Observe an emergency room (ER) in action and you might at first think you’re watching an exercise in chaos. Watch longer and you’ll notice carefully controlled patterns, a life-saving dance that relies on cooperation and collaboration between different healthcare professionals.
Trauma surgeons and emergency room physicians (also known as emergency medical specialists) both play major roles in the ER. Both respond to emergency situations with the ultimate goal of saving lives and limiting the lasting effects of illness or trauma.
However, medical students considering both careers should understand how the two roles differ.
Brant Putnam, MD, a trauma surgeon for the past 15 years, Professor of Surgery at the David Geffen School of Medicine at UCLA and Chief of the Division of Trauma and Acute Care Surgery at Harbor-UCLA Medical Center, explains the key differentiators below.
Expectations in the ER
Emergency room physicians treat all ER patients, regardless of illness or injury type. “They’re going to be able to take care of patients who come in with the early stages of a heart attack or stroke, or a patient who has been injured after a trauma,” Dr. Putnam explains.
ER physicians may intubate a patient, start blood transfusions and order testing — all while assessing the patient and making decisions about their care. “They’re very well trained in that initial stabilization and the majority of patients with minor trauma are largely managed by emergency room physicians,” says Dr. Putnam.
By contrast, trauma surgeons get called into the ER only when patients need surgery to prevent long-lasting or permanent damage or if they’re experiencing specific types of trauma, such as a drop in blood pressure after an accident. Furthermore, a trauma surgeon’s care extends beyond the ER. These physicians often assume primary responsibility for patients admitted to the hospital for long-term care.
ER physicians and surgeons start off with the same core medical school training. Specialization comes after graduation, during residency. Trauma surgeons typically train in residency longer than ER physicians.
“It’s a significant commitment to become a trauma surgeon,” Dr. Putnam says. “It’s usually a five- or six-year residency for general surgery, followed by a year or two of surgical critical care/trauma fellowship. Emergency medicine residency lasts three or four years, depending on the program.”
Another difference between trauma surgeons and ER physicians involves contact with patients. The role of an ER physician is to stabilize and treat patients, recommending further care from specialists if needed.
Trauma surgeons spend much longer with their patients, caring for them through rehabilitation through discharge from the hospital.
“I guess it’s really the commitment to taking care of a severely injured patient from the time of arrival through their need for surgery and acute hospitalization that is what makes a trauma surgeon different from an emergency room physician,” Dr. Putnam explains.