Medicine - who has what it takes to make it?

What kind of personality, grades , drive and type of person make a successful medical doctor or emergency medical personnel?

Resilience and the ability to learn under pressure

Emergency medicine specifically? Someone completely detached from their sensibilities, i guess

What do you mean by this? I've talked with a few people doing EM and they all said they loved it. They said it's intense but in a good way (you're never bored), you learn a lot about people, there's so much variety, the team spirit is great and because it's shift work with short-lived situations you don't end up worrying as much about your work when you go home as people in other specialties do. To me it seems like a really attractive specialty choice, am I missing something?

Those are all fair statements.

Its also sometimes intense in a bad way - when its super busy and you're working impossibly hard but still every patient you see complains they've been waiting 4 hours 'why are you so slow' it gets a little grating. Managing multiple emergencies at once can be exciting or impossibly stressful depending on your inclination/mood. You will have to deal with a lot of nonsense as well as exciting emergencies. There can be a lot of psychiatry - self-harm, addiction, psychosomatic problems/pseudoseizures - which is often something EM practitioners do not enjoy. And you will be working horrible horrible shift patterns well into your 30s and still pretty unpleasant shift patterns beyond that. Having a family under such circumstances is not easy, and there is a very high drop out rate among EM trainees.

I was being a little facetious - there are advantages as you say and it is great for some people. I think a little crazy is kind of mandatory in order to cope! But I could not hack it.

Yeah I can imagine that it takes a certain type of person to be able to enjoy the rush and the chaos. I kind of like the idea but am not sure I'd be able to do it day in day out either.

The people I talked with seemed actually pretty happy with their shift patterns even though they obviously weren't 9-5 monday-to-friday! To be fair they all work in London teaching hospitals so I'm guessing those in rural DGHs might have it worse. And as you said I imagine it can get tricky when you start thinking about a family.

They did mention that some patients with psychiatric problems take up a disproportionate amount of time and can get very frustrating yeah. In principle it sounds interesting to also have to deal with those kinds of problems although I can imagine that it gets annoying pretty quickly if you're in a rush.

Thanks!

One major thing I dislike about EM is that you don't get to follow the patient through. You admit someone with a stab wound, ring the adequate surgeons and that's it. You don't really know what happens to them next. While sometimes it is a good thing, especially if you don't enjoy certain aspects of medicine (be it psychiatry, resp medicine or T&O) I remember always wondering what will happen to that patient next when I did my shifts on EMU or A&E.

The only emergency medicine I can see myself enjoying is children's A&E as most of them can be managed there acutely and discharged. And even if they are admitted, most of the go home within 3 days and you can 'predict' their management without really getting involved.

Ah I see, that must be pretty frustrating! Now that I think of it, I imagine that you also can't develop a proper relationship with your patients and get to know them as people in the way I imagine you can e.g. in psych.

Out of curiosity, why is children's A&E so different? Because most cases are trauma instead of manifestations of diseases or?

most cases (especially now when I am on paeds) are respiratory tract infections, gastroenteritis, dehydration/difficulty feeding. There are occasional cases of sepsis, DKA/hypoglycaemia or other resus cases that needs further investigation.

And yeah, you don't really bond with your patients well when you work in A&E as your goal is to get them either out or admitted within few hours.