I am a 4th year medical student at the Medical University of South
Carolina (MUSC) planning to enter a career in PEM.
I would greatly appreciate any advice and recommendations regarding:
* order of board certification: peds then EM, the converse, or a joint
As someone who trained in Peds then did a PEM fellowship, and now work in a
general ED, my advice is to look at the job opportunities: there are more
openings per city or geographic region for general EM trained docs than PEM
trained docs -- although we're doing pretty good now for availability in many
regions (again, a gut impression).
As Deep Throat once said, follow the money. If you find that you are
interested in E-Med, go for dual training in Peds then EM, since many EM
programs are bound to look favorably on three years of experience in a
primary care field. You will be board eligible for the Peds, PEM and EM
In terms of satisfaction, if you enjoy adult medicine at all, this is by far
the way to go. If you pursue Peds then a PEM fellowship, you dpend the same
amount of time, and may end up in the frustrating position of being limited
in the jobs available to you, as well as the professional career you could
have: if you work in a general ED, you will see all the non-monitored adult
patients, fast-track patients, and Pediatrics. peds will make up, at best
50-75% of your practice, and probably more like 50%.
I enjoy the adult medicine I see, but face it: non-monitored adult E-med is
filled with lots of whining and none of the critical/acute stuff.
If Peds and peds alone appeals to you, go for Peds/PEM, and staywith
academia. If that's for you, then there are lots of programs and lots of
I hope this is helpful.
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