So You SOAP’ed into EM - What To Do Know
Written by Kaitlyn Thomas, DO
As someone who SOAP'ed into EM, I was very worried about making a big specialty change and trying to learn what exactly EM entailed and what kind of things I should know as a resident.
Here are some things I think are helpful. I am an emergency medicine resident at Guthrie Robert Packer Hospital. Thank you to my APD, Lindsay MacConaghy, MD, for her advice as well!
1. Learn about some of the sub-specialties and focus of EM
You may have tailored your entire medical education experience to a different specialty. If you have any rotations before graduation, try to switch around your schedule and pick out things that will be helpful for EM. Or be aware of things that EM doctors do. For example, I had no idea that we did sedation! Sedation is super cool! Other things like airway management or the amount of ultrasound experience may also be a surprise to you. Or the amount of critical care. Once you’re on vacation before the start of residency, don’t worry about trying to study or learn EM-tailored things. But, when you’re still a student or researcher, it doesn’t hurt to do some soft learning about the specialty. EMRA has a ton of amazing resources about EM in general.
2. Your EM Faculty are aware you may need additional clinical support – voice your needs! You may not have expected to do procedures or you may need a lot of help re-prioritizing your differential diagnoses to “never miss” emergencies as compared to other specialties where you focus on what’s most likely. We ultimately think a lot about what is most likely in the ED too, but through the framework of “what would be the scariest thing we can never miss.” You shouldn’t be afraid to ask for help with procedures – I have never seen a central line, and I have never done an A-line or an anesthesia rotation.
3. For IMGs
Be prepared that you may need to educate your faculty about some of your needs with prior medical experiences at your medical schools or visa renewals if one is needed, etc. You must advocate for yourself.
4. Open Lines of Communication
Your faculty cannot read your mind and may not be aware of all your strengths and weaknesses when you first start. Your faculty are paying attention to those things, but if you do some self-reflection and can vocalize your own needs, that will be very helpful when you start and you may feel the most lost. Find faculty and resident mentors in your program that can help you. If your program has former SOAPers who made a specialty switch as well, lean on them to help you through the process.
5. Faculty are nervous too!
It’s a huge change for everyone – some programs have never SOAP'ed before and want to find the best way to support you. Help each other be successful at making you a great EM doctor!
