Pain Medicine is an Official Subspecialty of Emergency Medicine

[Birdstrike]

Just a reminder. This fellowship exists for you. I just got a private message from another Emergency Physician who matched in Pain. EM people are getting in and have been for years now.

If you like cool procedures, it might be worth looking into. If you want more control over your life, schedule and patient population, if constantly changing shifts gives you chronic circadian rhythm dysphoria that you don't think you can sustain until retirement, it might be worth looking into.

The field of Pain Medicine needs more doctors, who've seen the ravages of opiate addiction first hand, who are committed to helping patients with non-opiate treatments and as little opiates as possible, preferably none.

Google spinal cord stimulator, kyphoplasty, radiofrequency ablation. Think about it.

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[deleted109597]

I'd love to pick your brain about this sometime.

 

[slippery_when_wet]

It's definitely open to EM, but will be a tough uphill battle to match. You will be competing against anesthesia, PMR, FM, Neurology, and Radiology.

 

[Birdstrike]

It's definitely open to EM, but will be a tough uphill battle to match. You will be competing against anesthesia, PMR, FM, Neurology, and Radiology.

You are correct that it's hard to get in from EM, tougher than if you're anesthesia, for sure. But it's no guarantee for them either; it's a competitive fellowship for anyone. But I can tell you that over the last 7 years I regularly get a private message from someone who I've been advising, that they matched in Pain. It's not every day, because not that many apply, but I can honestly say, more get accepted than you'd think. People seem to assume it's a 1 in a 1,000 type proposition. Maybe it was before, like when I applied 8 years ago, before Pain was even an official subspecialty under EM. But it's nowhere near that much of a long shot, currently, from what I've been seeing. I would estimate it's closer to 1 in 2 or 3. I might even be 50/50.

Some programs like to add one non-traditional specialty and save a spot for that. Plus, enough of us have done these fellowships, that word is out, we're really, really good, and that we can handle anything. Better than anyone (except us) expected.

 

[slippery_when_wet]

You are correct that it's hard to get in from EM, tougher than if you're anesthesia, for sure. But it's no guarantee for them either; it's a competitive fellowship for anyone. But I can tell you that over the last 7 years I regularly get a private message from someone who I've been advising, that they matched in Pain. It's not every day, because not that many apply, but I can honestly say, more get accepted than you'd think. People seem to assume it's a 1 in a 1,000 type proposition. Maybe it was before, like when I applied 8 years ago, before Pain was even an official subspecialty under EM. But it's nowhere near that much of a long shot, currently, from what I've been seeing. I would estimate it's closer to 1 in 2 or 3. I might even be 50/50.

Some programs like to add one non-traditional specialty and save a spot for that. Plus, enough of us have done these fellowships, that word is out, we're really, really good, and that we can handle anything. Better than anyone (except us) expected.

Yes I absolutely agree that more and more programs are receptive to non traditional specialties aka anesthesia and pmr, but there is still a HEAVY preference for anesthesia trained residents.

Additionally, other non traditional specialties including radiology, FM, neuro, and psych are also eligible, and one could argue that psych residents may be more suitable for pain given the psychosomatic nature of alot of pain patients.

All this coming from a non anesthesia, non pmr background resident. If you want to pursue pain from non traditional pathway, you have to be extra vigilant and put in the necessary leg work before applying.

 

[Birdstrike]

Yes I absolutely agree that more and more programs are receptive to non traditional specialties aka anesthesia and pmr, but there is still a HEAVY preference for anesthesia trained residents.

I know this. But you're telling me all these reasons why EM applicants can't get in. Well, I got in. And I was far from the first. And so have many other, now, over many years. And yes, we have to work harder. That shouldn't be news to anyone. Since when in EM, do we not have to "worker harder"? That's literally what EM is, "Work ----ing harder all the time when no one else will Medicine." In fact, that would be a much better name for the specialty. "Work Harder Medicine." That's much more appropriate and accurate than 'Emergency Medicine." But you're right, for people who give up easily, and quitters, this is not their path. They should steer clear.

 

[slippery_when_wet]

I know this. But you're telling me all these reasons why EM applicants can't get in. Well, I got in. And I was far from the first. And so have many other, now, over many years. And yes, we have to work harder. That shouldn't be news to anyone. Since when in EM, do we not have to "worker harder"? That's literally what EM is, "Work ----ing harder all the time when no one else will Medicine." In fact, that would be a much better name for the specialty. "Work Harder Medicine." That's much more appropriate and accurate than 'Emergency Medicine." But you're right, for people who give up easily, and quitters, this is not their path. They should steer clear.

No that's not what I'm trying to say. I just felt like you were trying to say in your posts that EM physicians make better pain physicians/better applicants than other nontraditional pain applicants from psych, family, neuro, or rads and I don't think that's true.

 

[Birdstrike]

No that's not what I'm trying to say. I just felt like you were trying to say in your posts that EM physicians make better pain physicians/better applicants than other nontraditional pain applicants from psych, family, neuro, or rads and I don't think that's true.

That was what I was saying. EM applicants are better. In fact, it's not even close. No one is even in the same building as us. We can handle anything. We're the best. Period. More should apply and more should be accepted.

 

[slippery_when_wet]

That was what I was saying. EM applicants are better. In fact, it's not even close. No one is even in the same building as us. We can handle anything. We're the best. Period. More should apply and more should be accepted.

Lol, ok there buddy.

You think you're better than anesthesiologists in maintaining airways?
You think you're better than psychiatrists in treating mental illnesses?
You think you're better than radiologists in image interpretation?
You think you're better than neurologists in treating strokes patients?

EM has little to no training in fluror guided interventions. I mean get off your high horse dude.

 

[lucid_interval]

Which places have pain medicine fellowships open to EM folks?

 

[AdmiralChz]

EM applicants are better. In fact, it's not even close.

Outside of seeing chronic pain patients in the ER in crisis, how is this the case? I think you’ve inflated the overall prospects for an EM applicant.

It’s going to be an uphill climb for them. Program desires for interventional pain management fellowships are, in order: Anesthesiology (by far top preference given exposure in residency and the field basically evolved from it), PM&R, Psych (the dual ability to deal with concomitant mental illness is key), Neurology and then everyone else including EM. Does this mean it’s impossible to get in? Of course not, but it’s very difficult and EM doesn’t have a ton of exposure to the field (in the real life chronic pain clinic, not chronic pain ER visits). I’m not in the field but I would be wary of an EM applicant, personally.

At the 4 institutions I’ve been affiliated with, none would probably consider an EM applicant without major research productivity or a super mega start applicant. It was at least 70-80% Anes, 10% PM&R, 10% Psych/Neuro.

 

[Birdstrike]

Which places have pain medicine fellowships open to EM folks?

All of them

 

[Birdstrike]

Lol, ok there buddy.

You think you're better than anesthesiologists in maintaining airways?
You think you're better than psychiatrists in treating mental illnesses?
You think you're better than radiologists in image interpretation?
You think you're better than neurologists in treating strokes patients?

Practicing pain medicine has little if anything to do with airway management, managing schizophrenia, reading mammograms or rehabbing strokes.

EM has little to no training in fluror guided interventions. I mean get off your high horse dude.

General anesthesiologists don't do fluoro-guided procedures, either. Unless they take a rotation in their residency, which an EM resident can do. Plus, EM physicians are stacked to the gills with procedural skills and can easily learn the interventional part of Pain, with a fellowship. I did. That's what the fellowship is for.

More EM physicians should apply to Pain Fellowships.

 

[Birdstrike]

Outside of seeing chronic pain patients in the ER in crisis, how is this the case?

70% of ED patients have a primary complaint of pain, and 40% of those have an underlying chronic pain disorder (Knox Todd et al). (And they're mostly awake, too! That helps.) EM physicians see all presentations of pain, acute, chronic, pre-op, post-op, fracture pain, CRPS pain, post-stroke pain, fracture pain, chest pain, abdominal pain, spine pain, cancer pain and every other pain complaint under the sun. We don't just see "acute pain" (which isn't even really acute pain, but really post surgical pain, which is only a tiny sliver of "acute pain"). Emergency Physicians have an extremely broad range of procedural skills. Learning fluoro-guided procedures is an easy task after you've learned to: Read x-rays, do lumbar punctures, place central lines under ultrasound, repair simple wounds, complex wounds, intubate adults, intubate children, paracentesis, thoracentesis, fracture reduction, conscious sedation and much more.

After completing and excelling in rotations such as EM, SICU, PICU, MICU, trauma surgery, general surgery, orthopedic surgery, hand surgery, plastic surgery, OB/GYN and other rotations, being able to complete and excel in a 12 month Pain fellowship is a certainty. To suggest than an Emergency Physician can excel at all that, but somehow doing Pain rotations is going to be the immovable, unconquerable force that finally stops them, is absurd.

 

[AlmostAnMD]

Well you should probably post lists of programs that accept EM

There was a time I was looking into this and cold called a few places and they straight told me EM is not accepted by them, and that was only a year ago.

 

[Birdstrike]

I think you’ve inflated the overall prospects for an EM applicant.

I haven't inflated the prospects. In fact, I've acknowledged that they'll have to work harder to get in. But thinking they're just as qualified (or more so) is not the same as denying the obvious and unjustified bias against them, that you so eloquently have endorsed.

 

[RandomChaos]

I am also EM trained and recently went through the application process, matching at my number #1 choice. On the interview trail I met a couple other EM people as well. We were definitely the minority, but I think that will change. EM also used to be the minority in CC and that is changing too. I think EM is a fairly newer specialty, within the past 40 years, so we are all still finding our niche in medicine.

That being said there were a few programs that did straight up tell me they do not accept EM applicants.

 

[Birdstrike]

I’m not in the field but I would be wary of an EM applicant, personally.

Thanks for acknowledging you're not in the field of Pain Medicine. I am. And I did it in the way you say can't be done. And that's by doing an ACGME accredited fellowship and by passing the same Pain Boards the anesthesiology pain fellows took. None of these "you can't do it" arguments are new to me. I heard them all along the Pain fellowship trail, from anesthesia, PMR and other applicants. I sure some of them got fellowships. I'm sure some did not. But I did.

Again, I acknowledge the unjustified, pro-anesthesiology, anti-everyone else bias that exists. And as I said, EM applicants will need to work harder to get in. But they're qualified. But an unjust bias, doesn't mean they're unqualified or even the most qualified.

 

[AdmiralChz]

All of them

I can rattle off a list of 4 institutions in the southeast that would be a pretty hard “no” straight up. I won’t to maintain something that resembles anonymity, but they are all large university hospital-based programs. Are there programs out there where it’s possible, I have no doubt there are some but it’s definitely a minority. A list of EM-friendly programs would be helpful to prospective applicants!

How many EM-trained pain docs are PDs? All i can think of are anesthesiologists and PM&R. Anyways, pretending the bias isn’t there doesn’t mean it’s not... peace!

 

[Birdstrike]

The Chief of Pain Medicine at Harvard is a Pain fellowship trained Emergency Physician. I wonder if he's equally unimpressed by these "EM can't do Pain" arguments?

 

[Birdstrike]

I can rattle off a list of 4 institutions in the southeast that would be a pretty hard “no” straight up. I won’t to maintain something that resembles anonymity, but they are all large university hospital-based programs.

Wow. There's 4 institutions that wouldn't have taken me? Cool.

Glad I could only attend one at a time.

 

[Birdstrike]

I can rattle off a list of 4 institutions in the southeast that would be a pretty hard “no” straight up. I won’t to maintain something that resembles anonymity, but they are all large university hospital-based programs.

How many EM-trained pain docs are PDs? All i can think of are anesthesiologists and PM&R. Anyways, pretending the bias isn’t there doesn’t mean it’s not... peace!

Most of those programs will say, "No" only because they have their Pain fellows do scut-only, purposeless general anesthesia call or rotations, that have zero applicability to Pain, so their Anesthesia attendings don't have to do it. Thank God none of them wasted mine time by accepting me.

 

[Birdstrike]

A naysayer has never inspired anyone to greater things.

 

[chudat]

A naysayer has never inspired anyone to greater things.

No one is saying EM shouldnt apply but to say EM applicants are better suited than everyone else is BANANALAND

 

[B-Bone]

Practicing pain medicine has little if anything to do with airway management, managing schizophrenia, reading mammograms or rehabbing strokes.


General anesthesiologists don't do fluoro-guided procedures, either. Unless they take a rotation in their residency, which anyone can do. Plus, EM physicians are stacked to the gills with procedural skills and can easily learn the interventional part of Pain, with a fellowship. I did. That's what the fellowship is for.

More EM physicians should apply to Pain Fellowships.

Anesthesiologist here. All anesthesia residents do several months of pain. Three months are required, and we did four. I did dozens of pain procedures under fluoro. I placed SC stimulators and intrathecal pumps. I saw patients in pain clinic for two months, and did inpatient pain consults for a year. There are numerous non-fellowship trained anesthesiologists doing basic pain procedures in their practices. they may not all place pumps or stims, but they do lots of injections. Personally, I hate pain medicine and am happy to have people from all specialties do it.

Pain medicine is not rocket science. You can learn all you need to in the year-long fellowship no matter which specialty you come from. But to suggest that anesthesia residents don't have a leg up (both clinically and when applying) is just ignoring the facts.

 

[Birdstrike]

Anesthesiologist here. All anesthesia residents do several months of pain.

That sounds like a phenomenal reason for an interested EM resident to schedule some elective time in Pain. And then apply to every accredited Pain program in the country.

There are numerous non-fellowship trained anesthesiologists doing basic pain procedures in their practices. they may not all place pumps or stims, but they do lots of injections.

Because some people skip the fellowship, boards and dabble with half-skills and no board certification, is not a good reason for interested Emergency Physicians to take a shot at getting proper training and certification.

 

[VA Hopeful Dr]

That sounds like a phenomenal reason for an interested EM resident to schedule some elective time in Pain. And then apply to every accredited Pain program in the country.

Because some people skip the fellowship, boards and dabble with half-skills and no board certification, is not a good reason for interested Emergency Physicians to take a shot at getting proper training and certification.

Dude, you're going off the deep end a little bit.

No one is saying EM can't do pain. What they are saying is that y'all do have more of an uphill battle than several of the other fields that historically have dominated pain. You did it and know others that did. That's awesome. I mean that honestly. But that doesn't mean at this moment that it isn't harder for an EM applicant to match than an anesthesiology applicant.

Also, I'm not sure that you can say with any actual truth that EM is universally better at pain than anyone else who can apply to the field. Every field that can apply has their strengths compared to the others. PM&R has more MSK experience, especially chronic, than any of the other fields. Anesthesia has more spine/nerve procedure experience compared to anyone else. Psych gets the mental health aspect better than the rest. Neurology gets the nervous system parts better than everyone else. I'd say EM is 2nd best at most which means better at many aspects than most others. But I think its a bit much to say you're better at every aspect of pain medicine than anyone else.

 

[Birdstrike]

What they are saying is that y'all do have more of an uphill battle than several of the other fields that historically have dominated pain. ....But that doesn't mean at this moment that it isn't harder for an EM applicant to match than an anesthesiology applicant.

I already said it's harder for EM to get into Pain than anesthesia, due to bias (posts 6, 16 and 18).

But I think its a bit much to say you're better at every aspect of pain medicine than anyone else.

I didn't say I'm better. I said EM applicants are better. (Post #8 above). More should apply to pain. The only thing EM applicants lack in the competition to get into Pain fellowships, is confidence. That's it. They lack nothing else.

And aren't you Family Medicine?

You have every right to apply to Pain as well. Don't sell yourself short.

 

[Birdstrike]

Over the years the people I've heard make these arguments the most were:

1. Anesthesia residents who didn't want any extra competition for Pain fellowships than they already had. They are highly motivated to discourage EM applicants for their own benefit.

2. Anesthesia attendings that relied on Pain fellows doing anesthesia scut and call, during their fellowship, so they could reduce their own call. They are also highly motivated to discourage EM applicants for their own benefit, to keep their call as light as possible.

3. Anesthesia-Pain attendings, many of whom didn't even do Pain fellowships and aren't even board certified in Pain, that don't want competition from other specialties on what they claim as their own 'turf.' There's a self-serving, financial motivation. Many of these are the same people who trained nurses to run their ORs and have PAs and NPs seeing patients and procedures in their own Pain offices. They'll tell you as an ER doctor, "You can't do it," while at the same time they're training someone who's not even a doctor to do the same. The only difference is, who's pocket the money ends up in.

Needless to say, I'm no more persuaded by their arguments now, than I was on the interview trail.

 

[VA Hopeful Dr]

I already said it's harder for EM to get into Pain than anesthesia, due to bias (posts 6, 16 and 18).



I didn't say I'm better. I said EM applicants are better. (Post #8 above). More should apply to pain. The only thing EM applicants lack in the competition to get into Pain fellowships, is confidence. That's it. They lack nothing else.

And aren't you Family Medicine?

You have every right to apply to Pain as well. Don't sell yourself short.

I meant you as in EM as a specialty not you as in Birdstrike. I have no objection to more EM applicants applying, in fact given how young many EPs are when they start burning out I think its a good thing. You're Exhibit A for that. I also agree that EM applicants aren't lacking anything (and the reason for the uphill battle is likely bias, I don't have the experience to say anything on that score with any confidence). But to say they are superior to every other type of applicant is a bit much.

I know FM can, but that's not the discussion at the moment.

 

[Birdstrike]

But to say they are superior to every other type of applicant is a bit much.

They only way for them to prove me wrong is to apply to every program in the country and see what happens. And I'm challenging all those interested to do just that. It's time. The time is LONG overdue. Do EM residents sit around, cry and whine about how IM applicants are better ICU applicants? Or do they let any other soul convince them of exactly that?

Some probably did 25 years ago, but I sure as Hell hope not anymore. And they shouldn't do it when it comes to Pain, either. This EM inferiority complex makes me want to puke.

It'd be nice if some of the people that have private messaged me to say, "Thanks" over the past few years that they got in to Pain fellowships, chimed in. But they probably won't because they're likely too busy, off doing well in their fellowship or excelling in their Pain jobs.

 

[slippery_when_wet]

I already said it's harder for EM to get into Pain than anesthesia, due to bias (posts 6, 16 and 18).



I didn't say I'm better. I said EM applicants are better. (Post #8 above). More should apply to pain. The only thing EM applicants lack in the competition to get into Pain fellowships, is confidence. That's it. They lack nothing else.

And aren't you Family Medicine?

You have every right to apply to Pain as well. Don't sell yourself short.

lol he can certainly apply, but he won't be as good of a pain physician as you EM background folks right?

 

[Birdstrike]

lol he can certainly apply, but he won't be as good of a pain physician as you EM background folks right?

He might be better. Who knows? The only way for him to know, is to apply. But honestly, I have no dog in this fight, really. I already did my fellowship, passed my boards and have been working for years now.

 

[slippery_when_wet]

He might be better. Who knows? The only way for him to know, is to apply. But honestly, I have no dog in this fight, really. I already did my fellowship, passed my boards and have been working for years now. But I'm still seeing that there's a confidence deficit out there among the EM applicants, not a skill deficit.

What's your story, @slippery_when_wet ? Are you an attending, resident, student? Anesthesia, EM, Pain, undecided? Trolling because you don't like my post? What's your story?

how am I trolling?

You're the one that said EM applicants are better applicants than every other specialty applying to pain and I think that's wildly preposterous. If anything you're the troll here. Recently matched pain from nontraditional pathway.

 

[Birdstrike]

how am I trolling?

You're the one that said EM applicants are better applicants than every other specialty applying to pain and I think that's wildly preposterous. If anything you're the troll here. Recently matched pain from nontraditional pathway.

You just got your fellowship, @slippery_when_wet. Congratulations! You shouldn't be over here giving a s**T what I'm saying over hear to EM docs, 99.9% of whom will never apply to Pain. Plus, you're not in competition with anyone anymore. You got your spot. Just kick a** in your fellowship and on your boards and you'll be fine. You may never even encounter an EM pain person in your life, there's so few of us. None of what's even being discussed here, will ever affect you, all.

What I'm trying to address, is that I see confidence deficit out there among the EM applicants, not a skill deficit. I'm trying to encourage people to apply, because I think more should. It has nothing to do with you, and doesn't reflect on you, at all.

Congrats on the fellowship!

 

[AdmiralChz]

This thread is truly a dumpster fire.

 

[slippery_when_wet]

You just got your fellowship, @slippery_when_wet. Congratulations! You shouldn't be over here giving a s**T what I'm saying over hear to EM docs, 99.9% of whom will never apply to Pain. Plus, you're not in competition with anyone anymore. You got your spot. Just kick a** in your fellowship and on your boards and you'll be fine. You may never even encounter an EM pain person in your life, there's so few of us. None of what's even being discussed here, will ever affect you, all.

What I'm trying to address, is that I see confidence deficit out there among the EM applicants, not a skill deficit. I'm trying to encourage people to apply, because I think more should. It has nothing to do with you, and doesn't reflect on you, at all.

Congrats on the fellowship!

But that's not what you said at all. You specifically stated that EM applicants are better than every other specialty applying to pain and that's what I have an issue with. Me matching into pain has nothing to do with this.

 

[cyanide12345678]

In an ideal world a part of me wants to explore the world of pain medicine. It sounds like a great gig. But I've seen your posts, and I've seen the complexity of the procedures that you are doing. I already hate lumbar punctures with a very strong passion, mostly because I'm not that great at them. It's my weakest procedure. I feel like i make a really good ER doctor, i don't think I'll make a half decent pain doctor

But right now, i plan on enjoying my 12 days of work a month for now.

 

[Birdstrike]

I already hate lumbar punctures with a very strong passion, mostly because I'm not that great at them. It's my weakest procedure.

Now imagine you have x-ray vision. They’re fun now, aren’t they?

 

[Birdstrike]

You specifically stated that EM applicants are better than every other specialty applying to pain and that's what I have an issue with.

I’m not sure how relevant it should even be to you, since at the end of the fellowship you’ll all have equal skills and training, regardless of where you started.

How many EM-physicians turned Pain-fellows, have you worked side by side with?

When that number is greater than zero, grade them and get back to me. Then I’ll let you have the final word. Do we have a deal?

 

[Arch Guillotti]

General anesthesiologists don't do fluoro-guided procedures, either.

Not true.

 

[Birdstrike]

Not true.

Which ones do you do?

 

[Birdstrike]

Well you should probably post lists of programs that accept EM

There was a time I was looking into this and cold called a few places and they straight told me EM is not accepted by them, and that was only a year ago.

There's no hard and fast list. I've given the list of programs that interviewed me and that I've known to take or interview EM people. But by no means should that be assumed to be comprehensive. I was told the same thing you were. But I applied anyways. Some of those programs that had on their websites "anesthesia and PM&R only" gave me interviews. Some were out of date. Some didn't even know EM can do Pain, or pretended not to know.

My advice to EM applicants is to avoid the temptation to ask people to say ahead of time they "might" accept you or to tell you they won't accept you. You're making it too easy for them to discourage you. Your best chance is to apply to all 80 or 90 programs, those in the match and those not in the match. You only need 1 to accept you.

 

[Birdstrike]

I am also EM trained and recently went through the application process, matching at my number #1 choice. On the interview trail I met a couple other EM people as well. We were definitely the minority, but I think that will change. EM also used to be the minority in CC and that is changing too. I think EM is a fairly newer specialty, within the past 40 years, so we are all still finding our niche in medicine.

That being said there were a few programs that did straight up tell me they do not accept EM applicants.

You got into Pain?
Congrats!
You obviously didn't listen to the naysayers, the Negative Nancy's. You rattled the cage until you got in.

Good for you.

 

[Birdstrike]

No one is saying EM shouldnt apply but to say EM applicants are better suited than everyone else is BANANALAND

Yep, it's provocative and I said it. And I stand by it.

Last year ago, it was, "EM even applying to Pain is BANANALAND."

Now it's, "EM should apply to Pain. But saying EM applicants are better is BANANALAND."

That's perfect. I may convince no one, that EM applicants are better suited to a Pain fellowship. But if I even convince a few to go from, "EM can't do Pain," to, "EM should apply to Pain," then I've moved the needle of persuasion in the desired direction, by getting you to think past the sale. Then more EM applicants apply, more get in, more get on faculty, on fellowship admission committees, and the odds for the next round of EM applicants increase. Repeat.

 

[thegenius]

Lol, ok there buddy.

You think you're better than anesthesiologists in maintaining airways?
You think you're better than psychiatrists in treating mental illnesses?
You think you're better than radiologists in image interpretation?
You think you're better than neurologists in treating strokes patients?

EM has little to no training in fluror guided interventions. I mean get off your high horse dude.

Ohhhh a fight. IT'S A FIGHT!! I LUV INTERNET FIGHTS!!!!

I think the question ought to be

Who is better at reading xrays? EM or Psychiatrist?
Who is better at maintaining an airway? EM or Neurology?
Who is better at treating stroke patients? EM or Anesthesiology?
Who is better at treating mental illness? EM or Radiology?


The answer is clear!!!



ER is second best at everything!!!! LOL. We are in second place in every single aspect of medicine.

This is why if an asteroid hit the earth and selectively wiped out all physicians except for one specialty, the world would be best served if ER doctors survived.

FIGHT!!!! LOL

( I just now recognize I'm a little late with my post LOL)

 

[nimbus]

The problem with pain medicine is that the vast majority of EM doctors and the vast majority of anesthesiologists would rather poke their their eyes out than practice pain. It’s for a select few who can tolerate that work.

 

[Birdstrike]

Ohhhh a fight. IT'S A FIGHT!! I LUV INTERNET FIGHTS!!!!

I think the question ought to be

Who is better at reading xrays? EM or Psychiatrist?
Who is better at maintaining an airway? EM or Neurology?
Who is better at treating stroke patients? EM or Anesthesiology?
Who is better at treating mental illness? EM or Radiology?


The answer is clear!!!



ER is second best at everything!!!! LOL. We are in second place in every single aspect of medicine.

This is why if an asteroid hit the earth and selectively wiped out all physicians except for one specialty, the world would be best served if ER doctors survived.

FIGHT!!!! LOL

( I just now recognize I'm a little late with my post LOL)

It may be a fight, but it's not even a fair fight. I've made more people think about the concept of Emergency Physicians doing Pain fellowships on this thread today, than have thought about it collectively in the last 10 years combined. And thank you for the much needed humor injection.

 

[thegenius]

I think doing the procedures would be fun, provided I never had to see the patient again.

Sticking needles in things is fun.

For example, it brings me great joy to do an inferior alveolar nerve block to a screaming lady who would rather chop off her mandible. And when the pain goes to zero she wants to give me a hug. Which is usually disgusting because most of those dentalgias have terrible teeth, which means in general they just don't take care of themselves and they smell and have bad breath and dirty hands and feet. But I hug them back. Because it think it's genuine.

I did a greater occipital nerve block the other day on a dude who said it was the first time in 1 year he had no pain. That s&^t makes me happy.

 

[thegenius]

It may be a fight, but it's not even a fair fight. I've made more people think about the concept of Emergency Physicians doing Pain fellowships on this thread today, than have thought about it collectively in the last 10 years combined. And thank you for the much needed humor injection.

I'm keeping track of this fight, and Birdstrike is winning 7-3. You will win in a TKO at this rate. Don't let your guard down. One of those guys above has a good uppercut.

FIGHT!!!!