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Medical Education
Medical Student Education

Career Information: Emergency Medicine

Specialty: Emergency Medicine

Completed by: David Duong

Date completed/updated: updated April 2013

  1. What can students do in the 1st and 2nd years to explore and/or prepare for this career?
    UCSF medical students can engage in several opportunities to explore and prepare for a career in Emergency Medicine:
    --Take the Introduction to Emergency Medicine elective
    --Take the Wilderness Medicine elective
    --Join the Emergency Medicine Interest Group (EMIG)
    --Attend the Emergency Medicine lecture series (organized by EMIG)
    --Attend the UCSF Annual Disaster Conference (organized by EMIG)
    --Shadow an Emergency Medicine physician at UCSF or SFGH
    --Set up meetings with one or more of the Department of Emergency Medicine advisors (both faculty and residents)
  2. What common variations exist in the length/content of residency programs for this career?
    Three variations exist in residency programs. There are three-year Emergency Medicine residency programs (PGY 1-3) and four-year Emergency Medicine programs (PGY 1-4 and preliminary year + PGY 2-4). The PGY 1-4 residency training programs have their four-year curriculum at one Emergency Medicine residency program. The PGY 2-4 residency training programs have their three-year curriculum at one residency program preceded by an ACGME approved preliminary internship year.
  3. What common variations exist in this career after training?
    There are many! Most graduates from an Emergency Medicine (EM) residency program work as a general EM physician, though a good number undergo fellowship training for subspecialization, including EMS and disaster medicine, toxicology, pediatric EM, ultrasound, critical care, hyperbaric medicine, sports medicine, and more. The majority of graduates work in a community emergency department setting. Others enter academics and practice in an emergency department affiliated with an academic EM department, and engage in research, global health efforts, and/or administration. There are also settings where graduates practice in a community practice emergency department that has an affiliation with an EM residency training program; in this setting, one has the opportunity to engage in the clinical training of EM residents.
  4. What is a typical work day for someone in this field?
    Every shift is different (and this is an understatement)! While on shift, EM physicians provide care for multiple patients, determining which patients need emergent or urgent resuscitation, interventions, procedures, or transfer. Whether it is a pediatric, surgical subspecialty, neurologic, or obstetric patients, EM physicians provide care for all that come into the emergency department. EM physicians also engage with consultants from other departments when specialty care is indicated on an urgent basis or when hospital admission is warranted. EM physicians work shifts that range from 6-12 hours, though the majority of shifts in practice are 8 hours p;us time to signout and finish clinical tasks. EM physicians work closely with a team of nurses, medical assistants, and social workers. They may work alongside other EM physicians, but do not usually care for the same patients simultaneously.
  5. What is the culture of this career?
    EM physicians have a diverse range of interests and personalities. Even so, EM physicians are comfortable with a team-based approach to patient care, working closely with nurses, pre-hospital providers, and medical staff as equals. Cohesive camaraderie is an appealing part of this specialty. Dedication to patient well-being is another common theme for this specialty.
  6. How compatible is this career with raising a family? How is this different for men and women?
    A career in Emergency Medicine is compatible with raising a family, for both men and women. The defined shift work makes scheduling fairly predictable in order to spend time for family life obligations. Shifts may be requested or traded between colleagues to offer further schedule flexibility. However, most EM physicians should expect to work a mix of day, evening, night, weekend, and holiday shifts. The majority of EM physicians do not carry a pager, so time at home can be dedicated to family life. The possible exception is being on-call. This means if a colleague is unable to work a shift, the on-call physician either needs to work that shift or arrange for another physician to work that shift.  At some work environments, EM physicians are able to work additional shifts to earn more income to meet financial goals for their family. 
  7. What are the most important qualities or character traits for a person in this field?
    Emergency Medicine physicians are a diverse group of individuals. However, there are aspects of our clinical work that attract people with certain general qualities. Each clinical shift, EM physicians work closely with team members (EM nursing, medical assistants, clerks, social workers) as well as pre-hospital personnel (EMT, firemen, policemen), consultants, and admitting physicians. Thus, EM physicians are comfortable and effective working in teams and engaging in various types of interpersonal interactions. EM physicians see all types of patients and with various severity of disease. Thus, EM physicians have a broad knowledge base and are comfortable seeing a sick child, an elderly stroke patient, a pregnant patient with abdominal pain, or a patient with acute vision loss. While EM physicians are specialists of emergency care and may have a niche, EM physicians are comfortable involving specialty consultants to advocate for a patient’s care when a presentation or disease process is beyond their level of expertise. EM physicians are also comfortable with some degree of uncertainty and decisive decision making. Patients present with symptom complaints and the disease process at hand is not established. Many times, EM physicians must act with very little information and/or time to determine if there is a limb-threatening or life-threatening condition.
  8. How competitive are the residency programs in this field?
    Emergency Medicine residency programs are becoming increasingly more competitive. This field is more popular than in the past, leading to a robust number of applicants each year. There are generally very few positions to “scramble” into each year.
  9. How competitive is the job market after residency?
    The job market is dependent upon location, with desirable cities being more competitive for jobs.
  10. What programs have been popular among UCSF applicants, or how should applicants go about considering programs?
    One of the most important aspects of an Emergency Medicine residency training program is fit. Where one trainee may thrive, another may struggle depending upon location, family obligations, curriculum, and relationships with colleagues and faculty. While this list is certainly not inclusive of all top tier programs and is in no particular order, commonly well-regarded EM training programs include UCSF, Alameda County (Highland), Stanford, USC, UCLA programs, NYU-Bellvue, Boston Medical Center, Harvard, Denver Health, Carolinas Medical, Vanderbilt, Emory, and Duke.
  11. What resources (eg, websites, books, professional groups) would you recommend for students interested in learning more about this field?
    The Society for Academic Emergency Medicine: www.saem.org
    Emergency Medicine Residents Association: www.emra.org
    American College of Emergency Physicians: www.acep.org
    American Academy of Emergency Medicine: www.aaem.org
    Emergency Medicine: The Medical Student Survival Guide. Harkin KE, Cushman JT, Wei HG, eds. Emergency Medicine Residents' Association.
    AAEM's Rules of the Road for Medical Students: The Guide for a Career in Emergency Medicine. Kazzii AA, Schofer JM, eds. American Academy of Emergency Medicine.
     
  12. How important are each of the following for admission to a competitive program?
 

Very Important

Somewhat Important

Not Important

Comments

Extracurricular/
volunteer work

 

x

 

Extracurricular and volunteer work can be important to competitive programs, but programs may also look for significant scholarly contributions

Research/publications

 

x

 

Scholarly work can be important to competitive programs, but programs may also look for significant leadership or service contributions

Honors in third year

x

 

 

 

AOA

 

x

 

 

Subinternship

x

 

 

 

Externship

x

 

 

In general, applicants complete two EM clerkships

Other: Board scores

 x 

Failure or very low board scores will make admission more challenging to competitive programs

 

 

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