Family Medicine to Emergency Medicine

So I’m due to start a family medicine residency in August – but I’m currently working in the emergency department and I LOVE this job. The hours are awful, other specialties can give me shit when referring patients, and patients often want more than what I can offer them, but I love the pace of the job and the work I do.

I’ve abandoned the thought of training in a surgical specialty because it requires a minimum of 5 more years of training (and most train for 7 years before becoming attendings). And speaking to my senior colleagues makes me realize that training is not as simple as keeping a surgical logbook and attaining specific surgical skills at different levels of training. In this country, it’s all about your tick-boxes: audits, audits, and more audits; research and publications, but not just in any journal – it must be a peer-reviewed journal; teaching, with “evidence” that you’ve taught; conference presentations and poster presentations. And you’re strewn all over the country at times. And they have almost the same requirements to get into the surgical training post as well – those who meet the tick-box requirements get in. There are no reference letters highlighting whether you’ve got the surgical skills to make it in the job. You don’t get “points” for being able to be a proficient first-assist in a laparotomy. The structure of the system is flawed.

I am now at the point where I’ll be entering general practice, and this also comes with its own set of requirements during training, one of which I’m particularly not looking forward to – reflections. Every week, a requirement is to two at least two reflections either about a patients encounter or on something you’ve learned from. Personally, I’m not one to reflect – in a blog, yes. But in a portfolio – no. Especially since I know it will be read and assessed by my supervisor. In that sense, I feel my reflections will be very superficial and I won’t be as honest as I truly feel. But, whatevs.

My other thought is what if I abandon general practice and try to jump into emergency medicine training. I’d be more satisfied with my job. But training would again be another ¬†years. The option I’m set on now is to endure the three years of general practice and then get a fellowship in emergency medicine and remain there. The options are endless. My career path is not a fluid one. The only path that’s certain for me with work is my return to Canada. My aim: return in a maximum of 3 years, if not earlier.

Locuming

I’m on vacation this weekend. Only, last week, one of the residents from the old hospital informed us that the old hospital was looking for someone to locum for a week for ¬£35/hour. I jumped on that as quickly as I could, especially since it was with my old surgical team. Unfortunately, I didn’t get the whole week, but Monday and Wednesday only – the two big non-surgical days.

It was nice to be back. I knew exactly where to go, I knew what to do, I knew where to find things, I knew who to call when I needed it. It felt great. Despite not being able to enjoy any actual surgery those two days, I felt on top of the world. Plus I didn’t mind staying late when I had to because I was getting paid hourly.

This is one of the perks of “graduating” from being a first year doctor to a second year doctor – you get full registration and are able to take up extra shifts anywhere else in the country. I believe you normally go about it via an agency, but if you know the managers at your old hospital, you can pick up shifts that way as well by being added onto the Staff Bank.

In a way, I’m glad I only worked two days, and not the entire week. Now I get to enjoy the next four days of sleeping in and lounging about.

This reminds me, I need to learn the entire head and neck anatomy by Tuesday so I’m ready for my grilling… And the boss loves his details too.