The ability to think clearly in a crisis is crucial to many careers, ranging from military officers in combat to doctors in the emergency room of your local hospital. The tempo of emergency medicine makes it especially demanding and stressful, even by the high standards of the medical profession. Emergency physicians face the same diagnostic challenges as every other doctor, but have far less time to manage them.
Emergency physicians typically work in the emergency rooms and trauma centers of hospitals and community clinics. The patients they see vary widely, depending on the location and type of facility. Emergency departments in major cities see thousands of patients every day, and they cope with gunshot wounds and other major trauma. In smaller communities, where doctors are in short supply, the emergency room of the local clinic or hospital might provide primary health care for large numbers of patients. Emergency physicians must be equally adept in routine diagnosis and high-speed emergency care.
Trauma and Critical Care
Trauma and critical care situations represent the high-stress portion of an emergency physician's workload. Victims of accidents and violence, acute and life-threatening illnesses, animal bites and accidental poisonings are all common in emergency medicine. Doctors must have the skills and knowledge to quickly recognize the most serious cases, stabilize the patients' condition, order tests, and direct others in providing the necessary care. Emergency doctors need a broad knowledge of all branches of medicine, as well as a strong grasp of cardiac resuscitation, epidemiology and toxicology. Most emergency physicians rely heavily on the expertise of their team of nurses, residents, physician assistants, orderlies, trauma surgeons and EMTs or paramedics.
Diagnosis and Care
Although patients with routine needs take a back seat during emergencies, their care is also an important part of the emergency physician's day, especially after normal doctor's office operating hours. Emergency room visits are varied enough to provide a challenge to almost any doctor's diagnostic and treatment skills. At any given time, they might include broken bones or sprains, a dangerous interaction between prescription drugs, children with unexplained fevers or pain, an adult experiencing inexplicable blackouts, or a woman whose baby decided not to wait until the expected due date. Emergency physicians deal with all of these scenarios, often with the help of physician assistants or nurse practitioners.
Emergency physicians begin their careers like other doctors, by earning an undergraduate premedical degree and then going on to medical or osteopathic college for another four years. After graduation, the newly trained doctor spends three to four years in an emergency medicine residency, learning the specialty by working with experienced emergency physicians in a hands-on clinical setting. After the residency, most emergency physicians choose to become board-certified, taking a rigorous exam administered by the Board of Emergency Medicine. Some physicians go on to specialize in areas such as medical toxicology or pediatric emergency medicine, which require up to two more years in fellowships and another set of board exams.