January 24, 2020

So, You’re Thinking About an EMS Fellowship?

By Puneet Gupta, MD, FACEP, and Tiffany M. Abramson, MD

Are you interested in a career in prehospital medicine? Are you considering an EMS fellowship? In this article, we will provide you with insight into the benefits of undertaking a fellowship and the life of an EMS Fellow. There are numerous benefits to be found in fellowship. – some obvious, some less so – however, as with all fellowship training, the cost is your time. So, is an EMS fellowship worth it for you? Well, read on and decide for yourself.

The benefits of an EMS fellowship are similar to those of most emergency medicine fellowships- becoming a subject matter expert, developing a specific niche, and potentially becoming board certified in your sub-specialty. An EMS fellowship will provide you the skills and background needed to become a successful prehospital medical director, educator, or researcher.

The fellowship will cover the core curriculum of EMS and prepare you for the EMS board exam, provide the opportunity to give medical direction and patient care in the prehospital environment, and complete a scholarly project. Additionally, studying under dedicated mentors will not only increase your knowledge base and skill set, but it will also help you become part of the local and national EMS communities. Being a member of the community will increase your opportunities for jobs and academic endeavors, expand your professional network, and will make you a stronger candidate for future EMS positions. Note: Since the practice pathway is now closed, an ACGME accredited fellowship is the only way to become eligible to sit for the ABEM EMS subspecialty certification exam. Board certification will attest to your dedication to the subspecialty and provide you an advantage when applying for more competitive positions.

That being said, a year of dedicated EMS study is incredibly fun! If you’re thinking about fellowship, you are probably as excited about this field as we are. Imagine a year where you get to immerse yourself in the craft. From spending time in the air to responding to calls on the ground. From tactical training to becoming part of a search and rescue crew. From lecturing to prehospital providers to delving into the intricacies of EMS policies and regulations. Being exposed to the multiple aspects of EMS is essential to EMS training, but it’s also a unique experience that can be obtained through fellowship. 

To be facile at prehospital medicine, you must understand the politics of working in an EMS environment with unique environments and multiple stakeholders, many of which are different from the hospital setting. To be competent, you must have an understanding of the vast body of knowledge required to advise on prehospital medicine, much of which is not touched upon during traditional EM training. As your experiences grow, so will your skill with dealing with these out-of-hospital emergencies that you may be called to advise upon with the support an experienced mentor to guide you along the way.

Now that you’ve established that you want to apply for an EMS fellowship, which fellowship do you choose? EMS systems differ significantly, as they grow to fit the community that they serve. As an EMS fellow, your system will be your training arena. If you know what system you want to work in, consider going there to establish a foundation.

You may also want to choose your fellowship based on your specific interest. Many fellowships have areas of focus (i.e., disaster, tactical, mobile integrated health, search and rescue, wilderness, event medicine, or prehospital research). If you know what type of practice you’re looking for, consider looking for an EMS system that exemplifies those traits and EMS faculty who can mentor you in those areas to optimize your training. If you don’t know, don’t panic! You’ll have so many experiences in fellowship training that you don’t need to choose. By the time you’ve finished, you’ll have a better idea of where you want to go. 

If you are drawn to prehospital medicine, we highly recommend considering a fellowship year. As the body of experience and knowledge of prehospital medicine grows, there is more and more information to know and more ways to impact a prehospital system. From developing political savvy to providing evidence-based online medical direction, the skills in an EMS physician’s toolbox must grow beyond that of an EM physician. While an EMS fellowship is full of exciting experiences, it also harbors a structured way to become competent. 

Is fellowship worth it? Well, that’s for you to decide.

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