5 Things I Wish I Knew Before I Became an Emergency Medicine Physician

emergency medicine

Editor’s Note: I’m grateful to Dr. Harry Karydes for sharing this guest post for The Specialist Series.  He has some great pearls to share for people interested in a career in emergency medicine.  

emergency medicineAre you interested in contributing an article to The Specialist Series?  It’s a great opportunity to share your wisdom with current and future members of your specialty, as well as get some free promotion for your blog, podcast, or business.  You can check out The Specialist Series home page here, or email editor@TheScopeOfPractice.com for more information.

How and Why I Became an Emergency Medicine Physician

From a young age, I knew I wanted to be a physician. While I had no one in my family in healthcare, I was fascinated by the human body. Knowing that someone with proper training and resources can save a life was mind-blowing to me. And, in many ways, I am still awed by this. Having a knack for science and math (yes, I was that kid), as well as a love for helping others, I knew medicine was for me.

The road to emergency medicine for me began in college. Quite innocently, I joined a friend who was taking an EMT-B course on campus. Both of us really enjoyed college sports and the only way to get “front row seats” at our football or basketball games was to be part of the medical team. This was our ticket to see the action up close and personal!emergency medicine

What happened next was life-changing. I fell in love with emergency medicine! I really enjoyed being the first on scene!  Also, many times not even knowing what or who we were responding to was exciting to me. After graduation, I had a tough decision to make.  Do I pursue medical school with the goal of working as an emergency physician?  My other choice was to go to paramedic school and become a paramedic.

I decided on the latter. I grew up in a middle-class family on the northwest side of Chicago and my entire circle of friends was firefighters, paramedics, police officers, plumbers, electricians, or carpenters. This was my trajectory, or at least that’s what I thought at the time.

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Then I started working as a paramedic in Chicago!

Chicago, like many large urban cities, is plagued with crime and poverty.  There’s also a tremendous lack of access to healthcare in a population of individuals with chronic disease.

But, through all that I was wide-eyed every time we brought a critical patient to the emergency department.  That was true whether it was a victim of multiple gunshot wounds or an elderly patient in septic shock. The emergency physician truly epitomized the “captain of the ship” persona, and I wanted to be a part of it. I was hooked and took the plunge into medical school and have never looked back.

5 Things I Wish I Knew Before I Became an Emergency Medicine Physician

1. Not Everything in “Emergency Medicine” is an Emergency!

Having worked as a paramedic, I intuitively knew this as I entered the world of emergency medicine. But, what was really eye-opening for me was that I practice quite a bit of primary care medicine. I was fortunate enough to have been in an emergency medicine residency that required me to complete a year of internal medicine training before I entered the emergency department.

While I may not have understood it at the time, that one year of internal medicine continues to serve me well in my day-to-day interactions with patients in the emergency department. For example, it’s important to understand how to manage hypertension before you can effectively manage hypertensive emergencies.

emergency medicine2. The White Coat Can Be Heavy at Times

Like many of my colleagues in emergency medicine, I need to make critical decisions with incomplete (and sometimes with no) information. There are times when we care for patients in extremis and have no report from EMS aside from “patient was found down.”. Many times I don’t even have a name, age, or past medical history.

As the “captain of the ship,” this can be an incredible burden to bear. Being comfortable with being uncomfortable is a prerequisite for a long career in emergency medicine.

3. Emergency Medicine Relationships Can Be Just as Important as the Medicine

Unique to emergency medicine is the breadth of patients that we see. I can deliver a baby in one moment and then tend to a 98-year-old septic shock patient all in the same shift. Emergency medicine is a team endeavor. Building and nurturing relationships with the nurses, consultants, and colleagues are vital.

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Medicine, similar to many other industries, has become segmented and fragmented. These silos have taken away the need to interact with each other. Nowadays, I can send a secure text message to a primary care physician or consultant about a patient in the emergency department. For me, nothing can adequately replace a phone call or, even better, the face to face interaction with a colleague.

For all the budding emergency medicine physicians, take the time to build and nurture relationships with any interaction you have in the hospital. It will make your day (and your career) far more enjoyable. If you haven’t read the classic How to Win Friends and Influence People by Dale Carnegie, pick up a copy today. It should be a must-read for every physician.

4. A Rotating Work Schedule Wreaks Havoc on Your Circadian Clock

One of the benefits of working as an emergency medicine physician is the shift work. You work your shift, and then you are done for the day (or night). Unless you work administratively, you don’t get texts or pings on your phone from patients, consultants, or hospital administration.emergency medicine

While that surely is a benefit, most emergency medicine physicians will have a rotating schedule.  In other words, in any given week you will likely work a day shift, an afternoon shift, and possibly a night shift.

Overt time, this can wreak havoc on your circadian rhythm. The adjustment is easier early in your career, but it gets harder with each year in practice. I have found developing a ritual upon awakening and another ritual just before I go to sleep (whatever hour that may be) has been a game-changer for me. These rituals bookend my day and I defend them fiercely.

5. Burnout is Real in Emergency Medicine

As someone who has felt the darkness of burnout, it is no surprise that emergency medicine consistently ranks first among physicians suffering from burnout. And, while the reasons for burnout are many, it is critical to develop habits, rituals, and tactics to grow and thrive in medicine. Recognizing that there was little written on physician wellness and even fewer resources for the struggling physician, I knew something had to be done.

For years now, I have been working with physicians, nurses, and other medical professionals across the country helping them beat burnout so that they may thrive in both their career and personal life. I developed a website and podcast called Medicine Revived.  My mission is to assist the physician, nurse, or paramedic in this journey by giving them the courage and the tools needed to help them learn, grow, and prosper in the important areas of their life.

Emergency medicine has been great for me. It fits my personality as well as my personal and professional goals.  It’s an incredibly satisfying career where I have the privilege of serving patients from all ages–from one patient having their first breath to another, sadly, having their last breath.

It’s a specialty filled with many emotions ranging from elation or incredible sadness. And, in all the chaos of an emergency department, the camaraderie and relationships that occur in the emergency department is something that I love and look forward to each and every shift.

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Final Thoughts

Overall, if I had to do it again, I would – without question.  Taking care of patients that want to get better and return to active lifestyles is very inspiring.  These are the things I wish I would have known.

Of course, as time goes by I learn more AND learn more of what I do not know.  That is what makes it fun!  Hopefully this will provide some insight to medical students, residents, and fellows as they progress through their training.

Further Reading


Please leave a comment below!  What do you know about emergency medicine that you want to share?  If you’re thinking about going into emergency medicine, what’s something you wish you knew the answer to?


Full Disclosure: Some of the links to the resources listed above may be affiliate links, which means that I will receive a small commission if you click through and make a purchase. But it doesn’t cost you anything extra—it’s just a way to show you appreciate what we do here. Thanks for this.


Meet Dr. Harry Karydes

emergency medicine

Dr. Harry Karydes is a board-certified emergency medicine physician and medical toxicologist.  He currently serves as the medical director of an emergency department.  He completed his residency and fellowship training at John H. Stroger Jr. Hospital of Cook County in Chicago.  He has been in practice for 11 years.

Dr. Karydes knows what it feels like to be pulled in five different directions at work and at home. He discovered that success at work and home begins with the individual. He helps overwhelmed physicians, residents, medical students succeed professionally and personally. His mission is to give you the courage and tools to learn, grow, and thrive in the important areas of your life. To live a life of focus and balance.

If you want to learn the tips, habits, and rituals successful leaders use–inside and outside medicine please go to www.medicinerevived.com/start

Also, one can subscribe to the podcast at www.medicinerevived.com/apple


Are you interested in contributing an article to The Specialist Series?  It’s a great opportunity to share your wisdom with current and future members of your specialty, as well as get some free promotion for your blog, podcast, or business.  You can check out The Specialist Series home page here, or email editor@TheScopeOfPractice.com for more information.


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