Em vs im reddit. Plus what everyone else said about getting good SLOEs. EM can be 4 years. In patient psych is just the coolest place. One was Gen Surg and switched to IM, another was neurosurg for 4 years then switched to IM. Many other hospitals don’t either. Procedures are fun but the novelty wears off and you have to realize the 30 minutes you spend on a procedure is 30 minutes you dont spend to keep the meat moving. Anesthesia w ferllowship is 1 year less. It’s consistent and you won’t be a burden to your family. 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. Apply very broadly, and apply to IMG friendly programs and those that don’t fill during this match. You can do any mix of inpatient/outpatient pulm plus crit care. FM also has better outpatient procedural training. Your pespective on what you want to do will change dramatically. And just like Yelp reviews; It makes me wonder if the only people that take the time to say it’s so awful and the select few that are having a bad experience whereas the EM Your best bet might be to try and switch to psych at your new residency institution. EM physicians can work tons of places that are not hospitals: urgent care, most any country on the planet, a cruise ship, life flight, etc. IR is built on a foundation of DR. Emergency Med because of the "lifestyle" and "pay". If you like procedures, you have GI, Interventional/EP Cards. If the former, consider Surgery, if the latter, do EM. Thank you. I like gen Med but there’s a lot of aspects I… I’m dual applying EM and IM, but the EM sub-I I am on currently has been brutal. There can be inspiring women in IM too, across all specialties, no OR time per se, but doing procedures in cardiology, GI, etc. EM is perfect for people with ADD who literally can't focus on one case for the length of time IM requires you too. (2) Hospitalist job prospects will be grim (NP encroachment). I know this has been brought up before and I've read some posts about this topic but looking for some more perspective if it is possible, and chance to get my thoughts out. I did not like rounding and writing the same things over and over in the notes every day. If you like continuity of care, then pick IM over ER. Anesthesia and EM also focus and learn a ton about crit care physiology over the course of their residencies, so I feel like they come in ahead. The best non-SICU ICU docs that I worked with started in EM. #2. Also provides the antidote to point 2f above. My two cents are on inpt vs outpatient. Most IM fellowships are 2-3 years (i believe, i am not IM so ¯_ (ツ)_/¯). If you enjoy puzzles and really find yourself liking to work within more structured environments and protocols, then IM/FM is probably a better choice. Solar Pearl might be kinda funky with EM Lisa though since, as you mentioned, it procs on her AAs and Es, and in doing so, buffs her Skill and AA DMG. Hey everyone, currently a 3rd year medical student looking for some guidance. Other than that, use rem. Yes emergency medicine is a sinking ship. Test it out on a boss and you will see. Third, in actual practice once you graduate you can do as much or as little surgery as you want. Bluesaurus said: Emergency Medicine vs. If you want to be a master diagnostician and OK at stabilizing (you know what to do but need someone to usually intubate), do IM. g. That might switch as EM salaries continue to dwindle. Don’t switch. So yeah. EM is more about resuscitation, and managing the undifferentiated patient. In my opinion the later of the two, EM and IM hospitalist, aren’t very amenable to having kids. If you're really set on doing EM and CC, then do that and don't add on IM. It’s also a 5y residency instead of 3-4. No. With that said, in EM you may have most encounters with acutely psychotic patients, however their management will consist of differentiating between an actual psych issue vs a medical issue. Anesth/ORs a bit less night and weekend volumes with more relative to 7A to 5P kind of hours. Outpatient clinic workflow options (with fellowship or not), I like clinic workflow c. Unsure of what role anesthesiologists play in more rural areas with CRNAs. I was in the same shoes last year. Keep in mind that your EM rotation as a pgy 1 IM resident is not representative to what being an EM attending is. We have less social work than IM. You would want to use em over rem when you want to be relative to the parent element, not the root element. I know these are the three broadest blueprints and there is a decent amount of Emergency Medicine. if you use Bennett in a vape/melt team, go EM sands. IM offers way better flexibility and attending life is much more cush. FM can do both, but if the jobs are saturating as they say, we’d be getting phased out Cons of EM for me: Often not the most fun population to work with. For melt/vaproize in general, EM will outdamage Atk% if you are always getting reactions off. 4. 4 MICU, 1 PICU, 2 SICU, 1 NICU, 1 An anesthesiology intensivist will primarily deal with perioperative patients, either patients who had complex surgery done, patients with surgical complications and so on. If you're interested in IM-CCM, then you'll likely need to use all of your elective time (and possibly discuss with your PD to get more) in order to complete IM rotations. But, ultimately chose IM to be able to have more continuity with patients, and able to get the final diagnosis. Schedule wise, anesthesia is probably better for most people over the long term, though the attendings at my hospital still do night shift (in hospital) every so often, so it Jul 17, 2005 · 1. Rads residency is twice as long counting the fellowship year everyone does but will be over before you know it. 🟡 Pronunciation / Intonation Hi guys, It is quite different to EM. Option to sub-specialize in something more niche, owning an organ system (see point 2a). Consider IM. Honestly I would run Attack sands 90% of the time, even if EM sands ends up edging ahead in theory. Same drivetrain as normal sedan Corolla from ‘14-19 (only difference is the engine is 2ZR-FAE, it includes valvematic). bro how much dmg difference between both. " Third-year med student still a bit torn between EM vs IM. If you don’t mind switching days and nights consistently then EM. 11. They also probably read more EKGs since a majority of patients in the ER get an EKG, although inpatient IM will read a lot of EKGs too. Of course this will vary based on demand, but for example at my hospital an unstable The sub is currently going dark based on a vote by users. Also, the iM is manufactured in Japan, so build quality can be better in many cases when compared to US max corollas You could do EM and then do PEM after. For someone who wanted psych FM is the clearest choice, imo. Meanwhile the number of emergency medicine residency spots has exploded from 1772 spots in 2014 to 2921 in 2022. Even if you don’t like kids/OB, I think FM makes more sense if you know you want to do outpatient primary care. The only reason to do IM is cardio or GI and those are 3 year fellowships which makes training as long as rads. can specialize further if hospitalist isn't as appealing in residency, get to follow patients and see them get better throughout their hospital course. However, with the likely chance to get board-certified in critical care after EM residency that reason is less pressing, and I think I'm better suited for EM residency than IM. If you are more into academics, a more structured schedule, and EM probably fits that personality. You're going to have a lot less control over the structure of your day and depending on practice environment the pace can remain high through the entirety of the shift. Residency does have a significant inpatient component in most places, but a much more robust exposure to musculoskeletal issues (as compared to IM issues) throughout your training as compared to EM/FM. I personally picked IM with the hopes of going into pulm crit vs EM residency because I like being able to do the follow up that comes with ICU work. Pros of OBGYN for me: L&D is kind of like the ED of OBYGN (I really loved L&D on my rotation) I enjoy the patient population. EM is shift work, snd every place does shift differently (8, 10, 12 hrs). Go to the EMRA Residency Fair and meet with as many PDs as you can and express interest in their program specifically (I got 6 interviews from this). You do transthoracic echos in preop and pacu to assess your patients and make rapid clinical decisions. Here's my pros and cons: IM: Pros: get to see a variety of pathologies, no 2 days look the same. There are many IM specialties. N. Family Medicine can work in ER as long as your cool with rural areas. All EM doctors iv rotated with say that the ability to not move out of them ER easily is an underrated negative that they wished they took more into account. Atk vs EM sands. I think anesthesia crit gravitates more to the sicu than the micu from what I’m told. EM. It's basically acute vs chronic. As for anesthesia vs EM vs IM - all three pathways offer the opportunity to make resuscitation a major part of your job as a physician without fellowship needed (although TBH EM & Anaesthesia offer much more in the way of resuscitation and procedural competency). - Relatively and quickly replaceable in practice, so less bargaining power with each individual hospital/group. Em/im programs are 5 years long. EM is 24/7 all days of year. 9. Residency is tough, of course, and would likely require at least one year of fellowship, but might be worth looking into if you really want to be surgical. If your family is your priority, consider the difficulty of Med-Peds residency. First, IM residency can be just as brutal as OBGYN. 16 votes, 13 comments. Are there any other reasons that IM would be a better choice than EM? I don’t know what to believe on Reddit, I had no idea the job outlook was terrible for EM docs. It is designed to highlight the differences between a medical doctor and midlevels in areas including training, research, outcomes, and lobbying. Mar 11, 2012. You can do some fellowships to get out of the ER a bit (tox, sports med, crit care). Ya you graduate residency 2 years earlier but you burn out about 15 years earlier, grats. If you like sick patients and resuscitation, you can do Pulm/Crit. If you want to be good at stabilizing but be OK at diagnosing, do EM. Could somebody chime in on EM -> CC? Each day is a new journey, a new ROL, and more questions that need to be answered. Did several EM rotations, including a HCA hospital, and the HCA program wiped the floor with the others. The physicians with the highest rate of burnout are surgeons. That's more than possible, but you don't need to do EM/IM to do that. , EMRA, ACEP, SAEM, etc. Em the breakpoint for hp is somewhere around 35k. The job market is largely easier for PCCM physicians in both academic and community settings, and IM will allow you to change specialty choice should your mind change during residency. Oct 9, 2010 · 90% primary care is nowhere near reality. the amount of demand for emergency medicine spots is more or less constant tracking with the population. A really good SLOE and a good IM letter If your goal is to be a hospitalist and you would be equally happy with IM or peds, you should pick IM to avoid a peds hospitalist fellowship unless you're ok with that fellowship. Moreover, I see more men than women in gyn onc too. Likely will have more managerial role in this setting. The second month was much more difficult. If working nights and random shifts is a good lifestyle for youthan its EM. You can definitely quit EM residency and apply for a psych residency. Pretty easy to get a job as a hospitalist that pays more than ER. My actual psych rotation during 3rd year wasn’t very stimulating either since I just sat in the corner so it is hard to tell if I’d actually enjoy the day to day. Or even consider direct primary care model. super high burn out rate. if you want to be master at both, do IM and pulm crit If you want 3) IM Pros. Internal Medicine. - Getting a lot of unfair abuse from consultants/getting your "mistakes" pointed out constantly. I like EM because I like undifferentiated patients and I like the pace. But even in intern year, medicine residents get 3+ months of relatively cush electives/outpatient months where the hours are much lower. emergency medicine internal medicine pgy-1 re-entering match transfer. Yoimiya in a vape team ideally would be vaping around 60-70% of her damage as her largest hits coincide with her ICD resets. If you want 7 off 7 on the IM. FM residencies are each a little different in their focus. EM vs IM. - A lot more nights and circadian rhythm disruption once in practice as compared to general surgery. EM vs IM vs neurology What is more competitive regarding step 1 scores and applicants and etc, I got 239 step 1 and am a green card holder, if I get a 250+ on step 2 ck, which specialty would you recommend for me, given the fact that I have no passion for medicine in the first place and just doing it because am stuck there Mar 10, 2012 · EM has better pay/hours worked, but you have to work more nights/weekends/holidays compared to an established IM doctor (once out of residency). If a psych issue then your management will almost always be the same. EM makes more money, more flexibility in scheduling/ but nights are hard, but more days off. What are the benefits of doing family medicine over EM and IM? Over in the EM and IM forums on here and SDN for example there is talk about how: (1) EM is getting saturated and are moving rural. Em. You will constantly be told your department is "losing money" (not true). If you want/have kids then FM is best. I personally was not. 1. But that is very subjective to me. Welcome to the Residency subreddit, a community of interns and residents who are just trying to make it through training! PM&R would be your best bet if you want to solely practice Sports Med. EM gives you the critical care piece as well as the acute management of many illnesses. While Psych does pay well, it doesn’t pay as well as many IM subspecialties and I will be the main financial provider for my family. coastalhiker. Research isn't required, but it certainly doesn't hurt. Ls1Camaro. The answer to the question "what can you do with EM/IM training" is "whatever you want. Your pharmocology game is ON point since you have sick peolple that you may or may not start meds with. throwawaybeh69 M-4 • 5 yr. An im intensivist will primarily deal with patients who have non-surgical problems. I would really dig deep into your motivation for IM in the first place and see if your sub I was jsut a fluke. Anesthesia residency hours are by no means easy, but there is a pretty major difference in working 70-80 hours a week vs 80-100 (as many surgical residents seem to). Just certain rotations like onc and gyn. But my (limited) experience on rotations in both fields involved a lot more managing of complex disease It depends on what you have in your personal life. Use of ED as primary care. Need to understsnd drug metabolism really well. Did a EM rotation and IM sub-I back to back beginning of M4 to really get an idea of what it’s like. Liked EM cus of the acute conditions you see and getting to work up an undiagnosed patient. You can find more information here. You'd be double boarded, which could offer some very interesting career paths, but most of these people end up primarily focusing on either Medicine or Peds in the end. If you want to do pulmonology, that's your only option, but that doesn't sound like your goal. This forum made possible through the generous support of SDN members, donors, and sponsors. You usually switch from being an em or im resident to the other every 3 months at most of the programs. pineapplerind0215 • 2 yr. Also you perception of the Gyn women attendings may very well be isolated, most people seem to dislike their OB rotations because of the attendings. You do whatever you need to do to help the person and have full control. So those 14 shifts you are actually working working 22 days. The flip side is that once you make it through residency, you can live a very good life as an orthopod. So IM and EM docs what was the selling point for you guys. Who gives af about 1 year. Plus, I'm too dumb for IM. After match last year I’m concerned about the EM future job market after the AAEM/ACEP studies came out and the anecdotal stories I’ve heard about lack of Internal medicine residency is only three years and flies by in the blink of an eye. EM grads do critical care fellowships of course but if you are gravitating toward critical care then maybe IM is a better option for you. Atk% will help with more damage with burst, which is actually good damage (~700% mod at level6). Anesthesia offered me many of the appealing parts of both EM and general surgery (fun procedures, cool resuscitations, fellowship opportunities to vary my practice environment This sub is intended as a repository of sources and a place of discussion regarding independent and inappropriate midlevel practice. Your literally a detective. The OB part is full of procedures and short surgeries. Or check it out in the app stores Tell 'em vs Tell 'im . If you think IM is just rounding don’t do it. I’m currently an FM Intern and I’m considering switching to EM. Most FM fellowships are 1 year. The attending lifestyle can be much better than either gen surg or EM. I’ve done both an EM elective/MICU elective in M3 year and a EM subI as a M4 year (RIP ICU rotation in April) and I found it very frustrating to not be able to sit and think about patients for a EM Vs atk is really only a debate if you’re using Bennett in the team and already have a massive amount of atk bonus, like from WGS. FM vs EM. The sub will be back up tomorrow night. In inpatient IM you have to be a good multitasker. Are you a bit more reserved, take a bit longer to think and do things, like complex problems, ambivalent about procedures, but really want to see a course play out from beginning to conclusion? Then IM probably fits that personality better. The ortho trauma guys especially get to work on sick patients in a more critical environment. Its literally EM on easy mode. Applied to both. balance of clinic + inpatient + maybe ER, which I would like. PEM is usually 2 years if you do EM first or 3 years if you do peds first. Hi all, I'm currently a 3rd year medical student struggling with the decision to choose between EM/IM and Psych at the moment. Share. FM = adults, kids, vaginas, and more outpatient focused (though this is program dependant) The fellowship options are also vastly different. Last I spoke to an EM colleague on my EM rotation was that 1/4 of the graduating class hadn't secured a full time job and many of the rest were pissed off or doing unnecessary fellowships to ride over things. We don’t consider critical care trained individuals for EM jobs anymore. It’s desirable to have the full complement of 3 months IM (either general IM or non-MICU subspecialty) and 3 months MICU. -17. Psych is a lot more abstract and the skill set can, in ways, be similar to what it took to do well in high level English classes. That's at least 400k-500k left on the table of your career, or two years of your life. EM and anesthesia are very similar, personality wise and a lot of procedural overlap. Cons: No M3 deciding between Psych and EM/medicine. This is at a prestigious place too btw. FM kind of does that too, but IM is much more acute while FM is more if you want to follow patients long term. EM/IM is 5 years and Pulm/CC is 3 years. The residents were happier, had great work-life balance, and seemed to be getting really great training and experience. EM makes more per hour, is generally more exciting with a lot more variety. If you like new drugs and more outpatient, consider Rheum/Heme/ONC. 28. The job market in EM is really really bad. EM will always see a wider variety of patients (OB/gyn, Peds, trauma in its many forms, and Rotated in both EM and IM. Supply and demand. Also, if you have any interest in ICU, it's important to pursue the medicine requirements in your training - ACCS for anaesthesia starts in acute medicine and ED, whereas ACCS EM starts in anaesthesia/ICU, so if you end up transferring, you'll need to do a year's "medicine" to catch up if you go on to dual train in Get the Reddit app Scan this QR code to download the app now IM vs EM vs FM EOR . b. Rural FM pros: Huge scope of practice, get to see all ages and could do small office procedures. Most of the time IR docs still spend quite a bit of their time reading . If you don't like kids/ob --> IM. Certainly more airway more spinal procedures, and more central lines in Anesth. #5. I remember talking to one of my fellow PM&R residents that was going into sports and he had a tough time getting interviews with the FM programs because they had a fellow expectation of staffing the FM clinic in addition to sports stuff. With all of this said, I still like the aspects of EM such as shift based, (usually) fast paced, decent amount of procedures, etc. I have an ‘18 iM. Anesthesia and EM both develop the necessary procedural skills more quickly than IM. You might wanna end up doing outpatient (i originally wanted hsopitalist job but missing out on half of your weekends all year with 7 on 7 off schedule sucked). The first month of IM I loved it. But more options this way overall to switch things up in your career. Do Crit Care if you want to do Crit Care. Also know that there are stretches where ER docs wont do procedures for a while, while gas will get procedures (maybe not as big of a variety) every day. The money is in geriatric IM, you can make easily over $400k or more. NonLinearPath. IM: lower pay in general but more opportunities for fellowships, job security, can have call schedule. CCM is the Jack of all trades (inpatient medicine-wise) coming from (EM) another field that is similar in that fashion. You have 25 years after that where you’ll be working in the real world and that’s what you should have your eye on. IM: Can be 7 on/7 off or regular office hours (8 to 5) So realistically, you're looking at 235+ Step 1 for most of these places. Things like massive expansion of EM residencies, midlevel creep (though I suppose this is an issue for pretty much all specialties), and CMGs taking over contracts makes me wary. They also have the second highest divorce rate among doctors. That being said, we generally are in agreement that 1) those things are all important parts of ICU care and 2) EM and anesthesia trained physicians receive on average far more direct training in these aspects of ICU care than IM trained physicians. sploogemonster1979 • 1 yr. Hey friends, I’m currently an M4 undecided between EM and IM. Add a Comment. 7 on/7 off schedule for hospitalist seems appealing - basically have half the year off. 2 extra years is a huge opportunity cost wasted if you really want to do EM/CC. Now I have 4IM and 2EM in 2 super friendly programs. Short version: I was wondering if any psychiatrists here felt like they had to give up a love of physical diagnosis/medical management in order to pursue careers in psychiatry The main difference coming from EM/IM is you'll be eligible for pulm/crit fellowships (PCCM), and you can apply to IM-based crit care fellowships that don't take EM docs. Most PDs were willing to work with less though when I interviewed. We have some yes, but nobody calls their doctor's office to schedule their MI. •. Personally most EM/IM/CC people I know just do EM/CC or CC. Make over 300k as a hospitalist in the bay area. Shifts: EM shifts are at all hours of the day, Hospitalist shifts are more in the nature of day vs Night (maybe a mid shift if you’re a triage hospitalist). I'm EM/CCM trained with EM/IM/CCM peers and my partner is FM. comments sorted by Best Top New Controversial Q&A Add a Comment EM irregular schedule + shift work + constant work during those 8-12 hours is a real thing you must consider. If you do IM with crit only it’s more micu oriented. Psych is in such a great place right now. Perhaps this program was an exception to the norm, but the Reddit hivemind of "grrr this program bad! downvote!!" EM pgy1 who considered IM for a hot sec and did my required AI on an IM hospitalist service. 2. IM is a lot more versatile. IM = adults and more equipt for inpatient. View community ranking In the Top 5% of largest communities on Reddit. 17 only drops to 13-14 after residency, but many span 2 days. It is a heavily in-patient curriculum that jams 6 years into 4 Hey guys, I’m an M4 applying soon and I’m stuck between EM and applying to IM with the goal of cards. It doesn't mean we'd make better ICU physicians. The EM residents where I’m at (huge hospital, level 1 trauma, all the EM stuff) work between 45-55 hours a week according A great deal of the sports fellowships are run by Family Med (FM) departments. Award. IM as a hospitalist can get boring tbh, but EM imo is much more stressful. In EM you have to be a great multitasker. Jun 16, 2021 · Re-applying to Residency Advice - EM to IM. Second, OBGYN is not surgically heavy all the time. My first rotation was not nearly as demanding, but doing three nights straight, one day off, and now six straight shifts is making me reconsider my own personal stamina for the specialty. Anesth - (Im guessing) Imagine as manage sicker patients in OR similar chaos ensues but overall more control. - rem is based on the font-size of the root (html) element. IM attending here, purely outpatient. I had initially applied EM, and now I might have an opportunity to switch residencies across the country. But if you get knocked back or accidently reset her combo even once, then this vape percentage plummets I don't have advice on how to choose between the two, but there might be a third option in Med/Peds. Like you guys I also feel like the negatives of IM outweigh the negatives of EM (except the unknown long-term sustainability and lack of follow-up) That being said! I’m truly interested in Cardiology vs EM, and I don’t know how to choose between those two. FM is less pay, and IMO overworked and less flexible in scheduling and wayyyy more paperwork. EM vs IM residency . I was getting to use my knowledge of pathophysiology to build differentials and I especially loved the cerebral aspect of it. That EM sands build is one of the best Hu Tao's I've ever seen in general. ago. I really like the subspecialties of IM: nephrology, pulm/crit, cards, ID, heme/onc. There are SO many interns and residents I’ve met like this. You become very comfortable, very good, and very employable at the end. It leaves the possibility for cards, interventional cards, med onc (probably future of medicine right here), and so many other paths. All the best, -wtffng. If that is important to you, make sure to weight it heavily in your decision. EM/CC is fairly common but you'll be using your electives for the Unit. If you do the pulm/crit pathway you can choose your adventure. So if you start EM it will still only be 5 years, but if you decide you want out of school after the first 3 you could practice as an emergency physician for a while before going back to fellowship. Anesthesia is doing a lot of cardiology-lite in real time; you do the transesophageal echos and watch your meds and fluid management work in real time or if the valve repair or CABG is working well. Don’t rely on any overlap because it won’t matter when you’re applying against other PGY2 trained pharmacists who actually did the specified residency. ) can be helpful. EM probably sees more cardiac patients, but in my experience they do a lot more stabilizing than managing. It’s a great car. EM is the dumping ground for everyone, literally everyone (specialists, nursing homes, families, PCPs, homeless shelters, police, your hospital administrators, etc), and you are constantly under resourced for what you do. The timings can also be different. I don't think there are many fields really removed from it--IM, FM, EM, gas, peds all have lots of midlevels, because they're among the busiest and most in demand fields. Maybe build like around 2k attack first, then you can build EM. Reply. now that's just flexing. - em is based on the font-size of the parent element. Cons of OBGYN for me: At some point, having more attack will give less damage. I love EM, the ED, the patients & staff etc- so the EM/CCM split was the way for me. Get the Reddit app Scan this QR code to download the app now. I wanted a combination but no iv from them. Intern year on inpatient rotations the hours are pretty similar (in fact our anesthesia interns who rotated in both gen surg and inpatient medicine haaaaated their medicine wards months much more). Which is more competitive and why. The funky thing with this playstyle is that you'll be essentially neglecting 4TF's CDR almost entirely, with the exception of Tap Es since you'll be discouraged from Hold E-ing with a full EM In general, you should establish a mentor with EM-CCM, preferably in the CCM field you're seeking (Anesthesia vs Surgical vs Internal Medicine) to help guide you. If you don’t use Bennett, go atk sands with EM in artifact substats. Obviously, you also get the benefits of being fully IM trained along the way IM is much more than rounding. Jun 16, 2021. IM theoretically emphasizes the cerebral portion of medicine, with more evaluating and diagnosing. brokemed. FM does give you continuity, inpatient, outpatient, OB, and peds. The main reason I wanted to do IM was to go into pulm/CC. Food for thought. You can make a lot more as you go more rural, or work more shifts. EM is pretty big on perceived commitment to the field, so being involved in your school's EMIG as well as national organizations (e. EM is having its dark days. a. EM: 3 year residency, higher pay, less opportunities for fellowship, currently low job security, but very flexible in terms of work-life balance, one of highest Nov 7, 2009 · Mar 20, 2011. lg yp ec ub pq hm wy yn na if