I can't see myself enjoying anything but EM. Is the job market *that* sketchy?

[alpinism]

Haha this SDN thread is dark as hell.

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[alpinism]

So I work in inner city Brooklyn in probably the highest acuity ED in the northeast. We're on track for over 500+ GSWs this year and have been consistently averaging 3+ nightly on the weekends. The vast majority are small caliber rounds from handguns fired by gang members who have never received any formal training in handling firearms. The predictable results are lots of grazing limb wounds that ultimately get discharged following tetanus, antibiotics, and negative imaging. I'd say overall maybe 10% actually need to be resuscitated with blood transfusions.
The point being that even at the busiest inner city hospitals time spent caring for severe traumas is a very small part of a normal shift.

 

[The Knife & Gun Club]

So I work in inner city Brooklyn in probably the highest acuity ED in the northeast. We're on track for over 500+ GSWs this year and have been consistently averaging 3+ nightly on the weekends. The vast majority are small caliber rounds from handguns fired by gang members who have never received any formal training in handling firearms. The predictable results are lots of grazing limb wounds that ultimately get discharged following tetanus, antibiotics, and negative imaging. I'd say overall maybe 10% actually need to be resuscitated with blood transfusions.
The point being that even at the busiest inner city hospitals time spent caring for severe traumas is a very small part of a normal shift.

Not to mention it’s not very exciting. Everyone except the sickest of traumas requires relatively little mental energy beyond the immediate primary survey.

It gets boring so fast.

 

[BoardingDoc]

So I work in inner city Brooklyn in probably the highest acuity ED in the northeast. We're on track for over 500+ GSWs this year and have been consistently averaging 3+ nightly on the weekends. The vast majority are small caliber rounds from handguns fired by gang members who have never received any formal training in handling firearms. The predictable results are lots of grazing limb wounds that ultimately get discharged following tetanus, antibiotics, and negative imaging. I'd say overall maybe 10% actually need to be resuscitated with blood transfusions.
The point being that even at the busiest inner city hospitals time spent caring for severe traumas is a very small part of a normal shift.

I know where you're taking about and that's not even taking into account what s*** is like during j'ouvert. Let's celebrate by shooting each other!!!

 

[RustedFox]

Jouvert isn't a word.

 

[Pudortu]

So I work in inner city Brooklyn in probably the highest acuity ED in the northeast. We're on track for over 500+ GSWs this year and have been consistently averaging 3+ nightly on the weekends. The vast majority are small caliber rounds from handguns fired by gang members who have never received any formal training in handling firearms. The predictable results are lots of grazing limb wounds that ultimately get discharged following tetanus, antibiotics, and negative imaging. I'd say overall maybe 10% actually need to be resuscitated with blood transfusions.
The point being that even at the busiest inner city hospitals time spent caring for severe traumas is a very small part of a normal shift.

Downstate? Brookdale?

 

[BoardingDoc]

Jouvert isn't a word.

I'd recommend against making that statement in Flatbush.

 

[dadaddadaBATMAN]

Literally everything. You don't experience EM as a med student.

I did five aways and residency was still nothing like being a med student.

When you have your cute clipboard and pen, meticulously seeing a patient I had already seen 3 more plus argued with a hospitalist and a consultant.

Med students rarely have to talk to hospitalists/consults. If you do, it's the "nice one" or it's an easy admit. And they just have some sweet summer child pitty on you if you do end up talking to them. Gloves are off as a resident and attending. You don't experience the daily pushback and lazy ass consultants and being the middle man between them.

When I send you off to do the lac, I have a moment of fleeting appreciation but then remember that without fail a horrible lac will completely brick me later outside mid-level hours. it immediately becomes your most hated procedure.

When I give you that intubation or central line that will be a highlight of why you love EM but even at high acuity places it's still uncommon. Especially with mostplaces just doing peripheral pressors or letting the CCM "provider" do it upstairs. Plus bipap hfnc continues to save the day. These are some of your highlights of fourth year. As a resident/attending you won't even remember them once you get home because of everything else slowly destroying your soul.

Interesting? Puzzles? When you're going through your med student ddx thinking of unicorns and zebras after your thorough presentation, I knew what 3-8 click boxes for this patient I was already going to click based off the CC and triage note. Listening to the patient is a formality. If anything it almost always decreases what I was going to order. Sure you eventually get some things that might be truly interesting, but that's not a good thing. All it means is multiple phone calls to people who don't want to work and likely transfer depending on where you're at and you'll like run into "we're at capacity" road blocks. Consultants don't want interesting so everyone is going to try as hard as possible to block a consult. "Send to X quaternary care center" that's probably full. Interesting doesn't pay. Why waste time with intellectual thought as a consultant when routine procedures/consults pay the same or more. etc etc.

Sure you can work up interesting things or look for zebras but after your LPs with pressures and full CNS MRI w/wo, your atypical lab test that's a send out anyway (and you'll lose the MRN and forget to follow up anyway), whatever you're wasting time on (that 99% chance will be normal), your bosses will wonder why you're the slowest doc with the worst metrics.

Literally a book could be written on why it's an extremely poor choice. Haven't even touched on all of it. The metrics. The drug addicts. The demanding googlers. The dozens of daily old people with nothing wrong except weakness, realistically familial abandonment and depression. Admins. CMGs. Hospitalists. Consultants. Being the punching bag for everyone outside the ED. Being the "dumbest doc in the hospital". All we do is "CT everything". "Hey could you get a CT of xyz before coming upstairs". Lazy partners. Understaffing. Resource shortages. Phone calls. Scheduling. Charting. Charting. Charting. Charting. AMAs (just kidding, ama is the best thing to ever happen on shift). etc etc etc


It all comes down to what I'll call "THE DREAD". You'll have your own. I bet many are similar to me. You can't experience this as a med student. The dread is what it sounds like. There's almost ALWAYS something on your board that you're dreading. For me it's a patient currently undergoing workup that I know the whole time is going to be a very difficult disposition. The dread sits there chipping away at your soul all shift. As soon as you finally resolve the dread. There's another one. Then another. Then maybe you go home on time. Probably not though. Then on your next shift there's the dread. Staring at you all shift. Whatever it is for you, it'll be there.

You forgot the biggest dread… the next shift.

It’s why I’m one foot out the door. I realized that every time I was off I was already dreading my next shift, even if it was 4-5 days away.

I still work shifts prn. Sometimes I love it, sometimes I hate it. It’s like an abusive ex that I need to break up with a few more times to realize it’s for the best.

Glad people enjoy it still.I like it more now that I’m further away, but I’m increasingly convinced I need to walk away for good. Glad that I’m working on that already.

 

[RustedFox]

I'd recommend against making that statement in Flatbush.

Flatbush isn't a word, either.
You guys need to stop making up words.

 

[GassYous]

Flatbush isn't a word, either.
You guys need to stop making up words.

Tell that to my exwife

 

[RustedFox]

Tell that to my exwife

Your ex-wife isn't real, either.
YOU tell her.

 

[alpinism]

Jouvert isn't a word.

It's French Creole for "daybreak" and is basically this all night block party that starts carnival season.

There's always lots of gang violence and multiple people usually end up getting shot most years.

6-year-old boy among 5 shot in New York during J'Ouvert celebration

"I saw the little boy on the floor full of blood, and I ran," one witness said.

www.cbsnews.com

 

[alpinism]

Downstate? Brookdale?

I’m mostly at Brookdale these days.

 

[RustedFox]

It's French Creole for "daybreak" and is basically this all night block party that starts carnival season.

There's always lots of gang violence and multiple people usually end up getting shot most years.

6-year-old boy among 5 shot in New York during J'Ouvert celebration

"I saw the little boy on the floor full of blood, and I ran," one witness said.

www.cbsnews.com

French Creole isn't a language.
Knock it off, guys






I know, amigo.
I'm just trolling for laffs.

 

[GonnaBeADoc2222]

You forgot the biggest dread… the next shift.

It’s why I’m one foot out the door. I realized that every time I was off I was already dreading my next shift, even if it was 4-5 days away.

I still work shifts prn. Sometimes I love it, sometimes I hate it. It’s like an abusive ex that I need to break up with a few more times to realize it’s for the best.

Glad people enjoy it still.I like it more now that I’m further away, but I’m increasingly convinced I need to walk away for good. Glad that I’m working on that already.

Whats your exit plan? Still searching for mine

 

[Franzd'Epinay]

Whats your exit plan? Still searching for mine

What have you considered?

This is going to be very situation-dependent.

Do you still want to practice medicine?
Do you need to do procedures?
Can you afford a pay cut?
Can you afford a big pay cut?
Could you stomach 1 year of fellowship?
Could you stomach 2?
Can you move?
Can you get health insurance from a spouse?

 

[GonnaBeADoc2222]

What have you considered?

This is going to be very situation-dependent.

Do you still want to practice medicine?
Do you need to do procedures?
Can you afford a pay cut?
Can you afford a big pay cut?
Could you stomach 1 year of fellowship?
Could you stomach 2?
Can you move?
Can you get health insurance from a spouse?

Maybe
No
Yes but don't want to
No
Yes
No
No
No

Prob screwed lol

 

[Franzd'Epinay]

Maybe
No
Yes but don't want to
No
Yes
No
No
No

Prob screwed lol

Not necessarily. I can think of a few thing off the top of my head

1. 1-year fellowships in your immediate area (HPM, Sports, Pain).
2. Non-fellowship medical work: occ med, wound care.
3. Remote admin-type stuff: Utilization review, Physician case management/coordination.
4. Depending on your geographic area, some of the pharma/biotech/tech stuff may be possible.

 

[EctopicFetus]

Even if the days of $300/hr in halfway-decent places are gone, haven’t FM/IM/Peds folks already been making disgracefully low pay in those places for years? I’ve seen stats (BLS, I think) saying that the median FM income in California(!) is barely 3 figures. Do you foresee EM getting that bad?

Em floor IMO is 140-160/hr. I think we get there by 2028. Denver is the roadmap.

 

[EctopicFetus]

You're not comparing apples to apples here and COVID exposing the weakness of the fundamentals of our job market makes no sense. What weakness did it expose that was previously unknown? You have supply (physicians/midlevels) and demand (patients). Patient volumes dropped by nearly half for a lot of places overnight. I don't think anybody with half a brain would be surprised what happens when your demand drops by half overnight in any industry. Supply of physicians/midlevels isn't doubling overnight. The trend is definitely up but the trend of patient visits will likely continue to increase as well although not as much as the supply. There will still be good jobs out there but there will be a lot of subpar physicians who will find themselves working for pennies or out in BFE.

I get it. Most of the people here are burned out on EM. The job market won't be as good as students think it is but it won't be as bad as many here say it will be, either.

I think the real flaw here is thinking it will be the subpar physicians who get cut. Your quality means literally nothing. First rule of thumb is that $ first. They wont pay the "smart" doc 1 penny more than the subpar one. Also, they will value loyalty and being subserviant to their stupid rules and plans.

I am 100% not burnt out on EM. I love my job. I enjoy my job. That being said the future is bleak. I would do whatever i could to prevent my kid from going into EM if that was what one of them wanted to do.

 

[Arcan57]

I think the real flaw here is thinking it will be the subpar physicians who get cut. Your quality means literally nothing. First rule of thumb is that $ first. They wont pay the "smart" doc 1 penny more than the subpar one. Also, they will value loyalty and being subserviant to their stupid rules and plans.

I am 100% not burnt out on EM. I love my job. I enjoy my job. That being said the future is bleak. I would do whatever i could to prevent my kid from going into EM if that was what one of them wanted to do.

Arthur

A central tenet of CMGs is that we're widgets. Anything that actively discourages that belief (differential pay, differential staffing, etc) is anathema. For most of us, that's going to mean making the same @$^%ty pay as the doc that's decided that they're being paid enough to show up but not enough to work. Bonus points if they use their freetime during the shift to complain about how hard they're expected to work.

 

[VA Hopeful Dr]

Em floor IMO is 140-160/hr. I think we get there by 2028. Denver is the roadmap.

I really hope not, I can get you an UC job in my town for 175/hr right now.

 

[Lexdiamondz]

I'd recommend against making that statement in Flatbush.

One might get shot making those statements

 

[Lexdiamondz]

The tourist comment hits it right on the head IMO.

Being a med student on an EM rotation is like being a tourist in Jamaica - yes the beaches are pretty, the food is tasty, the booze is cheap and the women are friendly and have big tits...but everyone who actually has to live there is very doggedly trying to GTFO. Just like how literally half of Jamaica's population lives abroad, literally half of all ER docs are scheming on how to GTFO.

 

[RustedFox]

The tourist comment hits it right on the head IMO.

Being a med student on an EM rotation is like being a tourist in Jamaica - yes the beaches are pretty, the food is tasty, the booze is cheap and the women are friendly and have big tits...but everyone who actually has to live there is very doggedly trying to GTFO. Just like how literally half of Jamaica's population lives abroad, literally half of all ER docs are scheming on how to GTFO.

1. Thank you for the compliment.
2. I really, really hope that the OP is still reading this thread.
3. I'm going to guess that the disconnect that students are affected by (and thus leads them to conclude that we're just all burned out here in SDN) is that the only exposure they have to an attending physician opinion on the matter is to their zoo animal academic attendings.

Wolves in a cage are docile and pleasant.
Wolves in the wild...

 

[Apollyon]

that the only exposure they have to an attending physician opinion on the matter is to their zoo animal academic attendings.

Wolves in a cage are docile and pleasant.
Wolves in the wild...

That's my imagery!

 

[RustedFox]

That's my imagery!

I knew it was somebody on here.
Credit given to Apollyon.

 

[JacobMcCandles]

I think the real flaw here is thinking it will be the subpar physicians who get cut. Your quality means literally nothing. First rule of thumb is that $ first. They wont pay the "smart" doc 1 penny more than the subpar one. Also, they will value loyalty and being subserviant to their stupid rules and plans.

I am 100% not burnt out on EM. I love my job. I enjoy my job. That being said the future is bleak. I would do whatever i could to prevent my kid from going into EM if that was what one of them wanted to do.

Arthur

I speak from an SDG viewpoint but the subpar physicians will get filtered out of the good jobs with time.

CMGs care about a warm body but that’s nothing new and nothing has changed there. The good jobs will continue to get the good physicians.

 

[Rekt]

I speak from an SDG viewpoint but the subpar physicians will get filtered out of the good jobs with time.

CMGs care about a warm body but that’s nothing new and nothing has changed there. The good jobs will continue to get the good physicians.

Eh. I've always been 100% pro SDG. I've seen incredibly weak physicians land SDG jobs only because they know someone. It's luck and connections, not skill or clinical competency. Depending on the hiring process, that weak physician is most likely still getting partnership.

 

[JacobMcCandles]

Eh. I've always been 100% pro SDG. I've seen incredibly weak physicians land SDG jobs only because they know someone. It's luck and connections, not skill or clinical competency. Depending on the hiring process, that weak physician is most likely still getting partnership.

I can only speak for our group but weak physicians find themselves in other jobs. You want to give them all the support and give them a chance to succeed but, unfortunately, sometimes it just doesn't work out. An interview won't tell you all you need to know but you can usually get a pretty good idea based on references if there is likely to be an issue.

 

[dadaddadaBATMAN]

Whats your exit plan? Still searching for mine

to be clear, my solution is far from perfect. Fellowship>new field. I’m a bit cagey because I like for doxing me to take a little bit of effort.

Pros:
-some locked doors between me and the masses
-there is essentially no way to f your circadian rhythms harder than you already are
-eat when I want, pee when I want, poop when I want, and feel better rested always
-I actually look forward to work, or at worst feel neutral about it

Cons
-$$$$$$$$$$$, opportunity cost
-being in training blows. My ego is wayyy more involved than it was last go round. Find myself wanting to argue when things are stupid (not dangerous, just stupid) instead of shrugging and moving on
-outside my actual area of expertise substantial part of time
-not like my new field can’t get saturated by Ed people jumping off a sinking vessel

 

[EctopicFetus]

I really hope not, I can get you an UC job in my town for 175/hr right now.

Problem is those rates will also come down and frankly all new grads will be told that they need to work in an ED.

 

[EctopicFetus]

I speak from an SDG viewpoint but the subpar physicians will get filtered out of the good jobs with time.

CMGs care about a warm body but that’s nothing new and nothing has changed there. The good jobs will continue to get the good physicians.

The good jobs will for sure. That being said finding a good job (and how one defines a good job) is very tough. From what i have seen is that there is now a line of people waiting to crack into the "good jobs". Hard right now to get it right out of residency. Will become only tougher.

As someone who spend a majority of my career with SDGs let me drop a little truth. I would feel safer in my group if every doc was an avg doc but was commited to the hospital, meetings admin etc than a 99th% group of doctors who just clock in and out.

My old SDG had some mediocre docs. Our contract was safe cause we were ingrained in the hospital. Hell one of the docs went in like 2 months later and amended a chart after he found out patient had a bad outcome. About 10-15% of the docs there were a few standard deviations below avg IMO.

 

[Mount Asclepius]

Making partner in a SDG is like making tenure for a professor. It is very hard to remove a partner without a potentially nasty legal fight. Sometimes weak physicians make partnership. The flaws only become accentuated with immunity.

 

[Groove]

I don't know if anybody else is having the same experience as myself but now that more and more hospitals are creating bylaws requiring ABEM docs in the ED...I seem to find myself in stronger and stronger groups. My current CMG gig probably has the best trained group of docs that I've ever worked with...an extremely competent and solid group. Most are young, 100% BE/BC (probably close to 50/50 or 60/40 male/female) and are anywhere from 1-5 years post residency. Very fun group. Energetic, excellent work ethic, high producers. Def keeps me on my toes...and my pantry stocked with energy drinks. It's either a result of the hospital climate changes or good candidate selection by our FMD...probably a combination of both. Maybe the jobs are just getting so competitive that employers can afford to be more selective...

 

[SeekerOfTheTree]

Maybe that’s why i regret EM so much. I truly had options and could have picked several other specialties. Interviewing in 2015 for residency felt different. Attendings everywhere bragging about the 300/hr job options, and the ridiculous job prospects. It was a hot specialty, a lot of high caliber students were going in to the specialty. We all got suckered in.

Interviewing in 2018 for my first post residency job felt great. Since my wife was pgy1, i had to stay within a 50 mile radius. Had 5 job offers within that radius, essentially got an offer at every place i interviewed. Had so much negotiation ability, was able to negotiate an extra 30/hr, plus a sign on and ability to basically dictate my schedule.

Interviewing in 2020 was terrible. It really dawned on me then that i had made a mistake, this was before the acep report for the projected surplus, the writing was on the wall, i already was seeing the surplus and the increasing residency spots everywhere. When i finally got a job that felt an upgrade in quality of life compared to my previous job, I didn’t even try to negotiate, granted it was a university hospital affiliated job, so room for negotiation was less. But i just took what i got and was happy to end up in a very stable hospital employed system making reasonable income and seeing a low volume of patients.

I think this sums us up. I was in the same boat. Alot of us that could have picked any specialty picked EM and now regret it. We regret what drew us there in the first place is no longer there. The money, schedule, independence, being wanted by so many places, etc...seemed sexy at the time. I had originally gone to medschool with the thought of being a radiologist but at that time that market looked doomed so I changed my mind. EM has this dread everyday of coming into work. It's knowing you have no control. You will have to see as many people that come through that door. You will see the the people and be cool regardless of how douchey they are. It really sucks when you think I could have been any kind of doctor and now I am here without any of the things I thought the specialty offered.

 

[EctopicFetus]

I would challenge anyone here to define the actual term good job. There are plenty of SDG‘s out there advertising jobs that I do not consider to be good or even remotely acceptable to be honest. I need high pay whatever I consider to be reasonable per patient money and for me most importantly a good group of people who do you can never tell I don’t believe that we will ever see reasonable hospital administration anytime in the near future.

 

[cyanide12345678]

I would challenge anyone here to define the actual term good job. There are plenty of SDG‘s out there advertising jobs that I do not consider to be good or even remotely acceptable to be honest. I need high pay whatever I consider to be reasonable per patient money and for me most importantly a good group of people who do you can never tell I don’t believe that we will ever see reasonable hospital administration anytime in the near future.

My favorite job to date was a 3000 volume shop, roughly 8 patients per day, 5-8 hours of sleep during a 24 hour shift. Only paid $130/hr but truly just went there to watch tv and sleep while intermittently id get to see a patient. $/pt is the most important metric for me, and that job averaged around $400/pt seen.

There was a day where i actually didn’t even order blood work all day. It was amazing.

 

[turkeyjerky]

I don't know if anybody else is having the same experience as myself but now that more and more hospitals are creating bylaws requiring ABEM docs in the ED...I seem to find myself in stronger and stronger groups. My current CMG gig probably has the best trained group of docs that I've ever worked with...an extremely competent and solid group. Most are young, 100% BE/BC (probably close to 50/50 or 60/40 male/female) and are anywhere from 1-5 years post residency. Very fun group. Energetic, excellent work ethic, high producers. Def keeps me on my toes...and my pantry stocked with energy drinks. It's either a result of the hospital climate changes or good candidate selection by our FMD...probably a combination of both. Maybe the jobs are just getting so competitive that employers can afford to be more selective...

I wouldn't count on it to continue. Last 5 years were a bumper crop in terms of quality for EM residents and it's rapidly fading.

 

[SeekerOfTheTree]

I would challenge anyone here to define the actual term good job. There are plenty of SDG‘s out there advertising jobs that I do not consider to be good or even remotely acceptable to be honest. I need high pay whatever I consider to be reasonable per patient money and for me most importantly a good group of people who do you can never tell I don’t believe that we will ever see reasonable hospital administration anytime in the near future.

24 hr shift, 150 an hr with 1pph or
12 hr shift 300/hr with 1.5-2pph.
Full benefits.
100 hr to be full time
Good support
Nocturnist available
Good payor mix and community
Great signout culture
Out on time

That's all I ever wanted.

 

[EctopicFetus]

24 hr shift, 150 an hr with 1pph or
12 hr shift 300/hr with 1.5-2pph.
Full benefits.
100 hr to be full time
Good support
Nocturnist available
Good payor mix and community
Great signout culture
Out on time

That's all I ever wanted.

So confused how it it that 150/hr x 24 or $300/hr x 12. Maybe I’m crazy but I like to work as little as possible. 2 pph is simple. I would also point out that what one person considers a good job might not scale.
i wouldn’t work a 24 for 150/hr. Working a 12 for 300/hr and 2 pph sounds good. I think those exist in SDGs.
if you are getting the $300/hr let’s say you are employed by the hospital why do you care about the payer mix?

 

[DeadCactus]

Yea, 1 pph for a 24 hour shift is more likely to be closer to 2 pph for 12 hours and then being trapped in the hospital for 12 hours doing nothing. The goal of a 24 is to make a little less annually but only work 5 days a month and not work as hard during those hours, not to drag out how long you spend in the hospital. Maybe $200/hr and like 0.75 pph for a 24-hour shift. Which is still probably ~$100/hr going to overhead and someone else’s profit.

 

[Lynx zwo drei vier]

2020 was a unicorn event. While it did feature a supply/demand mismatch, it felt like the driving factor in lack of jobs was the uncertainty regarding the revenue stream and the ability for a lot of shops just to make payroll. COVID spooked patients in a way that I don't see repeating anytime soon. I think there will still be a decent amount of geographic mobility in the future as jobs will be offered, just for significantly less pay.

How much less is significantly less? Because I think that in medicine, we sometimes have a distorted view of money.

Granted, I'm graduating without debt, so maybe I have a distorted view of what other students have to worry about.

 

[turkeyjerky]

How much less is significantly less? Because I think that in medicine, we sometimes have a distorted view of money.

Granted, I'm graduating without debt, so maybe I have a distorted view of what other students have to worry about.

Likely floor of 140-150/hr. The most you can reasonably work long term in this field is 130 hrs/mo. This amounts to 215 to 235k/yr. No benefits. High chance that you can't get this many hours due to 'flex staffing' arrangements and have to supplement w/ urgent care or telehealth work at a lower $/hr.

 

[RustedFox]

Likely floor of 140-150/hr. The most you can reasonably work long term in this field is 130 hrs/mo. This amounts to 215 to 235k/yr. No benefits. High chance that you can't get this many hours due to 'flex staffing' arrangements and have to supplement w/ urgent care or telehealth work at a lower $/hr.

OP: Side gigs alone make this much hourly with no nights, weekends, abusive patients, or med mal risk.

This is why it's dumb AF to go into EM now.

 

[EctopicFetus]

OP: Side gigs alone make this much hourly with no nights, weekends, abusive patients, or med mal risk.

This is why it's dumb AF to go into EM now.

Don’t want to sound like an ass but there are plenty of jobs with normal hours that make this money.

My BIL is a middle manager at a Fortune 500 company. Has been there since he graduated college and makes in the mid 300s with great perks and benefits. Had no debt and started putting money in the pension at age 22.

If medicine moves to this only an idiot would do this job. Em is crumbling and I am mildly more optimistic and think Pay will be 150-160/hr as a floor at a normal 2 pph job.

 

[RustedFox]

Don’t want to sound like an ass but there are plenty of jobs with normal hours that make this money.

My BIL is a middle manager at a Fortune 500 company. Has been there since he graduated college and makes in the mid 300s with great perks and benefits. Had no debt and started putting money in the pension at age 22.

If medicine moves to this only an idiot would do this job. Em is crumbling and I am mildly more optimistic and think Pay will be 150-160/hr as a floor at a normal 2 pph job.

You don't sound like an ass; you're just talking truth.

I wouldn't do this job for 150/hour at 2 pph.
No. Freaking. Way.

 

[EthylMethylMan]

You don't sound like an ass; you're just talking truth.

I wouldn't do this job for 150/hour at 2 pph.
No. Freaking. Way.

Only hope is that if this does happen, the supply of ER docs will drop due to decreased student interest and attendings quitting or shifting to another specialty. Maybe after that, we'd eventually see the supply/demand ratio improve and things could be doable again. Obviously talking about time on the order of years.

 

[RustedFox]

Only hope is that if this does happen, the supply of ER docs will drop due to decreased student interest and attendings quitting or shifting to another specialty. Maybe after that, we'd eventually see the supply/demand ratio improve and things could be doable again. Obviously talking about time on the order of years.

I was speaking about this with a non-medical friend of mine (whose opinions and thought processes I respect) and even he sees how this rapid proliferation of trash CMG residencies will churn out poorly educated/skilled ER docs.

He said: "Man, if you battle-tested guys all quit and the kids can't hack it; I see a scenario in which the hospital systems come knocking, asking the *good guys* to come back and ride again; like in some Liam Neeson movie."

I laughed and said: "The hospital systems don't care about you that much. If, at all."

 

[turkeyjerky]

Only hope is that if this does happen, the supply of ER docs will drop due to decreased student interest and attendings quitting or shifting to another specialty. Maybe after that, we'd eventually see the supply/demand ratio improve and things could be doable again. Obviously talking about time on the order of years.

Zero chance this happens. The lower pay goes, the more desperate people get and the more they work.

Sure, guys like ectopic might be able to drop out of the workforce. But guys like me far outnumber them. We didn’t get as big a bite during the good times, and aren’t FIRE-ready (and every year that gets farther and farther away, I was projecting a 10-yr timeline 3 years ago. Now it’s 15+). When push comes to shove, you can bet your sweet ass I’ll be right there fighting tooth and nail for hours.