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New Grad with a tough decision to make...

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Hi everyone! I am a new grad as of last month looking to work in emergency medicine. Here's my dilemma:


I've been accepted to a 1-year EM fellowship w/ rotations in level 1 trauma center, ICU, ultrasound, EM etc. etc., 55k/year with benefits and the opportunity to obtain full employment at the hospital following the fellowship.


I've also been offered a job in EM with 3 months intensive residency-esqe training at a hospital outside the city. Less acuity than the hospital that offers the fellowship, but sounds like a lot more autonomy. 100k starting and RVU bonus beginning at 1 year, similar benefits to the fellowship.


Not a bad dilemma to have, but what do you guys advise? Take the pay cut for the excellent training? Or start with a great salary and pretty decent training while learning on the job?

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Is the one year EM fellowship a good one?  How do other grads from the fellowship rate the program?  Do you get plenty of time and opportunity to learn the US, ICU, trauma care, etc. at the fellowship or will you be competing with physician residents?


A fellowship can give you that intense year of training that will qualify you  for the EM CAQ and may be the ticket to other EM opportunities in remote or critical access hospitals, if that is your ultimate goal.


As UGoLong states:  this will be ultimately up to you to decide which way to go.  It might be easier as a new PA grad to take the residency first, rather than the other way around.  It would be hard to give up a 100k salary later on for a resident salary if you decide to take a later EM residency.


P.S.  I do not work EM anymore.   I needed more skills to work to my highest level of my license and did not have any residency opportunities where I live.  My CAHs said they would train higher level skills but no physician ever really had the time or desire......so think about that, too.  Are the physician at the 100K job really invested in you? 

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If your financial situation allows either and the residency training is significantly better (based on all the information you can gather about it), go for it.


If your financial situation (eg family, loans, whatever) would be difficult to manage on that salary, go with the job.


Personally, if I were in your shoes but in my own situation, I'd go with the job hands down.  Sometimes being responsible for your own patients is the best way to learn.  I know we have a few advocates for residencies here and as I said, if you can afford it, then by all means in the long run it will only help.

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