Why would you choose a 4 year program? There are both 3 and 4 year training formats for training in emergency medicine. The truth is there is no solid consensus on which is the best format to provide the best training for a career in emergency medicine. A good 3 year program is probably sufficient to minimally prepare a physician to practice emergency medicine. It comes as no surprise that residents are tired of being in school. They want to get out, be done, and make money. Many probably see the extra 4th year as a loss of income. Objectively, however, emergency medicine has changed incredibly over the years. Our practice has morphed from a clinical scenario that was once filled by GP’s and dermatologists who were assigned by their medical staff to “ do their fair share” and work in the “ER” twice a month into a complex specialty practice. We now do things that weren’t even considered a few years ago.
The body of knowledge and skills necessary to practice emergency medicine (ultrasound, procedural sedation, critical care, etc.) continues to grow every year. That doesn’t even include the incredible array of practice opportunities available and the fellowships that accompany them. Add to all of this the demands for high quality and the importance of safety, and you have a recipe for mediocrity if training is limited to only 3 years. To end up with a satisfying career, residents need the extra time to consider all their options, to discover the possible avenues like teaching, research, administration or involvement in advocacy and policymaking at state or national levels. Almost all positions now require physicians to contribute something other than just their clinical work.
We believe that our four year program will allow the resident to not only maximally prepare for their practice in emergency medicine, but also will provide them with the foundation and experience to create a satisfying life long career that will give them the best experience for the rest of their life. Is an extra year that provides you with an optimal education, and prepares you for all aspects of your professional and personal life allowing you to have maximum flexibility in the future worth it? That is a question a physician entering this specialty has to answer for themselves. Hopefully this perspective will help you make the best decision for yourself as you consider residency programs.
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