So You Want to Be an EMERGENCY MEDICINE DOCTOR [Ep. 9]

so you want to be an emergency medicine doctor you like the idea of high pressure adrenaline and saving people's lives let's debunk the public perception myths of what it means to be an emergency medicine doctor and give it to you straight this is the reality of emergency medicine dr jabal med schoolinsiders.com welcome to our next installment in so you want to be in this series we highlight a specific specialty within medicine such as emergency and help you decide if it is a good fit for you you can find the other specialties on our so you want to be playlist a lot of you asked for emergency medicine in our poll so that's what we are covering here if you want to vote in upcoming polls to decide what future specialties we cover make sure you are subscribed if you'd like to see what being an em doctor looks like check out my second channel kevin dubal md where i do a second series in parallel called a day in the life once the world is back to a more normal baseline we'll be doing a day in the life of an emergency medicine doctor emergency medicine is the specialty concerned with treating patients who are acutely ill with urgent health care needs this can be treating acute conditions like a myocardial infarction or heart attack or treating exacerbations of chronic health conditions stabilizing patients involved in trauma and more because em doctors treat acute conditions from every field of medicine they have to know a little bit about everything but don't dive deep in any one specific domain think of them as the jack of all trades master of none if you're having a heart attack and don't have a cardiologist nearby then seeing an em doc is the next best thing as my emergency medicine colleague says if you ever have a medical problem we are the second best doctor generally speaking the job of the em doctor is to stabilize the patient and then refer them to the specialist in the appropriate field for example if a patient comes in with multiple fractures after a motorcycle crash they'll stabilize the patient's airway breathing and hemodynamics meaning their blood pressure and circulation after that they'll call the orthopedic surgeons to assess the extremity fractures and the plastic surgeons to address the facial trauma by the way that's an actual case from when i was in plastic surgery residency the practice of emergency medicine is largely a function of location what type of hospital do you work at at an academic center you'll be at the cutting edge of research equipped with the latest and greatest in medical technology therapies and resources in terms of salary you won't get paid as well as a community or private practice doctor but you'll have better benefits and job security you'll have protected time to pursue research and you'll enjoy paying it forward by mentoring and teaching medical students and residents if you're at a level 1 trauma center you may expect to see more complex cases compared to other settings as a community emergency medicine doctor expect to do everything at a larger community hospital there will be more specialists for support but at smaller community hospitals in more rural settings there's less support and a larger scope of practice you'll be treating more on your own but you'll also be transferring more complicated patients to other facilities that are better equipped lastly urgent care is unique in that you're working at a standalone facility generally without a hospital or other specialties for backup you'll be handling lower acuity cases with the option to transfer patients to the emergency department for sicker patients this is a less stressful environment and is considered a good option for doctors wanting to ease a bit towards the end of their careers for many non-surgical specialties you first do three years of internal medicine residency and then sub-specialize into gastroenterology or cardiology or infectious disease or another specialty through fellowship emergency medicine is different as it has its own residency training emergency medicine residencies are either three or four years in duration some experts in the field say that four-year training programs are optimal as it provides better preparation an opportunity to further develop personal maturity improve in patient interactions and have greater self-confidence additionally it provides more time to explore and pursue areas of interest such as those related to research on the other hand three-year programs have distinct advantages such as spending one less year in trading and earning an attending salary one year sooner plus most graduates say they are satisfied with their training and don't feel they are lacking in preparation on average more academic institutions with research incorporated into the training will have four-year programs whereas more community focused institutions without a research focus will have three-year programs given the highly diverse and varied nature of emergency medicine it makes sense for the residency curriculum to also be highly diverse and varied most of your time will be spent on emergency medicine rotations but there's also rotations on trauma orthopedics ultrasound critical care anesthesia pediatric icu obstetrics and more emergency medicine paved the way in residency admissions with the standardized letter of evaluation or slow applying to residency is similar to applying to medical school in that you fill out your primary application with your personal statement but also submit letters of recommendation the slow is a way to standardize the letter of recommendation rather than a gushing letter saying how great you are the letter writer must answer a standardized set of questions such as the nature of how they know the student the student's commitment to medicine how they compare to their peers and more this makes it much easier to quantify standardize and compare letters of recommendation this will likely become more commonplace amongst other specialties as step 1 transitions to pass fail the residency interview process is more laid back than most other specialties which is reflective of the specialty being less formal than most rather than grilling you on standardized questions em interviews are more about the beer test meaning having a casual conversation and deciding whether this is someone you'd enjoy having a couple beers with after a shift the stereotypical em applicant is the student who loved everything in medical school who couldn't sit still and always needed to be active and doing something they're the ones that want to know a little bit about a lot of things rather than a lot about a few things some would even say 80d easily distracted and always on the go these are often the athletic outdoorsy and adventurous types who enjoy camping running and rock climbing as with other fields in medicine you can sub-specialize with fellowship after completing your residency one of the most popular em fellowships sports medicine is concerned with non-operative treatment of musculoskeletal injuries pre-participation evaluations and management of acute and chronic medical conditions of athletes if you want to do operative treatment you'd want to check out orthopedic surgery with a sports medicine fellowship which we covered in a previous video wilderness medicine is focused on meeting the unique challenges of emergencies in austere environments this includes tropical and travel medicine hypothermia altitude related illnesses envenomation and other animal-related injuries ultrasound is being pushed heavily in the ed for its non-invasive diagnostic strengths fellows specializing in ultrasound also get to explore novel and future uses of the technology toxicology focuses on the treatment of drug overdoses and withdrawals envenomation chemical exposures and toxic ingestions if you want to work in the pediatric emergency department you'll complete a peds fellowship after completing your emergency medicine residency hyperbaric medicine focuses on using hyperbaric chambers and hyperbaric oxygen therapies for certain conditions and also includes the medical aspects of deep sea diving ems often combined with disaster medicine focuses on pre-hospital care this translates to ground or air transportation and responding to or managing larger disasters there is a lot to love about emergency medicine in terms of lifestyle some love it others hate it on average em doctors work around 40 hours per week which usually translates to three to four shifts every seven days meaning you have several days off this is shift work meaning you clock in and clock out and don't take work home with you which isn't something you can say about most other specialties in medicine it's a double-edged sword though that also means you'll be working irregular hours depending on your shifts whether during the day or at night so a regular circadian rhythm is hard to come by also it's not uncommon to miss important family events or holidays which may actually be a good thing compensation amongst emergency medicine doctors is highly variable based upon the region and type of hospital you're practicing at we found the highest salary of 395 per hour in new mexico and the lowest of 130 per hour in new york the average em doctor makes roughly three hundred and fifty thousand dollars per year em is also unique in that sometimes it's more of an eat what you kill compensation structure meaning the more patients you see and more hours you work the higher your compensation there's a great deal of teen dynamics at play in emergency medicine as you're constantly working with nurses techs and doctors of other specialties there's a large degree of social interaction at play not only between healthcare professionals but you'll be having a large amount of face time with patients and their families as well you'll constantly be on your toes the entire shift without much downtime or breaks between patients some love the fast pace whereas others wish they could get more than just a couple minutes to scarf down a snack em can also be incredibly inciting with a large amount of uncertainty you won't know what types of patients are coming in or when they'll be coming in you have to be ready for anything emergency medicine is not without its drawbacks unfortunately a large number of patients abuse the emergency department which can prove to be a large source of frustration this is not a discussion about why the ed is abused social issues political issues or what changes should be made to curtail this but rather what you will be experiencing as a physician working there my em colleague who helped me in the creation of this video mentioned a patient coming in for dry cracked lips during the current pandemic no that is not a joke you'll also have illegal immigrants or uninsured patients using the ed as their source of primary care rather than for urgent medical conditions homeless patients may feign medical conditions to secure a roof over their head or food for the night those addicted to narcotics visit the emergency department exhibiting drug seeking behavior to secure painkillers which has become an increasingly common issue given the opioid epidemic these situations aren't necessarily the patient's fault but as an emergency medicine physician the emergency department serving as a safety net becomes a source of frustration dealing with highly agitated or intoxicated patients also means that em doctors are at higher risk of physical harm from their patients compared to most other specialties for these and other reasons em doctors experience some of the highest rates of burnout some contributing factors include working on the front lines consistent high intensity and stress unpredictability increasing time required for charting at the expense of patient interaction and irregular circadian rhythm there's also a fear of litigation looming over your head given the higher rates of malpractice claims compared to the average physician you won't be seeing exciting stuff non-stop either the bread and butter meaning the most common things you'll be seeing day to day often include chest pain abdominal pain and headaches the standard workup can become monotonous and the treatments are not always definitive lastly you may get some heat from other specialists who are quick to forget that em doctors must go an inch deep but a mile wide whereas most other specialists go a mile deep but an inch wide you won't know the nuance of every condition because your job is simply to handle urgent cases stabilize and hand off to the specialists when appropriate for this reason some specialists will get frustrated at you for not managing cases to the same degree of nuance that to them may seem obvious how can you decide if emergency medicine is a good field for you if you thrive in fast-paced sometimes chaotic and unpredictable environments it may be a good fit you shouldn't mind working an entire shift with non-stop action even if it's not always the most exciting action you may be forced to practice intermittent fasting more specifically time restricted feeding as you won't have much downtime on your shifts you'll work hard when you're at work but you'll get to completely unplug when you're off no pager no following up on patience or taking home call you should enjoy the reward of saving lives as emergency medicine is one of the few specialties that truly do you won't always be thanked though as patients are in the scariest and most stressful moments of their lives you also shouldn't shy away from procedures you'll be doing more than most other medical specialties although obviously not as much as surgeons these procedures are wide ranging including incision and drainage of abscesses lumbar punctures paracentesis thoracentesis suturing lacerations reducing fractures and even thoracotomies and chest tubes big shout out to dr jacob schmulevich attending emergency medicine physician who was instrumental in helping me create this video a large thank you to the multiple emergency medicine physicians at medicalinsiders.com who also provided their input if you're interested in pursuing emergency medicine who better to learn from than em doctors themselves if you need help acing your mcat usmle or other exams our tutors can maximize your test day performance if you're applying to medical school or emergency medicine residency our em docs can share the ins and outs of what it takes and how to navigate the process most effectively learn more and see why we have the highest satisfaction ratings in the industry at medschoolinsiders.com thank you all so much for watching what specialty do you want me to cover next leave a comment down below and make sure you are subscribed to vote in the upcoming polls if you enjoyed the video hit that thumbs up button to keep the youtube gods happy much love to you all and i will see you guys in that next one you

Channel: Med School Insiders

Views: 174,158

Rating: 4.956439 out of 5

Keywords: Pre-med, Premed, Med Student, Medical School, Med School, Medical Student, so you want to be, emergency medicine, em doctor, emergency medicine doc, emergency medicine residency, emergency medicine subspecialties, emergency medicine fellowship, academic vs community, urgent care, sports medicine, wilderness medicine, ultrasound, toxicology, hyperbaric medicine, emergency medicine services, ems, should i become an emergency medicine doctor

Id: RaWl6-l-t4g

Length: 13min 9sec (789 seconds)

Published: Sat May 23 2020