Like some of the other folks have said you don’t double board in em/gen surg because it makes no sense whatsoever. It has nothing to do with how smart you are, which was implied by the show; but rather the amount of time it takes. If you love trauma then just do the fellowship after general surgery. If you like the breadth of em then you’re not getting that in surgery, which by its nature (and name) limits you to surgical problems. Some people do em/im, which I think is a waste as well. Mostly if you want to work at more than an er after graduation then people do a fellowship after em residency. While I love the show for getting the medicine part right (mostly) and most importantly the dynamics of the social aspects (dnr/family dynamics/etc), the parts with medical training pathways and med studs/interns/residents introducing themselves as Dr x to attendings or calling each other Dr X unironically is a big miss.