What, Where, Why

I've been asked the question a bazillion times, "What should I want in an emergency medicine training program?" My response has never wavered.

Look for a program with balance. Every truly great team combines terrific offense and stifling defense. In emergency medicine, the pairing is clinical prowess and academic acumen. To be a consummate clinician, you must understand how to read a journal article and what conclusions truly apply to your practice and your patients. To be a gifted academician, you must provide exceptional care and compassion as a teacher but as importantly, in its own right, for the sake of your patients. And, the fundaments of basic, clinical and translational research are predicated upon clinical need, i.e., what do we require to know, develop or create in order to provide the best care possible to our patients. Academicians acquire this skill set by caring for and being with patients and their families. Besides, you may not know which direction you'll take, clinical or academic, whether it's at graduation or somewhere down that road known as your life.

The balance equation doesn't end there. The faculty and program you choose should have breadth and strength in as many areas as possible. If you should acquire interest in EMS, ultrasound, research, teaching, pediatric emergency medicine, toxicology, international medicine or any of sundry special interests within our field, you'll be fortunate to have a faculty role model to help guide and mold you.

Finally, your program must transition you from resident to emergency physician. It must imbue you with those qualities requisite to this transition. This is accomplished in two major ways. The faculty should blend for you the right mix of autonomy, hands-on teaching and got-your-back protection. Second, if you're around a deeply committed, passionate group of faculty and residents who are loyal to the tenets of emergency medicine, you can't help but be steeped in these same qualities. You may not appreciate this second transition phase for some years but eventually it will be clear that you have become that big picture emergency physician and how vital this step is.

Emergency medicine is an incredible challenge and absolutely exceptional opportunity. While I have touted certain critical features of an emergency medicine residency program, the truth is, you will be the key driving force in your training and what you eventually become. Your energy, intellect, common sense, work ethic and human qualities will be the touchstone of your potential greatness. The wise Yogi (Berra, not any Yogi) has been widely quoted as saying, "Baseball is 90% mental -- the other half is physical." What you bring and who you are will be at least 90% of the reason for what you can become. Please remember that and best of luck to you in the process.

John Marx, MD
Chair & Chief
Emergency Medince