While career planning in other specializations typically involves a similar mix of employer, private practice, administrative, or academic options, emergency medicine is unique in that the vast majority of the patients you see will be in the hospital setting. Since so many patients are in critical stages of their illness or injury when you see them, emergency medicine can provide a stimulating, rewarding, and satisfying chance to see directly how your medical knowledge can make a difference.
However, the other side of all this excitement is that long shifts and high stress conditions can easily lead to burnout – as seen in the number of physicians who retire from their emergency medicine careers early. So how can you avoid burning out early? Career planning can not only help you to secure a positive and satisfying trajectory for your career, it can also keep you engaged and introduce you to a number of later-career options. Whether you’re finding the emergency room stressful or are just interested in learning more about where your career can take you, here are some career planning options to think about:
Fellowship Training/Sub-specialization
Although many graduates from emergency medicine programs work as general EM physicians following their training, a good number of others choose to continue their studies in areas like EMS and disaster medicine, pediatric emergency medicine, pain management, sports medicine, and more. Doing a fellowship following medical school is the easiest way to find yourself working in one of these specializations, although it isn’t impossible to pursue them after a few years of clinical practice – while still highly competitive, the number of fellowship programs in some specialties has more than doubled. If you’re anticipating burnout or not enjoying the typical emergency medicine setting, focusing on one of the emergency medicine subspecialties is an option to keep you challenged over the course of your career.
Academic Medicine
Since relatively few emergency medicine physicians enter the academic realm, it is often easier for them to advance up the ‘academic ladder’ than doctors in other specializations – this is good news for ER doctors who are looking to explore their options, since an academic career (either doing research, teaching, training residents, or some combination of the three) can be a challenging and satisfying way to take the diverse range of experience you’ve seen over the course of your time in the ER and connect it to the practice of medicine as a whole. If you have a knack for teaching or you’re interested in learning more about specific areas of medicine, joining the academic ranks might not be a bad idea.
While most academic medicine jobs don’t pay as well as ER jobs, at least to start, they offer a lot in terms of benefits, work life balance, and job flexibility. Whether you’re teaching medical students, residents, paramedics, or physicians taking continuing education, academic medicine offers you a rewarding chance to connect with other doctors, travel for conferences, and meet some of the leaders in your field. And since the hours for academic ER doctors aren’t as long as the ones you’d face in the emergency department, it also gives you a chance to have a long and stable career, with less risk of burnout.
So how does an emergency medicine doctor move into academic practice? If you’re interested in research, you likely want to start by looking for academic fellowships in emergency medicine, which will furnish you with the skills and research experience to make a strong impact in your career. If you’re thinking of going the teaching route, a fellowship often isn’t necessary – you can start looking into teaching positions with the various medical schools right away, however, it’s always a good idea to bring up your interest in going further with academic practice with the department looking to hire you before accepting the role.
Community Practice
Thanks to their diverse experience with patient populations, emergency medicine specialists are highly suited to different types of patient care roles, including family medicine, urgent care centres, and walk-in clinics. The hours you work and the amount of time you’ll spend on-call will likely be less in these settings than an emergency department, with the same amount of diversity in your patient profile. However, if the critical care aspect of emergency practice is what you enjoy – and many doctors find this part of the job both stimulating and rewarding – be careful to think about the kind of patients you might see. If you’re an adrenaline junkie seeking your next challenge, you don’t want to position yourself in the middle of a quiet family practice – but if you’re nearing retirement and looking to slow down, the same role might be just the ticket.
There are plenty of options in all types of settings, so with a little research you’re sure to find something you enjoy – and because emergency medicine specialists tend to deal in the more ‘exciting’ side of medicine, there are even some interesting non-traditional career directions available to you as well! You could work on cruise ships, for airlines, or even consult for television or film companies who are all looking to hire from the pool of skilled ER doctors. While some of these options might not be as financially beneficial to you as working in the emergency room, they can be a fun way to break up your work life and potentially offer some considerable perks – after all, cruise ship doctors are paid little, but cruise for free!
Working Abroad
One of the perks of being an emergency medicine professional is that it is a young and growing specialization, with staffing challenges, meaning ER doctors are needed all around the world. As an emergency medicine specialist, you’re in a prime position to take advantage of this. There are no shortage of locum, contract, or full time medical roles abroad, and the demand for the specialty in Canada also means there will always be a job waiting for you when you return.
If you’re feeling burned out in your Canadian emergency practice, many of the countries looking for locum doctors abroad can potentially offer shorter shifts, less on-call time, or a less busy patient flow. Even if the work is busy everywhere you go, the luxury of spending time in other parts of the world can make up for it – many locum roles for ER doctors abroad offer paid travel and living expenses, which means you could travel for free.
If you’re willing to leave the country, there are even more non-traditional ER options around the world for doctors who like a challenge. Organizations like Doctors without Borders is an option for doctors who have a more humanitarian bent, and certification programs for expedition or ‘wilderness’ medicine can teach you how to practice in all kinds of situations outside of a clinical setting. Whether you’re attending to Himalayan mountain climbers to scuba divers, companies and other organizations who run charity trips or relief work are often looking to hire trained medics to accompany travellers to remote situations.
Conclusion
Emergency medicine can be one of the most diverse, intense, and stimulating medical specializations in the industry. While this intensity can lead to early retirement due to burnout, the experience you gain from the emergency department and the ability to keep a cool head in an emergency situation can take your professional development in so many different directions. So if you’re an emergency room doctor, think outside of the box! Connecting with other doctors and doing your research could lead you to a career that’s even better than you could have imagined – and one that is even more fun!
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
Additional Reading
Dr. Nour Khatib left medical school for a finance career, but a persistent calling encouraged her to return years later and become an emergency physician.
