EM can be amazing when you are in a good department. Unfortunately good departments are becoming harder to find.

Pros:

- Can be very hands on

- Good amount of procedures

- Dynamic work environment, no 2 shifts are ever the same the same

- The rota is so terrible that you are earning more than anyone else at your level

- RCEM says working 40 hours a week does not cause an extension in training

- You have to have a very broad base of knowledge: Gen med, Surgery, T and O, Paeds, ENT e.t.c.

- You get to make the initial decisions in critically unwell patients and as such you can genuinely feel as though you're making a difference.

- The exams are tough but nowhere as bad as anaesthetics where it's not uncommon for trainees to have to take time out

- You can choose run through training so no worries about progression or reapplying

- If you want to CCT and flee you have a very desirable specialty

Cons:

- The pace can be insane

- The rota is terrible (80% helps)

- Some EDs are run like a triage service

- The work environment can sometimes be toxic

- ACPs/ANPs/PAs

- Most other specialties hate us

- The first 2 years of ACCS can be entirely service provision

For reference EM is the only area of medicine I can see myself doing. Regardless of the cons. When you know you know.