3 vs 4 Year Emergency Medicine Programs
Written by Puja Singh, MD
The dreaded question of every 4th-year medical student applying to emergency medicine (EM). As if we don’t already have enough unknowns, things to consider, and choices to make, the choice between three and four-year programs can often feel heavy and confusing.
So how can you approach this decision? The most important thing to consider is that both will give you adequate training. There are even studies to show residents score similarly on ABEM (the board exams) and have similar rates of malpractice.
Here is a little breakdown to help make your decision:
4-year Programs
4 years of training (1 extra year of a resident-level salary)
Typically a heavier focus on research
The 4th year to create your “niche” or a “mini-fellowship” within the realm of emergency medicine
Potentially easier to get an academic job straight out of residency
1 extra year on top of fellowship (if fellowship is something you are considering)
More time on off-service rotations
More elective time
3-year Programs
3 years of training (1 less year with a resident-level salary)
Not as heavy an emphasis on research, but still space to pursue this if it interests you
More EM focused curriculum with a heavy emphasis on resuscitation, trauma, and procedures
Less off-service rotations
Some people tend to think by choosing a 3 year they are more likely to pursue a fellowship since you had 1 less year in training and 1 less year with a lower salary
Slightly harder to get an academic job straight out of residency without a fellowship
Tighter schedule based on 3 years, so less elective time
Either way, you cannot go wrong with either one since you have already chosen an awesome specialty!
Choose a program that you vibe with - the people, the mission, the location, the patient population, and mentors. Try to go into the application process with an open mind, not leaning towards a 4 vs 3 more than the other. Ultimately, 3 vs 4 years is not the most important decision. It is about finding a program that you love, no matter the length.
