Here are some highlights from my recent Ask Me Anything Post on the Reddit Pre-Med Community.

You can read the full thread Here

Q: What was the single piece of information you wish you'd known most heading into medical school?

Your first two years don't matter. All you have to do is learn enough to do fantastic on step 1. The "pre-clinical" information you learn, with a few exceptions, is almost completely useless as a practicing physician. Don't stress, and get pulled into all the drama of other pre-clinical students. Have fun, learn as much as you can, and get ready to focus during 3rd and 4th year when it really counts. Also take a badass vacation before med school because getting the time off to travel is going to be tough for the next like... 7 years.

Q: Why did you choose emergency?

EM is a very broad specialty which appeals to me. Specialty selection is a very personal choice. Also I hate being on call. I absolutely despise it. When I'm off, I can do WHATEVER I want with no fear of getting pulled back into the hospital. Also in terms of dollars per hour its fantastic.

Q: What are the dollars per hour like?

For a new grad you can expect 130-230/hr depending on the part of the country you are practicing, and how your reimbursement is structured.

Q: Is this hourly rate after malpractice? Can you generally pick up as many hours as you want? What's the average number of hours per week?

Malpractice is typically paid for by the contract management group. This is pretty standard for EM. In my current situation I could take as many hours as I wanted and people would love me for it. I typically work 140-160 hours a month, at times up to 180.

Q:How did you personally balance work and life?

I do my best to group my shifts, working 4-6 in a row then having 5-7 days off. I have a family so that occupies most of my "life" time. It is so important to keep up non-medical hobbies and interests. Most EM docs have no problem with this, the schedule is very conducive to hobbies.

Q:Are there other specialties that allow for that kind of schedule?

Yes, lots of other specialties are transitioning to "shift work", Hospitalists, anesthesia, critical care, even some "Acute Care" surgeons. I suspect this will be the future for many specialties, if they can make it work.

Q: What are your thoughts on the ER being a "dumping grounds," for other facilities and how would you foresee a remedy to this so that serious patients can be seen on a timely basis?

Doesn't bother me yet. That's what I'm getting paid for. It will probably take a few years for these things to really start wearing on me. I do see how it could over time.

Q: I've heard that the timing of shifts in EM can really wear one down. How old do you expect to be when you stop practicing? How old are some of the older EM attendings you've met? Do you know anyone who has regretted going into EM? If so, what kinds of things about the specialty have they found themselves disliking?

Night shifts suck, and may very well shorten your life. There's no way around it, I will always work nights, weekends and holidays. I hope to continue practicing into my 50-60's, but if all goes well financially I won't "have" to. The older EM docs I know have been around so long, and seen so much that for them the job is dramatically less stressful than it is for me as a new doc. I know some in their late 60's who are still doing overnights and going strong. I would be honored to have them care for me or a family member. Its a marathon not a sprint.

Many regret medicine or their specialty choice. Far more people leave their specialty to go into EM than leave EM for another specialty. EM can be tough due to how broad it is, you have to be able to make decision based off limited data, and defend these decisions when/if later they turn out to be not the best. There is almost always a specialist or sub specialist who is more than willing to criticize you and you have to be OK with this. You have to be good at interacting with a very diverse group of people, and customer satisfaction is super important. There is also a very significant malpractice risk.

Q: What are some tips on how to get a good letter of recommendation?

Just show up, act interested and be normal! The ED is busy and you have to have some social understanding of when its a good time to ask a question and when to observe. Most docs want to help you out and write the very best letter possible, do your best to give them that opportunity by not pestering them.

Q:Based on your experiences, do you believe EM is a "lifestyle specialty?" I have heard before that generally radiology, ophthalmology, anesthesiology, and derm are generally considered as lifestyle specialties, but it seems as though the pay and schedule of EM are great.

It depends on what lifestyle you want. EM is shift work, this is both good and bad. You will likely never have a very regular schedule, you do have lots of time off. You will work nights, weekends and holidays. You can't really compare that to a private dermatologist who works 7am-3pm 4 days a week. That said I know a dermatologist who works 12 hour days and frequently comes in on the weekends. It just depends on your particular situation and job. Its hard to make broad generalizations. There are people in just about every specialty out there who have found a way to make their situation a "lifestyle specialty"

Q: As someone who's about to start medical school and is interested in EM, do you have any advice about how to position myself going through school so that I can match into a good EM program?

Score as high as you can on step 1. Make early contacts in the ED, try to get involved with journal groups and hang out with the residents as much as possible. EM is usually a pretty social group. Do away rotations and work hard. You will be fine!

Q: I've been thinking about condensing college into three years, since I'm entering in with a few core class credits from doing dual enrollment senior year. Do you think it is a good choice to do so?

I had a lot of AP and community college credit that I racked up in High school so I was able to essential get out of a lot of "Gen Ed" classes and such. It would have been difficult for me to justify taking 4 years unless I added a 2nd major, which I wasn't interested in.

I think its a good idea if you can do it easily. Its not worth trying to take 20 credit hours a semester and risk doing poorly on a class. Keep in mind that you will need to cram all your EC's, research and MCAT into essentially 2 years. I think with the increased competitiveness of med school, being a viable candidate with only 3 years of undergrad is becoming much more difficult, but still very possible.

Q: Can you give a few do's and don'ts for a M1 doing an elective in the ER?

As an M1 you are essentially going to be shadowing. Again try to make sure you time your questions at appropriate times, be as helpful as possible! Offer to grab things, set stuff up, run back and check on patients. Don't try to talk yourself into trying procedures or seeing patients yet.

Q: In all honesty, do you enjoy what you do? Is it a drag to go to work every day?

I work at many different hospitals, some of them are fun, some of them are a bit of a drag. Overall, yes I do enjoy what I do. There have been some studies that one of the biggest determinants of someone liking their job isn't what they do, it's who they do it with. There are some other great doctors, nurses, medics and other team members that make work fun, and some that can make it much more difficult.

Ask your question in the comments below!