Job #1 for New ER Docs: After Being a Good Clinician, Find Your Emergency Medicine Niche

As I left residency a mere two months ago, my program director imparted a couple principles to his departing residency class:

  1. Be the strongest clinician you can be, don’t stop learning, and spend the first year just providing good care.
  2. After that, find a “niche” in Emergency Medicine.

The first point is without a doubt important as it ensures that new graduates continue to grow as clinicians and mature as time progresses. Our physicians group has a rigorous orientation program in which each new provider completes two full shifts as strictly an “additional” provider, and then, for the first two months a new provider is never “alone” in the department. Meaning for the first two months of working there is always a more senior physician to discuss cases with and to provide additional support. Our group’s commitment to the first principle is seen in every shift from day one.

The second principle is equally important, if a little cryptic. A “niche” is an interest in Emergency Medicine – an aspect of patient care that you as a provider find particularly interesting.  A niche can range from complicated, fellowship-trained fields like toxicology or ultrasound, to something as simple as pediatric psychiatric complaints, or difficult airways and intubations.

Here new providers are given the opportunity to pursue their own interests by having separate roles at each campus for different providers based on provider interest. Our group encourages that by providing funding for continuing medical education (CME) that can be used however a provider chooses.

In addition, we seeks to have everyone involved in helping the company grow. Each provider’s voice is heard, and each provider has the opportunity to change the place in which they work.  Some people can focus on Quality Assurance (QA), some Ultrasound, some on Observation Medicine. The list goes on. Through constant commitment to progress and pushing the boundaries of emergency care, providers can even pursue fields that haven’t even been formally created – e.g. transitional care.

My interests in Emergency Medicine include Observation Medicine and Emergency Department flow, and as the year progresses I hope to be involved in each.  I know this company will encourage that growth and has already put me in touch with key people in each field.