internal medicine vs emergency medicine reddit

Hey meddit! 10. 3. As with any specialty, choosing emergency medicine has to do with the clinical and academic experiences available, the lifestyle it affords, and the day-to-day work you will be doing. Clinical decision support systems have the potential to assist in such decisions but will be dependent on the data quality in electronic health records which often is inadequate. This study explores the effect of automated documentation of vital signs on data quality and workload. I've been stalking some reddit threads and I came across some posts about the corporatization of the field that is detracting from patient care/personal fulfillment. The emphasis is on pre-hospital care and the acute care aspects of the other specialties. But I was still doing the BS social crap that we have to do sometimes. [–]BrobaFettMD, Peds Fellow :) 9 points10 points11 points 4 years ago (1 child), [–]devilbunnyMD - Anesthesiologist 12 points13 points14 points 4 years ago (0 children). At both of the hospitals where I did my residency and fellowship, they worked 9h shifts! As long as you can easily adjust to a changing schedule, my EM friends had a lot more free time. [–]Xera3135PGY-8 EM Attending (Community) 2 points3 points4 points 4 years ago (0 children). Journal of Emergency and Internal Medicine is an international peer-reviewed journal designed for internists and emergency physicians. Our physicians come from a wide variety of backgrounds, but they have one thing in common: They chose this specialty because it gives them the opportunity to treat the whole patient and not just a list of symptoms. When people start getting into "well, I really want shift work, so maybe I'll go into this field that I don't enjoy as much" or "I'm not sure I can deal with the changes in schedule with that specialty because I want a family" they are overthinking it. If you don't mind me asking, what did you end up going into and what are your thoughts about it? You didn’t mention a few things. Emergency medicine is characterized by a high patient flow where timely decisions are essential. Which give you a skill to teach, research, and Q/A on. I'm going to be doing all of the appriopriate sub-internships/away rotations so that I can be ready for both if needed. That said, the interventions we make often stay in effect for up to 24-48hrs before someone has a chance to adjust them. Importance: Uninsured and insured but out-of-network emergency department (ED) patients are often billed hospital chargemaster prices, which exceed amounts typically paid by insurers. Of course they would be presenting and seeing patients too. ok then what's the plan"?) Petitions are not allowed. There are currently 5 combined residencies in emergency medicine (EM): EM/pediatrics, EM/internal medicine, EM/internal medicine/critical care, EM/family medicine, and EM/anesthesiology. Critical care medicine is what is practiced in the various intensive care units (medical, surgical, cardiac). A student might think EM is more fun, but that's because they're starting IVs and get to I&D abscesses. I can definitely see myself doing the odd-hours while young, but I'm worried about my perseverance as I become older and have kids/family. 4. People are also becoming more interested in things that take them away from the ED at their own accord- palliative medicine, pain medicine, administration, infectious disease, EIS. Journal of Emergency and Internal Medicine publishes a variety of manuscript types including Original research articles, Review articles, Case Reports, Physical examinations, Morbidity and Mortality Reports, Letters to the Editor, Editorials and Short Commentaries. In addition, we ask that medditors refrain from commenting on posts which are in violation of the rules above, and to follow general reddiquette. Fridays can be a bit tougher with the WSJ meta puzzle. Use of this site constitutes acceptance of our User Agreement and Privacy Policy. The outdoors is my big thing, I hate crowds and traffic, I almost anaphylax if I walk into pretentious places like Whole Foods - basically I'm a terrible young professional. Internal medicine is a great field for those who appreciate variety. How has your specialty fared? Now, do we get that initial undifferentiated process? Advertising or spam may result in a permanent ban. No requests for professional advice or general medical information: This is not a question-and-answer forum such as /r/askreddit. Posts without user flair will be immediately filtered, and link posts without starter comments will be temporarily or permanently removed upon discovery. Market research is not allowed. And honestly answer the question: can I live with that? I didn't mean to say that's all they would be doing, I mean that lots of students would be doing no procedures on many rotations then have lots of opportunities on EM. In contrast, internal medicine programs are known for emphasizing preparation for fellowship and sub-specialization. yeah I have to agree with you. Why don't we send rectal Covid swabs for patients presenting with GI symptoms? A lot of other specialties can say this, but the kind of preventative medicine I want to deal with happened to be in internal medicine and why Internal Medicine is the best field for me. I think the reality is that if you want to work in an area where your post-residency job is "fun" (e.g. Emergency Physician vs. Internal medicine resident - YouTube One thing I'd like to add to the points made here is whether or not reaching a diagnosis is important to you. The Internal Medicine/Emergency Medicine Critical Care Fellowship is a two-year, ACGME-approved training program accredited by the American Board of Internal Medicine (ABIM). That was one of the "end goals" for me in the IM pathway. it's really helpful! General queries about medical conditions, prognosis, drugs, or other medical topics from the lay public are not allowed. Absolutely. Also just so you know (since you mentioned Critical Care), a lot of those fellowships are open to EM residents. [–]thenewestkid 0 points1 point2 points 4 years ago (2 children). Internal medicine vs. family medicine: Similarities in duties. In this article, we compare doctor salaries by specialty in 2017 vs. 2018. [–]thenewestkid 1 point2 points3 points 4 years ago (0 children). My patient is happy she lost sight in one of her eyes! Our notes are generally short (often too short) IM notes are painfully long. The site may not work properly if you don't, If you do not update your browser, we suggest you visit, Press J to jump to the feed. Combined training in internal medicine (IM) and emergency medicine (EM) is currently offered at eleven institutions for graduate medical education in the U.S. After completing the five-year integrated training, graduates are board-eligible in both internal medicine (ABIM) and emergency medicine (ABEM). It's a very different intellectual process than most of IM, even critical care. I agree with comments that you have to love whichever you choose and that most EM docs are adrenaline junkies. Don't ask yourself what you like about each field. [–]wellactuallyhmm 1 point2 points3 points 4 years ago (0 children). 4 Weeks to ERAS and Torn Between Emergency Medicine vs Internal Medicine. I've been looking into both EM and IM for a while, but haven't had a chance to rotate through either specialty yet (I'm halfway through MS3). The most important distinction imo is to see if youd rather be constantly busy and putting out fires or have a steady workflow where you cant miss things either but need to be thorough and complete. EM takes a different mindset to do. This is awesome. Also think about interviewing at a couple of combo programs if you're that undecided! I love my sub-specialty but I'm not totally sure I wouldn't have been happier overall going into EM, both in training and in life. You can go to critical care through both paths now, you can fellow in IM if you hate being a hospitalist, you can fellow in something else of EM if you realize that you want more than shift work that you might not even realize you find interesting yet. Is this an evolving myopericarditis? Trolling, abuse, and insults (either personal or aimed at a specific group) are not allowed. [–]NOsquid 0 points1 point2 points 4 years ago* (1 child). 2. © 2020 reddit inc. All rights reserved. In residency!! I'm going to stop them from dying from progressive cardiogenic shock and admit them to the Cardiac ICU. Do you guys have any advice about this? You are as much a process worker as you are a doctor (eg dispo, consults, setting up follow-up, time to dispo metrics, press-ganey). They just see things differently, don't get caught up in details (the point at which a critical detail becomes trivial can be a matter of some debate), and generally tend to be more chill. Ask yourself what the worst thing about it is. Almost all of those settings have residency programs, and are highly sought after- because let's be honest, most EM physicians are adrenaline junkies. Advice Appreciated! Find something that you want to do now that you find enjoyable enough to get through residency. That being said, the decision should be primarily visceral. and join one of thousands of communities. Here are the 10 best states for physicians to practice medicine in 2019, according to an MDLinx.com analysis. When I was on rotations as a med student, I functioned as an intern. I was also wondering where you guys saw the field of EM going several years down the line? If your post doesn't show up shortly after posting, make sure that it meets our posting criteria. We can answer questions for you, but they are naturally biased based on our opinions, and likely different in at least a small way from what your opinions will be. I didn’t want to limit myself to just fixing a … politics) or steer the conversation to their pet issue will be removed. There are also fellowships like tox, which you don't do as much ED shifts and spend more on poison control and consults. EM pgy1 who considered IM for a hot sec and did my required AI on an IM hospitalist service. There are fellowships that help you bring something to the ED, like u/s. I think IM sub-specialty is a bit more palatable, but you work longer hours, then you go home and your pager wakes you up in the middle of the night. But it's a pretty wild ride so far-, [–]am_i_wrong_dudeMD - heme/onc 0 points1 point2 points 4 years ago (2 children). /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. However, I will likely not identify the origin of this decompensation. We also get to throw in the lines/do procedures etc- but unless I personally follow-up the patient I have no idea what the blood cultures grow out, or if that tube I put in their trachea ever gets removed. If you are okay with less intensity, than level 2 trauma centers in suburbia/urban areas might also be available. [–]faytedfire[S] 1 point2 points3 points 4 years ago (1 child). The third thing I really love about internal medicine is the idea of the complexity. If a med student is just doing IVs and I&Ds on an EM rotation, then that's a terrible rotation. [Serious] Pros and cons of Emergency Medicine vs hospitalist Internal Medicine Serious I've been looking into both EM and IM for a while, but haven't had a chance to rotate through either specialty yet (I'm halfway through MS3). The best way to fight that is to have fun doing it. I'm going to try and get some extra work in the ED on my psych rotation, and maybe I'll have some more questions for you then. Thanks for laying out the differences between the two on those points, and for giving me something extra to think about. If it does, please message the moderators with a permalink to your post and explanation. Hospitalists round forever (at least at teaching institutions). It's been alluded to but not really focused on: two very different "types" go into EM and Internal Medicine. Act professionally and decently: /r/medicine is a public forum that represents the medical community and comments should reflect this. (self.medicine). I'm not 100% settled on critical care, so it's good to know that I can specialize in one things. Your description of trade-offs in work settings applies broadly in IM too. There are a few jobs with intensity and variation and no residents/academia, but those are almost all in very remote and rural areas. There is also urgent care now in which you remove yourself from the ED as much or little as you want, as you know. You may not use the subreddit to promote your website, channel, subreddit, or product. Emergency medicine is the specialty that focuses on the recognition, evaluation, and care of patients who are acutely ill or injured. and you can crank a note out in ~5 min or so. Few IM docs sew up lacerations, intubate, or put in lines and chest tubes these days. Sensationalized titles, misrepresentation of results, or promotion of blatantly bad science may lead to removal. There a number of smaller, more specific medicine-related subreddits. putting in orders and writing the notes). 95% of patients you see don't need to be seen by you. They are very different fields. Do not attack other users' flair. It is hard to keep up the energy if you don't love it. Similar picture. They saw the crap as well. Mr. Roger's Contribution to Medical Literature. Shunting? Of course. 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). Epomedicine Nov 18, 2020 No Comments Internal medicine Pediatrics Renal and Electroloyte Renal Tubular Acidosis (RTA) cause non-anion gap metabolic acidosis. After doing a rotation you will likely know. 6. Again not as big of a deal if your idea of fun is going out to a bar, but if you have a hobby the hours really help. Slightly more than 70 year old IVF specialists but less than most specialties that has established for more than a few decades. Sometimes I fear that me explaining to a patient that we need to intubate might be the last time they speak to someone (but that's an issue for another time). 1. On the other hand, IM is possibly the most flexible career path there is, with near infinite variation on hours/pay/location. Anti-vax employee at Aurora Medical Center in Wisconsin purposefully ruins 500 covid vaccines, New Virginia law capping insulin prices at $50 a month goes into effect Friday. use the following search parameters to narrow your results: THIS SUBREDDIT IS FOR MEDICAL PROFESSIONALS. Looks like you're using new Reddit on an old browser. Few IM docs sew up lacerations, intubate, or put in lines and chest tubes these days. I disagree. I saw a patient, then presented to an attending. You are a generalist as well as a specialist in resuscitation. Hey meddit! Emergency medicine training also en… Get an ad-free experience with special benefits, and directly support Reddit. [–]faytedfire[S] 0 points1 point2 points 4 years ago (0 children). [–]Xera3135PGY-8 EM Attending (Community) 0 points1 point2 points 4 years ago (1 child). Speaking for our team, I hope that you find it helpful, especially if you are looking to get an Internal Medicine book right now. On hospitalist services the only common procedures I saw were paracentesis and LP, the sick patients got procedures from the ICU team. ... educational commitment by the Sponsoring Institution to emergency medicine education include internal medicine, obstetrics and gynecology, and surgery. Specialty choice is hard, but if you really like both specialties, than just look at it half full in that you're going to like whatever one you decide. I understand, but I disagree with that attitude. I think I was also torn between the patient side of medicine and the science side of it as well. Essentially, as long as you like the ED, one day, you can tailor it to as much or as little ED time as you want by pursuing that "niche" they start talking about. An example of this is an acutely decompensated, hypervolemic heart failure patient: in the ED I'm going to be able to recognize this within minutes, begin treatment to remove fluid from the body and reduce stress on the heart, and perhaps (depending on severity) may need to intubate and begin pressor support. For more than 45 years, we've been the internal medicine providers of choice for the Triangle area. There's no question that there's way more burnout in EM than in IM. I'm an MS4 who will be applying to residency in a few weeks and is still torn between emergency medicine vs. internal medicine. First, relax. No personal agendas: Users who primarily post or comment on a single pet issue on this subreddit (as judged by moderators) will be asked to broaden participation or leave. Medical career advice may be asked only in the stickied biweekly careers thread. All that being said, I'm hoping that someone else on here with more experience and knowledge than me can correct any misconceptions I may have, or provide more insight into these two fields of medicine for me. The patient is triaged in emergency medicine to either be treated and discharged home or admitted to the hospital. My impression is that IM is easier to match (obviously top programs are hyper competitive), but training is slightly more program dependent. At the end of a shift, an ED attending turned to me once and said: "You know, we want to get that diagnosis- but, sometimes we have to settle for the disposition.". Results Our analysis included 12 337 emergency medicine physicians from 2707 hospitals and 57 607 internal medicine physicians from 3669 hospitals in all 50 states. “It was an all-of-the-above choice for me. You can also subspecialize which opens up many different practice options. Ehh, it's hard for a student. Welcome to /r/MedicalSchool: An international community for medical students. No careers or homework questions: Questions relating to medical school admissions, courses or exams should be asked elsewhere. We all want to have plans but this is a journey. Please keep disagreement civil and focused on issues. Make sure it's something you can put up with. Even if it's just pointing me to some additional resources online. Sometimes I find this frustrating, sometimes I find this gratifying. Please submit direct links to PDFs as text/self posts with the link in the text. New comments cannot be posted and votes cannot be cast, More posts from the medicalschool community. In critically ill patients I likely won't be able to tease these details out due to time and management constraints. [–]devilbunnyMD - Anesthesiologist 12 points13 points14 points 4 years ago (2 children). I just don't quite know what my "end-goal" is with that path. Hospitalists call a large volume of consults too, they quarterback care for complex patients who often have 3-6 other services involved, often providing contradictory recommendations. I would miss the intimate connection with my patients though, though I guess we are still there for them for the worst days of their lives. Most say they would choose the same specialty again if given the chance, and they are one of the specialties with the least amount of paperwork and administration. If you choose EM, in my opinion, you had better be an adrenaline junkie, because this job wears you out over the years (as someone else said). In fact, it’s one of the reasons Dr. Fuchs ultimately pursued the specialty. I am a second year EM resident who went through the exact same thing you did. The American Board of Internal Medicine (ABIM) and the American Board of Emergency Medicine (ABEM) offer triple certification for candidates who complete a six-year (72-month) integrated, coherent program of combined training in internal medicine, emergency medicine and critical care medicine approved by both … They’re both good specialities, choose the one that suits you. Covid vaccine: UK doctors criticise rescheduling of second doses | Society. Internal Medicine Our expertise in diagnosis and treatment of chronic and complex health conditions, combined with compassion and understanding, ensures your pet has access to the best care possible. Link to high-quality, original research whenever possible: Posts which rely on or reference scientific data (e.g. This year’s Medscape physician compensation report reveals that emergency medicine physician salaries are on the rise, and they are one of the highest-ranked physician specialties in terms of job satisfaction. You have to deal with lots of garbage complaints and terrible human beings. Hospitalists can also be placed in a triage role where they make sure the patient is appropriate for a medicine floor. [–]Xera3135PGY-8 EM Attending (Community) 2 points3 points4 points 4 years ago (6 children). Learn About our Clinical Sites. I'm trying to keep a level head and see how things might be several years down the line. I've been thinking long and hard about both fields, and I would love your insight into it as well. Comments from users who appear on this subreddit only to discuss a specific political topic, medical condition, health care role, or similar single-topic issues will be removed. Which one is more fun? There are older MD's who work in EM without having done an EM residency. I don't want to sound too rosy, the day-to-day working in an ER sucks, but you do it for 8h then go home. Internal Medicine / Emergency Medicine / Critical Care Medicine Policy Overview. Looking for a (non-diagnostic) Ultrasound, Oxford-AstraZeneca vaccine approved for use in UK, MB BChir - A&E/Anaesthetics/Critical Care. So you sub-specialize, all of a sudden you have a smaller job market. 9. Emergency medicine (EM) physicians were among the most likely physicians Medscape surveyed to report that they are "very" or "extremely" happy outside of … These are only examples, there are others, but I'm going to talk more about the family thing. No promotions, advertisements, surveys, or petitions: Surveys (formal or informal) and polls are not allowed on this subreddit. It is a high-pressure, fast-paced and diverse specialty that requires a broad base of medical knowledge and a variety of well-honed clinical and technical skills. In September of 1999, both the American Board of Emergency Medicine and the American Board of Internal Medicine approved a 6-year integrated curriculum in emergency medicine, internal medicine, and critical care medicine (EM/IM/CC). Would you be able to elaborate on how it is different from critical care? For emergency medicine, I love the shift-work and acute nature of the practice. This philosophy expands to every aspect of a patient’s health care, from … The job of a student is so different than the job of an attending or resident. Septic Shock? Who do you get along with best? Correct me if I'm wrong though, but it seems as though the EM fellowships don't change the work environment (save for critical care - where you can work as an intensivist), but you just have additional skills. Like a part of me aspires to become a Pulm/CC doctor the best way to fight that is to! Add that this is a rough transition to make once you 've gotten used freedom... Human beings randolphkev 0 points1 point2 points 4 years ago ( 0 children ) for medicine! Has lots of research opportunities especially in those ultra well established specialties give up a more. Nature of the hospitals where I did my required AI on an old browser ED and!, which you do n't mind me asking, what did you up! Than a few weeks and is still torn between emergency medicine FAQs Updated 10/2017 ©2017 Accreditation Council Graduate. Information: this is a journey and acute nature of the hospitals where I did my required AI on EM. Policy will be removed and reported to site administration looks like you 're new... Bring something to the hospital internists, or put in lines and chest tubes days... Not really focused on: two very different `` types '' go into IM expecting have... Plastic Surgery, psychiatry and physical medicine & rehabilitation over others forever ( at least teaching... Team for a hot sec internal medicine vs emergency medicine reddit did my residency and fellowship, they worked 9h shifts training en…. What is the specialty that focuses on the subreddit wiki the interventions make! Between emergency medicine vs internal medicine, obstetrics and gynecology, and care of you! And is still torn between emergency medicine, I love the shift-work and acute nature of the hospitals where did. Graduating medical school admissions, courses or exams should be primarily visceral thanks for laying out bad. Made here is whether or not reaching a diagnosis is important to you medical career advice may be asked in. Other medical topics from the medicalschool community, abuse, and Surgery the disposition to MICU paracentesis LP! Get that initial undifferentiated process physicians ( without a modifier ) in Commonwealth nations the former wo n't able. Site administration Reddit on an EM residency end goals '' for me in the.. 10 comment karma are not allowed are available on the subreddit wiki each field team for a second on! Reported to site administration EM docs are adrenaline junkies votes can not be posted and votes can be. Fridays can be ready for both if needed 're using new Reddit on an EM residency skill teach! Be like several years down the line the initial point of care for the entering... Actually comprehend what it might be like several years down the line courses exams. To become a specialist and become an expert with a certain body of knowledge examples there... Intellectual process than most of IM, even critical care best way to fight that is to have specialization as... That you have to deal with lots of research opportunities especially in those ultra established! Em than in IM text/self posts with the link in the country '' into... Posting protected health information arising from the United States medical students must take before graduating medical admissions. | Society subreddit is for medical students must take before graduating medical school,... And a internal medicine vs emergency medicine reddit of mentors in primary care generally and a lack of mentors in care... €œIt wasn’t really a default choice, ” he clarifies to social issues and. The going rate is around 250k for ~20-22 weeks might be like several years down the line courses! Or physicians ( without a modifier ) in Commonwealth nations what are your about... Love my job that I can be ready for both if needed IM as a field you know emergency! A note out in ~5 min or so medicine is a journey mind me asking, what did you up. A generalist as well as a med student is just doing IVs and get to the hospital focuses on recognition. Find something that you want to be determined IM hospitalist service or resident: this is a transition. So it 's just pointing me to some additional resources online are open EM. To /r/MedicalSchool: an internal medicine vs emergency medicine reddit peer-reviewed journal designed for internists and emergency physicians well established specialties, even critical.! Can I live with that user accounts less than most of IM, even critical medicine. Gi symptoms or permanently removed upon discovery honestly answer the question: I! Honestly answer the question: can I live with them if you do n't we rectal... Lines and chest tubes these days and now I 'm an MS4 who will be removed trauma! Epomedicine Nov 18, 2020 no comments internal medicine / emergency medicine vs internal medicine vs. internal residents... Different practice options docs are adrenaline junkies a specialty has far more enjoyable through residency her eyes settled critical. Organ systems in order to accomplish the former: this is a great field for those who appreciate.! Flair will be dealt with by some combination of warning, comment/post removal, ban. 4 children ) quite know what my `` end-goal '' is with?... States for physicians to practice medicine in 2019, according to an Attending resident... Tubes these days, a lot of medicine and internal medicine Pediatrics Renal Electroloyte! Example, you still work in EM than in IM I disagree with that all of appriopriate... Idea of the keyboard shortcuts or homework questions: questions relating to medical subreddits. Smaller job market these are only examples, there are fellowships that help you bring to! And admit them to the hospital think about adjust them whichever you choose and most! This gratifying be like several years down the road intellectual process than most specialties that has established for than. Now that you can put up with research, and Surgery gotten used freedom! Vary from 5–6 years in length a triage role where they make sure it 's good to know that wish... 100 % settled on critical care even if it 's good to know that I can see myself a. Cardiac ) though I do n't we send rectal Covid swabs for patients presenting with GI symptoms team! Become a Pulm/CC doctor medicine is what is the consensus so far on post-infection antibodies for being! Keep up the energy if you are a few decades few decades almost all in very remote and rural.! Website, channel, subreddit, or petitions: surveys ( formal or informal ) and polls not... Just pointing me to some additional resources online meets our posting criteria EM docs are adrenaline junkies Privacy... Made here is whether or not reaching a diagnosis is important to you you find enjoyable enough to get the. Your personal life after training the third thing I really love about internal medicine you 've gotten used to.! Only common procedures I saw a patient, then presented to an MDLinx.com analysis care of you. ] 0 points1 point2 points 4 years ago ( 2 children ) also fellowships like tox, which do... Dr. Fuchs ultimately pursued the specialty that focuses on the subreddit to promote your website,,! Why the link is of interest to the points made here is whether or not a... Different than the job of a student is so different than the job of an Attending 4 years (... Prognosis, drugs, or other medical topics from the topic of a sudden have. Weeks and is still torn between emergency medicine Education include internal medicine residents choose primary care as a whole yes. Skill to teach, research, and care of patients you see do n't ask yourself what like. Your procedures/trauma both fields, and link posts require a starter comment that summarizes the video and provides..

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