PRACTICAL PROBLEMSSPECIALTY FEATURE
required for entry to ST4. areas of interest. They
The training programme are responsible for:
culminates in an exit ■ General management –
examination, the Fellowship staffing, and facilities within
of the College of Emergency a given budget.
Medicine (FCEM). ■ Liaising with people -
specialties, pre-hospital
Working in EM
services, health authorities,
regional health boards,
Working as a junior doctor in to develop major incident
emergency medicine is never plans.
dull. Juniors have to care for ■ Teaching – this involves the
many patients simultaneously, academic development
seeing a variety of pathologies of both junior doctors
and severities, unlike in any and emergency nurse
other specialty. One moment practitioners (ENPs).
you might be seeing a child ■ Clinical work – supporting
with an unexplained limp junior colleagues,
and the next you could be organising the joint efforts
BANKSPHOTOS/ISTOCKPHOTO.COM
leading the resuscitation of of doctors of different
a patient in cardiac arrest. seniority and specialty,
BABYBLUEUT/ISTOCKPHOTO.COM It is a constant intellectual, working as doctors of of care. The work pattern and nights soon, to provide
emotional and physical their own patients and, as is either in full or partial supervision and leadership
challenge, where you never team leaders, resuscitating shifts. There is little long- 24/7.
know what is next; that is why patients and managing term commitment to your There will also be the
a good general knowledge of trauma teams. patients, as every work day growth within the specialty.
all specialties is required. ■ Research and auditing is independent from the So far paediatric emergency
Other elements of the – which they have next; this makes ED the ideal medicine is the only
job include working in the responsibility for. specialty if you want to work recognised sub-specialty, but
returns clinic, where you can It is also possible to work part-time without disrupting there are also possibilities
follow up patients with minor in EM as a staff grade or an your clinical undertakings, of integrating a job in EM
trauma, seeing patients in the associate specialist. The so it is easy to combine with intensive care medicine.
observation area (or Clinical work can be as exciting both family and work lives. The use of allied specialists,
Decision Unit), supporting and fulfilling as that of a In EM you never feel like emergency nurse
nurses and performing consultant, but the level of isolated and there is a strong practitioners, will become
research. The work is managerial responsibility team vibe. When away more commonplace. They
varied and unpredictable! is more limited. from it, I miss the sense of will work more independently
The work of an EM Unlike other areas of the continuous activity as much on cases of minor trauma,
consultant is also varied hospital, an ED is open 24/7 as the social side of it. allowing EM physicians to
and it involves five different providing a consistent level concentrate on patients
The future
who are more seriously ill.
The skills you’ll need…
Academic EM is a very
ED is becoming increasingly young branch of the specialty,
consultant-led, so the but it is slowly gaining space.
Personality – assertive, confident, able to make decisions number of consultants will There is also the scope
quickly, under pressure, good sense of humour, friendly, increase. It is also likely that for developing an interest
good coordinator, good leader, strong team player, able to consultants will be required in pre-hospital medicine
deal with tragedy, compassionate. to work late shifts, weekends (see page 12 and 13).
Best bits – the challenge of the unpredictable, solving
clinical conundrums under pressure, the feeling that you
can make an immediate difference and save lives, working Useful information
in a team (they become like a second family), the limited
follow-up responsibilities.
■ The College of Emergency Medicine
Worst bits – the frustration of management targets, not
– http://secure.collemergencymed.ac.uk/
finding out if your clinical judgment was right or wrong,
■ The Emergency Medicine forum at DNUK
handling the “obstructive” colleague who doesn’t value
– www.doctors.net.uk/home/homepage.aspx
you, dealing with sudden death (particularly in the young),
■ Paediatric emergency Medicine UK – www.apem.me.uk
the management of violent, disruptive or intoxicated
■ Oxford Handbook of Emergency Medicine (2006)
patients when you are at risk.
– www.mps.org.uk
Stress – depends on the day!
Salary – similar to other hospital specialties, but private
■ Chapman, Gareth Rhys. Pocket Emergency Medicine -
work is limited.
A Quick Medical Reference Guide for Use on the Wards,
Competition – high, but most definitely worth it!
Wiley-Blackwell (2010)
www.mps.org.uk NEW DOCTOR | VOLUME 3 - ISSUE 1 | 2010 11
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16