Emergency Medicine: Is This Specialization for You?

Olivia Kelly, MD
Updated April 23, 2021
Emergency Medicine: Is This Specialization for You?

Table of Contents

Throughout medical school, each student is burdened with the mapping out of their desired track and progression throughout their studies and training. From theoretical studies to their residency and fellowship programs, a careful review of each step with the utmost consideration for various relevant factors such as finances, time, convenience, and ability is necessary. In addition to that, talent and preference introduce additional variables to the mix – making the decision-making process a gruelling procedure that ultimately results in a half-baked plan that is continuously overwritten as they progress. As such, it is important to know the various options available for their skillset and outline their possible options according to the variables previously discussed.

Emergency medicine is one of the many choices available for students to undertake and focus on. This branch focuses mainly on unforeseen injuries and illnesses that are usually presented at an incredibly varied and unpredictable rate. It is difficult to create a standard as to what qualities are the best fit for such a program as some qualities that might be attractive for some might be repulsive to others. Having a different perception of the perks provided by such a program could also create a rift. As such, the decision regarding the track’s appropriateness ultimately boils down to the person’s assessment of their condition and ability to perform. Self-assessments would always be the main option in trying to visualize oneself performing under a certain training program. However, there are always procedures that could aid and haste this conundrum.

Knowing the intricate details of each program would greatly help in knowing the ins and outs of the path that you’re about to take. Being able to gather as much information will help open avenues for any further examination which could, in some way, help push out unnecessary doubts and worries. Cleared of all uncertainties, you could then ask yourself the ultimate question: Is this specialization for you?

What is it About?

As mentioned earlier, Emergency Medicine is a specialization that mainly deals with patients who are suffering from acute presentations and other varied manifestations ranging from surgical and psychiatric, to even social conditions. The patients being handled may come from all age groups and their handling is mainly focused on the acute care aspects of other specializations. The variation of these patients requires a deeper knowledge base that is necessary to operate in most situations and be able to carry out the appropriate treatment regimen. Emergency physicians are widely exposed to an array of complaints, and acting on each of them requires skills and immediate recall to administer the fastest intervention possible for critical patients (which is very common in their department). As such, the pressure and swift pace of this department are intimidating for some and discouraging for many. It is not a program that is appropriate for everyone, but it sure does have its perks and benefits as compared to other tracks.

Its residency program has varying durations as some programs offer 3-year courses while others offer 4-year courses. Sub-specializations or fellowships are also available, and their lengths vary from 1 to 2 years on average. The following are the available fellowship programs for Emergency Medicine:

  • Disaster Medicine (1 year)
  • Emergency Ultrasound/Imaging (1 year)
  • EMS – Pre-hospital (1 year)
  • Medical Toxicology (2 years)
  • Pediatric Emergency Medicine (2 years)
  • Sports Medicine (1 year)
  • Critical Care (2 years)

Competitiveness of the Program

The probability for a Match is particularly higher when it comes to Osteopathic Students (DO) and International Medical Graduates (IMGs). IMGs have a lot of available slots presented for them and DO applicants have a high Match rate for Emergency Medicine. With these statistics, Emergency Medicine is probably going to be an effective choice if these students would ever opt to utilize this residency program during their training. In addition to that, the average USMLE Step 1 score for emergency medicine was around 230 while the average USMLE Step 2 score is around 240 – making the competition in this specialty somewhere along the medium scale. However, this data should never be construed as an opportunity to slack off and fall behind when it comes to other aspects. Statistics would always remain as statistics, and just as how variable the scope of this program is, results are also ever-changing.

The Allure of its Qualities

As previously mentioned, Emergency Medicine focuses on acute cases and variable conditions that need critical analysis and meticulous procedures to ensure that the treatment is delivered efficiently and swiftly to the patient. In addition to managing various cases, sometimes even simultaneously, you are also presented with missing data and information that could prove to be critical to the patient. Having no medical history or accurate review of presentations before the actual event is enough to shake anyone and induce panic upon having no clear direction to proceed. Being able to work through this environment would need accurate technical skills coupled with a vast clinical sense and perspective.

The program will defeat anyone who is not prepared to face such a rigorous process. However, this is also the reason why many people find it attractive and alluring. The department offers a lot of opportunities to develop a physician’s experience in trauma handling. Trauma departments are always met with sudden and critical cases that need quick thinking and interventions. Being exposed to such an environment is more than enough to hone one’s clinical instincts and develop their skills further as a physician. In addition to that, taking risks is also a big part of the responsibilities that emergency medicine residents would have to deal with. Taking risks when there’s no clear medical history or a clear understanding of the previous event preceding an accident is sprinkled throughout the program duration. The skill to know when and how to take risk is therefore also sought-after by medical students who wish to develop that special sense, as well as those who are highly attracted to adrenaline-inducing situations. Whatever their motivation might be, these kinds of people are the ones who are most likely to choose and proceed with Emergency Medicine as their specialization of choice.

In terms of convenience, emergency medicine is probably the most flexible of the programs available for students. Emergency Medicine shifts are pre-set and appropriately scheduled – making their work hours concrete and well-structured. Usual shifts would last for 8 to 12 hours, but 24-hour shifts might also be given depending on the scheduling method and situation in one’s hospital department. This provides residents and emergency physicians alike with the freedom to adjust their schedule around their pre-set shifts, and be able to establish a clear divide between their professional and personal life. Some residents would opt to take on more shifts for the sake of experience, but they are always provided with the utility to adjust their schedule to their liking. It could be construed to be negative especially when particularly disadvantageous shifts are being given around (graveyard shift, holidays, busy season, etc.), but it is still widely dependent on each location. Nevertheless, being able to adjust your schedule is still a great deal, and is relatively better as compared to what you get from other programs. This could either be advantageous or disadvantageous to you, but the ultimate decision would always depend on your instances. Assessing your situation first before fully diving in would probably serve you well in the long run.

The Compensation

Sufficient compensation is necessary to ensure that the physicians are satisfied with the work that they’re putting into their profession. It is also one of the many driving factors in many jobs anywhere in the world. Emergency medicine, for that matter, remains to be a decent-paying profession with an annual pay rate of $357K as of 2020’s report. As compared to the results of other professions, it is still relatively average with Orthopedics leading the board at $511K and Pediatrics lying below at around $232K. Amidst the COVID-19 pandemic, this current rate is an increase from the previous rate of $353K. This goes to show that the appreciation for this field is still up and running, and it is bound to see more improvements soon


Emergency Medicine is a myriad of many, if not all, possible uncertainties and doubts that one could encounter when choosing an appropriate specialty for their residency. It presents a huge risk, scheduling could prove to be disadvantageous, a deep knowledge base is necessary, quick and critical thinking is a must and many other factors are present that are ensured to induce doubts and make any student question their intentions of taking this field. However, one needs to remember that no field that is made for everyone. There is also no guide meant to show a student the most appropriate option for them. Knowing yourself, your strengths, weaknesses, preferences, and other determining factors is the only way to properly gauge your affinity to your chosen path. Emergency medicine is not for everyone, but it sure is a great choice nonetheless. It may not be for everyone, but who knows? Maybe this is exactly the specialization for you.


  • IndustryNews. (2020). Emergency medicine physician salaries 2020: Modest compensation growth but high job satisfaction.
  • Prospective Doctor. (n.d.). How Competitive is an Emergency Medicine Residency?
    • Rosen, B., Rosen, P., Schofer, J., Asher, S., Wald, D., Cheaito, M.-A., … Kazzi, A. (2019). Is Emergency Medicine the Right Choice for Me? The Journal of Emergency Medicine, 56(3), e35–e38. doi:10.1016/j.jemermed.2018.11.001
  • Washington University School of Medicine St. Louis. (n.d.). Emergency Medicine.


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