Med school? I’m not even close. Right now I’m a junior in high school, but I plan to become a doctor. Right now I am involved in a SAR group that practices an EMT-B standard of care and I often do rides with a local FD, Littleton Fire Rescue. What I want to know is what type of positions are out there for med student graduates in Emergency Medicine such as Emergency Care Physician or Trauma Surgeon? Real basically: what are the perks of each? What is each job like? Which gives the most opportunites to leave a hospital and go out into the real world? Do any medical helicopter systems use Flight Physicians like they use Flight Nurses? How long is the internship? How hard is it to get an internship? How well do the internships pay? How well do the positions pay? Which positions are in highest demand? Which positions gives you the most opportunity to interact with individual patients without jumping straight from patient to patient every five minutes? Which positions give the most opportunity to advance into chief positions in hospitals without becoming an administrator? Which positions are more “fun”? Diverse? Which positions attract the most admiration and attraction from the opposite sex? 
Basically, getting into and through med school is hard work, but you end up with an MD and membership in a worthey profession.
Much has been said about how being a physician ain’t what it used to be. There are lot’s of hassles involved in getting that MD, and you can count on lots of hassles getting through internship and residency, and even more hassles having to deal with “managed care” and the beurocratically regulated and quasi-socialized medicine we now have in the USA.
That being said, being a doctor is still a very highly satisfying and financially rewarding profession. You can pretty much still select the kind of work you want to do, and you can be guaranteed to find a job that allows you to support yourself considerably above the poverty level, which cannot be said for many other professionals, including those erstwhile high-flying dot.com’ers who are know scurrying for work to meet their mortgage payments.
Neurodoc, I really appreciate the response, but I was wandering more specifically what type of physician I wanted to work towards.
With most med school programs and internships, how much opportunity will one have to try out different positions? Can I try out both an Emergency Care Physician and Trauma Surgery internship, or do I basically have to know what I want to pursue straight out of med school? What if, after 5 years as an ECP, I decide to go into Trauma Surgery, Pediatric Trauma Surgery, or even cardiology? How long would each new residency last? If it takes three years to do an ECP internship and five to become a trauma surgeon, could I do it in two years extra? Three years?
Thanks a lot,
Elliot
Elliot, it sounds as though you have LOTS of questions regarding medical education and practice! I’d suggest that in addition to posting on this messageboard, you check out a few books on medical education from your local library to fill in the “broad strokes” about what’s involved. and don’t feel committed to making any decisions yet, because as a junior in high school, you still have lots of time to decide exactly what you want to be when you grow up
A general overview of medical education:
Med school lasts four years - in most schools, the first two years are spent primarily in the classroom. During the final two years, the student rotates on different services in the hospital. Some services are elective, but all medical schools have mandatory rotations in internal medicine, general surgery, pediatrics, obstetrics and gynecology, psychiatry, and often family practice. Most of the mandatory rotations are done during the third year, so that by the time the middle of fourth year rolls around and the student has to start applying for residency positions, he/she has seen a broad overview of medicine, and usually has a fairly good idea of what field he /she wants to enter. If the student is still unsure, it is possible to do a one year internship in either medicine or surgery (which may or may not apply towards later training).
Difficulty of getting a residency position varies depending on the medical field - ER is generally very competative, general surgery is less competative overall, but it’s still not easy to get into a top-rated program. ER residency lasts for 4 years, general surgery is 5 years, and trauma surgery or pediatric surgery require additional fellowship training. It is possible to switch fields during or after residency, but often it’s not easy - in general, you can switch into a less competative field, but may not be able to enter a field thats more competative than the one you originally trained in. With few exceptions, your previous training won’t count towards meeting the completion requirements in the second residency. Residency pay is not great - I earned about $40,000 last year in my sixth year of training. You will also work long hours. I don’t know the current salary information for ER physicians or general surgeons, but they’re not poor.
In general, ER physicians are hospital-based (it’s not cost-effective to use them to do work that a nurse or paramedic can perform instead). ER physicians typically don’t have a lot of time to spend with patients; general surgeons have more, but neither field is a good choice for someone who wants to get to know individual patients well and have long-term relationships with them. Its not possible to advance into “chief” positions in any field of medicine without doing administrative work - administration IS the principle function of the department chief! As to which field is the most “fun” - well, that depends on your personality. Different personality types are attracted to different medical fields, and they all feel that their specialty is the most fun!
Hope this is helpful. If you have more questions, bring them on, and I’ll do my best to answer them.
artemis
Yes, you pretty much have to know your specialty when you leave med school. If you choose surgery you can narrow the choice later (neuro, plastic, general, pediatric, etc.). Same with medicine (cardiology, endocrinology, gastroenterology, etc.). But, if you choose something like ob/gyn or psych you have fewer options later on.
Have you given any thought to quality of life issues? If you go into emergency medicine, you will probably be employed by a hospital, do your shift and go home free and clear (more or less). On the other hand, if you become a surgeon, you may get to do cool surgery but you will also have to maintain regular office hours, make post-op hospital visits, get more involved with financial paperwork than you ever thought, and take a lot of calls from sick or worried post-op patients that can intrude considerably on any private life.
If you want to work with one patient at a time, forget emergency medicine. Think anesthesiology.
All specialties are attractive to the opposite sex. The money is best in surgery, worst in pediatrics and psychiatry.
As for fun, that is a matter of personal taste. Right now you seem attracted by the high adrenaline hero stuff but that may change as you mature and develop.
Best of luck.
To provide a short answer to your question:
Trauma surgery is a specialization after a general surgery residency. General surgery residencies are usually a minimum of 5 years after medical school. As a trauma surgeon, you are either the guy cutting open a chest in the ER or receiving the gunshot wounds in the OR after the ER stabilizes them.
Emergency medicine is a field which spans both medicine and surgery. It is a separate residency which is 4 or so years post medical school. If you are an emergency doc, you will be diagnosing strep throat in a kid as well as belly pain, seizures, and cutting chests and delivering babies.
At the community level 1 trauma facility associated with my med school, we don’t have emergency medicine docs. The medicine department, OB/Gyn department, pediatrics, and surgery divvy up the ER. The triage nurse deals out the incoming patients and we work them up. Surgery/Medicine/OBGyn/Pedi residents and attendings take months or shifts in the ER. This is not the way that most places do it, but we feel this offers the highest quality care to incoming patients, and trains all docs to deal with emergent care.
Coming out of medical school, you will need to know whether you want to do emergency medicine or surgery. In some cases you may be able to do a transitional year during your first year post medical school to help you sort things out. At most medical schools, there is ample opportunity to rotate in ERs, as well as do mandatory surgery months. 99% of people know what they want to do by the time they are a fourth year medical student.
The 3rd and 4th years of med school let you try out various specialties. Take advantage of that. In your 4th year, you can try out a semester of what is called a “sub-internship,” which lets you follow a resident around in the hospital and do things like take overnight call and generally see what the specialty is all about. At my med school I did two of these sub-internships, and the one in neurology hooked me…The other one, believe it or not, was in OB-GYN…
If you graduate from med school still not sure of what you want to do, you can do a PGY-1 year (the old “internship”) as a “transitional” year (that is a mishmash of everything and closest to the traditional notion of the Intern) or a “priliminary” or “categorical” medical internship. I did a “categorical Internal Medicine” internship. This would allow you to shift over into almost any specialty, but the “transitional” program would favor subsequent surgical residency specialties.
The fact is that most MDs who get through internship and get licensed can find some niche to practice in, and this flexibility is quite unique to medicine. I have met a few pathologists, for example, who later in their careers decided they wanted to practice general medicine, and they were able to do so successfully. I must say that I haven’t met any psychiatrists who have done so, but psychiatry is a bit peculiar…
As a Sophomore medical student and a student representative to the American Association of Medical Colleges, I’d like to refer you to http://www.aamc.org/medcareers This is a resource that offers descriptions of many residencies available to MDs. Also the most popular site for such information is http://www.scutwork.com
Good Luck with all the schooling you have in front of you,
Diver
Thank you very much for the responses that you’ve given. I didn’t really mean to imply that I don’t like working with more than one patient. One thing that I think that I would really appreciate is the ability to not get bogged down in too much paperwork or a single patient for too long.
Thanks for the links, Diver. I really like the http://www.scutwork.com site.