Rank list help 2021

[zurc2014]

Hello,

I am applying to EM and wanted some help with my top choices. I loved all of these and could see myself living in any of these locations. The cons were similar so that cancelled out. I plan on using prestige to rank since I have determined these to be a tie for all other factors I care about. How would you rank these institution's overall prestige?

WashU (Saint Louis)
UT Southwestern
Mount Sinai-Florida
University of Rochester
U of Miami-Jackson

I am ranking 12 programs but want to order the top 5 by prestige.

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[Rekt]

...I am ranking 12 programs but want to order the top 5 by prestige...

 

[zurc2014]

View attachment 345623

I assume you're talking about the slew of "get out while you can" posts that I am expecting. I hesitated to even post this here but hopefully I can get one or two straight to the point answers and be done.

 

[Rekt]

I assume you're talking about the slew of "get out while you can" posts that I am expecting. I hesitated to even post this here but hopefully I can get one or two straight to the point answers and be done.

No. You've already dug your grave. You'll take hits for talking about prestige, which is completely useless in emergency medicine.

The real answer is which program gave you the best/most genuine answer to "How are you going to secure jobs for your residents?". If you didn't ask this question them you're already not in the right mindset and it's game over for you.

It's not a joke. We're now at 4 studies from different authors, including acep, stating there's going to be a 7-10k oversupply in 6-9 years.

You know what acep has done despite their studying being done for over half a year now? (Not to mention the studies before theirs two years ago).

Nothing.

 

[zurc2014]

No. You've already dug your grave. You'll take hits for talking about prestige, which is completely useless in emergency medicine.

The real answer is which program gave you the best/most genuine answer to "How are you going to secure jobs for your residents?". If you didn't ask this question them you're already not in the right mindset.

I have 3 standard questions that I asked every program and that was one. Yea, I figured asking about prestige is a no-no on sdn just like salary or anything else found to be taboo/off limits. Eh, its anonymous and I would like to know so why not ask?

 

[Tipsy McStagger]

The only prestige these days is how fast can you see and dispo patients and how little money will you accept. If HCA person is faster than Denver, then HCA gets the job. Unless you want to work in saturated academics, then academic prestige trumps efficiency and skill.

It's not that it's a no-no question, it's that there is no answer.

 

[Dr Mantis Toboggan]

Hello,

I am applying to EM and wanted some help with my top choices. I loved all of these and could see myself living in any of these locations. The cons were similar so that cancelled out. I plan on using prestige to rank since I have determined these to be a tie for all other factors I care about. How would you rank these institution's overall prestige?

WashU (Saint Louis)
UT Southwestern
Mount Sinai-Florida
University of Rochester
U of Miami-Jackson

I am ranking 12 programs but want to order the top 5 by prestige.

Isn’t Wash U 4 years? If so rank any 3 year programs you like above it.

 

[RustedFox]

Ask yourself: which of these are P O W E R H O U S E programs?

 

[Lexdiamondz]

Hello,

I am applying to EM and wanted some help with my top choices. I loved all of these and could see myself living in any of these locations. The cons were similar so that cancelled out. I plan on using prestige to rank since I have determined these to be a tie for all other factors I care about. How would you rank these institution's overall prestige?

WashU (Saint Louis)
UT Southwestern
Mount Sinai-Florida
University of Rochester
U of Miami-Jackson

I am ranking 12 programs but want to order the top 5 by prestige.

There are only a handful of residencies in EM that are truly "prestigious". None of the ones you listed make that list.

Institutional prestige =/= prestige within a specialty. WashU and UTSW are large, well resourced academic institutions but that doesn't actually translate into being big name EM programs. Nobody is gonna be reading a CV from any of the aforementioned sites and think "wow".

The other posters in this thread are correct - your main concern should be "will I have a job at the end of this?". Just to put things into perspective, the PD at Mount Sinai - Miami was having exceeding difficulty finding jobs in FL for their grads this time last year despite their department chair being a former president of AAEM. If that doesn't speak volumes, I don't know what does.

People's concerns about the job market aren't hyperbole. Sorry to burst your bubble but none of the places in your top 5 are going to be an umbrella in the coming ****storm that is Emergency Medicine in the united states.

 

[Rekt]

The only prestige these days is how fast can you see and dispo patients and how little money will you accept. If HCA person is faster than Denver, then HCA gets the job. Unless you want to work in saturated academics, then academic prestige trumps efficiency and skill.

It's not that it's a no-no question, it's that there is no answer.

I've been interviewing at multiple places recently. A shocking amount contacted my references asking solely about my PPH, procedure numbers, and how fast I finish my charts. The future of EM right there.

 

[Franzd'Epinay]

Here's the answer to your question:

Prestige in EM doesn't really exist.

Here's the answer to the question you probably meant to ask:

WashU is likely the name you'll be able to drop at a dinner party and impress a layperson.

For your purposes, you should choose WashU and stay in the area, where its name will carry more lay prestige than in other parts of the country.

All that being said, this is a terrible way to go about choosing your residency.

 

[Lexdiamondz]

Also, see the other thread about the guy from the academic powerhouse contemplating adding extra years of training because their residency doesn't have enough acuity and loses procedures to other specialties in their own ED.

Unless you are dead set on academics, chasing prestige is pointless.

 

[RustedFox]

I've been interviewing at multiple places recently. A shocking amount contacted my references asking solely about my PPH, procedure numbers, and how fast I finish my charts. The future of EM right there.

It really is.

I had this exact discussion regarding "prestige" and training in the world of EM with family members lately. They are completely unable to grasp that EM doesn't work like IM/Cards/Subspecialty surgery where prestige comes with complexity of training and huge, research-based academic settings. My stepmom (who I have actually told to her face: "You are what is wrong with America") couldn't help but open her fat mouth and give her typical offering of "No, no, no. I've been a NURSE for eleventy years; and where a doctor trained is amazingly important."

"Okay. - Tell me why."

"Because. It is."

Facepalm.

I really hate even my own family these days.

 

[Torsion]

I've been interviewing at multiple places recently. A shocking amount contacted my references asking solely about my PPH, procedure numbers, and how fast I finish my charts. The future of EM right there.

The future and the past. The most important qualification for a job is how well you can do it. Throughput means more revenue and can also mean less liability and better patient care if the department runs smoothly. I don't think there is anything more dangerous than a full ER waiting room and a staff that can't handle the volume.

 

[turkeyjerky]

The future and the past. The most important qualification for a job is how well you can do it. Throughput means more revenue and can also mean less liability and better patient care if the department runs smoothly. I don't think there is anything more dangerous than a full ER waiting room and a staff that can't handle the volume.

I think you missed the point. Historically, it was basically assumed that if you finished residency you could do the job (of course, I recognize that this isn't necessarily the case, but employers were forced into it). The fact that it's now a competitive marketplace should be horrifying to potential applicants, because that means there will be, by definition, losers. Losers who've spent 7 years in postgraduate training, have hundreds of thousands of dollars in medical debt and will be lucky to cobble together some semblance of gig work. (And the winners get a shiny new cmg sweatshop gig).

There are a number of job postings that require 1-2 years of post-residency experience. That would be unfathomable 5 years ago, when many of these same hospitals were likely letting residents moonlight.

OP, it's hard to reply honestly to your question because you haven't defined what you want. Are you talking about prestige within the EM community or names that will impress your stepparents? If it's the former, then pretty much none are really held in any special regard. If it's the latter, then you deserve all that you get, hopefully your inlaws are impressed by your degree and job at CareNow. Sounds like you're not really a competitive applicant though...

 

[GatorCHOMPions]

Adding a slightly different perspective here. If OP wants to pursue a fellowship during residency, especially a non-traditional EM one (Pain, Sports, CC), superficial prestige will likely be a factor. With that said I would put WashU first. UMiami Jackson and UTSW have regional prestige, probably slightly more than Rochester. Mount Sinai FL has to be last.

 

[EctopicFetus]

I think you missed the point. Historically, it was basically assumed that if you finished residency you could do the job (of course, I recognize that this isn't necessarily the case, but employers were forced into it). The fact that it's now a competitive marketplace should be horrifying to potential applicants, because that means there will be, by definition, losers. Losers who've spent 7 years in postgraduate training, have hundreds of thousands of dollars in medical debt and will be lucky to cobble together some semblance of gig work. (And the winners get a shiny new cmg sweatshop gig).

There are a number of job postings that require 1-2 years of post-residency experience. That would be unfathomable 5 years ago, when many of these same hospitals were likely letting residents moonlight.

OP, it's hard to reply honestly to your question because you haven't defined what you want. Are you talking about prestige within the EM community or names that will impress your stepparents? If it's the former, then pretty much none are really held in any special regard. If it's the latter, then you deserve all that you get, hopefully your inlaws are impressed by your degree and job at CareNow. Sounds like you're not really a competitive applicant though...

With more and more residencies opening some with no volume or acuity it does matter. I will never (NEVER) hire someone to be my partner who finished an HCA residency. Seems harsh right? It is.. It shows a complete lack of sense to train at one of these places.

TRuth is many of the new applicants are snowflakes. They want to go where the hours are easier. It is the MLPing of EM. I agree scut work sucks and you shouldn’t do it (if possible) but I have a major issue with people thinking they are too good to do other parts of the job.

 

[RustedFox]

With more and more residencies opening some with no volume or acuity it does matter. I will never (NEVER) hire someone to be my partner who finished an HCA residency. Seems harsh right? It is.. It shows a complete lack of sense to train at one of these places.

TRuth is many of the new applicants are snowflakes. They want to go where the hours are easier. It is the MLPing of EM. I agree scut work sucks and you shouldn’t do it (if possible) but I have a major issue with people thinking they are too good to do other parts of the job.

See; I'm not the only one on here who says : "These new guys and gals; total snowflakes."
I usually get hell on here when I say something like that.

 

[Lexdiamondz]

See; I'm not the only one on here who says : "These new guys and gals; total snowflakes."
I usually get hell on here when I say something like that.

To be fair, we haven't had quite the degree of snowflakery in the past that we do now.

It's one thing to think you're special, and medical education generally selects for people who think somewhat highly of themselves since, well, they're part of a very selected group.

However, it's another thing to decide to choose a career path, ignore the counsel of the people who have walked that path before you and do the thing in real life, and discount the data and statistics provided by the two largest organizations in North America representing said career path.

You need to be a real snowflake to think you're gonna beat the odds of 7k unemployed coming out of Mount Sinai Miami. That's some mind blowing **** I ain't seen before.

 

[zurc2014]

I think you missed the point. Historically, it was basically assumed that if you finished residency you could do the job (of course, I recognize that this isn't necessarily the case, but employers were forced into it). The fact that it's now a competitive marketplace should be horrifying to potential applicants, because that means there will be, by definition, losers. Losers who've spent 7 years in postgraduate training, have hundreds of thousands of dollars in medical debt and will be lucky to cobble together some semblance of gig work. (And the winners get a shiny new cmg sweatshop gig).

There are a number of job postings that require 1-2 years of post-residency experience. That would be unfathomable 5 years ago, when many of these same hospitals were likely letting residents moonlight.

OP, it's hard to reply honestly to your question because you haven't defined what you want. Are you talking about prestige within the EM community or names that will impress your stepparents? If it's the former, then pretty much none are really held in any special regard. If it's the latter, then you deserve all that you get, hopefully your inlaws are impressed by your degree and job at CareNow. Sounds like you're not really a competitive applicant though...

LOL Thanks for adding that extra sentence in there But overall I appreciate the honest responses.

 

[thegenius]

Hello,

I am applying to EM and wanted some help with my top choices. I loved all of these and could see myself living in any of these locations. The cons were similar so that cancelled out. I plan on using prestige to rank since I have determined these to be a tie for all other factors I care about. How would you rank these institution's overall prestige?

WashU (Saint Louis)
UT Southwestern
Mount Sinai-Florida
University of Rochester
U of Miami-Jackson

I am ranking 12 programs but want to order the top 5 by prestige.

Nah man don't let the haters hate on you. It's fine to rank by prestige. You just won't get any reliable answers on this.

If all the programs "are the same to you", then consider where you want to practice when you are done. For the most part, people stay in the city / area where the practice. It's just easier to get a job all things considered.

While it's not impossible to get a job in the Bay Area if you trained in Philly...most of the people we have hired over the past 5 years where I live in the Bay Area have all come from UC Davis, Highland, UCSF, or Stanford. And they happen to be the 4 closest programs too to where I work.

 

[thegenius]

No. You've already dug your grave. You'll take hits for talking about prestige, which is completely useless in emergency medicine.

This is incorrect.

 

[thegenius]

I have 3 standard questions that I asked every program and that was one. Yea, I figured asking about prestige is a no-no on sdn just like salary or anything else found to be taboo/off limits. Eh, its anonymous and I would like to know so why not ask?

It's fine to ask. There are probably buckets of prestige. High prestige, middle, and low perhaps. Rankings are difficult to come by. But yes there are some programs that are better than others. Some of the high powered academic institutions have very good programs. Does that mean they have the best teachers? Not necessarily. But your education is not solely dictated by your ER attendings. There is also a wealth of knowledge from other smart doctors in other specialties that you get access too.

Again don't let the haters hate. I won't give you a ranking because I simply don't know.

 

[TheComebacKid]

If I could have convinced my SO at the time, would've 100% gone to WashU. Beast of a program, extremely underrated because people don't want to move to St. Louis but out of all the sites I rotated at the acuity was unparalleled there, it was basically the best county/academic hybrid set up I had seen. And the people were cool.

That being said, I agree with what's been addressed already. The institutional reputation of a place like WashU in terms of their US News and World Report rankings from the standpoint of their medical school has absolutely no connection to their EM residency, and prospective employers don't care even a little bit.

I trained at a 4 year academic site that had a great reputation in terms of "my grandmother was impressed with the name of the place". Now I'm an academic attending at 3 year EM residency. Nobody cared or really brought up the reputation/prestige of the location I trained at when I applied/interviewed for this position.

 

[Franzd'Epinay]

You need to be a real snowflake to think you're gonna beat the odds of 7k unemployed coming out of Mount Sinai Miami. That's some mind blowing **** I ain't seen before.

Damn. The word "snowflake" has lost all meaning.

It's ok not to use buzzwords whose meaning you don't know. I promise you'll still be able to be part of the millennia-long tradition of old people complaining about young people.

 

[EctopicFetus]

I will second wash u. It’s been a while but I was super impressed when I interviewed there. The 2 big issues are it’s a 4 year program and it’s in St. Louis. I think the 4 year thing is particularly important in the current job market as it means you will come out to a more saturated job market in 2026 than in 2025. About 3k more docs will be in practice. You can discount this but jobs are already becoming much tougher to get than 5 years ago. I wouldn’t want to be looking for a job in 2024 and beyond. Em has a lot of young docs which means you can’t rely on retirements. 10k too many docs means we will be fully saturated years before 2030. That means you won’t be able to get the hours you want or you will at a lower and lower rate.

 

[Lexdiamondz]

Damn. The word "snowflake" has lost all meaning.

It's ok not to use buzzwords whose meaning you don't know. I promise you'll still be able to be part of the millennia-long tradition of old people complaining about young people.

Pardon, English is my 3rd language. By all means, enlighten me about the true meaning of "snowflake" so that I can reach my 31 year old crotchety potential

 

[sylvanthus]

1) Internal med
2) Family med
3) psych
4). Not EM
5) Not EM

 

[Brigade4Radiant]

Prestige doesn’t matter much in the field of EM other than getting an academic job and if that’s the case you can just go to in old EM residency and do a fellowship and the institution you want to work at.

EM job market is awful so the academic openings will be at HCA facilities.


EM is like FM but less in a way. The patient goes to the ED not to see a specific EM doctor. Surgical specialties also publish the very specific niche and basic science of their field.

EM is very clinical so we don’t do much basic science research. A lot of EM research is Education we don’t put out research like Oncology or Cardiology.

It also matters of EM is it’s own department or under the field of another department.

Typically Surgery specialties and specialists Are the top dogs of prestige EM is lower like FM

 

[sylvanthus]

I do gotra laugh that an above poster said prestige mattered, but then had no idea on ranking the programs. It matters so much that they cannot even tell you which programs were prestigious.

PowerhOUsE program man! Dont let the naysayers get you down! You can lead teamhealth and ACEP into a bright future! Hahhahahahahah. Gagged alittle writing that.

 

[RustedFox]

 

[bravotwozero]

To be fair, we haven't had quite the degree of snowflakery in the past that we do now.

It's one thing to think you're special, and medical education generally selects for people who think somewhat highly of themselves since, well, they're part of a very selected group.

However, it's another thing to decide to choose a career path, ignore the counsel of the people who have walked that path before you and do the thing in real life, and discount the data and statistics provided by the two largest organizations in North America representing said career path.

You need to be a real snowflake to think you're gonna beat the odds of 7k unemployed coming out of Mount Sinai Miami. That's some mind blowing **** I ain't seen before.

I moonlight at an academic EM program twice a month. Their residents see like 1pph, and that’s by choice, as opposed to lack of volume, this is a level I county place.

You tell them to pick up the pace and they’ll start to complain.

I’m full time at the community trauma III gig that has less coverage but volume is much lower. We’ve had at least three graduates from my moonlighting gig go there and quit in less than a month, saying it was ‘too busy’…

 

[GonnaBeADoc2222]

How fascinating is it to see medical students continue to flock to EM, despite the data and the subjective advice from multiple generations of ER physicians.

Is it hubris? Delusion? Narcissism?

 

[Lexdiamondz]

How fascinating is it to see medical students continue to flock to EM, despite the data and the subjective advice from multiple generations of ER physicians.

Is it hubris? Delusion? Narcissism?

All three

 

[zurc2014]

How fascinating is it to see medical students continue to flock to EM, despite the data and the subjective advice from multiple generations of ER physicians.

Is it hubris? Delusion? Narcissism?

Not sure about others but many students I know, including myself, took the advice into strong consideration. At the same time, we didn't completely throw the specialty away because of it. EM dropped pretty low on my list of specialties after reading that the world is ending and we will be making less than $100/hr soon on sdn. After going through the other specialties I seen that I would have hated going into those fields. Surgery was a close contender but damn did I hate the culture among the staff (worse than the attendings). Anesthesia was on the list but I wasn't a fan of interacting with the surgeons daily and they also say the world is ending with CRNAs and oversaturation of pain fellowships. They stress how students should not enter the field (calling students that enter that field hubris, delusional and narcissistic). I would rather take a EM job in an undesirable city for less pay than to go into FM, IM, psych, ect. It's not that students dont hear you (Im sure some dont) but for some of us there literally are no other specialties we want to do. Not even a little. I really tried to find a passion for another field but God the other fields was not for me.

 

[zurc2014]

Thanks for the responses everyone! I do have to say, now that I am off for interviews, I miss sdn lol. It's like its own little world. In person EM docs are the most laid back, chill, funny docs that will shoot the **** with you at 2am. Coolest people ever. One of the main reasons I vibe with the field. If you come on sdn and say you are interest in EM, faculty docs will rib your dingus apart like the delusional snowflake you are. I just find drastic contrast with person vs online personalities funny.

 

[HemorrhagicShock]

Thanks for the responses everyone! I do have to say, now that I am off for interviews, I miss sdn lol. It's like its own little world. In person EM docs are the most laid back, chill, funny docs that will shoot the **** with you at 2am. Coolest people ever. One of the main reasons I vibe with the field. If you come on sdn and say you are interest in EM, faculty docs will rib your dingus apart like the delusional snowflake you are. I just find drastic contrast with person vs online personalities funny.

I guarantee you everybody here is a "chill, funny, laid back" person while on shift. What you are forgetting is that you simply can't say the things you read here in real life otherwise one's job would be seriously threatened.

Do you honestly think the docs who post here are going around in real life parroting these real-life professional realities on a day-to-day basis? Of course not, their directors would hear about it and promptly remove them from the schedule for being "Unprofessional" and "creating a hostile culture."

While I think your reasons for choosing EM are somewhat well-researched (from a purely medical perspective), you really need to be prepped for the very real future where you might only make $100-125/hr seeing nearly 3 PPH. It's really really really hard to fathom what this is like until you become an attending, so I truly urge you to really make sure this is what you want.

 

[EctopicFetus]

I guarantee you everybody here is a "chill, funny, laid back" person while on shift. What you are forgetting is that you simply can't say the things you read here in real life otherwise one's job would be seriously threatened.

Do you honestly think the docs who post here are going around in real life parroting these real-life professional realities on a day-to-day basis? Of course not, their directors would hear about it and promptly remove them from the schedule for being "Unprofessional" and "creating a hostile culture."

While I think your reasons for choosing EM are somewhat well-researched (from a purely medical perspective), you really need to be prepped for the very real future where you might only make $100-125/hr seeing nearly 3 PPH. It's really really really hard to fathom what this is like until you become an attending, so I truly urge you to really make sure this is what you want.

Agreed. It’s a great job. It’s fun. But I would tell any student to avoid. It’s foolish to go into this field and understand you will end up with a below average job You could go to the best residency but often those places have little to no connection to what a good job is or where they are. I went to a good residency and lucked into a great job. My attendings knew very little about the job even though many had been attendings for quite some find and knew a huge number of the docs in the group. Your “partners” who are really just your colleagues will be great. Your bosses be they CMG clowns 🤡 or hca pimps are what will make your job unbearable but don’t worry you won’t have any other options.

 

[thegenius]

While I think your reasons for choosing EM are somewhat well-researched (from a purely medical perspective), you really need to be prepped for the very real future where you might only make $100-125/hr seeing nearly 3 PPH. It's really really really hard to fathom what this is like until you become an attending, so I truly urge you to really make sure this is what you want.

I do not think this will ever be the average. I think ER salaries will slowly go down over time, but it will not get to 100/hr seeing 3 pph. Or 125/hr seeing 2.6/hr.

And yes I read all the threads on this forum.

Over the last seven years I've made increasingly more money in EM (more $$/hr specifically). While I anticipate the trend to stabilize or reverse itself, there is way too much doom and gloom on this board.

 

[Lexdiamondz]

Not sure about others but many students I know, including myself, took the advice into strong consideration. At the same time, we didn't completely throw the specialty away because of it. EM dropped pretty low on my list of specialties after reading that the world is ending and we will be making less than $100/hr soon on sdn. After going through the other specialties I seen that I would have hated going into those fields. Surgery was a close contender but damn did I hate the culture among the staff (worse than the attendings). Anesthesia was on the list but I wasn't a fan of interacting with the surgeons daily and they also say the world is ending with CRNAs and oversaturation of pain fellowships. They stress how students should not enter the field (calling students that enter that field hubris, delusional and narcissistic). I would rather take a EM job in an undesirable city for less pay than to go into FM, IM, psych, ect. It's not that students dont hear you (Im sure some dont) but for some of us there literally are no other specialties we want to do. Not even a little. I really tried to find a passion for another field but God the other fields was not for me.

That's probably the root of the problem, to be honest.

No matter how much you may like emergency medicine (and I fxcking love EM on good days), the reality is that you are looking for passion whereas everyone else sees you, and intends to treat you like an employee.

Your passion won't matter when your boss calls you in because your metrics aren't where they want them to be.

Your passion won't matter when you have 20 patients in the waiting room while you're fighting with the hospitalist to accept a social admit and EMS pre-notifies you that some full-code 90 year old COPDer is obtunded on CPAP, ETA 4 minutes away.

Your passion won't matter when a belligerent, feces covered inebriate assaults you in your workplace and your employer tries to dissuade you from pressing charges because "the paperwork won't be worth it".


None of the aforementioned examples are hyperbole. Every single one is an event that has happened to me. In. the. last. 6. months.




Every medical student thinking of EM should listen to this debate from SMACC DUB where they discuss whether or not Emergency Medicine is a failed paradigm. The reality is the job we sell medical students emphatically IS NOT the job you're going to be doing once you graduate residency. If you get a job at all.


Every single resident and attending on this forum is somone who, like you, thought "they couldn't see themselves doing anything else". You, MS4, are unfortunately not special or unique in this regard - we have all said something along the lines of what you've said here. Several years on, most of us, if given the chance, would probably do something else had we known what we know now.

And I say this as someone who went to a very well regarded residency and secured what many would consider a "good" job upon graduating residency.

 

[Lexdiamondz]

I do not think this will ever be the average. I think ER salaries will slowly go down over time, but it will not get to 100/hr seeing 3 pph. Or 125/hr seeing 2.6/hr.

And yes I read all the threads on this forum.

Over the last seven years I've made increasingly more money in EM (more $$/hr specifically). While I anticipate the trend to stabilize or reverse itself, there is way too much doom and gloom on this board.

What do you think most salaries in NYC are currently? There's no shortage of **** tier jobs in that area offering $150 ish an hour.

 

[HemorrhagicShock]

I do not think this will ever be the average. I think ER salaries will slowly go down over time, but it will not get to 100/hr seeing 3 pph. Or 125/hr seeing 2.6/hr.

And yes I read all the threads on this forum.

Over the last seven years I've made increasingly more money in EM (more $$/hr specifically). While I anticipate the trend to stabilize or reverse itself, there is way too much doom and gloom on this board.

This is already the going rate (~$135/hr) at a few community hospitals within Los Angeles, Denver, and apparently NYC (per Lexi's post above).

And you and I both know that you cannot survive in those busy urban departments without seeing nearly 3 PPH.

While you may be correct that this won't be the "average" across the nation, it's already a reality in many desirable urban markets.

Remember you got into EM when the getting was still reasonable, perhaps you've stayed with a group where your seniority has built over time, and as a result, your effective hourly rate has increased given your own individual/personal situation. I don't know, I'm assuming a lot here regarding your situation, but there's an abundance of evidence to suggest that a medical student deciding to match EM in 2021 won't have nearly the same opportunity.

You gotta aim for where the puck is going, not where it is currently.

 

[RustedFox]

Yeah, as much as I like optimism of @thegenius, the actual real life numbers I've seen really bother me. I absolutely would not do this job for anything less than a set amount in my head - and that number is far higher than "Denver" rates.

 

[thegenius]

What do you think most salaries in NYC are currently? There's no shortage of **** tier jobs in that area offering $150 ish an hour.

This is already the going rate (~$135/hr) at a few community hospitals within Los Angeles, Denver, and apparently NYC (per Lexi's post above).

Not the average. I said it won't ever be the the average. That implies that 1/2 the jobs people will be making LESS THAN $100/hr seeing 3/hr. Or even seeing 1.5/hr.

Of course there will be a spattering of jobs where this low rate exists, but it will not be the norm. People have been predicting that ER salaries will go down over time, and I've seen mine gone up over the past 7 years. And I used to work for TeamHealth for most of my life until recently.

Interesting I trained in NYC, and I remember that a ER associate professor at Cornell was making something like $225/year + BENEFITS. Those benefits were quite good. And they were not seeing anything close to 3/pph, and they can admit any symptom they want. I know because I admitted those patients. Now that might be on the order of $125/hr or so but you are not calculating the value of the entire compensation package which is often quite more than just the base salary.

 

[alpinism]

Right now most NYC jobs are in the 125-150/hr range. But as noted above that does not include benefits so its more like 175-200/hr when compared with your typical independent contractor jobs for the corporate groups. Not great by any means but also not among the lowest salaries in the country. That being said considering the high taxes and cost of living in the city you'll be taking a huge paycut compared to jobs in most other US cities.

 

[EctopicFetus]

I do not think this will ever be the average. I think ER salaries will slowly go down over time, but it will not get to 100/hr seeing 3 pph. Or 125/hr seeing 2.6/hr.

And yes I read all the threads on this forum.

Over the last seven years I've made increasingly more money in EM (more $$/hr specifically). While I anticipate the trend to stabilize or reverse itself, there is way too much doom and gloom on this board.

I think nationally the floor is 160-180/hr for 2 pph plus MLP supervision. Certain locations will be worse others better. I view the current job market at 215-235/hr. That’s just to give a guide as to where I think we go. Also agree it will be gradual. I think 4 years from now when an m4 starts a job we will see moved toward lower pay.

 

[EctopicFetus]

I think one issue is how we define a “good” job. Now I have my criteria. Note it’s without qualifications. So I’m not referring to a “good job in Denver”. Just a good job. For me that is $300/hr in a functional Ed.
i also think getting no less than $100/pt and more like $125/pt. That’s my simple criteria. Yes there is a lot more missing and there is a lot of nuance. Nuance like ownership and not in the bs USACS way. How admin is and treats you etc.
to keep it simple I’ll say a good job is at least $300/hr and $125/pt. Note every patient the MLP sees I count as half a patient to the doc in credit.
Chicago is at this crap ass rate too fwiw. That’s the future. You’ll have to drive far or work a miserable job if you aren’t an owner very soon. New grads will be left to pick from the bottom of the barrel. I have like others expected a pay cut for some time. It’s not happened to me. I am confident unlike before that the major change is coming. All the signs point against us and the cmgs have stolen the good will we as em docs rightly deserve.

 

[Torsion]

I go to residency in a nice medium sized city in a growing area that pretty much everyone on earth has heard of. My local VA offers 300k + benefits to sit around seeing about 1 pph. While this opportunity is attractive to some people, there is yet to be a mob of local ER docs battering down the door for that gig. Local CMG rates and even pre-partner rates at local SDGs are still more attractive to most people. If things change, I'd definitely take the cozy VA gig over some of the nightmarish scenarios speculated on here.

 

[Lexdiamondz]

I go to residency in a nice medium sized city in a growing area that pretty much everyone on earth has heard of. My local VA offers 300k + benefits to sit around seeing about 1 pph. While this opportunity is attractive to some people, there is yet to be a mob of local ER docs battering down the door for that gig. Local CMG rates and even pre-partner rates at local SDGs are still more attractive to most people. If things change, I'd definitely take the cozy VA gig over some of the nightmarish scenarios speculated on here.

300k to watch your skills atrophy at 3x speed? Nah.

Furthermore, the VA unfortunately seems to be leading the pack in replacing doctors with noctors. I wouldn't bank on those jobs existing for new grads in 2030, especially when they're far more shielded from the liability of midlevel malpractice and generally don't have that much acuity that would require one with robust resuscitation skills.

 

[EctopicFetus]

I go to residency in a nice medium sized city in a growing area that pretty much everyone on earth has heard of. My local VA offers 300k + benefits to sit around seeing about 1 pph. While this opportunity is attractive to some people, there is yet to be a mob of local ER docs battering down the door for that gig. Local CMG rates and even pre-partner rates at local SDGs are still more attractive to most people. If things change, I'd definitely take the cozy VA gig over some of the nightmarish scenarios speculated on here.

Check the hours at the VA. Yes it is easy but it is a ton of hours and its not 300k. But yes, its not there yet, I dont think anyone claims that. How many of your seniors took jobs making under 250/hr. I’m guessing 100%. Most got jobs in the 200-220/hr range. With CMGs there is no upside and no perks.

The VA job you refer to is paying about 175/hr and is a career killer. Talk to me in 5 years. I have seen the future and for work in EM it blows.