Working in the Emergency Department as a FP

[FrankNecrosis]

I've browsed a few threads on this topic, mostly in the Emergency Medicine Forum. I wanted to get a fresh perspective on this forum about the future of working in the ER with Family Practice Training.

I am just finishing my ER rotation and I LOVE IT! I had finally decided earlier this spring that I wanted to go into Family Practice. However, since starting my ER rotation I am questioning this decision. My main reason for writing of ER as a residency choice is because my fear of having to make quick life or death decisions, and dealing with the chaos and critical traumas, etc. I still am a little scared of having to do that, but as I gain more and more experience on this rotation I am gaining more and more confidence in things I was scared of before.

Regardless, I think it would probably be to late for me to pursue Emergency Medicine Residency. I am a third year DO, soon to be fourth year and applying for residency. I have not set up any audition rotation (nor do I think I could get any at this point) and I am a pretty average student all around.

My question is, as a Family Practice Doc, would I be able to work ER shifts 4-5 years down the road? I've heard that Hospitals are making it more and more difficult for Family Docs to practice in the ED's, and that this trend is likely to continue The hospital I am working in is in a smaller midwest community (not rural) and they have a lot of Family Docs working there (they typically aren't allowed to work alone during overnight shifts).

What does everyone think off the trend of FP's working in the ER? Will it become more and more difficult in the future? I would think FP's fit a very needed role in the ED considering the many shortages in coverage. Also, since PA's/ NP's are increasingly working in the ED, I would think Family Docs are certainly as qualified/ if not more qualified as midlevels.

Thanks for your thoughts everyone.

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[Octagonecology]

I've browsed a few threads on this topic, mostly in the Emergency Medicine Forum. I wanted to get a fresh perspective on this forum about the future of working in the ER with Family Practice Training.

I am just finishing my ER rotation and I LOVE IT! I had finally decided earlier this spring that I wanted to go into Family Practice. However, since starting my ER rotation I am questioning this decision. My main reason for writing of ER as a residency choice is because my fear of having to make quick life or death decisions, and dealing with the chaos and critical traumas, etc. I still am a little scared of having to do that, but as I gain more and more experience on this rotation I am gaining more and more confidence in things I was scared of before.

Regardless, I think it would probably be to late for me to pursue Emergency Medicine Residency. I am a third year DO, soon to be fourth year and applying for residency. I have not set up any audition rotation (nor do I think I could get any at this point) and I am a pretty average student all around.

My question is, as a Family Practice Doc, would I be able to work ER shifts 4-5 years down the road? I've heard that Hospitals are making it more and more difficult for Family Docs to practice in the ED's, and that this trend is likely to continue The hospital I am working in is in a smaller midwest community (not rural) and they have a lot of Family Docs working there (they typically aren't allowed to work alone during overnight shifts).

What does everyone think off the trend of FP's working in the ER? Will it become more and more difficult in the future? I would think FP's fit a very needed role in the ED considering the many shortages in coverage. Also, since PA's/ NP's are increasingly working in the ED, I would think Family Docs are certainly as qualified/ if not more qualified as midlevels.

Thanks for your thoughts everyone.

They are only going to answer by saying this question has been posed dozens of times in these forums and to search for it.

Anyone in EM is very territorial about the ED and will tell you that any FM or IM is not qualified whatsoever to work in the ED. I work at a huge tertiary hospital as a critical care medic and can tell you from experience that the FP trained ER docs are some of the absolute best most highly thought of by the ED staff.

 

[EdibleEgg]

If you really want to be an ER doc do an ER residency. Your options will be limited as an FP. However, you can practice in the ER in a variety of settings as an FP and those jobs are not going away.

 

[drsarah82]

I think that you'll be surprised to still be able to find spots to do interview rotations in EM, especially at DO programs (try Peds EM or trauma surg if you cant to straight EM) and worth the calls to see. If you are still on the fence at this point I think that you should schedule as many FM and EM rotations early in your 4th year as you can to help you make your decision. After you have completed more rotations, its easier to get a better understanding of what will be right for you, and much easier to switch now than to wait until after the match.
Good luck!

 

[thethom]

My main reason for writing of ER as a residency choice is because my fear of having to make quick life or death decisions, and dealing with the chaos and critical traumas, etc.

Keep in mind that in any specialty, you will have to make quick life/death decisions, especially in the ICU and during codes. Also big trauma will go straight to the surgical residents through the trauma alert page, not emergency medicine.

Though it seems you really like both EM and FM, the only thing I can tell you is that as FM you can do primary care office, hospitalist, and ED work, but as EM you are limited to ED work...

The cool thing is that you can do sports medicine with both!

 

[Octagonecology]

Keep in mind that in any specialty, you will have to make quick life/death decisions, especially in the ICU and during codes. Also big trauma will go straight to the surgical residents through the trauma alert page, not emergency medicine.

Though it seems you really like both EM and FM, the only thing I can tell you is that as FM you can do primary care office, hospitalist, and ED work, but as EM you are limited to ED work...

The cool thing is that you can do sports medicine with both!

Thethom....would the same hold true for IM?

 

[thethom]

IM tends to be more limited in the ED (and finding ED positions) due to lack of exposure to pediatrics during training. FM and EM train extensively in adult and peds medicine.

 

[dr_almondjoy_do]

"My main reason for writing of ER as a residency choice is because my fear of having to make quick life or death decisions, and dealing with the chaos and critical traumas, etc. I still am a little scared of having to do that, but as I gain more and more experience on this rotation I am gaining more and more confidence in things I was scared of before."


This is something you will see in any primary care specialty. You have to get over that notion. And you will once you get out there.

As far as the ED, there are too many ERs out there to staff board certified ER docs. In NY, the board certified docs run the ER (Directors, Assistant Directors, mostly in the offices and sending out memos and having long meetings) And the IM and FP doctors are in the ER working shifts. I know this is not the same in many places, but right now this is the reality.

Also not to mention the outpatient Urgent Care centers that are hiring us to work. ER doctors work there too. And they love it, low drama, same pay, non urgent cases... more like an outpatient fast track. Too many Urgent Care centers to staff them too.

And yes, PAs, and NPs work there too and they don't have the clinical training, DEA priviledges, and responsibility we do, so we love to work with them and there are not enough of them to drive us out.

So many options for Family Medicine.

 

[Octagonecology]

"My main reason for writing of ER as a residency choice is because my fear of having to make quick life or death decisions, and dealing with the chaos and critical traumas, etc. I still am a little scared of having to do that, but as I gain more and more experience on this rotation I am gaining more and more confidence in things I was scared of before."


This is something you will see in any primary care specialty. You have to get over that notion. And you will once you get out there.

As far as the ED, there are too many ERs out there to staff board certified ER docs. In NY, the board certified docs run the ER (Directors, Assistant Directors, mostly in the offices and sending out memos and having long meetings) And the IM and FP doctors are in the ER working shifts. I know this is not the same in many places, but right now this is the reality.

Also not to mention the outpatient Urgent Care centers that are hiring us to work. ER doctors work there too. And they love it, low drama, same pay, non urgent cases... more like an outpatient fast track. Too many Urgent Care centers to staff them too.

And yes, PAs, and NPs work there too and they don't have the clinical training, DEA priviledges, and responsibility we do, so we love to work with them and there are not enough of them to drive us out.

So many options for Family Medicine.

DocJoy you know your thing still says medstudent under your name, right? Not sure if you care but you could change it to attending and get the "we're not worthy" bow from us a'la Waynes World.

 

[Station51]

Also big trauma will go straight to the surgical residents through the trauma alert page, not emergency medicine.

True only in some places. For example, the city I'm training in has four high-volume trauma centers and EM is involved in every major trauma either running the trauma codes and/or doing the procedures in the ED, including all the intubations.

Though it seems you really like both EM and FM, the only thing I can tell you is that as FM you can do primary care office, hospitalist, and ED work, but as EM you are limited to ED work...

The cool thing is that you can do sports medicine with both!

FM is certainly very flexible but there are also options for EM grads outside of the ED including sports medicine as you've mentioned. There's also toxicology, critical care, urgent care, cruise ship, hyperbarics, EMS, and that's about all I can think of right now.

 

[dr_almondjoy_do]

Octagonecology, I'm a medical student for life, as are all of us. Don't let the time spent and the multiple (and I do mean multiple) graduation ceremonies and papers on the wall fool you!

 

[Octagonecology]

Octagonecology, I'm a medical student for life, as are all of us. Don't let the time spent and the multiple (and I do mean multiple) graduation ceremonies and papers on the wall fool you!

Excellent. Wish there were more with that sort of attitude....

 

[DrJosephKim]

There are still many opportunities in small towns, rural areas, and other non-metropolitan areas for family physicians to work in the ER. Many family physicians also "moonlight" in ERs, so keep that in mind as another option.