A career in emergency medicine can be truly rewarding, despite the long hours and adverse conditions. The decision to embark on this journey typically starts during medical school, usually with the allure of resuscitations and life-saving procedures performed in the fast-paced environment of the emergency department. During an emergency medicine residency, the young physician is faced with career decisions that may involve working in a community or academic emergency department setting, or pursuing specialization through fellowship. Following residency and fellowship training, the emergency physician may decide to purely work clinically in an emergency department, or combine clinical responsibilities with administrative, education or research pursuits.