Patient contact. End game is, gotta shadown in an ED. 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. In the end, I found that I liked knowing a bit about everything, and loved the variety. Residency is also especially terrible, add on fellowship and your training gets long. I have a drive to be a good doctor, but not to the stereotypical sense that surgeons do. The Trauma Surgeon will typically work in emergency rooms, performing operations on … Specialists vs. Generalists The main difference between an ER doctor and a trauma surgeon lies in specialization. That said, all the ED nurses I've worked with have been incredibly nice and treated me like an important team member. 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. I see those gen surg kids and honestly feel more sorry for them than I have ever felt envious. Probably because the nurses are so damn competent. Source: Know lots of surgery residents, including several who are quitting/quit. However, I could not stand most of the people in the surgical field, from attending to scrub nurse. Edit: In all seriousness. switching days/nights all the time is pretty rough though. Making critical decisions with incomplete information. The trauma surgeon is responsible for initially resuscitating and stabilizing and later evaluating and managing the patient. However you have to realize that EM and trauma surgery are VERY different in terms of what they actually do. 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. Just FYI, anybody who sneers at you for being a “lifestyler” is bitter and/or a masochist. I don’t regret my choice a single day. I was deciding between these two as well. 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. 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. I didn't want that to be the rest of my life. 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 University of Utah Affiliated Emergency Medicine Residency is a PGY 1-3 program. Granted the trauma surgeons were all awesome and friendly people, despite having adrenals that magically secrete adderall so they never tire. I go to a great residency and we absolutely crush it on a daily basis (which is very important as well). Good and happy surgeons do exist in real life. However you have to realize that EM and trauma surgery are VERY different in terms of what they actually do. 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. 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 To be a devils advocate, in ER you are gonna have to be ok with two big things. The fellow will be exposed to trauma as part of the Trauma Service, the TTL team, and as well during Emergency Medicine shifts. Cookies help us deliver our Services. /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. 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. see, i LOVE being scrubbed in and i LOVE the sterile field, etc etc. By using our Services or clicking I agree, you agree to our use of cookies. I need to do things with my hands. 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. Now I'm on EM and finding it quite fun. 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. 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 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. So that's the general gist of where I am at mentally in regards to what I am looking for in a career. "Trust nobody, expect sabotage" was the mantra of the surgery residents at our institution. 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. It's all my peers that love to think they are superior or know more. EM resident here. "It's usually a five- or six-year residency for general surgery, followed by a year or two of surgical critical care/trauma fellowship. "It's a significant commitment to become a trauma surgeon," Dr. Putnam says. 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. Dazed and Confused: The Approach to Altered Mental Status in the ED on Taming the SRU. ern i know who was choosing between two fields see. If you want to do surgery, be a surgeon. 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 know you say it doesn’t matter but you may change your mind down the road when you literally live at the hospital. Cookies help us deliver our Services. The Pupil Exam in Altered Mental Status on PEMBlog It seems custom built to create conflict in the trauma bay. 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. Press J to jump to the feed. I was deciding between a surgical subspecialty and EM. I struggled with this problem also. I felt the same way as you when I was a medical student. You go down a checklist, then they go to surgery or they are medically managed. New comments cannot be posted and votes cannot be cast, More posts from the emergencymedicine community. Killer coma cases part 1 (the found down patient) and part 2 (the intoxicated patient) on Emergency Medicine Cases. Ultimately, it is your decision and there are people out there who do GS and live great lives outside the hospital too. 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