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I have not experienced trouble with the job market, yet. But the numbers kind of don’t add up .. graduating twice as many EPs as 12 years or so ago for the same # of jobs is clearly going to cause an oversupply unless burnout rates are much more than expected .. which .. is that the job you want either?

The job itself is not what it seems from the outside looking in. I feel very fortunate that I also like what EM actually is, because it easily could have not been that way.

It’s just .. it’s so constantly busy.

The staffing companies and hospitals want to run as short staffed as possible. Most of any given shift I will have 12-20 patients on the board. I am told that the numbers don’t support additional staff. They don’t understand that you need a little cushion in case you know .. someone in the ER is actually having an emergency.

At PGY 16 I am perfectly capable of dealing with all the emergencies that come up, but it’s still disheartening to have the next 12 patients with runny noses yell at you or file a complaint because they had to wait while you were handling the emergency.

More and more we are expected to work people up out of the waiting room. With inexperienced nurses. With no social work or ancillary staff. But don’t ever miss a sepsis alert or forget to order restraints!

I don’t see any of this changing for the better in the next ~ 15-20 years.
 
Yes, it is a downward path for EM. We have no power to create change. More and more the hospital is looking to the ER to save money (staffing levels, bed holds, etc). Scope creep is definitely happening, and I am seeing more shops with 24 hrs physician coverage and 48 hr+ midlevel coverage. The patients are getting more angry and they are acting out against staff (verbal abuse, physical abuse). The working conditions for EM are horrible.

There is no end of the downward trend in sight.
 
do you have any advice as to what other specialties i should be exploring as i start school?

Any other one.

i know it’s still very early for me, but i’m concerned that if i don’t have a good idea of what i want to do early on, it’ll be tougher to match into something more competitive than EM.

No.

I appreciate everybody’s thoughts! i’m just trying to keep an open mind. i’m really interested in EM, but if the math just isn’t mathing with the job market, then i don’t know what else to do…

Forget the job market, it's the job.
 
Thank you all very much for your insights. I will be sure to keep them in mind as I explore further.
 
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