Selecting a Specialty: Emergency Medicine

Are you currently in medical school or looking to start? You may be wondering what medical school specialties you might want to pursue.

Emergency Medicine is the medical specialty dedicated to the diagnosis and treatment of unforeseen illness or injury. Emergency medicine physicians care for adult and pediatric patients in emergency situations, making immediate decisions and taking action to save lives and prevent further injury.

Meet three doctors currently practicing in emergency medicine to share what led them to choose emergency medicine as a speciality, what a day in the life of an emergency medicine doctor looks like, how you can stand out in the field of emergency medicine, and more.

We asked our doctors six questions around emergency medicine. Read what they had to say, and learn how emergency medicine can be a rewarding specialty, especially during this global pandemic of COVID-19.

  • Dr. Jessica Best graduated SGU in 2012 and is currently the Associate Medical Director at Christus Santa Rosa Hospital in New Braunfels, Texas. Best also works at a freestanding emergency room.

  • Dr. Ninad Desai, a recent graduate from SGU, is an Emergency Medicine Resident at Wyckoff Heights Medical Center in Brooklyn, New York.

  • Dr. Yalda Safai, a 2012 graduate from SGU, is a third-year psychiatry resident at New York Medical College who, in addition to having her MD, also holds a Master of Public Health degree.

Your path to residency starts at St. George’s University. Are You In?

Question 1: What Led You to Choose a Career in Emergency Medicine?

Dr. Ninad Desai had always loved working with kids and adolescents and had experience working with autistic and disabled children. Originally, he wanted to specialize in pediatric hematology and oncology. During his clinical rotations, he discovered that he didn’t enjoy the pace or pathology of being in a clinic and  found himself continually attracted to the emergency department. 

“I realized I needed variety,” Dr. Desai said. “I needed a little bit of action. I had a couple of weeks dedicated to the pediatric emergency department. Same thing when I was on my psych rotation — I went to the psych emergency department. When I was in internal medicine — again, same thing: Emergency department. And that's how I discovered my love for the emergency department because everything led to emergency medicine.”

Dr. Jessica Best had exposure to emergency medicine prior to medical school when she volunteered in an ER. She was drawn to the variety of emergency medicine, saying, “You never know what you’re going to get. You see young patients, you see old patients... from every walk of life, every background. I love it.”

"You never know what you’re going to get. You see young patients, you see old patients... from every walk of life, every background. I love it.”

Question 2: How Did Medical School Prepare You for Emergency Medicine?

Dr. Desai stressed the importance of St. George’s University’s Office of Career Guidance and Student Development (OCGSD) in preparing him. “[They] put me in touch with some emergency medicine residents, and they got me in touch with a 4th-year medical student who had been interviewing for Emergency Medicine at the time that I decided to apply. They also told me about specialized letters and evaluations, which are key for emergency medicine residency, and helped strengthen my interviewing skills.”

The OCGSD also proved to be extremely vital in helping students refine their personal statements and strengthen their interviewing skills when preparing to interview for residencies. In addition, medical students also have access to a voluntary tutoring system from the Department of Educational Services.

Dr. Yalda Saifa says that having her Master of Public Health degree in addition to her MD has proven invaluable during the global pandemic of COVID-19. “In today's climate, it's important to get the big picture, to learn about diseases and pandemics in other countries, how they can affect us and how we're all connected. We're not like different healthcare systems; the way one works will affect the other. The MPH gives you that big picture. You learn about health policy, epidemiology, what diseases around the world are killing people, causing morbidity, mortality and why that's important to us as physicians in the U.S.” SGU offers a dual degree program, a combined four-and-a-half-year program that results in holding both an MD and an MPH degree. Dr. Saifa notes that adding the dual degree only extends your time in medical school by 6 months, and the benefits of having the MPH degree are well worth it.

Question 3: What Does a Day in Emergency Medicine Look Like?

Dr. Best works in a less urban area which creates its own rhythms to her days and nights. “I work single coverage, so I’m the only doctor who’s going to be in the emergency department for my entire shift. So things get busy.” Because she is not near a major trauma center, and because her facility does not admit children, she is frequently stabilizing patients to have them transferred to a neighboring larger city. Dr. Best enjoys the challenges of being in this smaller area, saying, “I love practicing in more of this rural community setting because it really, really pushes your skillset.”

About his typical day, Dr. Desai says, “First of all, it’s nothing like Grey’s Anatomy. So that’s the number one thing that everyone needs to know. I have a 12-hour shift so I could start my day off with a patient with chest pain, or with a patient coming to the resuscitation bay, or I could simply be speaking to my attendings or my mentor about the research. And then it’s just churning out patients.” Dr. Desai is quick to add, “In emergency medicine, there’s a very fine balance in seeing the number of patients as well as evaluating them properly.” He also points out the importance of collaboration with other parts of the hospital as an emergency medicine doctor. “We deal with everyone in the hospital from administration to transportation to radiology, internal medicine, psych, OB for all the consults. It involves a lot of talking to other folks. So I literally do everything at all times and the hardest part is learning how to balance it.”

In addition, emergency facilities often serve as primary care centers for patients without access to primary care so emergency medicine doctors can find themselves serving as educators, helping diabetics understand the importance of insulin management or sharing how to properly take medications for blood pressure management. Emergency medicine varies greatly based on where the facility is located, and the days are rarely the same.

Question 4: Did Graduating From an International Medical School Negatively Impact Your Ability to Practice Emergency Medicine?

All three doctors were emphatic that graduating from a Caribbean medical school had no bearing in their practicing emergency medicine.

Dr. Safai said, “After you match into residency, nothing else matters. Nobody's ever going to stop you and ask you where you went to medical school. Once you're a doctor, you’re a doctor. It doesn't matter where you graduated from.” Dr. Safai added, “I always tell people that Grenada is a perfect place to study. Despite being an island and being tropical and beautiful, there really are no distractions. You’re there for a reason; everybody around you is studying all the time.” Dr. Desai also appreciated the climate of the Caribbean, saying, “Grenada is gorgeous. The weather is 75° to 85° all year round, and I played basketball in January, which was incredible.”

Dr. Best, who did her first year of St. George’s University in the U.K. and her second in Grenada, found the international experience to have quite a positive impact on her. “It inspired me even more to go and do global health work.” She suggests that if you are hoping to eventually practice in a specific hospital, you can look to see if they have taken international graduates in the past, but adds, “There are people who know about Grenada and they’ll ask you about it. You will not have to worry about a job whatsoever because most people are going to be very interested to know your story.”

Dr. Desai also felt strongly that he has never been treated differently as a graduate from a Caribbean medical school. He said, “Through pediatrics, general surgery, neurosurgery, you name it — all of my rotations, I was never ever, ever, ever treated differently.” But he reminded future students that what matters most is putting in the work. “It doesn’t really matter where you go as long as you study hard and you’re willing to participate.”

Question 5: How Has the Current Pandemic Affected Emergency Medicine?

Dr. Safai’s Master of Public Health degree has proven invaluable during this global pandemic of coronavirus. “It's important to get the whole big picture and learn about diseases and epidemics and other countries and how they can affect us and how we're all connected.” As a psychiatric resident, Dr. Safai sees another side to what the world is going through. “In the middle of the pandemic, we're seeing a lot of anxiety. But after the pandemic, we're going to also see, I'm sure, a lot of depression, a lot of PTSD if someone they knew was affected with COVID or someone they knew died of COVID, or if they were in the front lines of working with COVID patients. So the prediction is that after the pandemic, the need for mental health is going to go drastically up.”

With most elective procedures being canceled right now, and non-essential physicians giving up their space for COVID-19 patients, Dr. Best talked about the crucial need for emergency medicine doctors. “Right now, we're in a pandemic and emergency medicine physicians are a frontline provider. So you're always going to be needed in the field. You know that for sure. A lot of my friends who are specialists aren't really needed right now. They can't do much. So you're going to have some job security with that as well.”

Question 6: How Can Others Stand Out in the Field of Emergency Medicine?

All three doctors agreed that strong interview skills and letters of recommendation are key. However, Dr. Best explained that letters of recommendation are a bit different for emergency medicine. “Instead of someone writing a few paragraphs about you, they actually have a rating system. So it compares you to the other medical students that were rotating at the time, in addition to comments from faculty from that department.”

Dr. Desai stressed the importance of interactions with your Attending physicians. “The number one thing that your Attendings value is that you take the initiative to learn and to put your patients’ best interests before anything else.”

Dr. Best also touched on the importance of relationships, saying, “If you do very well in your rotations and the faculty members really enjoyed having you and they thought you worked really hard, that is definitely going to work to your advantage.” She also suggested joining a group such as EMRA, the Emergency Medicine Residents’ Association. “There is a student section and it's amazing how many students are a part of it and how involved they are. It's really hard to get involved with research, per se. If you have a patient that had a really interesting presentation or whatnot, or just something very rare, writing up a case report is something that is very easy, and you can maybe get a resident to help you or a faculty member and it doesn't take a long time. And it's pretty easy to get stuff like that published.”

Dr. Desai shared ways to shine on your rotations. “Show interest, be enthusiastic, always be available to help out and do anything that's required. The one thing that was always taught to me is no matter what it is, you have to be willing to do it. Because in one way or another, that's going to come back to help you. You're never too good to go get a history of a patient; you're never too good to just go ask the patient for their pharmacy, because every interaction with the patient is another chance to examine them and to learn about them so that you can help them more.”

If you would like to learn more about emergency medicine, or other medical school specialties, sign up for a virtual information session, or learn more about how you can apply for medical school.

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