Process to become an ER/Critical Care

[walnutboi]

Hey all!

I’m starting vet school this fall, and I have a interest in specializing in small animal ER/critical care in the future. Just curious about the process to become a ER vet and what are some of the things that you’d recommend doing during vet school to accomplish that? I’ve read about doing research and so on, but not sure what I can do to make myself a competitive candidate?

Thank you in advance!!

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[TheGirlWithTheFernTattoo]

So it depends on whether you want to do emergency as a non specialist, or be a boarded criticalist.

If wanting to be a criticalist, after vet school you will need to do a 1 year rotating internship followed by a 3 year residency and then your speciality board exams. Research during school will help you with this, as well as spending time shadowing/volunteering in ERs to get experience with the ECC environment and caseload.

If wanting to be an ER doctor without being boarded, there aren’t really many requirements. You can either do a 1 year rotating internship before going into it, or you can go straight from graduation to an ER with strong mentorship. Many people recommend a rotating internship or at the very least one of the corporate mentorship programs, and I’m inclined to agree with that. I heavily considered this option, although I eventually decided to go the ECC specialist route (above). With the current staffing situation, having the type of mentorship you need to set yourself up for success as a new grad is becoming trickier. Of the two friends of mine who went straight into ER practice, I think both of them were very overwhelmed at the beginning (even though both had significant ER experience while students). If you choose this option you NEED to spend a significant amount of time in ERs before graduation. I can’t imagine walking into ER as a new grad without having a solid ER base. The practice environment, caseload, and really everything is very different than GP and it is not for everyone. I’m not as strongly against new grads going into ER without an internship as a lot of people are, but I definitely understand their view and the reasons behind it.

My background for this is that I am a critical care resident who previously spent significant time in ER private practice (and was debating taking that job out of school directly). Ultimately I did an internship because I hadn’t ruled out specializing, and decided fairly early on in my internship that residency was the way I was going to go. Feel free to message me if you want to chat further or have additional questions.

 

[battie]

I'm one of those folks who went into practice straight out of school. I graduated in 2021, went to a GP/ER hybrid practice. Realized I love ER after starting ER shifts 4 months into practice. I have now been in a 100% ER position for just under a year now.

I agree, the mentorship is key. The ER mentors I had at my job were good, but the practice itself was not well managed. The current place I'm at is much better managed as they aren't juggling the ER vs GP aspect, and the mentoring is spot on. I am very comfortable two years out managing the average ER case load and case variety.

 

[walnutboi]

Thank you all for the replies! That was very helpful to know the differences between the two paths to go into ER! I PMed TheGirlWithTheFernTattoo regarding this, but I thought I’d ask about this too here: what do you think would be the advantage on becoming board-certified? It’s going to be an additional 4 years before you can actually going to “officially work”, but so I’m trying to weigh the advantages and disadvantages. Would it make someone more competitive in the job market/career-wise, or would the salary also be more competitive if you’re board-certified versus not? Thank you all again!!

 

[Trilt]

Honestly the jobs really vary depending on where you work, but in general board certified criticalists will do more of inpatient care vs. initial intake and tend to have slightly more "normal" schedules. They're also generally the people doing the more advanced care like ventilation, dialysis, etc and tend to work at big multi-specialty hospitals vs. smaller ERs.

But there are definitely people who straddle the line in both directions.

It's worth hanging out with criticalists vs. ER vets at both your school and a local specialty practice or two to get a better idea of how things work and talk about their experiences. If you haven't worked ER, it's also just worth just getting some of that experience in general before going too far down the rabbit hole - it's really not for everyone, though lots of fun imo.

(yet another path option: I worked GP for four years post-grad, then swapped to ER mid-COVID).