working in an ER as an IM

[bhs_runner]

Can you work in an ER if you are an IM doctor? I know that FP docs work in smaller ERs but can IM docs do this also.

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[Adcadet]

Have you been to Seattle? The Harborview ED is run by IM. So, yes, it can be done. I'm sure the EM folks have some good arguments why the best route to doing ED work is through EM.

 

[Apollyon]

Can you work in an ER if you are an IM doctor? I know that FP docs work in smaller ERs but can IM docs do this also.

You can try, but it is unlikely that an ED will hire a straight IM-trained doctor. When was the last time you intubated someone? How much trauma experience do you have? I mean, it can be done, but is falling away. The FM folks find their way in still because EM is very broad, as is FM training - however, there are a few things that FM still doesn't do (like trauma). It's a closer fit, but still not EM.

Now, would you want an EM doc treating the IM clinic patients? I sure wouldn't (having done an IM year - even if it was prelim). FM docs could treat those patients, but, still, it's not the perfect fit. You want the right person for the right job.

The Harborview example is unique, in that there are no other civilian EM residency programs that have non-EM boarded faculty running them (ABEM - the American Board of Emergency Medicine - states that you can have non-EM trained people on faculty, but the core has to be EM-trained and BC/BE - or, as the parlance now goes, "BC/BP") - that is why the UW civilian program is no longer, and it's military only now.

The Harborview ED runs like the stereotype people have of the ED - doing not much, and consulting out the butt. The more the doc in the ED does, the less he calls someone else, and the smoother things go.

 

[Eidolon6]

Some community ERs will use IM trained folks in the ER. VA hospitals routinely employ non-EM trained physicians for their "ERs". Little major trauma to be had at many of these places, where training in ATLS and a trauma referral route would suffice. Triaging patients is a skill shared by IM, FP and EM although they all have their nuances.

As with other areas of medicine...EM is underserved (which still makes me wonder why some of them are so hot about wanting critical care certification...but I digress) and rural areas, as usual, are underserved.

Many of these are "moonlighting" opportunities.

Historically, many if not most grandfathered ER physicians had IM backgrounds.

All this being said, you will not likely be employed at a tertiary referral center or larger hospital as an "ED" physician unless you have the EM training background or were fortunate enough to grandfather in back in the 80s. If you have a bug to do ED work, then your best bet is to do EM or a IM/EM combined residency.

 

[PhillyGuy]

Time has changed. You can no longer be certified in EM if you've only completed an IM residency. I think you have to do an EM fellowship after the residency if you want to the board eligible, which is a requirement for a job at a lot of places.

 

[kungfufishing]

there is not an EM fellowship after IM residency that I am aware of. If you want to work in EM, train in it. Who would you rather your doctor was - one formally trained in the specialty or one working outside of his/her area of expertise?

 

[Trepp]

there is not an EM fellowship after IM residency that I am aware of. If you want to work in EM, train in it. Who would you rather your doctor was - one formally trained in the specialty or one working outside of his/her area of expertise?

IM docs are like supermen/women. We can do ANYTHING!