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On 5/23/2020 at 5:27 AM, rmorelan said:

first thought - passing an exam without the support and guidance of a full program? That sounds horrible (doing the same with full support and resources for my exam was literally the most academically stressful thing I have ever done ). The exam history you get at the school it extremely valuable. 

I’m totally bias here being trained in the 5 year stream. But I just can’t fathom one being able to accumulate the equivalent knowledge, confidence, and department management skills needed without dedicated support provided by a training program. 
 

Becoming an expert in emergency medicine takes more than some CME, some hours logged and an exam. 

Edited by rogerroger
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This is by far one of the most common questions people who are interested in EM ask. Lots of good answers on here about it.  It’s also a reasonable question with perhaps an unsatisfying non-black and

Here you go:   Just joking here with the picture above. I don't have a definition. However, there are some medical students who just don't give a good vibe to others. Examples

In a way it would make more sense for it to be the exact opposite (not that I'm advocating for that). To come to a provisional diagnosis and manage a patient without having CT available is probably a

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On 5/29/2020 at 12:11 PM, rogerroger said:


I went into my emergency medicine residency considering critical care. It was one of a handful of potential options I was considering for the “extra specialization year” built into the 5 year training. 
 

In my first three years of residency I spent just shy of 1/2 year in the ICU, and didn’t like it that much. In the ED sick patients often get better, get worse, die, or stay the same and get admitted over the course of a shift. The ICU with all it’s hours of rounding and the gradual changes in patients status didn’t really fit what I was looking for from a work satisfaction standpoint. Don’t get me wrong. There is also some fascinating medicine going on there. When it was interesting, it was really interesting. But it just didn’t have the turn around of the ED which I really enjoy. 

My impression is that critical care docs work really hard when they are on. There are different models out there, but many cover the ICU for a couple days. Those few days seem to be fairly focused on the ICU with call etc. During the off times most of these folks go back to their regular programming, such as being an emerg doc, anesthesiologist, respirologist, surgeon, etc.. I imagine what sort of overall lifestyle this job presents is probably highly dependent on what else you are doing when not covering the ICU.

As an aside, the ICU rotations during emergency medicine training are some of the highest yield over the five years. Many residents come out of the ICU and return to the ED with a much improved repertoire of knowledge and skills. So even if critical care isn’t your cup of tea, it’s hugely translatable towards determining the type of emerg doc you will be.

 

thank you!

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On 5/23/2020 at 7:18 AM, medigeek said:

How come you say it's a lot of work and dedication? You're working and making physician income, while accumulating hours. The remaining part is passing the exam, which is the same exam PGY3 people write.  

It is a lot of work because you need to work in emergency department and sometimes it may not be easy if you live in a large city and cannot move. In addition, you need to keep up with the reading and procedural skills outside of practice because often you are working in emergency departments with no back up. It takes a while to accumulate the hours and some people may just lose interest over time.

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On 5/23/2020 at 12:18 AM, medigeek said:

How come you say it's a lot of work and dedication? You're working and making physician income, while accumulating hours. The remaining part is passing the exam, which is the same exam PGY3 people write.  

Also, as of this year requirements for practicing physicians have changed. The most significant change is that the site the physician is working at must have advanced imaging such as CT. This means that docs working in smaller rural centers with no CT cannot use those hours to qualify to write the exam. A lot of people who have been working towards practice eligibility are now excluded and quite upset. 
https://www.cfpc.ca/en/education-professional-development/examinations-and-certification/examination-of-added-competence-in-emergency-medic/eligibility-and-application

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41 minutes ago, The Bunny said:

Also, as of this year requirements for practicing physicians have changed. The most significant change is that the site the physician is working at must have advanced imaging such as CT. This means that docs working in smaller rural centers with no CT cannot use those hours to qualify to write the exam. A lot of people who have been working towards practice eligibility are now excluded and quite upset. 
https://www.cfpc.ca/en/education-professional-development/examinations-and-certification/examination-of-added-competence-in-emergency-medic/eligibility-and-application

 

I believe they have discussed this and are looking at a way to not exclude rural docs in this context. This includes possibly revising the new criteria soon.

"Rural" is also a bit of a vague term. There are places that see a fair bit of acuity and range of pathology but doing a CT involves sending a patient out 25 minutes. you generally need far stronger clinical skills in those settings. And lets be serious here - how many central lines or airways are actual academic staff even doing? They "supervise" them. The small community (aka most of which is "rural") guys are doing the procedures all alone without any help in house. 

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