“You’re going to have to find a way to establish yourself in the Emergency Department in order to motivate yourself
and find a starting point somewhere in your career, e.g. Ammar for ecg interpretation or Abrar when it comes to Blood gas analysis”
When I first heard this by my consultant, Dr Hassan, during the early months of residency my first thoughts could be summed up as this “aren’t we supposed to be the jack of all trades, the guys who are adept at doing the initiative of all patients regardless of whom they go to?” While the general idea behind my thoughts were somewhat correct the context behind it was far from it being so. As budding emergency physicians we are the guys who see the patient, make all the necessary polishing that needs to be done and then send the patient off home or admit them under a speciality, in order to do so we need to have a vast but adept skill set e.g ecg interpretation, blood gas reading, interpretation of x rays, so on so forth.
However, with ED being such a huge field of work with so many things you need to be competent at in order to do a good job, it is next to impossible to find a subset of the skills EM has that you get to be the go-to-guy for. one of the advantages of starting up on being the go-to-guy for a certain skill set as a junior is that you have somewhere to start, as a junior it can be pretty intimidating in pointing out where and how you would like to start out in your foundation as an emergency medicine because of how vast are scope of work is. Another advantage is that your feeling of being valued as an “expert” can be extremely motivating especially in the early years of residency where establishing yourself as a functioning doctor can be extremely draining and depressing when you’re at your absolute bottom/start of your career.
How do you start?
When it comes to finding out niches there will always be a couple of things in our skill disposal that you might find either very easy or a skillset that really catches your attention which causes you to give more time towards said skillset (more on that later). As human beings we will always have unique interests mostly not related to work, however
what sets a professional interest from a hobby is that sometimes we are forced to work on things that you don’t like at all at first, but because by the will of your career, you will be forced to work with it/them. Now with this situation being the bane of every junior’s existence you can get help from a senior who will guide you, but this is temporary, you can’t expect your seniors to help you out in every situation that you find difficult without learning anything from the prior difficult situation that you called a senior for. This where your own effort comes in. The point of my prior sentence is that sometimes certain aspects of Emergency medicine aren’t going to come out and peak your interest, rather sometimes you are going to have to put effort and find out afterwards that you really enjoy doing your skillset.
Conversely some aspects of ER can bring a natural talent of someone out, however this is not something you should use as a motivating factor nor is it something that you should be hoping for as a junior on how you should find your niche in ER and subsequently hope this can be the same in other aspects as an emergency doctor, the reason being is that not everybody is a potential prodigy in something, heck, you could be blank canvas when it comes to starting skills with no outstanding features in the beginning barring passing exams.
Point being is that just because you’re not good at something it doesn’t mean that you will never be good at it, However if you are one of those individuals who are blessed at having a strong starting skill set then you shouldn’t let it distract you from the fact that you still have to work with a lot of other demanding skills and the fact as a scientific specialty, have to keep yourself updated and consistently keep yourself at the top of your game.
I did mention earlier that somethings will peak your interest not because you are good at them, but just because they intrigue you. By keeping your eyes and ears open you could find something that really peaks your interest, however unlike the prodigy and very much like the prior scenario of being forced to work with something that you don’t like you are going to have to put effort in order to achieve practical function.
One of the major ways of finding your niche interests is via off rotations, while the sudden sense ease can be quite relaxing, it is a perfect opportunity to hone in on your craft without distractions and setting up a clear set goal e.g if you’re in the ICU rotation you could hone in on the critical aspects of ER with a well planned study. Gradually you can find and perfect your craft.
With all of this being said, there is one very important point that I would like to point out. You may or may not find your interests in the early years of residency. As you grow as a physician and as a person you will change causing you to discover new things about yourself, the way you approach people etc. What I am trying to say here is that you will probably not find your niche in your early years and you shouldn’t be disheartened.
EM is a big field and it is nearly impossible to not find a certain interest in a lot of the skill sets it provides. Like I mentioned above, there are multiple ways of finding out your interests/niche(s). Some easy, some difficult, some can be grasped easily, some will require effort, some can really get on your nerves in the beginning, and sometimes you will not find your interests immediately.
Dr. Ismail Abdulrasheed, Indian, Emergency Medicine, PGY2 from Al Qassimi Hospital-Sharjah.
I occasionally like to read short horror stories or a bit about dinosaurs, take my car out for a drive. I would like to travel the world or part of it someday. You find a bit about yourself everyday more so when you come across hurdles, whether this is something because of who you are innately or because you have to change yourself to accommodate everyday challenges, is kind of difficult to tell. But hey, the more you know yourself the more you can be amazed at how you’ve come so far.