200+ Unfilled EM Spots

[nimbus]

Anyone who applied for EM this year is a hobby doc or fairly foolish. I don't see a way out of this mess, and I agree with the comment above from @Kryptocoin about the scourge of DO schools (for profit, no standards ASFAIK) and the willing applicants lining up for open admissions medschool.
EM is the canary. Medicine aside from those going to top 20 schools and into fields like urology that protect their own, is imploding, like law and academia.

Speaking of top 20 schools, EM was very popular this year at Stanford, UMich, and CWRU. Maybe they all have tech spouses or family money.

---

Members don't see this ad.

 

[EMedGrrl]

Copied from another social media site which shall remain nameless but has a large EM physician community (cough and starts with F cough):
- Established academic programs directly affiliated with an allopathic medical school: 8 programs, 11 spots
- Established (>5 years) community programs: 15 programs, 35 spots
- Programs formerly accredited through osteopathic pathway now accredited by ACGME (within the last 3 years): 23 programs, 74 spots
- Community programs non-corporate as far as I could tell accredited in the last 3 years: 8 programs, 33 spots
- Corporate programs accredited > 3 years: 6 programs, 16 spots
- Corporate programs accredited in the last 3 years: 6 programs, 36 spots
This tally came up with a few less spots than NRMP reported, maybe because all didn't participate in SOAP? Or because of the not-really-open-to-anyone spots. IDK.

 

[Lexdiamondz]

Speaking of top 20 schools, EM was very popular this year at Stanford, UMich, and CWRU. Maybe they all have tech spouses or family money.

Most likely they feel their pedigree shields them from the realities of the job market.

 

[Franzd'Epinay]

I do find some amusement, though, in the arrogance of EM as a field (which has shown serious cracks for a decade or more), especially regarding their oh-so-precious SLOEs and obsession with away rotations and other weed-out criteria, and the denial of many a shyster program director that the day of reckoning was nigh. Like, many were completely ostriching and pretending this wouldn't happen.

Now they will take anyone. SLOE or no SLOE. US grad or not. No audition needed.

Ahh, the hubris.

I never saw it as a weed-out process--after all, getting away rotations wasn't difficult (or at least it wasn't ~10 years ago). I saw it as a more sane way of evaluating med students from very different educational backgrounds. It certainly seemed way more reasonable than putting an outsized focus on Step 1 like the other specialties.

 

[Prehealth1011]

Getting away rotation was stressful af for my classmates. They started looking early, finding new ways to obtain rotations all the time (applying to new programs, former DO programs, cliniciannexus i.e. bypass vsas which everyone knows). They wouldn’t tell each other if someone found a rotation. It’s 100% not something you can get without planning ahead and being productive

I also know people that asked our 4th years, found the sites that basically give everyone an average sloe (less risky) and specifically targeted those places. All matched successfully

 

[Angry Birds]

Please don't attempt to equate USIMGs with US grads.

Is that really what you got out of my post?
First: my post was primarily about FMGs.
Second: Do you really think that an American grad from a middling undergrad and low ranked American medical school (no value judgement on my part here) is really "better" (in some ontological or transcendental sense) than an Oxbridge graduate?
Third: I clearly said that it makes sense for residencies to prioritize US grads (even those from low ranked programs). My issue is not with the policy. It's with the disdain shown by some including by people who themselves went to low ranked schools in their lives.
Fourth: I only stated that I myself have not noticed any significant difference between Ross/St G grads compared to AMGs. Myself being almost a decade out of residency, I find it strange to show disdain towards them.

 

[emergentmd]

Maybe its just me, but looking at my gmail inbox, it looks like EM jobs are picking up. I am getting offers for jobs, locums coverage, and also Medical director feelers.

No one knows what will happen to EM and everything is just speculation. It may pick back up. May stay stagnant and many new grads would be happy to make $200/hr punching the hourly clock.

But whatever field you go into, make your money, save, invest it in stuff outside of medicine. Our healthcare system is bloated and unsustainable.

 

[EctopicFetus]

This sort of logic is justifying the ignorance and parochialism of a segment of our society, most of whom cannot speak more than one language, have never traveled anywhere, and know next to nothing of the world.
Of course, these hoi polloi can be forgiven for their lack of sophistication and cosmopolitanism, but I don't think the same can be said of fellow doctors with advanced degrees.

On that note, it might surprise people to know that there are many excellent medical universities in the world, outside of America, many of which are insanely competitive due to burgeoning young populations. But, their accent! -- often said, I must say, when their statements are understood or at least when zero attempt is made to understand, quite in contrast to many other parts of the world where polylingualism is the default assumption.

I get this. However the reality is what we do. I dont view patient care as some equal opportunity event. I have no issue with these folks but reality is many international medical schools dont cripple people with debt like we do here. It would place US Med grads at a disadvantage. In addition especially in the imperfect setup of an ED having some shared experience and knowledge is helpful.

I’m not saying it is right or proper but it is true. I mean why is there a push for more POC in medicine. The shared experience and appearance leads to more trust and in some studies better outcomes. Again, we dont have to like the truth but it doesnt change the truth. I myself am polylingual. If you speak an uncommon language and you see a patient and you share that language their face lights up.

 

[nimbus]

Maybe its just me, but looking at my gmail inbox, it looks like EM jobs are picking up. I am getting offers for jobs, locums coverage, and also Medical director feelers.

No one knows what will happen to EM and everything is just speculation. It may pick back up. May stay stagnant and many new grads would be happy to make $200/hr punching the hourly clock.

But whatever field you go into, make your money, save, invest it in stuff outside of medicine. Our healthcare system is bloated and unsustainable.

This part is particularly bloated and unsustainable. These are the same folks crying to and bribing Congress about OON physician billing.

UnitedHealth Group earned $17.3B in 2021, according to earnings report

The company's full-year revenue grew more than $30 billion, or 11.8%, to $287.6 billion year-over-year.

www.healthcarefinancenews.com

 

[voxveritatisetlucis]

This part is particularly bloated and unsustainable. These are the same folks crying to and bribing Congress about OON physician billing.

UnitedHealth Group earned $17.3B in 2021, according to earnings report

The company's full-year revenue grew more than $30 billion, or 11.8%, to $287.6 billion year-over-year.

www.healthcarefinancenews.com

Why don’t physicians just buy stocks in HCA, UNH, HUM, THC etc. to hedge. If the companies like the one mentioned in your article do well at the expense of physicians, you still win

 

[miacomet]

Most likely they feel their pedigree shields them from the realities of the job market.

Yep, just like law and academia. And literally no one in the community cares if you did your residency at Stanvard

 

[Angry Birds]

I get this. However the reality is what we do. I dont view patient care as some equal opportunity event. I have no issue with these folks but reality is many international medical schools dont cripple people with debt like we do here. It would place US Med grads at a disadvantage. In addition especially in the imperfect setup of an ED having some shared experience and knowledge is helpful.

I’m not saying it is right or proper but it is true. I mean why is there a push for more POC in medicine. The shared experience and appearance leads to more trust and in some studies better outcomes. Again, we dont have to like the truth but it doesnt change the truth. I myself am polylingual. If you speak an uncommon language and you see a patient and you share that language their face lights up.

Thanks for this. Like I said, I have no problem with schools prioritizing American grads. From many different angles, it makes sense to prioritize local grads.

(On an [un]related note, our system of saddling students with hundreds of thousands of dollars of debt is clearly in need of radical reform.)

 

[hundreddaysoff]

Why don’t physicians just buy stocks in HCA, UNH, HUM, THC etc. to hedge. If the companies like the one mentioned in your article do well at the expense of physicians, you still win

Because then we'd become an even bigger part of the problem.

(Says the man whose retirement is dependent on VTI, VXUS, and USUCS.)

And it's not just medicine. Not by far.

Hollow Men, Hollow Markets, Hollow World

Apocalypse Now (1979), based on “Heart of Darkness” by Joseph Conrad Kurtz: Did they say why, Willard, why they want to terminate my command? Willard:

www.epsilontheory.com

</soapbox>

 

[Franzd'Epinay]

Why don’t physicians just buy stocks in HCA, UNH, HUM, THC etc. to hedge. If the companies like the one mentioned in your article do well at the expense of physicians, you still win

How's that hedging?

It's like asking chickens to buy KFC buckets to hedge their bets.

 

[Kryptocoin]

Why don’t physicians just buy stocks in HCA, UNH, HUM, THC etc. to hedge. If the companies like the one mentioned in your article do well at the expense of physicians, you still win

Because in the end, they win. If you invest in HCA funds, their stock price rises. So they get flushed with even more money and expand their market share. Flood the market with even more residents, leading to further depression of wages and increased unemployment/underemployment.

 

[qwerty89]

If you were wondering how bad could it get. UCLA Chemistry department has no shame is listing a non-paid assistant adjunct professor position.

"The Department of Chemistry and Biochemistry at UCLA seeks applications for an Assistant Adjunct Professor on a without salary basis. Applicants must understand there will be no compensation for this position."

lolwut

 

[Dral]

If you were wondering how bad could it get. UCLA Chemistry department has no shame is listing a non-paid assistant adjunct professor position.

"The Department of Chemistry and Biochemistry at UCLA seeks applications for an Assistant Adjunct Professor on a without salary basis. Applicants must understand there will be no compensation for this position."

lolwut

Position benefits:
You have something to do during the day.
One flask or beaker per year of your choice. (UCLA will not be responsible for breakage replacements).
It's sunny here.
Access to fun chemicals! (Background check may be required for position)


The best thing would be if someone actually takes that position and then somehow gets fired down the line. "Ummm, yeah, so we're going to unfortunately have to let you go. We've discussed it and despite us giving you in essence nothing, you're just not giving us enough back"

 

[Pons Asinorum]

If you were wondering how bad could it get. UCLA Chemistry department has no shame is listing a non-paid assistant adjunct professor position.

"The Department of Chemistry and Biochemistry at UCLA seeks applications for an Assistant Adjunct Professor on a without salary basis. Applicants must understand there will be no compensation for this position."

lolwut

Been said a million times, folks will do ANYTHING to live in the blue parts of CA. Look at physician pay, same thing. You'll take a bigger haircut working an attending job in Oakland that this young chemistry Ph.D. will who probably has a full time gig at CSUN and will benefit from the CV juice that the UCLA position imbues upon it. Every high-achieving chemist kid born in CA (and a lot outside) will rationalize the **** out of taking that job and be happy to do it. #Weird.

 

[hundreddaysoff]

Been said a million times, folks will do ANYTHING to live in the blue parts of CA. Look at physician pay, same thing. You'll take a bigger haircut working an attending job in Oakland that this young chemistry Ph.D. will who probably has a full time gig at CSUN and will benefit from the CV juice that the UCLA position imbues upon it. Every high-achieving chemist kid born in CA (and a lot outside) will rationalize the **** out of taking that job and be happy to do it. #Weird.

To play devil's advocate: If you were born in CA and you already have money, why not take it? In natural terms, CA is paradise, it cannot be denied.

(Except for the permadrought, I mean.)

Unfortunately, I do not already have money, and in my case you are right that taking a doctor job here involves a big haircut. Especially with the recent formation of "USACS West" and Big Brother's The Holding Company's 83(b) private-equity-inspired looting shenanigans.

This is why I'm acquiescing to the wife and leaving.

Makes me very sad, no doubt. Life is too short to spend half the year freezing one's butt off.

 

[bravotwozero]

Because in the end, they win. If you invest in HCA funds, their stock price rises. So they get flushed with even more money and expand their market share. Flood the market with even more residents, leading to further depression of wages and increased unemployment/underemployment.

....Unless we as docs can band together as part of a coordinated strategy to buy enough shares to become majority owners of HCA. Hard, but not impossible.

 

[Kryptocoin]

....Unless we as docs can band together as part of a coordinated strategy to buy enough shares to become majority owners of HCA. Hard, but not impossible.

So basically become another USACS?

 

[hundreddaysoff]

....Unless we as docs can band together as part of a coordinated strategy to buy enough shares to become majority owners of HCA. Hard, but not impossible.

HCA's market cap as of today is ~$78B.

This is a company that famously turned down $1.5B in COVID-19 stimulus money from the Feds in 2020, because they already had enough money.

So, I don't think us docs have enough money to buy them out. Especially when USACS is taking us over "merging" with us and raiding our future earnings for their existing shareholders, or for The Holding Company, or for whoever else they're doing it for who is not us.

A more promising avenue, I think, is to support the federal regulators. (I know, that sentence sounds strange to me too.) These days, they seem to actually be enforcing the existing antitrust laws on the books, at least somewhat.

Matt Stoller's Substack is a good read in this regard.

 

[Arcan57]

A more promising avenue, I think, is to support the federal regulators. (I know, that sentence sounds strange to me too.) These days, they seem to actually be enforcing the existing antitrust laws on the books, at least somewhat.

Matt Stoller's Substack is a good read in this regard.

I think that's the key. I don't think most of us got into EM to pad our bottom line by selling out our colleagues to whoever was willing to pay us. EM physician led groups fall prey to the exact same issues that the current CMGs do, it's just a matter of size. Once your organization chart becomes big enough that you haven't met most of the people that are making you money, you're going to replicate the behavior of the current CMGs

 

[nimbus]

HCA's market cap as of today is ~$78B.

This is a company that famously turned down $1.5B in COVID-19 stimulus money from the Feds in 2020, because they already had enough money.

So, I don't think us docs have enough money to buy them out. Especially when USACS is taking us over "merging" with us and raiding our future earnings for their existing shareholders, or for The Holding Company, or for whoever else they're doing it for who is not us.

A more promising avenue, I think, is to support the federal regulators. (I know, that sentence sounds strange to me too.) These days, they seem to actually be enforcing the existing antitrust laws on the books, at least somewhat.

Matt Stoller's Substack is a good read in this regard.

Reno anesthesiologists were supported by the DOJ in their effort to void their noncompete agreement with NAPA. Looks like the anesthesiologists were allowed to continue working in the same hospitals and community without being affiliated with NAPA.

https://www.justice.gov/atr/case-document/file/1477091/download

 

[solitarius]

If you were wondering how bad could it get. UCLA Chemistry department has no shame is listing a non-paid assistant adjunct professor position.

"The Department of Chemistry and Biochemistry at UCLA seeks applications for an Assistant Adjunct Professor on a without salary basis. Applicants must understand there will be no compensation for this position."

lolwut

They're targeting some useless trust-fund babies who have a chemistry degree.

 

[Franzd'Epinay]

They're targeting some useless trust-fund babies who have a chemistry degree.

Getting a chemistry PhD from a reputable university is no joke and everyone should be fairly compensated for their labor and knowledge, trust fund or not. Besides, if this gets accepted, that will depress the salaries of those without trust funds or make it so that only rich people can become science professors.

 

[Kryptocoin]

Why well-qualified medical school graduates can’t get jobs — despite doctor shortages

The US is fighting a modern pandemic with a 1990s-sized workforce.

www.vox.com

And the media drum beat continues. I did find this highlight interesting :

"Medical schools are growing, but residency program growth has stagnated​

Since the limits on medical school seats were lifted 15 years ago, class sizes and school numbers have grown, Orlowski said. She expects the number of US medical school graduates to increase by about 3,000-4,000 over the next three years."

So we are expecting an extra 4k debt-saddled med students in the next three years. If the choices were between unemployment or EM, most would choose EM. The supply and demand are already warped. As long as there is an unfilled slot, some desperate med student will fill it up.

And every passing year bring us closer to the ACEP projection of 10k+ surplus of EM physicians.

 

[nimbus]

Getting a chemistry PhD from a reputable university is no joke and everyone should be fairly compensated for their labor and knowledge, trust fund or not. Besides, if this gets accepted, that will depress the salaries of those without trust funds or make it so that only rich people can become science professors.

There is some conjecture that job has already been filled by somebody with independent “soft money” funding (foundation or some other outside grant) and posted only to comply with university rules.

 

[nimbus]

Why well-qualified medical school graduates can’t get jobs — despite doctor shortages

The US is fighting a modern pandemic with a 1990s-sized workforce.

www.vox.com

And the media drum beat continues. I did find this highlight interesting :

"Medical schools are growing, but residency program growth has stagnated​

Since the limits on medical school seats were lifted 15 years ago, class sizes and school numbers have grown, Orlowski said. She expects the number of US medical school graduates to increase by about 3,000-4,000 over the next three years."

So we are expecting an extra 4k debt-saddled med students in the next three years. If the choices were between unemployment or EM, most would choose EM. The supply and demand are already warped. As long as there is an unfilled slot, some desperate med student will fill it up.

And every passing year bring us closer to the ACEP projection of 10k+ surplus of EM physicians.

Add FMGs, USIMGs, and prior year unmatched USMDs and USDOs to the mix and it’s even more unbalanced. Almost 48000 med school grads competing for 39000 residency positions. I think most people will pick an EM spot over a dead end prelim surgery spot.

 

[WilcoWorld]

There is some conjecture that job has already been filled by somebody with independent “soft money” funding (foundation or some other outside grant) posted only to comply with university rules.

That actually makes a lot of sense.

 

[Angry Birds]

There is some conjecture that job has already been filled by somebody with independent “soft money” funding (foundation or some other outside grant) and posted only to comply with university rules.

I think this is just damage control on the part of UCLA.

In any case, back to the topic at hand, I thought this is fitting for this thread:

 

[medicineguy791]

Does anyone know of any specific EM (preferred), IM, or FM programs that are currently looking to fill vacant spots?