Emergency medicine practice and training in Canada.

train in an RCPSC program for 5 years only to enter a purely clinical practice. This needs to be made clear to medical students before and during residency interviews. Most CCFP-EM residents should expect to enter a practice that is focused primarily on patient care, but which may also accommodate interests such as clinical or didactic teaching. For emergency medicine to fulfill its role in coming years, we need to prepare residents for the emergency department as it now exists and how it is expected to evolve — not how we wish it could be. We will not be working in emergency departments where admitted patients move immediately to ward beds. Family medicine, the CCFP-EM program and the RCPSC fellowship each provide training that leads to satisfying, but different, emergency medicine careers. There will always be exceptions in emergency medicine training, but those exceptions should not be used to conclude that the programs produce similar results. All 3 training pathways are essential in providing quality emergency medical care in Canada. Commentary