Join the ED team. St.Emlyn’s

Estimated reading time: 3 minutes

I have always said that there are no bad careers in medicine, there is a place for everyone and although some people really do get a kick out of being super-specialised (Mrs C is a specialist in ocular surface and corneal transplantation – yawn  (Ed – does she read this blog????) ), that’s not for me and it’s not why most people first go into medicine. I chose EM after starting out in surgery and I’ve never looked back. Having said that Emergency Medicine feels like it’s been under the cosh of late, but I genuinely feel that we are at the bottom of a curve that is about to rise. We have fantastic leadership from @cempresident and a quick look at twitter will show that there are some fantastic UK docs out there in our speciality who are not just the present, but also the future of emergency care.

If you’re a junior doc and you can answer yes to the following then EM might just be the career for you.


Did you go into medicine to help people?

Did you watch TV shows and get a little bit of buzz watching the resuscitation teams in action?

Do you want to make a difference to patients and public health?

Do you like working with people?

Are you slightly crazy?

Do you have a remarkably short attention………SQUIRREL…….span?

And of course remember that…..

Grunt doc is so right, do you want to go to a party full of emergency physicians or one full of ophthalmologists, or dermatologists, or radiologists??? I’ve been to all of these  and I can tell you that any story that ends up with a room full of people laughing at the punchline to a joke ” ….in the end it was just a huge angle kappa!” cue howls of laughter…. is not a job for me. Watch the video at the top of the page about EM in the US. We are a bit behind in terms of speciality development, but that’s all the more reason to get in now so that you can help shape the future of emergency care.

So get your applications ready to join the best team in medicine. If you’re cleverer enough, brave enough and possibly crazy enough you’ll know what to do…….

Here’s an update on the film from EMRA




PS. Contact us via Twitter or the blog if you need a bit of extra persuasion 🙂

Cite this article as: Simon Carley, "Join the ED team. St.Emlyn’s," in St.Emlyn's, November 9, 2013,

17 thoughts on “Join the ED team. St.Emlyn’s”

  1. A family came to my reception yesterday to thank me for looking after their father who had died. They refused to leave until all of them had shook my hand. A real plus of this job is when do it well, our patients and their relatives really value what we do. It is the most interesting job in medicine

  2. A potential trainee

    Good points. Nice post. As a potential EM trainee currently doing core anaesthetics (and not telling anyone i work with about my real career interest) the recent CEM developments are interesting. Add in The Shape of Training Review suggesting that all trainees will have to spend more time in acute specialities and there is potential for things to massively improve.

    Personally I’m not interested in more money but would be swayed by more generous study leave time, flexibility and funding.

    I’m keeping my eye on it.

  3. Other reasons to be an ER doc:
    Do you thrive on making life-altering decisions in a millisecond based on incomplete data?
    Do you enjoy assaulting people with tubes and sharp objects?
    Does the sound of a siren make your pulse quicken?
    Does the smell of melena in the morning invigorate you?
    Have you ever looked at a spot on your clothing and said “I hope that washes out” without once asking yourself what it could possibly be?
    Are you willing to make the phrase “pucker factor” part of your normal vocabulary?
    Have you found 13 alternative uses for paper clips, needle caps, and ultrasound gel?

    There are so many more…

  4. thinkingaboutleavingUKEM

    I read about DL/VL debates, push dose pressors, peri mortem sections, pulmonary twists etc etc..but the UK dgh reality is endless collapse ? cause and ‘fast’ af. is there a reg rotation in the UK where over all three years I could actually get to learn the skills I read about? (e.g. ED airway management in all the hospitals i rotate through) or is it just about management of ‘flow’ and referring as quickly as possible? where I work the surgeons lead trauma calls, the medics are called and lead every ED arrest, the gasboard do (and wont let us touch) all the airways, and the paeds blue calls bypass the ed docs and go straight to the paeds reg!…this is why ED has a bad rep in the UK and why people leave. Im inspired by what I read on St Emelyns, but if you’re at St Elsewhere the reality is very different in my experience.

  5. UK ED needs to change

    If only the social media dream of VL/DL, perimortem sections, push dose pressors, pulmonary twists etc was anything like the reality of the UK DGH ED. More like: collapse ? cause/ ‘fast AF’: refer as quickly as possible. Where I work, Medical Reg runs all ED arrests, Surgeons run trauma calls, gasboard to all tubes and lines, Gynae goes straight to gynae, Paeds ‘blue calls’ bypass ED docs and go straight to the Paeds Reg, and doing ultrasound with some form of supervision is near impossible. Whilst St Emelyn’s may be fantastic (the website is certainly inspiring), the reality of St Elsewhere is pushing trainees abroad.Is there a Reg rotation where ED Docs manage the airway at every hospital they rotate through? UK ED needs to change.

    1. Sorry to hear that.

      Hmmmm, that’s not an emergency department that anyone working in Virchester would recognise. It sounds like a hospital I worked in 20 years ago rather than in 2013…, but I also realise that times are tough in some areas.

      Where are you working and are you an EM trainee already, or looking to get in (or more likely get out from the theme of your post)?

      Anyway, you could always work at St.Emlyn’s or somewhere similar (they do exist).


      1. We need to be careful not to over-glamorise the specialty otherwise we may lose good trainees when the result doesn’t match what was sold. Outside of the major centres ISS>15 trauma is now a rarity, and there is not always the support to develop the critical care skills in the resus room that was learnt in CT2. In one department I was not allowed to place seldinger drains for (large spont) ptx as it was ‘a job for the medics’, which then led to farcical situations of me supervising medics performing a procedure I wasn’t permitted to do myself!
        The day to day reality though for most in DGH land is elderly majors. This can be really interesting and diagnostically challenging medicine in the right department, but it is not sexy medicine and can be a never ending conveyer belt on auto pilot to MAU in bad ones.

        Whilst my training experience wasn’t as demoralising as that described in the post above, it didn’t leave me confident enough to enter ST4 with the level of skills and knowledge I wanted at the stage of 3yrs pre-Consultant. I like EM, and I like rural DGH EM, but a significant number of departments in the UK do the speciality and it’s trainees a disservice. I have gone abroad to continue learning, and have yet to decide when or if I’ll return.

      2. Cheers, we might be blessed with lots of interesting things to do in Virchester (that is true)…

        It’s quite a common theme to hear that trainees are apprehensive about entering ST4 as that’s still quite junior to be left in charge of a department overnight (when consultants are not normally resident in the UK). I know of many docs who are taking an extra year off the conveyor belt to have a rest, consolidate and expand their knowledge, skills and experience. I think that’s absolutely fine to do and if you want to do that abroad then great – I think that’s what I would do as well (in truth it’s exactly what I had planned at about the same stage – but children arrived and scuppered that plan….!).

        Hopefully we can drag you back at some point 😉 , but if you’re having a good time where you are then great. If you do come back I hope you’ll be an inspiration to your trainees and deliver the type of leadership and support that you wanted when you were a trainee.

        vb and good luck


  6. I think one has to realise that there are DGH Emergency Departments and DGH Casualties and there are certain elements to both that can be enjoyed. It is an interesting challenge developing the latter into the former, even at a trainee level you can introduce different ways of working (to be fair this is often easy in the DGH casualty as no-one is really looking). Transforming a department with a group of like-minded consultants is a fascinating task, there are so many people to persuade that things can be done differently, ITU, physicians, radiology and most importantly of all your own medical and nursing staff (that breakthrough is by miles the best- when they stop putting out crash-calls for seizures and start telling the ortho reg he needs to talk to you before he’s allowed to touch the midazolam).
    DGH EDs if you join one, or build your own, also come with their own set of challenges, not every specialty is on site, so as the ED consultant you are often the local expert on that particular patient group. That group is often kids or kids still in ladies’ tummies, with no paediatrician for twenty or so miles (unless they’re living in the housing estate opposite the ED, which for my place would come as a surprise) which can lead to interesting times in resus and the occasional ambulance ride and there is a certain satisfaction in knowing that at the big hospital they would have had paediatrics, paediatric anaesthetics and the paediatric kitchen sink down and the kid would have been whipped off to PICU within half an hour, whilst you and your reg/SHO have dragged him/her back to wellness so they can be fit for transfer or last long enough for the retrieval team to come get them. Similarly you are often the only one who has the first clue about trauma, rarer though it may be it is still going to turn up.
    Having been a consultant at St Emlyn’s (hello everyone by the way) and in more than one DGH I can say I have enjoyed big hospital medicine but have been more challenged by DGH stuff. It’s still an evolving specialty and there are changes to be made across the spectrum.

    1. Fantastic to hear from you Stewart. We miss you and would have you back in a shot 🙂

      I think you are absolutely right about the different challenges in different centres (I was oddly enough having the same conversation with another Virchester alumnus in the 7th circle of hell today (The Trafford Centre)).

      Great and wise words as always and a heartfelt hello from all at St.Emlyn’s.


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