Is EM right for me?

Updated July 2022

While there is no substitute for doing an EM rotation and talking to practicing Emergency Physicians (EP's), there are a few characteristics of the clinical work and lifestyle that may help you decide if this specialty might be a good fit for you.

What is the clinical work like?

• Undifferentiated patients - The ED has developed into the diagnostic center for many hospitals and communities. Emergency Physicians (EP) are often the first health care provider to assess a patient. And in a public health crisis EP's are on the front line.  
• Quick rapport - You need to rapidly establish trust with patients and families you have never met before.
• Critical decision making - The acuity of the ED requires you to make management decisions based on your clinical assessments, often without full information or diagnostic testing.
• Multi-tasking - This may be better described as "distracted decision-making" as EP's need to rapidly shift focus from patient to patient amongst a variety of distractions. You need to do this without compromising your decision-making.
• Procedure oriented - EP's must be experts at resuscitation and airway management, and be able to perform a variety of other procedures ranging from the basics like suturing and vascular access to life-saving procedures like pericardiocentesis and thoracotomy.
• Safety net - No patient is too poor, too non-compliant, too old, too young, or too pregnant to be seen in an Emergency Department or by an Emergency Physician.  

The practice of EM is well summed up by a quote from Joe Lex, (@JoeLex5), the Godfather of FOAMed:

"Emergency Medicine is the most interesting 15 minutes of every other specialty".

What is the lifestyle of an Emergency Physician like?

• ED shifts are a sprint, not a marathon - You will be at the hospital for a fixed amount of time, you will work really hard, and then you will go home to spend time doing the other things you love.
• Shifts vary in length - This depends on the ED where you work, with 8 - 12 hour shifts being the most common. There are even some ED's where the physicians work 24 hour shifts, though these are usually low volume ED's.
• You will work during the day and at night.  You will work weekends and holidays. - No job is perfect.
• You will not take call for a panel of patients, though it is not uncommon to have someone on back-up call in the event of illness or disaster.  Not having a panel of patients means that you also lose some of the patient continuity found in other specialties.

Who is Successful in EM?

• The attributes that serve you best in the ED include being kind, hard working and honest - While this may seem overly simplistic, your character is the cornerstone of your ability to be the leader of a team. Your colleagues need to know they can count on you to always be ready to jump in and do what needs to be done.
• A tolerance for chaos and uncertainty serves you well- The ED is ever changing, no day is ever the same, and you will be repeatedly challenged with situations you have never coped with before. There is an element of letting go and trusting you instincts and those around you that is integral to a satisfying career in EM.
• A balance of OCD and ADHD traits - There are a ton of details that you need to accurately track throughout your day and getting easily bored helps you move from one task to the next.

Want some other thoughts and opinions?

• Check out this discussion from the St. Emelyn's blog.
• Read this insightful post from Dr. Kara Barker on "Why EM"
• Watch this discussion of how to decide if EM is right for you from the ALiEM EM Match advice series