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Emergency medicine or internal medicine?

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1 Emergency medicine or internal medicine? on Thu Feb 17, 2011 9:57 pm


I'm a 4th year med student applying for the match right now. I just finished interviewing in both internal medicine and emergency medicine and am trying to decide between the 2. Since i love them both, it's coming down to flexibility of lifestyle after residency. I don't have a family yet, but plan on having my first baby right at the end of residency. I would like to find a situation where I can make good money working 3 days a week? or so. The thing is, I don't know what it's REALLY like for EM physicians after residency and in the community. How hard is it to find the part time jobs in desirable locations? Are there actually places with nocturnists that are common so you don't work a ton of overnights? What's the real scoop? I have to rank in a month so any insight would be so helpful.

2 Re: Emergency medicine or internal medicine? on Sat Feb 19, 2011 1:26 am


I actually am very happy with my choice of EM. It's kinda weird, because my answer to the question changes as the years go by as to the "why" I like it.

Today, I'm happy with EM because I can make *almost* 2K each time I work, so working 6 shifts/month brings in over 10K (minus taxes). I can live on 10K! And I'm gone 6 days/month (one overnight). I have 3 kids now, and am trying to get into yoga, meditation, and other things that are good for me

I have not worked full time since I graduated residency 5 years ago (except for a short stint at Kaiser in Northern California, and another short stint as an academic attending). Which promptly lead me to realize that...I don't wanna work full-time (eventhough "fulltime" is 120 hrs/month or 10 12-hour shifts (still doable, right?)

Being a doctor is good, when you don't have to do it all the time, LOL. Working part-time is VERY easy in EM, even in big cities. One of the drawback I'm realizing is that lots of EM jobs are independent contract, which is okay if healthcare is thru your hubby's job. But getting healthcare coverage if you happen to have someone with a chronic illness in your family, can be expensive or not possible at all without employer sponsored group health plans. So, for me/us, if that time ever comes...my husband will have to get a job with benefits, or I will have to (and they do exist, but ususally require full-time work).

Also, I don't like working overnight anymore. It's just...disruptive to my routine, you know? But no less disruptive than being on-call q4 day and having a pager wake you from sound sleeping multiple times a night...for the rest of you career!!

My overnight load has not been too bad over the years. Usually I worked 2-3 overnight a month. Now, I'm working less because I'm working so part-time at two different ERs, so I get to pick my shifts.

Also what I like about EM is I know alittle bit about everything, right? So I can treat myself and my family (which I have no qualms about doing, especially with the price of healthcare these days), advise, suggest, and advocate for their health care needs better, I think. EM offers a variety of "things to do" so I find I'm not tired of what I do. I do get tired of the overnights...and working in general...which is why EM works for me. Because I can do it part-time.

EM is exactly what I expected it to be. Lots of social issues to deal with in EM. But overall a fun job. Not often to I get trauma, codes, procedures (except lacs), in the community...which I have come to appreciate. I like the money. I like the flexibility. And feel (now) it's the only way I could balance my life and still do medicine at all...

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