I've just come back to the forums after a hiatus-finishing residency and starting a new job. Anyway, I had a bunch of messages regarding EM as a specialty and the pros and cons for the working woman. Personally, I think EM is the perfect specialty for women, especially since you don't have to deal with a lot of the issues that other specialties do. So...to distill it down for those who like lists (me, me, me!) here goes...

Pros: flexible schedule, can be home during the day or during important school functions, can work part time, can join a hospital based group or a private group, see the whole range of problems and ages, you can do trauma and procedures, great team like atmosphere, no repeated visits, can schedule around hobbies, you get paid to multitask (just like you do in your own life every single day!)

Cons: working evening/nights, working holidays (at least some), no repeated visits, the patients are not "your own"

I'm sure I've forgotten a ton, but hopefully these will answer some of those lingering questions and if not...well, let's get a thread started!

EMMOM

Preach it sista!

Actually, occasionally there is continuity of care. Usually it's not the good kind, (So Mr Jones, what it is today?), but the other day I picked up a chart and recognized the name as a head bleed I'd intubated a couple of months prior. He'd bradyed down and almost coded. And here he was, talking, thanking me for saving him. He didn't remember me, but I remembered him.

Patients like that make it so worth it.

D

Thanks for the info! As a second year med student thinking about EM, I really appreciate it! One question, how often do you work nights, say as a percentage compared to days? Do you usually do 12 hour shifts or does it vary?

In residency, days and nights have to be split equally, so it's 50/50 if you're working 12s. Once in the "real world" there is often a shift differential, or a couple of people who want to work all the nights, so it really depends on the group. It also depends on your coverage and when the busy times are.

My residency works 12s; my new practice works 8s, 9s and 10s.

I think EM is indeed great for moms. Full time is about 120 hrs/month. Some groups consider your work full time with even less hours. The other's are right, night shift actually does have advantages a many places. You get paid more per hour, you get more "credit" towards your partnership, night staff is awesome, it's more peaceful with less admin BS, and you'll have plenty of opportunity to work (i.e. you'll likely get all the shifts you want, and the days off you want). There's usually less patients (but also less staff...so your workload may actually *increase*). This can be good for your productivity numbers...but, of course, being overly busy isn't safe.

I work about 2-3 night shifts/month. I work a total of 10-12 shifts/month. The more shifts you work, the more night shifts are expected. I typically get major holidays off...but not completely. Like, I'll beg/borrow/steal to get Christmas day off...and will agree to work Christmas eve or New Year's eve or New Year's Day in exchange. Some places pay DOUBLE TIME to work *on* the holiday...which may make it worth it to take 8 hours Christmas evening and make well over $2500 in that time. Those 8 hours...pay for Christmas!!

Overall, I love the flexibility EM offers...

I was hoping some of you EM docs could give me some advice...

i'm interested in EM and have shadowed some docs, but because of my maternity leave and my school being inflexible, i will not be able to do an EM rotation before applying for residency. obviously a problem for 2 reasons-- 1. how do i know if i really like it? 2. how will i get 3 LORs (much less one)?

my school has advised me to shadow in my free time. (what free time? i'm in 3rd year and have a new baby!?)

i just don't know how to resolve this....

also, what do most people do when they apply EM? do they apply to backups too? i'm just an average candidate overall (grades,board scores) and am worried i'm not competitive enough.

Can you do anything EM related? Toxicology? Sports medicine? Ultrasound? EMS? That may help your case. Can you ask your school to let you do an EM rotation and put off one of your other core rotations until 4th year? (like OB or something similar)

Also, if you can find room for even ONE shift with your program director or department chair, often they are willing to write letters based on that. We had so many students applying EM from our school last year that we each only got one or two shifts in with the VIPs. However, those VIPs were willing to write us all letters based on the scant experience. Make sure you tell them at the start of the shift that you are looking for a letter, and that you'd like to present exclusively to them. Then, at the end of the shift, ask if you can set up a time to meet and talk about yourself, your career goals, etc. I had two EM letters, and one IM letter, so it's acceptable to get letters outside the specialty.

I did not apply to any backups, but if you're worried about it, ask your dean or EM program director if they would reccomend applying to backups in your situation.

Feel free to PM me, I'm a first year EM resident, and I was very recently in your shoes. (my daughter turned 1 yesterday)

These stories are so encouraging!! I begin medical school (God willing) next August, and am getting married the following June, right after my first year of school. I have alwaysss wanted a family and like I have said on other threads, I want to actually be a mother and not just reproduce. I would like to have my first baby perhaps during my residency, unless it is better to have baby #1 during the 4th yr of school?? I really would not know. Anyway, it seems really encouraging that some of you feel EM is the perfect specialty for moms. I love the idea of EM (constant change, broad range of ailments, team feeling, lively atmosphere... and I had at one point wanted to do surgery but am thinking it will not be conducive with mothering... so being able to do some procedures would be fantastic)! Any advice would be greatly appreciated.. Thanks so much!!

Do you guys worry about the lack of options in EM? It sounds ideal to me (I think) I have even been doing some shadowing, but what if I like it less in 10, 20, 30 years? There isn't really any room to specialize/ change. Can you shift into non-emergent primary care as an older doc? Can you do an FP or IM fellowship as an EM doc?

Current fellowships for emergency medicine physicians are toxicology, sports medicine, pediatric EM, EMS directing, critical care (can't get boarded yet, but we're working on it), ultrasound, research, teaching, international, and hyperbaric medicine. (I'm sure I'm missing one or two, feel free to add to the list.)

I do know one or two EM docs that have gone to urgent care centers, but most EM physicians find outpatient primary care medicine to be unattractive. I think the personality types that are drawn to EM versus IM or FP make it less likely that an EM doc would want to make that transition.

There is room for change in the specialty. An academic EM job is very different from a community practice, and practice locations (city versus more rural) are also very different.

Burnout is a problem in all specialties, and I don't think that EM is any worse than anywhere else. I think you are faced with the same lack of options for change as a cardiologist or a surgeon 20 years into your practice if you decide you don't like it. In all cases, changing would mean another fellowship at a minimum, possibly another residency.