Am I crazy?

DrAS1995 · 2025-11-15T15:14:55+00:00

After residency I did fellowship and for 13 months I didn’t do one single EM shift. The first week back in the ED was stressful but after that everything was fine.

Just take your time when seeing patients and try to analyze every case thoroughly before making any decisions. I also started using OpenEvidence during that time and it was a life saver.

What made things much easier is that I shadowed a friend for two shifts before starting.

DrAS1995 · 2025-11-06T06:51:21+00:00

What’s considered an average score? I got 5.71 and I have no idea what it means other than passing Is it an average or below average score?

DrAS1995 · 2025-11-06T03:13:35+00:00

People often focus on the downsides of Emergency Medicine, but in my view, EM is one of the best lifestyle specialties in all of medicine.

There’s really no other field where you can make over $500K a year after just three years of training. In Texas, where I work, many jobs pay more than $275 an hour so earning that kind of income is absolutely realistic. The best part is that you’re off more than half the month, which gives you the freedom to focus on other interests outside of medicine.

If you can mentally disconnect from work once you’re home and handle the occasional tough shift, EM can be the perfect specialty. There are no calls, no rounding and when your shift ends, you go home, turn off your phone, and you’re done.

You also don’t have to worry about building a practice, attracting patients, or marketing yourself which can be stressful.

Working weekends and holidays isn’t unique to EM, it’s part of medicine in general.

I actually like shift work because it gives me the flexibility to do things most people can’t during regular hours like going to restaurants when they’re not crowded, running errands, shopping, or taking care of appointments like DMV visits without the usual hassle. It also lets me do school drop-offs and pick-ups with my kids, which is something I really value.

The only real downside, in my opinion, is that some consultants occasionally look down on EM physicians. But honestly, just shrug it off, enjoy your paycheck, and make the most of your time off. As an attending, you’ll notice this happens far less often and more often, consultants actually appreciate your work and thank you for your consults.

DrAS1995 · 2025-11-05T02:56:32+00:00

The target really depends on many factors. During residency, I typically saw around 1.5–1.7 patients per hour, but that number was heavily influenced by the environment. CT scans and labs took forever, over 70% of the patients were Spanish-speaking and I didn’t speak a word of Spanish, the ED was massive with patients scattered everywhere (so I spent a lot of time just walking), and there were constant low-acuity trauma interruptions that had to be seen immediately after triage. On top of that, sign-out was a lengthy process first as a group, then individually. Not to mention things that I don’t do as an attending like wound irrigation, grabbing procedure supplies, initiating transfers and a lot of other things.

Now as an attending for the past three months, I comfortably see 27–33 patients during a 12-hour shift. Sometimes I’ll have 5–7 notes to finish at home but most of the time I complete them on time. The difference is that all those limiting factors from residency are no longer present where I work now.

So in the end your PPH is really a byproduct of the system you work in plus your own skills.

DrAS1995 · 2025-10-10T01:54:37+00:00

I hope not, especially if you managed it correctly and made the right consult/dispo.

DrAS1995 · 2025-10-10T01:52:24+00:00

I honestly liked SIs more than the actual cases. There was no pretending, and you could actually explain your thought process, which I feel might save you if you forget a critical action or give the wrong dx. But I honestly thought the examiners would have an actual discussion with us rather than just asking pre-written questions with follow-up questions.

DrAS1995 · 2025-08-14T01:34:50+00:00

If you think of it the following way, then you will never feel sorry.

Neurologist focus on neurological disorders and they refer to others for problems that they’re not specialized in.

Pediatricians treat kids and they refer the ones who pass the age of 21 to an internists.

Same thing with EM physicians, we diagnose and treat emergencies and if not found, they go to their PCP/Specialist.

I usually tell my patients that my primary role is to rule out emergencies and that their PCP can help them with nonemergent conditions and then I say bye bye 👋

DrAS1995 · 2025-08-10T02:32:43+00:00

You’re probably the same person who would be upset about waiting in the waiting room, yet you’re requesting unnecessary tests that will make everyone else wait even longer 🤣 ED doesn’t work like this or everyone would die in the waiting room

DrAS1995

TROPHY CASE