Blog Archives

How the Show ER and New Residency Programs Change the Economy of a Specialty

Here’s an interesting piece called “Are There Too Many Emergency Physicians?” by Thomas Cook MD, an emergency medicine program director. Dr. Cook chronicles the growth of emergency medicine residency positions from a total of 1821 in 2015 to 2488 in 2019. This rapid growth in the field may lead to an oversupply of emergency physicians.

The paradox here is that only recently there was a shortage of emergency physicians. And back when I graduated from medical school in the mid-1990s, almost no one was applying for emergency medicine. In my class of around 150 students, there were three of us. As the popularity of the show “ER” waxed, the number of applicants to the field swelled. Then, years later, the field contracted again. 

Other fields have also recently seen a boom in the number of residency spots, including family medicine, psychiatry, and anesthesiology. Of course, opening up more residency positions is a good thing for medical students (especially international medical graduates) and patients, but the growth in certain fields may lead to a change in the economy of those specialties. It will be an interesting experiment.

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Preliminary Year: What do I do with my Personal Statement?

Candidates who apply to certain fields – dermatology, ophthalmology, etc. – need a preliminary or transitional year of residency before initiating their specialty training. So does that mean those applicants need to toil over two personal statements?

No, thankfully. It’s very appropriate (and strategic) to use the same essay with minor modifications. Ensure you explicitly address why a prelim year will advance the rest of your career and how you will contribute to the prelim training program as a future specialist.

When you use a very similar essay, you can be honest about what your professional goals are. After all, the reader knows you’re applying for a one-year position.

Remember that many preliminary/transitional year programs are eager to match residents who are moving on to competitive fields. In general, those applicants will have strong USMLE scores, evaluations, and clinical skills.

Want help with your residency personal statement? See Dr. Finkel’s editing services.

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Choosing a Specialty and a Life

During the winter season, I spend time talking to a lot of residency applicants about their future specialty choices: Want the majority of your time to be in the operating room or in the clinic? Like procedures?

But another fair and reasonable approach is to consider lifestyle. A recent New York Times piece noted that 50% of physicians are burned out. Burnout is particularly severe among emergency physicians and critical care doctors.

As you go through your third-year clinical rotations ask yourself if you can find a role model who fits – not just your professional goals – but your personal ones. Ask to meet individually with faculty members for their opinions on their fields’ pros and cons.

Considering the growth in patient volume and the continued dearth of physicians, it’s critical to determine whether you can see yourself happy in a busy, lifelong career in a particular field.

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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