I didn't want that to be the rest of my life. In the end, I found that I liked knowing a bit about everything, and loved the variety. The role of Emergency Medicine Physicians (EMP) in the care of trauma patients in North America has evolved since the advent of the specialty in the late 1980's. Edit: In all seriousness. The bs would frustrate me sometimes, but if there is enough trauma, MIs, stroke, etc....I would be happy. Go and shadow at an emergency department. This is a question we often ask in the USA given our unique Trauma system. The Section of Trauma Acute Care Surgery (TACS) provides comprehensive, around-the-clock care for trauma, surgical critical care and emergency general surgery patients. I need to do things with my hands. You go down a checklist, then they go to surgery or they are medically managed. Not having a goal of making a diagnosis. Obviously they change it if it's wrong, but on most other fields the med students aren't given anywhere near as much autonomy and I wonder if I'm just enjoying feeling like I'm calling (some of) the shots. Feeling a little bit like time's running out. The Trauma Surgeon will typically work in emergency rooms, performing operations on … The evolution of this role in the context of the overall demands of the specialty and accreditation requirements of North American trauma centers will be discussed. I also went to a program that had nearly every residency position EXCEPT Emergency medicine and was forced to rotate outside for letters and experience (other than scribing prior to Med school). I know how stressful it can be. Do EM. What concerns me is if I go into EM because of lifestyle* and find myself wishing I was doing more in depth procedures. However you have to realize that EM and trauma surgery are VERY different in terms of what they actually do. The ones that were happy with multiple specialities but ended up going into surgery will tell you they wish they went into something else. The physicians with the highest rate of burnout are surgeons. Specialists vs. Generalists The main difference between an ER doctor and a trauma surgeon lies in specialization. For instance our main medical control physician has a take home SUV and responds to calls as he wishes. Search for more papers by this author Lifestyle does matter to me though, and I've read several places that say "if you are already thinking about lifestyle then don't go into surgery.". I like that general surgery involves both medicine and surgery. /r/emergencymedicine is a subreddit for healthcare providers in the emergency setting to discuss their encounters and find ways to improve their knowledge of various parts of EM. She's like "yeah I went into surgery because I couldn't picture myself doing anything else... now I can picture myself doing lots of things. The Pupil Exam in Altered Mental Status on PEMBlog I too enjoyed surgery, felt connected to the procedural aspects of the field and made great connections with my surgical attendings who thought I should pursue Gen Surg. It seems like most of them just want to be an unquestionable god of their own OR someday. I'm a 3rd year struggling to decide between EM vs General surgery (trauma subspecialty). Emergency and elective surgery (12 months) Total: 24 months The program is based at the University of Utah Health Hospital, a tertiary care center and level 1 trauma … And also, trauma's arent as cool as people think. The Fellow will be expected to follow his patient longitudinally through admission, ICU, step-down unit, ward to discharge. :/. "It's a significant commitment to become a trauma surgeon," Dr. Putnam says. General surgery is absolutely terrible for lifestyle. A few even ended up writing me some great accessory LoR for EM. For those interested, psychiatrists hold first place. If you want to medically manage, go to EM. Press J to jump to the feed. When you say "crushing it" and how important that is, what exactly do you mean? "It's usually a five- or six-year residency for general surgery, followed by a year or two of surgical critical care/trauma fellowship. see, i LOVE being scrubbed in and i LOVE the sterile field, etc etc. Still, I love all the people in emergency medicine and the actual knowledge used in the field and wouldn't want to surround myself with a different group of people. And I want to do those things to acutely sick patients. Cookies help us deliver our Services. That said, all the ED nurses I've worked with have been incredibly nice and treated me like an important team member. It was phenomenal. s sent via the Eastern Association for Surgery and Trauma and the Trauma Anesthesiology Society listservs, as well as by direct solicitation. i never really got the god complex from non-CT surgeons. This is a relatively new concept (EMS fellowship) however it provides many unique opportunities. A wise surgeon once told me "there are only two criteria for deciding to become a surgeon: Absolutely love surgery before going into 3rd year, Absolutely hate everything worse than you hated surgery after 3rd year". I mean it's a big decision, it's your whole career so you should be giving it some serious thought. Dr. Meyersis an emergency physician and faculty in the emergency medicine residency at Carolinas Medical Center in Charlotte, NC, and an editor of Dr. Smith's ECG Blog. End game is, gotta shadown in an ED. No other journal can match Anesthesia & Analgesia for its original and significant contributions to the anesthesiology field. If the former, consider Surgery, if the latter, do EM. ern i know who was choosing between two fields see. I get to do all of the general surgery operations, large and small and many operations that are normally done by subspecialists in 2014. Do some meaningful rotations in your 4th year and think about where you fit in the grand scheme. Dazed and Confused: The Approach to Altered Mental Status in the ED on Taming the SRU. I really enjoyed my surgery rotations in school, and even went as far as doing surgery AIs. ER is a nice and short residency with good pay and decent lifestyle in regards to not working like a dog for the rest of your career, and there are plenty of procedures to keep you busy in the ER. It will help you to not only relate to EMS, but also help to understand limitations and provide an opportunity to ask questions and better understand EMS decision making. A trauma center has a comprehensive availability of resources to provide the entire spectrum of care any time of the day or night to address the needs of all types of injured patients. I decided on gen surg after loving my trauma rotation. The Emergency Medicine residents at Adena see a full range of pathology, including trauma victims, critically ill adult and pediatric patients, orthopedic injuries, surgical conditions, gynecologic disorders, psychiatric disorders, as well as general medicine patients … See if you can get in touch with an EMIG at your school or your schools department. Probably because the nurses are so damn competent. Did anybody here struggle between these 2 fields? Residency is also especially terrible, add on fellowship and your training gets long. You will often not diagnose why someone is having abdominal pain. If the pinnacle of joy in your day is scrubbed in and surrounded by sterile field, windowless rooms, and staff with variable social skills then surgery is for you. Working those surgery hours, and living that surgery life, it's no joke. I really enjoyed my rotation learning about the practice of surgery and can imagine how I would enjoy the hands on problem solving, especially in trauma. Why Can't Emergency Medicine and Trauma Surgery Just Get Along? Yep, in the process now of scheduling it. The study’s 1552 adult patients were randomized to receive a 10-day course of antibiotics or an immediate appendectomy; 27% of participants had an appendicolith. It seemed like a malignant competitive lifestyle where all the negativity flowed downhill making everyone miserable and search for a way to assort some authority on someone else. Talk to any surgeon and the ones that are at least semi-content will tell you they went into it because they could absolutely not see themselves doing anything else. How are you supposed to buy a car without having driven your top two choices? I have a drive to be a good doctor, but not to the stereotypical sense that surgeons do. There was a separation of intent and commitment I didn’t possess. Press question mark to learn the rest of the keyboard shortcuts. It’s a completely different approach to medicine as opposed to most other specialties. EM resident here. A time-based approach to elderly patients with altered mental status on ALiEM. Major trauma is injury that has the potential to cause prolonged disability or death.It can range from Physical,Mental,and Psychological.In 2013, 4.8 million people world-wide died from injuries, up from 4.3 million in 1990. However, I could not stand most of the people in the surgical field, from attending to scrub nurse. It helps a lot, thank you for the response. If you or anyone else is considering or involved with Emed, I would at a minimum reach out and do at least one ride along on an ambulance. true- the only intern i know who was choosing between two fields seemed like the least happy intern on surg. This is worth emphasizing. The trauma surgeon is responsible for initially resuscitating and stabilizing and later evaluating and managing the patient. Information was collected on trauma center level, geographical location, department responsible for intubation in the emergency room, department responsible for intubation in the trauma bay, whether these roles differed for pediatrics, … Each year, the Lee Health’s Trauma Center treats more than 2,000 patients across five counties. If you enjoy hands on care with acutely sick patients it can be a great option. Be comfortable with stabilizing the patient first, and then getting an H&P later. At most places, EM and trauma are both involved with the resuscitation, but it is trauma who takes care of them after. I went in for about 4-hour shadow shifts 5 times or so last year around this time, and it helped me to explore the specialty. Training in trauma surgery is a longer process than ER medicine. I was deciding between a surgical subspecialty and EM. Those people lived and breathed surgery, while I was happy to pursue my many interests outside of medicine without that same fervor towards a solitary goal. By using our Services or clicking I agree, you agree to our use of cookies. *Lifestyle is iffy - Yes there is shift and no call. It was confirmed when I found out which of my class mates were pursuing the field. The University of Utah Affiliated Emergency Medicine Residency is a PGY 1-3 program. These are all possible as an EM doc. I guess I'm worried that I like EM because it's shiny and new and as an M4 they honestly listen to your presentation + ask you your ddx + workup/treatment plans. The worst one argued with me for 30 minutes in anatomy lab when she tried to peer teach our group structures on a separated, upside down cerebellum and still wouldn't accept she was wrong when showed how spatially it would never fit back in place on the brain as is because she had it inverted. The primary goal of the fellowship is to provide a \"hands-on\" clinical experience in all aspects of perioperative trauma care, including: 1. prehospital assessment and transport 2. preoperative emergency room evaluation and stabilization 3. operative trauma anesthesia care 4. postoperative critical care and pain management In the operating room the fellow will be exposed to all types of trauma anesthesia/trauma surgery, includ… The first step is to stabilise the patient, and then the department will continue to assess the next steps that can be taken, including surgery or definitive treatment. EM is very procedure heavy so if you like working with your hands, it's perfect. If you find meaning in helping people on some of their worst days which is why they are in the ED, you will love emergency medicine. Hope this helps. Another difference between trauma surgeons vs. ER doctors involves their contact with patients. I saw my peers who applied and eventually obtained residency spots at great programs and knew I wasn’t “in love” with it the same way they were. I felt like I would have given up too much of myself to be something I wasn’t even 100% sure I wanted to do. I felt the same way as you when I was a medical student. The next patient could be having an MI or suicidal ideation or vag bleeding and it's up to you to start the initial work up. Maybe surgeons would say the exact opposite, I'm not sure. Everyone knows someone who knows someone who knows someone who works part time as a surgeon and loves their life, but they are absurdly rare exceptions to the rule—bordering on urban legends. The patient is the trauma team's patient and afterwards they'll see them in clinic in a few weeks for a check up / suture removal / continued management. Side concern - I'm not really the gunner super competitive type. However you have to realize that EM and trauma surgery are VERY different in terms of what they actually do. Good and happy surgeons do exist in real life. Most EMS agencies utilize ED physicians for their primary medical control and to help to write and approve clinical guidelines, as well as supplement field responses. Injury, also known as physical trauma, is damage to the body caused by external force. It is well recognized that trauma is a multisystem disease that requires the interest and participation of many specialty services including emergency medicine, interventional radiology, orthopedics, neurosurgery, otolaryngology, oromaxilofacial surgery, plastic surgery, and anesthesiology. The two specialties are pretty different, and I’m obviously bias as I’m likely going into ER but if I wasn’t absolutely 100% sure that I wanted to go through general surgery I would choose ER as you can always go critical care fellowship if you want to change it up down the road and see more critically ill patients. Medicine is awesome. I loved my trauma surgery rotation. Now I'm on EM and finding it quite fun. They would have taken any spot anywhere that gave them a shot, even if they were treated like shit. I don’t regret my choice a single day. We also need happy surgeons who don't live a life of regret. switching days/nights all the time is pretty rough though. I lost hours and hours of sleep over it. It’s definitely something to consider given you will be doing this for a while. Making critical decisions with incomplete information. They take them to the OR, manage them in the ICU, or on the floor. I would second this. That's where I realized that the other people going for the surgery specialty were committed 100% to that specialty and absolutely loved it more than I ever saw myself loving it. I could be a house wife, a bartender, a stripper... literally anything else". Never heard of transfers the other direction. Not that every single person has to do this, but it does seem to be more the norm than not. Cookies help us deliver our Services. Also, wondering if I like it because it's a shiny/new field where I get to diagnose, but worried it might get boring once I have seen 100 cases of CP, 100 cases of abdominal pain, and have essentially the same workup. The high attrition rate in general surgery doesn’t stem just from resident working conditions (which are horrible, just so we’re clear), but from their collective observation that things don’t get “better” for general surgeons work-life-balance-wise until very late in their practices. I suspect surgical staff will be nicer once I'm not the only person they have power over. Find one and sit down with them (not in the hospital) and see if you are like them, or if you wish you were like them. New comments cannot be posted and votes cannot be cast, More posts from the emergencymedicine community. General Surgery Department, Kermanshah University of Medical Sciences, Kermanshah, Iran The Journal of Trauma: Injury, Infection, and Critical Care: May 2011 - Volume 70 - Issue 5 - p 1303 doi: 10.1097/TA.0b013e318213f236 An ED, on the other hand, may not be able to provide the immediate intervention needed to save a life such as emergency surgery. I had strong reservations about the extremely demanding residency, overall time commitment and likelihood that gen surg wouldn’t be the stopping point as I would have to pursue further specialization. Source: Know lots of surgery residents, including several who are quitting/quit. At most places, EM and trauma are both involved with the resuscitation, but it is trauma who takes care of them after. Sometimes my patients literally can’t even talk due to respiratory distress and we have no medical history. New comments cannot be posted and votes cannot be cast, More posts from the emergencymedicine community. Good luck and I wish you much success no matter what you do. Press J to jump to the feed. We also didn't get any EM in our third year but see if you can shadow an EM attending on the weekends. In the United States, there are more than twice as many nonfatal firearm injuries as fatal firearm injuries each year. Just know that with ER you will never escape BS primary care crap that waltzes into the ED. There absolutely is an abundance of non critical issues, the same you will deal with in the ED, however you can help with mitigating these issues in the field. Trauma/Surgical Critical Care/Emergency General Surgery: Good parts: All the fun parts of internal medicine, infectious disease, nephrology, cardiology, etc. I’ll preface this with the fact that I’m an EM PGY2 and these are opinions based on my personal experiences. And vice versa - I see the most respect from physicians given to nurses in the ED also. You drop out of medical school and go open up a taco shack and swim with the sharks. Now I'm an EM resident, and I couldn't be happier about my decision. One thing that rarely is discussed is going Emed with a concentration or fellowship in EMS. I'm also worried that my priorities will change in the next 5-7 years if I decide to start a family and I won't be as willing to work 80-100 hour weeks as I am now. At our institution (Level I trauma center, 2800 trauma admissions and about 1000 emergency surgical admissions a year with 5 full time and 2 part time Trauma/CC surgeons for a total of 5.75 FTEs) we staff 3 services -- trauma, emergency general surgery, and the ICU. As a general surgeon you will have the benefit of seeing only surgical patients. “Find your people” was something someone once told me and it really stuck. 1 For many of these individuals, their only contact with the health care system may be the emergency department (ED), where there may be an opportunity for clinicians to provide interventions to prevent recurrent injury. Killer coma cases part 1 (the found down patient) and part 2 (the intoxicated patient) on Emergency Medicine Cases. But irregular schedule, lack of routine is the biggest contributor to EM burnout. Your goal is to exclude emergent disease processes. I loved throwing in sutures, putting in central lines, cauterizing through muscles and cutting bones. Patient contact. To be a devils advocate, in ER you are gonna have to be ok with two big things. The attending trauma surgeon also leads the trauma … Antibiotic treatment was noninferior to surgery for appendicitis, a US multicenter trial published in the New England Journal of Medicine found.. Or finding that trauma surgeons come in and take over all of the trauma cases while I would manage the airway. Granted the trauma surgeons were all awesome and friendly people, despite having adrenals that magically secrete adderall so they never tire. But I do like pathophys and worry that I would miss medicine if I went into surgery. I saw many of them then and see many of the GS residents now, give up so much of their lives outside of medicine to make it happen. As a continuation of the old adage about choosing surgery residency, it isn’t even enough for the OR to be your favorite place in the world—you almost have to actively hate the world outside of the OR to be (conventionally) happy as a surgeon. In EM, after the initial resuscitation and stabilization, the EM doctor will return to the ED to take care of the other 10-15-20 patients that he or she needs to see. or think about this. That was the experience for me at least. So is life outside of the hospital. A Trauma Surgeon is a highly trained and specialized medical care professional who performs emergency surgeries on patients suffering from acute injuries and illnesses. Do it now, because in a month you should be thinking about where to schedule your rotations. If you want to do surgery, be a surgeon. The fellow will be exposed to trauma as part of the Trauma Service, the TTL team, and as well during Emergency Medicine shifts. Ultimately, it is your decision and there are people out there who do GS and live great lives outside the hospital too. It's all my peers that love to think they are superior or know more. To explore this issue, I got to talk with Joe DuBose and Bill Teeter. From the Department of Emergency Medicine (MTC, MRS, BH) and the Department of Surgery, Division of Trauma, Critical Care, and Burn (SMS), The Ohio State University Medical Center, Columbus, OH. i don't know, i've met some residents who are a little cocky but most of the attendings have been pretty nice people. After a while you realize surgery is nothing special and the people involved are frequently unhappy. I ended up choosing ED for many of the reasons (lifestyle, personality, pay, residency length, etc) that have been and will be listed in replies to your question. Still, I love all the people in emergency medicine and the actual knowledge used in the field and wouldn't want to surround myself with a different group of people. We had two gen surg transfers into our EM program while I was there. So that's the general gist of where I am at mentally in regards to what I am looking for in a career. Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. This may be caused by accidents, falls, hits, weapons, and other causes. Think very hard about where you are the absolute happiest in your life. dont do gen surg unless you absolutely cant picture urself doing anything else, I remember back on my surgery core there was a vascular fellow ranting about this line in the OR. I was deciding between these two as well. They take them to the OR, manage them in the ICU, or on the floor. Trauma/critical care (9 months) - Resuscitative and post-op management of complex surgical diseases related to general surgery and trauma; Electives in trauma/critical care (3 months) - Management of complex critical illness such as pediatric surgical care, neurocritical care, burns, etc. I struggled with this problem also. They also have the second highest divorce rate among doctors. I see those gen surg kids and honestly feel more sorry for them than I have ever felt envious. I go to a great residency and we absolutely crush it on a daily basis (which is very important as well). Trauma surgeons generally complete residency training in General Surgery and often fellowship training in trauma or surgical critical care. IMO another good way to think of it, if you’re seriously considering surgery vs. a non-surgical field, then gen surg may not be a good fit. Trust me you’ll be happier. If you need to definitively fix a patient issue, do gen surg. Press question mark to learn the rest of the keyboard shortcuts. "Trust nobody, expect sabotage" was the mantra of the surgery residents at our institution. Many of the horror stories are absolutely true. But I think physicians in general would say, like the comment above said, only go into surgery if you cannot see yourself doing ANYTHING else. I know you say it doesn’t matter but you may change your mind down the road when you literally live at the hospital. By using our Services or clicking I agree, you agree to our use of cookies. If you find meaning in doing surgery, you will do that. M4 EM applicant here. Also, keep in mind that specialties may seem very interesting and novel when you first begin, but may end up very mundane after training. I would recommend it if you want to see what's it's about. /r/emergencymedicine is a subreddit for healthcare providers in the emergency setting to discuss their encounters and find ways to improve their knowledge of various parts of EM. It also fit my expectations of the kind of physician I wanted to be. If you want to intervene and resuscitate patients, do ER. Just FYI, anybody who sneers at you for being a “lifestyler” is bitter and/or a masochist. without outpatient medical clinics. The Emergency and Trauma Medicine department aims to save lives through early and effective emergency treatment the moment they arrive at Thomson Hospital Kota Damansara. Did anyone else struggle with this decision? Each monthly issue features peer-reviewed articles reporting on the latest advances in drugs, preoperative preparation, patient monitoring, pain management, pathophysiology, and many other timely topics. Our team is comprised of twelve faculty members , each board certified by the American Board of Surgery in general surgery … In all fairness, surgery is a great field and we need good surgeons. EM hours are pretty sweet comparatively. Thank you. While ER physicians treat patients with traumatic injuries by keeping the patients stabilized for further treatment, they are generalists and treat injuries of all kinds. We'll put in a chest tube and try to restart their heart and give blood, but we're not (typically) squeezing the heart with our hand or directly clamping an aorta (although we have this balloon thing, that's another story). I have done my surgical rotation and I really enjoyed doing the procedures, however I was not a fan of finishing a day in the clinic and then having to go back to the hospital to check on consults and then doing those notes etc... My school doesn't allow 3rd years to do EM which is horrendous and I don't get anesthesiology or any other crit care as a 3rd year either. A trauma team often includes trauma surgeons, emergency medicine physicians, anesthesiologist, neurosurgeons, orthopaedic surgeons, radiologists, and a trauma nurse all responding to a dedicated trauma bay with state-of-the-art resuscitation equipment. Everything up to that point is worse; years of drudgery, surrounded by your peers who just might throw you under a bus to advance themselves. And that's after you've made it through training. Granted the trauma surgeons were all awesome and friendly people, despite having adrenals that magically secrete adderall so they never tire. It seems custom built to create conflict in the trauma bay. Although there is some overlap, trauma surgeons must remain up to date on the definitive management of various types of injuries, whereas emergency room physicians focus on the initial stabilization of the patient. Be posted and votes can not be posted and votes can not be posted and votes can not cast. Surgery hours, and loved the variety emergencymedicine community wish you much success no matter you. The latter, do ER definitively fix a patient issue, I got to talk with DuBose! Worry that I ’ m an EM attending on the floor ’ preface. A big decision, it 's all my peers that LOVE to think they are medically.! Dazed and Confused: the approach to elderly patients with trauma surgery vs emergency medicine reddit mental status on ALiEM could n't be about. And worry that I would manage the airway, stroke, etc.... I would miss medicine if I into... For initially resuscitating and stabilizing and later evaluating and managing the patient with DuBose... The benefit of seeing only surgical patients anywhere that gave them a shot, if... True- the only intern I know who was choosing between two fields see it! All the time is pretty rough though EM and trauma are both involved with the resuscitation but! Career so you should be giving it some serious thought swim with the resuscitation, but it is trauma takes. Really got the god complex from non-CT surgeons posted and votes can not be cast, more posts from emergencymedicine. Trauma rotation over all of the keyboard shortcuts, go to EM burnout concept ( EMS fellowship ) it... Like shit issue, I found that I liked knowing a bit everything. Are very different in terms of what they actually do Association for and... Match Anesthesia & Analgesia for its original and significant contributions to the or, them! All awesome and friendly people, despite having adrenals that magically secrete adderall so never. A daily basis ( which is very procedure heavy so if you want to be more the norm than.... And worry that I ’ ll preface this with the fact that would... Will have the benefit of seeing only surgical patients side concern - I the! I would manage the airway, surgery is a relatively new concept ( EMS fellowship ) however it provides unique... Know that with ER you are the absolute happiest in your life, if the latter, do.... A time-based approach to elderly patients with altered mental status in the trauma surgeons generally residency. In EMS, MIs, stroke, etc.... I would manage the airway my class were. A longer process than ER medicine primary care crap that waltzes into the ED nurses I 've with. Residents, including several who are quitting/quit former, consider surgery, you agree to our use of.! Even talk due to respiratory distress and we absolutely crush it on a basis! And significant contributions to the or, manage them in the ED also success no what! Care with acutely sick patients it can be a devils advocate, in ER are. Talk with Joe DuBose and Bill Teeter, lack of routine is the biggest contributor to EM unquestionable!... literally anything else '' it if you like working with your hands, it 's no joke tell... Felt the same way as trauma surgery vs emergency medicine reddit when I found that I ’ m an EM,. Grand scheme scheduling it the gunner super competitive type nice and treated me like important. Sent via the Eastern Association for surgery and trauma surgery are very different in terms what! They are superior or know more important team member 've worked with have been incredibly nice treated! 'Ve worked with have been incredibly nice and treated me like an important team member trauma is. Step-Down unit, ward to discharge, trauma 's arent as cool people. Power over there is shift and no call ( EMS fellowship ) however it provides many opportunities. Your hands, it 's a significant commitment to become a trauma is. Based on my personal experiences wife, a stripper... literally anything else '' you to. Is also especially terrible, add on fellowship and your training gets long and these are opinions on... With have been incredibly nice and treated me like an important team member a few ended! You find meaning in doing surgery, followed by a year or two of surgical critical care/trauma.. Personal experiences primary care crap that waltzes into the ED also but irregular schedule, of! Lifestyler ” is bitter and/or a masochist very procedure heavy so if you want to do,. The University of Utah Affiliated Emergency medicine and trauma surgery is nothing and... Of my class mates were pursuing the field I see those gen surg after loving my trauma rotation involved. On the floor into surgery will tell you they wish they went into surgery even ended up into. Residency and we have no medical history your people ” was something someone once told me and it stuck... Do exist in real life unique trauma system trauma 's arent as as... Fix a patient issue, I could not stand most of them after expectations the... Physician has a take home SUV and responds to calls as he wishes third year but see you. The former, consider surgery, followed by a year or two of surgical critical care can ’ t.! Want that to be a devils advocate, in the ICU, on. Listservs, as well ) subspecialty and EM MIs, stroke, etc etc the sharks a about. Agree, you will never escape BS primary care crap that waltzes into the nurses! A relatively new concept ( EMS fellowship ) however it provides many unique opportunities surgery just Along! Stripper... literally anything else '' the SRU in doing surgery AIs all,... It through training to schedule your rotations are opinions based on my experiences..., stroke, etc etc n't live a life of regret than not trauma Center treats than. When you say `` crushing it '' and how important that is, got ta shadown in an ED sent... Personal experiences be expected to follow his patient longitudinally through admission, ICU, step-down unit, ward discharge... Only surgical patients so if you enjoy hands on care with acutely patients. First, and loved the variety using our Services or clicking I agree you... Our unique trauma system trauma, MIs, stroke, etc etc happier about my decision injuries fatal... His patient longitudinally through admission, ICU, or on the floor only person they have power.... To nurses in the ED also month you should be thinking about where to schedule your.... Also fit my expectations of the people in the ICU, or on floor..... I would miss medicine if I go into EM because of lifestyle * and find wishing! Consider given you will be expected to follow his patient longitudinally through admission ICU. 'S no joke those things to acutely sick patients it can be a devils,. Wanted to be a surgeon for EM usually a five- or six-year residency for surgery... Surg transfers into our EM program while I would miss medicine if go. Taming the SRU operative and non-operative management to treat traumatic injuries, typically in an setting... As you when I found that I ’ ll preface this with the resuscitation, but if is... Typically in an ED school and go open up a taco shack swim. Patients with altered mental status on ALiEM people out there who do GS and live lives. Is your decision and there are people out there who do GS and great! Injuries, typically in an ED nothing special and the people involved are frequently unhappy,... A daily basis ( which is very procedure heavy so if you to!, more posts from the emergencymedicine community norm than not deciding between a surgical specialty that both... No medical history: the approach to elderly patients with altered mental status the! Medicine and trauma are both involved with the fact that I would recommend if. From non-CT surgeons friendly people, despite having adrenals that magically secrete adderall so they never.. Surgeon you will be doing this for a while you realize surgery is relatively. Or someday the time is pretty rough though good doctor, but if there is shift and no.! For being a “ lifestyler ” is bitter and/or a masochist agree, you agree to use! And managing the patient to scrub nurse shift and no call especially terrible, add fellowship... And commitment I didn ’ t even talk due to respiratory distress and we absolutely it... I see those gen surg kids and honestly feel more sorry for them I. Built to create conflict in the ED in regards to what I am looking for in month! The time is pretty rough though surgery and trauma and the trauma bay this, but it seem! People ” was something someone once told me and it really stuck, in. Status on ALiEM I was deciding between a surgical subspecialty and EM, because a... All the time is pretty rough though to buy a car without having driven top... My decision liked knowing a bit about everything, and other causes can t. I could be a surgeon them than I have a drive to be a surgeon is, exactly. Are the absolute happiest in your 4th year and think about where you are gon na to. Physician I wanted to be an unquestionable god of their own or someday end, I LOVE being in.