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Emergency Medicine

Overview

If you hit your head while playing sports or slice open your hand while working in the kitchen, there’s a good chance you will end up in the emergency department to be treated by an emergency medicine physician. A physician who works in a hospital’s emergency department sees patients with a variety of conditions, for emergent conditions such as heart attacks, strokes and car accidents as well as for lower acuity conditions such as lacerations or musculoskeletal injuries.

A hospital’s emergency department can be a chaotic place. When patients have serious or life-threatening symptoms, the physician must make decisions and start treatment immediately.

Physicians and nurses on staff must quickly prioritize incoming cases to ensure that patients with the most serious conditions are seen as soon as possible – a process known as triage.

Physicians in the emergency department take a medical history, examine the patient, decide which tests to order, make a differential diagnosis (determining, when symptoms are similar, what the disease or condition is), determine treatment and decide whether to admit the patient to the hospital or treat him and send him home.

Long shifts with heavy caseloads of often critically ill patients can make working in the emergency department one of the most challenging jobs in health care. But for physicians who enjoy solving “medical mysteries” at breakneck pace, emergency medicine can be an exciting and rewarding career.

Working Conditions

In most hospitals, the emergency department operates 24 hours a day, 365 days a year. Emergency department physicians typically work in eight-, 10- or 12-hour shifts, during which they may see dozens of patients who have a wide range of symptoms or injuries.

The work requires physical endurance, mental acuity and the ability to maintain a clear head in stressful situations.

Patients may come to the emergency department on their own or in an ambulance. The triage process determines the order in which patients are moved to treatment areas so they can be seen by a physician.

An important rule in emergency medicine is “rule out the worst case scenario.” That means the physician must determine whether the patient’s symptoms could be caused by a serious medical condition.

For patients in distress, the emergency department physician may perform emergency resuscitation, start intravenous lines or take other steps to stabilize the patient before transfer to another area of the hospital. Less serious injuries, such as lacerations or broken bones, can be treated in the emergency department.

Other patients may be admitted to the hospital for further work-up. Some patients will be discharged to follow up with their physician for additional evaluation as an outpatient.

Finally, the physician must fully document the case. In a busy emergency department, patient charting can add significantly to the physicians’ workload. 

Despite the demands of the job, many emergency physicians find that they have chosen a satisfying life-long career of service and patient care.  

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About Health Care Careers

The American Academy of Emergency Medicine has updated this profile.

Academic Requirements

Becoming an emergency medicine physician takes years of preparation.  First, you must complete a four-year college degree, taking appropriate courses and earning high enough grades to be accepted into medical school.

You’ll be in medical school for four years training to become an allopathic or osteopathic physician. During medical school, you will likely take a rotation in an emergency department.

The Liaison Committee on Medical Education (LCME), which oversees accreditation of U.S. medical schools, has recommended that all medical students spend some time in an emergency department, since every physician needs the ability to quickly assess a patient’s condition and design a treatment plan.

In order to qualify to practice emergency medicine, you must complete a three- or four-year emergency medicine residency, which must be approved by the Residency Review Committee. Residencies in emergency medicine are highly competitive, so you’ll need excellent grades and recommendations from your medical school professors.

Once residency is complete, board certification requires passage of both the written and oral examinations with recertification by written exam every 10 years. Board certification also requires advanced training in life support.