Do I Want To Be An Emergency Medicine PA?

How do I know if Emergency Medicine (EM) is right for me? What’s the schedule like? What kind of patient’s will I be seeing? What’s the stress level? Will I be happy with my career choice?

These are questions that myself and I am sure many of you are having while in PA school, on rotations, or looking to switch specialities.

The GREAT thing about being a PA is there is always the opportunity to switch fields. That being said, to become a master in your respected field it takes years of experience, switching fields resets the time clock.

Why Emergency Medicine?

One of the biggest reasons why I chose EM was the variety of patient cases. If you ask my wife, I have a short attention span and instant gratification, PERFECT for emergency medicine. I love the fact that I can suture a hand laceration and treat CHF in the same shift. You may see a 9 month old with a cough and and 95 year old with a cough at the same time. The wide variety of ages, procedures, and patient cases is difficult to find in other specialties.

Now, the “TV drama” appearing ER shifts where you are using paddles to shock patients and every case is an “emergency”, well this is just NOT the case. There is going to be your fair share of low back pains, upper respiratory infections, and dental pains. This is just the nature of the beast.

Some days it is nice to see the less acuity of patients. It is still important to keep a high index of suspicion, even in the most benign cases, as you just never know when that low back pain is going to be an epidural abscess.

I really enjoy the “team” aspect. The collaboration between the techs, RNs, PAs, and Docs is a unique experience. Without this “well oiled” machine, the flow of the ER would come to a crashing halt. Some days are better than others when it comes to this “teamwork”.

The autonomy you get working in the ED is quite unique. You want to work in a place that has the autonomy you WANT and the oversight you NEED. I enjoy working with the docs that allow me to see my own patient’s, order my own diagnostics, and admit my own patients, but if I have a question or would like them to go see the patient then they have no problem doing so. This allows you to feel as though you are really using your knowledge and skills to take care of patients.

What is the schedule like?

Do you enjoy working holidays, nights, and weekends, then emergency medicine may be the speciality for you. Now while there may be some sarcasm in that statement, some of this holds true. You will have to work Christmas some years, you will work on the weekends, and you may even have to do some night shifts. Most EM positions you will work one out of the three summer holidays (Memorial day, Fourth of July, Labor day) and one out of the three winter holidays (Thanksgiving, Christmas, New Years).

I personally enjoy the idea of shift work; you come in, do your work, and then go home. You may work 5 days in a row, but then you have 5 days off. The ever changing schedule may be too much for some people, but you normally get your schedule 3 months in advance and it is very reasonable to plan around this once you figure out the in’s and out’s.

The first ER group I worked for had 8 PAs (two different EDs), the current group I work for has approximately 60 PAs (seven different EDs). There is a much larger variety of schedule in my current group given the number of shifts that need to be filled. You just need to figure out a schedule/times that work for you. Do you enjoy early morning shifts and then have the rest of the day off? Would you rather have the morning off and working 3pm to 11pm? Maybe you are a night owl and can do all overnights and have the whole day off. While the variability may seem like a con, I think there is also some positivity in this as it allows you to create a schedule that is unique to your lifestyle.

How will I deal with the stress?

With any field, there are certainly more stressful days than others. It is extremely important to balance work with pleasure. Find something that you enjoy outside of working: golf, spending time with friends, traveling with family, going to the beach, alcohol (sometimes a beer is needed after a long shift), etc. My wife (who is not in the medical field) and I try our best to not spend a great deal of time talking about our work. Of course some days a good rant or vent is necessary, but we really try to separate our personal lives from our work lives. Just walking through the front door of my house is a huge stress reliever. Working with seasoned physicians, this seems to be the KEY to avoiding “burnout”.