doing it.

 

[MedicineZ0Z]

Train for the job you want. The right way. Sure you can get certified and credentialed and what have you. But your training is inferior and you are putting patients at risk.

So I assume you're at the front-line fighting midlevels in their push for autonomy?

 

[betamale]

Congrats yo! Time to make ca$h. But don't burn out.

 

[Kach]

Congrats yo! Time to make ca$h. But don't burn out.

Man, I'm telling you! Ill try not too!

 

[MidwestPAC]

Absolutely 100% disagree. The Midlevels did not go through 4 years of medical school AND 4 years of post-graduate training. The FM physician did a 3 year FM Residency followed by a year long EM fellowship. The PA Did 4 years of undergrad and 2 years of PA school, or a 5 year combined UG-PA route.

5-6 years vs 12 years. The FM doctor with an EM fellowship is 100x more capable of critical thinking and correctly diagnosing things in the ED (Assuming both the midlevel and FM doc have had the same length of ED experience)

Not that it truly matters but PAs do 100 weeks of graduate school and physicians do around 145-155 weeks so right at a year difference. You guys have summers off and other breaks. PA school we had 4 weeks off in 2 years. So 7 years for PAs and 11 years for MD or DO. Just making a point that your info is a little wrong. Now your training and 80 hours in residency do add up and your education is far superior to mine. I understand my role and know you guys are the captain of the ship. Does not bother me one bit. I just hate when people state that physicians go to school for 4 years and PAs only 2 years which is not true.

 

[MedicineZ0Z]

Not that is truly matters but PAs do 100 weeks of graduate school and physicians do around 145-155 weeks so right at a year difference. You guys have summers off and other breaks. PA school we had 4 weeks off in 2 years. So 7 years for PAs and 11 years for MD or DO. Just making a point that your info is a little wrong. Now your training and 80 hours in residency do add up and your education is far superior to mine. I understand my role and know you guys are the captain of the ship. Does not bother me one bit. I just hate when people state that physicians go to school for 4 years and PAs only 2 years which is not true.

I had 8 weeks off for the 1st year summer, 4 weeks for 2nd and like 7 weeks total all of 3rd and 4th year.
You didn't take real boards. I did. Several of them actually. You didn't do 2 years of (hands on) rotations including 20 weeks of inpatient, month of ICU, 2 months in the ED etc. I did.

So no, even on day 1 of residency - a resident is drastically ahead of the PA. Don't fudge the numbers.

 

[Kach]

I have a lot of questions:
How do you balance your time between Hospitalist and EM duties? Do you do them in the same hospital? Are you technically "full-time" at one hospital system, or are you like per diem/part time for both jobs? Do you regret not doing an IM/EM residency? Did you not know you wanted to do EM before residency? What does 200/hr equate to salary wise for you as a FM physician working the ED? What is the normal hourly rate for EM physicians? I probably have more I can think of but I'll just ask these for now.

Didnt see this post.
How do you balance your time between Hospitalist and EM duties?
I do EM at one hospital and hospitalist at another hospital.

Are you technically "full-time" at one hospital system, or are you like per diem/part time for both jobs?
full time for EM, per diem for hospitalist.

Do you regret not doing an IM/EM residency?No

Did you not know you wanted to do EM before residency? No

What does 200/hr equate to salary wise for you as a FM physician working the ED?
200 X 12 hour shifts X however many shift you want to work.

What is the normal hourly rate for EM physicians?
200-300/hr

 

[Kach]

Not that is truly matters but PAs do 100 weeks of graduate school and physicians do around 145-155 weeks so right at a year difference. You guys have summers off and other breaks. PA school we had 4 weeks off in 2 years. So 7 years for PAs and 11 years for MD or DO. Just making a point that your info is a little wrong. Now your training and 80 hours in residency do add up and your education is far superior to mine. I understand my role and know you guys are the captain of the ship. Does not bother me one bit. I just hate when people state that physicians go to school for 4 years and PAs only 2 years which is not true.

More power to you man. I did my first hematoma block with a PA.

 

[MidwestPAC]

I had 8 weeks off for the 1st year summer, 4 weeks for 2nd and like 7 weeks total all of 3rd and 4th year.
You didn't take real boards. I did. Several of them actually. You didn't do 2 years of (hands on) rotations including 20 weeks of inpatient, month of ICU, 2 months in the ED etc. I did.

So no, even on day 1 of residency - a resident is drastically ahead of the PA. Don't fudge the numbers.

Haha you got something to prove? I am not fudging the number. These numbers are from curriculums I looked up at various schools. The minimum requirement is 130 weeks of medical school. That's a fact, look it up. If you would calm down and read my post I state your training is far superior and that's something I am fine with. I chose PA over medical school. I had every prerequisite as any medical student plus some more. My point was correcting people when they think MDs and DOs go to 4 years of school and PAs only go to 2 years of school. Not true. I did 45 weeks of family medicine rotations (he was FM but did OB so did alot of C sections, LEEPs etc plus psych and long term care), 4 weeks ED, 5 weeks ICU, 4 weeks general surgery, 4 weeks hospitalist, 2 weeks UC, 1 week opthlmatology and a few other smaller rotations. Glad we are comparing with each other. I have nothing to prove cause I know my physician colleagues are much smarter than myself and I'm fine with that. Also you do take several boards but funny think our boards mimic step 2 CK and CS. I studied from step books. Lastly how are our board "not real boards" when they literally copy what you guys take just not as in depth and as many. Again I am not a physician so why do I need to take everything you take? Think about it...

 

[KeikoTanaka]

Haha you got something to prove? I am not fudging the number. These numbers are from curriculums I looked up at various schools. The minimum requirement is 130 weeks of medical school. That's a fact, look it up. If you would calm down and read my post I state your training is far superior and that's something I am fine with. I chose PA over medical school. I had every prerequisite as any medical student plus some more. My point was correcting people when they think MDs and DOs go to 4 years of school and PAs only go to 2 years of school. Not true. I did 45 weeks of family medicine rotations (he was FM but did OB so did alot of C sections, LEEPs etc plus psych and long term care), 4 weeks ED, 5 weeks ICU, 4 weeks general surgery, 4 weeks hospitalist, 2 weeks UC, 1 week opthlmatology and a few other smaller rotations. Glad we are comparing with each other. I have nothing to prove cause I know my physician colleagues are much smarter than myself and I'm fine with that. Also you do take several boards but funny think our boards mimic step 2 CK and CS. I studied from step books. Lastly how are our board "not real boards" when they literally copy what you guys take just not as in depth and as many. Again I am not a physician so why do I need to take everything you take? Think about it...

Just to clear the air, I didn't mean to say your schooling was only 2 years, I was just repeating what someone had said earlier. My undergrad had a 5 year combined Undergrad PA program in a mid-sized city and I ended up going to that school with 8 of my friends straight from high school and 3 of them were in that PA program. So, I know nothing about the traditional route of going through PA school, my experience has only been that 5 year school. Other than that I have tremendous respect for my PA colleagues, and a bit of jealousy. They've all been practicing ~3+ years now while I'm only in my 2nd year of med school (I had no idea I wanted to do med school while in undergrad, I wouldn't be so behind if I didn't have to go back to school for pre-reqs). I see pictures non-stop on Instagram of their world-travels and national park visits. They're all fit and driving hella nice cars. The only upside is my husband and I are in med school together, so I know in ~10 years we'll be killing it from the financial lens, but it's still hard to watch now knowing my youth can't be spent like theirs - but I'm okay with that, I'm too much of an egoist to not want to be at the top of my field. If I didn't go to med school I'd be in a PhD program somewhere, so my youth no matter the track I chose would be "wasted" on education.

 

[DO2015CA]

This thread went to ****...again

Lol yup went from EM vs. FM to MD vs. PA

This is why we can’t have nice things

 

[Splenda88]

I love my PA colleagues; can't say the same for NP

 

[Perrotfish]

If we had enough board-certified EPs to cover every ED in the country, this wouldn't be an issue. We don't. This seems a decent 2nd best option.

Its interesting to see the contrast between how the FM Emergency medicine fellowship is perceived vs the Pediatrics emergency medicine fellowship. Right or wrong Peds EM docs have convinced the majority of children's hospitals that their fellowship trained pediatricians are the best option and that someone with just an EM residency is a 2nd best option. On the other hand it seems like even FPs buy into the idea that their fellowship is a second best option behind an EM residency.