According to the Center for Disease Control and Prevention over 136 million people will visit the emergency room this year. Of those 136 million, over 40 million will be injury related and the rest either disease or illness related. Emergency room physicians are the only doctors who see everyone – every age, every background, every income level, and every ailment.
An ER doctor may see a homeless person with injuries and no resources in the same hour a wealthy individual with a heart attack and full insurance coverage. No matter what, the Emergency Room is open and no one is turned away. And it's due to the diversity in patients and highly stressful nature of this profession that the path of learning how to become an ER doctor can be challenging for many potential candidates.
What is an ER Doctor?
An ER doctor treats the physical injuries and sicknesses of patients who are admitted to the emergency room, usually with acute (severe or critical) medical problems. ER doctors can administer medicine and are trained to use various medical devices in the care of the patients. They work closely with support and ancillary staff in order to provide patients with the care and attention they need in their most critical moments.
ER doctors may do any number of tasks relating to patient care including:
Emergency room physicians experience great stress along with their opportunity to help people. One of the main qualifications of an ER doctor is that they be able to handle the burden of making major, potentially life changing decisions for the patients that they see. It is important for anyone who is considering specializing as an ER doctor to fully consider the pressure of the position and the real gravity of the situations that they will encounter.
Educational Requirements for Becoming an ER Doctor
The minimum educational requirement for an ER doctor is a medical degree. The specialty is highly competitive and it is advised that aspiring ER physicians work hard to maintain high grades throughout their education as well as high scores on all exams in order to be accepted into emergency room programs.
Step-by-Step Educational Path to Becoming an ER Doctor
Bachelor’s Degree
Students who aspire to attend medical school have a lot of options when it comes to undergraduate education. However, no matter what degree they choose to pursue, there are specific requirements and pre-requisites in order to take the MCAT and get into medical school. Because many of the pre-requisites are science based, some undergraduate students choose to major in a science-based undergraduate program like biology, which will automatically ensure their coursework and lab credits are complete.
ER doctor’s who excel during their residency and fellowship often have patient-care experience that was received during their undergraduate work. This may include volunteering at a hospital, becoming and working as an EMT or finding a position in a clinic. Undergraduate students who take the time to get patient care experience will find that it helps with their confidence, interaction and decision making skills as they move throughout their education and into their career. See our Tips for Success below for more information about obtaining experience.
MCAT
The Medical College Admissions Test is the test that distinguishes the students who are ready to enter medical school from the students who still require further study or skill development. Medical school is a demanding, intensive study of the human body, physical sciences and medical profession and a student’s MCAT score can inform their entire course of study. The MCAT will test a student’s critical thinking, problem-solving skills and writing skills by asking questions in the topics of physical sciences, biological sciences, verbal reasoning and writing.
Medical School
After successful completion of an undergraduate program and passing the MCAT, a student can apply to and enter medical school. Accredited medical schools are located throughout the United States and offer differing courses of study. During medical school students will take courses, work in a laboratory setting and complete clinical work during the four years they are in medical school. Classes include: microbiology, anatomy, pharmacology, medical ethics, physiology and immunology among others.
The final two years of medical school give students an opportunity to experience various medical specialties and work alongside practicing doctors to get experience in different settings. These clinical rotations are meant to give students an idea of what specialties most appeal to them and help them choose their focus which will inform their internships, residencies or fellowships as well as their continuing education, salary and career prospects. Emergency room doctors often find that they are interested in many of the specialties they encounter during rotations as they are most drawn to having a broad knowledge base that allows them to help many different types of patients.
Take the United States Medical Licensing Examination
The United States Medical Licensing Examination (USMLE) is a three-part exam that ensures medical school graduates are able to care for patients and work in a medical and emergency setting. According to the USMLE website, “The USMLE assesses a physician’s ability to apply knowledge, concepts and principles and to demonstrate fundamental patient-centered skills that are important in heath and disease and that constitute the basis of safe and effective patient care.”Passing the USMLE and receiving state license in the state where the doctor will be practicing is required before any doctor is allowed to practice medicine in the United States.
Residency
Aspiring doctors must complete a medical residency program. Emergency medicine residencies last three years and include training, lab work and working in a clinical simulations. During this time, doctors will face the day-to-day situations that they come across in a healthcare setting while being supervised and observed, receiving peer review, and attending seminars to further their understanding of emergency medicine and procedures.
Board Certification
After completing residency, ER doctors have to become board certified in their area of specialty. This certification is the proof that the physician has met the minimum requirements and established expertise in their field.
For emergency medicine there are two certifying boards: The American Osteopathic Board of Emergency Medicine (AOBEM) and the American Board of Medical Specialties (ABMS).
Fellowship
After residency, some doctors may choose to further specialize in their field. Emergency medicine, by nature, is a very broad topic that appeals to doctors who desire to help a wide variety of people in a wide variety of situations. However, some emergency room doctors may find that a subspecialty furthers their career goals, makes them more desirable in a competitive job market and gives them an added boast in salary once they do begin work. Subspecialties for emergency medicine can include:
Continuing Education
Continuing education is required to maintain active board certification as an ER doctor. Both the AOBEM and the ABMS have developed programs for board certification maintenance. Most doctors work within their medical school’s department of continuing education to keep up on their requirements. If a doctor has chosen a subspecialty it is also important that they maintain their subspecialty board certification and maintenance requirements through continuing education.
Understanding the Career
Many people think of popular television shows when they think of emergency room doctors. While the fast pace of those exciting series’ is accurate, there is a lot more to being an ER doc than they depict. Dr. Stefen Ammon, an ER doctor in Colorado, shares with us the true nature of the position: “As far as a work environment, it’s relatively hectic,” he says, “Sometimes the single pleasure you can provide yourself during a busy 10-hour shift is to go to the bathroom.” In busy ER departments, doctors find themselves in constant interaction with patients, support and ancillary staff, family members, and other doctors.
Recent studies have shown that ER doctors get interrupted every five to ten minutes with information or situations that need immediate attention. With their focus being constantly diverted and a constant attention to critical situations, plus the need to always be fully present and engaged in patient care, the 8-10 hour shifts that ER doctors generally work can be quite tiring.
“You are going to have something walk through the door that is going to be scary and difficult and hard and hard to manage and you need to be up to the task,” says Dr. Ammon, “You really need to be in the moment and paying attention to what you are doing.”
Work Environments
Emergency room physicians do not have as many options for where they work as other physicians have, but they do have options for how they are employed. An ER doctor can be directly employed by the hospital where they do their shifts, can be employed by a physicians group that is contracted through the hospital, can be both part owner and employee in the physicians group, can be an independent contractor or a solo practice owner. Each of these positions affects hours, control over schedule, and pay.
The majority of emergency room physicians report spending 30-40 hours per week with patients. ER physicians spend a higher than average amount of time with each patient (compared to other specialties'):
Emergency room doctors are also less likely to spend extensive amounts of time on paperwork. The majority of doctors spend less than four hours per week on administrative duties.
Salary Overview
According to the Medscape Emergency Medicine Physician Compensation Report[ii], the majority of emergency room doctors (69%) make between $200,000 and $349,000 per year. Only 10% make under $124,999 while another 10% make over $400,000. Generally speaking, male ER physicians make 14% more than female physicians.
Practice Setting
Compensation ranges throughout practice setting and work situation with the following mean incomes[iii]:
Practice Setting
Work Situation
Geographical Location
Earning potential adjusts based on geographical location. The highest compensation area is in the south central United States, which includes Texas, Oklahoma and Arkansas while the lowest compensation comes from the northeast.
Tips for Success
An emergency room is a high-stress environment that requires a lot of energy and focus to navigate. One of the tips from our experts is to get experience working in patient care as early as possible in one’s education. Patient care experience will help establish a student with the confidence they need to function in the emergency room.
There are several ways to get patient care experience.
Regardless of the type of patient interaction, it is beneficial and important for aspiring ER doctors to gain this experience as early as they can in their education. They will likely find that their studies are strengthened by their experience and that they excel when rotations and residencies begin. Having the experience on an application for medical school is positive, as is having the experience to show when applying to residencies.
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