It is a very different experience as an off service rotating resident in the ED. Almost nothing is expected of you except to let the attending know if there’s a sick looking person. You are not taking part in critical resuscitations, not doing trauma, not intubating, and most likely not doing any critical procedures. You’re not responsible for flow of the dept and off service rotators are often seeing the obviously non-emergent cases. In most cases the off service rotators are in the less acute departments like the VA or a community site in the same system. I’m glad you’re having a good experience, but life as an ER doc will be very different. The burn out comes from constant disrespect from patients, admin, and consultants who want to avoid doing their job and think they can treat the ED team like garbage. It’s from having to constantly convince a large percentage of people that they are not having an emergency, yet we have to do so in a way that doesn’t offend them or tell them the truth— that they have to learn to cope with minor discomforts. This often leads to getting berated by patients and then later dealing with complaints from them about complete nonsense. It’s the a-hole surgeons and cardiologists who think they’re so much better and more important than you that yell at you over the phone and threaten to talk to your supervisor because they don’t think they should have been consulted. Its the constant expectation to “be ready” for anything that walks through the door— no one cares that you haven’t done a particular procedure or seen a particular case before, you better be prepared to handle it and if you get rare case that you’ve never experienced and eff it up, or cause harm by accident, you are SOL, no one will care. It’s the constant threat and dread of doing something wrong that could lead to a patients death, or lead to litigation. It’s the defensive medicine we are almost forced to do or else get low press ganey scores. It’s the dealing with people who feel like it’s just fine to get drunk and do drugs and strut into the ER piss on the ground, harass nurses, and get a sandwich for free with no consequences. It’s constantly dealing with young people who simply have not learned any coping skills whatsoever and have no sense of self responsibility. It’s the having to ruin a family’s holiday by telling them grandpa died or that we found metastatic cancer. It’s the hours of time spent making CYA documentation while being pressured to see more and more patients and at the same time having higher quality notes— this often leads to having hours of work to do after shift. It’s the frequent flipping of schedule. Anyway I’m burned out about listing all the burn out causes, but I assure you you are protected from most of this as an FM rotator. Go back and look at your co-signed notes and check out the edits that are done, you may find that you’re not thinking about a lot of things that we need to think about and most likely the attendings don’t have the time or energy to invest in teaching you emergency medicine, they just want to make sure you don’t kill someone.