Name: So You Want to Be an EMERGENCY MEDICINE DOCTOR [Ep. 9]
Uploaded: 2020-06-08T03:40:36.000Z
Duration: 13 min 9 s
Description: Thousands of YouTube videos with English-Chinese subtitles! Now you can learn to understand native speakers, expand your vocabulary, and improve your pronunciation...

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

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's 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're covering here. If

you want to vote in upcoming polls to decide what future specialties we cover, make sure

If you'd like to see what being an EM doctor looks like, check out my second channel, Kevin

Jubbal, M.D., 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

Emergency medicine is the specialty concerned with treating patients who are acutely ill

with urgent healthcare needs. This can be treating acute conditions like a myocardial

infarction, or heart attack, or treating exacerbations of chronic health conditions, stabilizing

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, 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

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

The practice of emergency medicine is largely a function of location — what type of hospital

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 I Trauma center, you may expect to see more complex cases compared

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 stand-alone 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, or ED, for sicker

patients. This is a less stressful environment and is considered a good option for doctors

wanting to ease a bit toward the end of their careers.

For many nonsurgical specialties, you first do three years of internal medicine residency,

and then subspecialize 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 3 or 4 years in duration. Some experts in

the field say that 4 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, 3 year programs have distinct advantages, such as spending 1 less year in

training and earning an attending salary 1 year sooner. Plus, most graduates say they

are as 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

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 SLOE. 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 SLOE 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 you know the student, their commitment to

emergency 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 ADD, easily distracted, and always on the go. These are

often the athletic, outdoorsy, and adventurous types who enjoy camping, running, and rock

As with other fields in medicine, you can subspecialize with fellowship after completing

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

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 noninvasive diagnostic strengths.

Fellows specializing in ultrasound also get to explore novel and future uses of the technology.

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

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