Em 4Th Year

[mononoke]

Unlike other specialties, emerg has the option of doing a masters /fellowship year in the 4th year. What do people generally do during that year? Can you work (on salary)? and Can you do it at another institution?

[ploughboy]

In my cohort (and those immediately above and below me that I'm familiar with)

 

1) Masters Degrees

 

- MEd was popular, done either at home school, or away, or by distance ed.  

- MPH at Harvard also popular

- Clin epi at LSHTM

- MBA.

 

 

2) Clinical Training

 

- start formal Royal College fellowship (ICU, tox, peds)

- additional clinical training in area of interest (ICU, transport med (Ornge, TEMS, or overseas), peds, ultrasound, trauma, addictions)

- itinerant ER rotations, to try out different hospitals and make connections for when you're done (no disrespect to those who do this, but probably not the best use of that year)

- aerospace medicine (in the last few years we've had a couple of people go down to Houston.  Kinda badass when they post pictures of themselves at NASA)

- wilderness medicine (aka hiking, skiing, and climbing mountains for a year)

 

 

3) Moonlighting

 

- can't do this exclusively, you need to have some sort of academic plan and goal.  But if there is some downtime programmed into your year, even a couple of moonlighting shifts a month can really bring in some good cash and give you good experience.

 

 

When I was going through, you had to submit a plan and a rationale for what you wanted to do.  But the committee who had to sign off was pretty accommodating.  As long as you were doing something that sounded sensible they generally signed off.

 

So the sky is (literally, in some cases), the limit.

[anesthete]

This is extremely interesting to me.

 

Would those masters taken during 4th year be partially funded by the residency program? I'm familiar with the clinical investigator training program but in my understanding those are only applicable at the specific school at which you're studying... if for example it were my goal to do an MPH at Harvard during my fourth year, is that exclusively self funded? Are you still paid your resident salary?

 

Thanks! Sorry for going a bit off track OP.

[anesthete]

Also is this type of "4th year off exclusive to EM or do other residencies allow for this as well?

 

Thanks!!

[mononoke]

This is extremely interesting to me.

 

Would those masters taken during 4th year be partially funded by the residency program? I'm familiar with the clinical investigator training program but in my understanding those are only applicable at the specific school at which you're studying... if for example it were my goal to do an MPH at Harvard during my fourth year, is that exclusively self funded? Are you still paid your resident salary?

 

Thanks! Sorry for going a bit off track OP.

It's not self funded, you're still paid your resident salary

 

I was wondering how often people actually end up going into what they did for fellowship/ masters. For example, aerospace medicine sounds really cool but is it easy to go into that?

[NLengr]

Also is this type of "4th year off exclusive to EM or do other residencies allow for this as well?

 

Thanks!!

Pretty exclusive to EM as far as I know. Some people in surgical specialties take time to do a masters but time away from surgical studies means reaidency is lengthened.

[Byrne]

Unlike other specialties, emerg has the option of doing a masters /fellowship year in the 4th year. What do people generally do during that year? Can you work (on salary)? and Can you do it at another institution?

 

 

There is generally a remarkable amount of flexibility, so long as this Royal College requirement is met:

 

 A minimum of six (6) months devoted to achieving particular expertise either in a 1.3.scholarly activity or a clinical area, pertinent to the practice of the specialty of Emergency Medicine. This activity must be clearly identifiable and structured, with specific activities, objectives, and measurable goals. This activity must be formally approved by the program. Some examples of these areas of expertise are: education, clinical research, health care management, pre-hospital care, pediatrics, toxicology, and critical care

 

I am currently doing a part-time Masters course in the United Kingdom, which I started in my PGY2 year and expect to be finished by the end of my PGY4 year. I am currently looking at complementing this with clinical training there during my PGY4 year.

 

Feel free to PM me if you want more details.

 

It is worth mentioning that no one quite knows what will happen to the traditional EM 4th year once we switch over to a competency-based curriculum.

[Lactic Folly]

Pretty exclusive to EM as far as I know. Some people in surgical specialties take time to do a masters but time away from surgical studies means reaidency is lengthened.

General surgery at Western has PGY3 as an elective year. Many of the residents do a masters - seems like a nice opportunity. I do not think the overall residency is lengthened.

[hkmedic]

This is extremely interesting to me.

 

Would those masters taken during 4th year be partially funded by the residency program? I'm familiar with the clinical investigator training program but in my understanding those are only applicable at the specific school at which you're studying... if for example it were my goal to do an MPH at Harvard during my fourth year, is that exclusively self funded? Are you still paid your resident salary?

 

Thanks! Sorry for going a bit off track OP.

 

Your residency program will not fund this, however you may be able to find external funding to support your graduate program. For instance, in my neck of the woods, our department head for the region will provide some funding to your Master's program if he believes that the extra skill set and knowledge you acquire will bring unique expertise and benefit to the emergency department.

[ploughboy]

It's not self funded, you're still paid your resident salary

 

I was wondering how often people actually end up going into what they did for fellowship/ masters. For example, aerospace medicine sounds really cool but is it easy to go into that?

 

Like everything, it depends.  Neither of the aerospace med folks is doing anything with it as far as I know.  I think they saw an opportunity to do something they might never get a chance to do again, and took it.  I shouldn't presume to speak for them, though.

 

Pretty much everybody else I cited has incorporated something from their 4th year into their clinical practice.  It's a good way to get your foot in the door at some places.

[boringem]

We wrote an article on this year / enhanced training in emergency medicine that does a pretty good job of answering these sorts of questions:

 

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9914935&fileId=S1481803515000615

 

I agree with the comment above noting that it has not yet been determined what will happen with this year / time as CBME is rolled out.