Anyone want to guess at the number of unfilled spots this year?

[WhatJobDoIPick]

The boom cycles of each field seem to be predicated by shortages. EM is not going to have a shortage anytime soon. This is what the students don't understand.

---

Members don't see this ad.

 

[EctopicFetus]

There may be more information, but you still have to be willing to entertain the conclusion(s), even if they aren't palatable.

People love their echo chambers.

This is so true. People just hop in those echo chambers and get into their own positive feedback loop.

 

[GatorCHOMPions]

This is so true. People just hop in those echo chambers and get into their own positive feedback loop.

And negative feedback loops. Some of us here are guilty. The truth lies somewhere a little closer to SDN than Reddit, though.

 

[timpview]

At this moment I'm not even thinking in terms of the impact on the career and the market.... I'm thinking about how totally piss poor some of my older colleagues practice medicine (sorry. But only some of them). And I don't even mean the fact that they are out of date on their literature. I mean that some of them are just.... Like.... Not exactly *the best* physicians but because of momentum, grandfathering, or just different education standards they are still in emergency medicine while being noticeably less academic and rigorous in their thinking. Again not all of them ... But some of them.

And now I'm left wondering if we are about to get a wave of people 3-4 years from now hitting the market who are just academically not of the quality we need. So much pride was taken around the time that I was in residency that emergency medicine was not going to be the dumb overpaid triage nurses that we had been stigmatized as. We were going to be the people who knew the basics (and intermediates) of everyone else's field better than them and can school them on anything except niche specifics of their fields. Now I'm afraid that we are going to fully live up to the idiots with lyringoscopes stereotype. And I don't think a bunch of people with questionable education centers and below snuff starting characteristics are the wave of the future I want to have replacing my generation eventually.

How many years away are you from being piss poor?

 

[Apollyon]

How many years away are you from being piss poor?

Years?? Pffh.

 

[DocEspana]

How many years away are you from being piss poor?

Was born piss poor

 

[DocEspana]

Years?? Pffh.

See. You get it

 

[EctopicFetus]

And negative feedback loops. Some of us here are guilty. The truth lies somewhere a little closer to SDN than Reddit, though.

I think the difference is that we have experience. Some negative feedback loops but i can tell you what 10-15 EDs around me pay.. Who is hiring etc. those folks have no clue others than bad data given to them by others. On here IMO is the doom and gloom of the future. Some of us on here are burnt out. Some hate our jobs but we have real life data points. I have a solid gig. I still like coming to work. The failure of many to realize the strain the job will take on them is sad. I planned against burn out from before residency. I got lucky but man there is major pain at times with my job which I would argue is a rare exception in this craptastic job landscape. That being said i think my hospital leadership is bad, holds are bad our consultants are often painful especially to those who havent been around a while.

 

[WuMedic]

"Poco ma non troppo" means "a little, but not too much" in Italian. I got it from an opera. It's not a line, but from the music.

It's been a while since I've touched a musical instrument, but I can't say I've ever seen it that way. I think "poco" needs to modify something. I've seen "allegro ma non troppo" meaning allegro, but not too allegro, but while poco is presumably modifying "more" as in poco piu ma non troppo, it is implied and not actually modifying anything in your sentence.

**musical theater nerd exits stage right**

 

[WuMedic]

The gap has been filled with lower-quality candidates for whom EM is now an achievable specialty since it's no longer desirable by top-tier high-achieving medical students. Of course, nobody involved in EM (especially EM training) is going to say this publicly with their name attached.

The cynic in me thinks this is what "the system" wants since it'll be a steady stream of warm bodies to fill an ever-growing CMG footprint. A swarm of indebted EM graduates who are easily exploited and gaslit into high-stress and high-burnout clinical careers.

Two outcomes I see in the near future (3-5 years): Heavy downward pressure on wages AND an extremely competitive fellowship environment for subspecialties that allow one to escape the ED (e.g CCM, pain, HPM, etc.)

Not just a steady stream of warm bodies, but a steady stream of warm bodies that would otherwise be making ≈$30,000 a year in their home country and will be thrilled to make $125 / hour in the US

I think you two hit the nail on the head. Assuming this trend does not reverse, we will hit a point where wages will stagnate or have downward pressure on them because 1) Increased supply to demand ratio (even if the ratio is still in our favor for a few more years, altering the ratio will have significant impacts) and 2) a "supply" of newly minted grads and IMG's who see the depressed wages and still think "holy f***, that's 3x (or 5x or 10x) what I make here in [home country] so it's still work it to me! I was a long shot before, but with all these openings, yeah, the calculus is still in my favor at $100/hr!".

The $5MM question though is how do we (established attendings) market ourselves to be worth the extra $$$ we currently command, and not tumble down with them? We will have to figure out what metrics admin cares about that we have a meaningful difference. I hate for this to become and "us vs. them" but it kind of has to. Just providing better patient care doesn't mean squat to the suits across campus. We have to show that we can alter the metrics that they care about, whether it be patient satisfaction (because a language barrier may turn some patients off), efficiency and RVUs/hr (and to a slightly lesser extent, pt/hr), (once again, language barrier thing--if you asked me to chart in Spanish, my efficiency would tank by about 95%), having trouble navigating the system leading to poor outcomes (because they are not used to a ton of patients with no PCPs which may lead to missed or delayed diagnoses), etc.

Or maybe the answer is that we can't differentiate ourselves in any way, and we need to all hunker down for the next 3-5 years because there is no way for us to market ourselves to stay at the top and we just need to focus on getting to our personal number as quick as possible or prepare to pivot.

 

[alpinism]

So if you look at the most recent match figures:

The number of total MD applicants has plummeted 40% while the number of total IMG applicants has skyrocketed 40% in the past 4 years.

Basically US docs are being replaced with non US docs looking for a residency spot here in the United States.

 

[Dr Mantis Toboggan]

So if you look at the most recent match figures:

The number of total MD applicants has plummeted 40% while the number of total IMG applicants has skyrocketed 40% in the past 4 years.

Basically US docs are being replaced with IMG docs looking for a residency spot to work in the United States.

And yet people still believe choosing this specialty is a good idea. Delusional.

 

[Apollyon]

It's been a while since I've touched a musical instrument, but I can't say I've ever seen it that way. I think "poco" needs to modify something. I've seen "allegro ma non troppo" meaning allegro, but not too allegro, but while poco is presumably modifying "more" as in poco piu ma non troppo, it is implied and not actually modifying anything in your sentence.

**musical theater nerd exits stage right**

There was an Italian social worker who told me after I'd found it out when I lived in New York. She was a native speaker. She'd seen it that way, which was good enough for me.

 

[HemorrhagicShock]

I think you two hit the nail on the head. Assuming this trend does not reverse, we will hit a point where wages will stagnate or have downward pressure on them because 1) Increased supply to demand ratio (even if the ratio is still in our favor for a few more years, altering the ratio will have significant impacts) and 2) a "supply" of newly minted grads and IMG's who see the depressed wages and still think "holy f***, that's 3x (or 5x or 10x) what I make here in [home country] so it's still work it to me! I was a long shot before, but with all these openings, yeah, the calculus is still in my favor at $100/hr!".

The $5MM question though is how do we (established attendings) market ourselves to be worth the extra $$$ we currently command, and not tumble down with them?

My prediction for how this will play out comes down to geography. IMGs and low-achieving/low-capability EM graduates will have no choice but to take jobs in incredibly undesirable locations.

The "tiers" of EM will end up being divided along those lines. High-achieving and high-capability will be able to maintain jobs in Denver, SF, Seattle, etc., (we can define capability here in a lot of ways -- ultimately this comes down to what the system values and incentivizes)

Pay will necessarily have to decrease for everybody, and you hit on another grim reality of the future. We will continue to become our own enemies, and pay will be split among a ruling class of admin EM docs who can claw themselves up the ladder to positions where they can exploit grads for their own benefit.

So if you look at the most recent match figures:

The number of total MD applicants has plummeted 40% while the number of total IMG applicants has skyrocketed 40% in the past 4 years.

Basically US docs are being replaced with IMG docs looking for a residency spot to work in the United States.

"The pendulum is swinging back!" - Residency Directors
"EM is great again" - Naive medical students
"Yes, yes, more, more" - CMG leadership

 

[Lynx zwo drei vier]

And yet people still believe choosing this specialty is a good idea. Delusion

I was hoping that the fly-by-night for-profit programs would remain unfilled and go to the chopping block (if only because no residents = less $$$ for the CMG that owns them). Instead, people thought it was a buyers' market for applicants and rushed into them.

HCA, Team Health, and the rest are to EM what the Caribbean is to medical schools, and there needs to be a sticky warning people away from them.

 

[WuMedic]

There was an Italian social worker who told me after I'd found it out when I lived in New York. She was a native speaker. She'd seen it that way, which was good enough for me.

I'm sure it makes more sense if you are a native speaker and can pick up on context clues. The old orchestral conductor in me would have to do more research on the piece the first time I saw it if there were more than one direction in the vicinity of it. I'm imagining myself sitting at my desk thinking "poco ma non troppo... poco WHAT? poco forte? (get a bit louder, but not too loud)? poco accelerando? (speed up, but not too fast!)"

 

[WhatJobDoIPick]

It's actually really sad what's happened to our field.

 

[cyanide12345678]

2 IMGs from pakistan matched into my 40+ year old program.

I mean win for my fellow pakistanis - but this specialty is now the bottom of the barrel competitiveness officially.

 

[Lynx zwo drei vier]

It's actually really sad what's happened to our field.

I foresee EM being stratified into three tiers going forward.

1. The people who really loved EM, went to schools that showed them the full spectrum of the specialty, accepted the risks, applied and ranked wisely, and ended up at reputable, well-established programs.

2. The people who "loved" a tailored EM clerkship that didn't show them the specialty's ugly side, had advisors who told them that "a residency is a residency," and applied to bad programs because they wanted to be somewhere warm and sunny.

3. The people who never should've gone for EM, but wanted a guaranteed residency in a location that they liked, and decided that EM was the easiest way to do it.

Tier 1 will take some collateral damage from the other tiers, and burnout will go up, but they'll largely be fine. The less debt they have, the finer they'll be.

Tier 2 will end up working the urgent cares, the cowtown EDs, and the toxic places in NYC. They'll get burned out fast. Some will grit their teeth and bear it. Others will get Stockholm syndrome and defend the status quo. And of course, many of them will start looking for other careers.

Tier 3 will be burned out before they leave residency. They won't just regret EM; they'll regret medicine, period.

 

[Lynx zwo drei vier]

My prediction for how this will play out comes down to geography. IMGs and low-achieving/low-capability EM graduates will have no choice but to take jobs in incredibly undesirable locations.

The "tiers" of EM will end up being divided along those lines. High-achieving and high-capability will be able to maintain jobs in Denver, SF, Seattle, etc., (we can define capability here in a lot of ways -- ultimately this comes down to what the system values and incentivizes)

Pay will necessarily have to decrease for everybody, and you hit on another grim reality of the future. We will continue to become our own enemies, and pay will be split among a ruling class of admin EM docs who can claw themselves up the ladder to positions where they can exploit grads for their own benefit.



"The pendulum is swinging back!" - Residency Directors
"EM is great again" - Naive medical students
"Yes, yes, more, more" - CMG leadership

Yup. You've said exactly what I said, but more articulately and with more years of experience to back it up.

 

[GatorCHOMPions]

2 IMGs from pakistan matched into my 40+ year old program.

I mean win for my fellow pakistanis - but this specialty is now the bottom of the barrel competitiveness officially.

My old program used to never take IMGs as recently as last year and this year they make up 50% of the class.

 

[Emapp20177]

So if you look at the most recent match figures:

The number of total MD applicants has plummeted 40% while the number of total IMG applicants has skyrocketed 40% in the past 4 years.

Basically US docs are being replaced with non US docs looking for a residency spot here in the United States.

EM is the new FM

IMGs have been duped

 

[Lynx zwo drei vier]

so officially 137 (idk where the other two not accounted for on reddit came from).

I noticed some really good (but not great) programs had openings - i guess they didnt adjust interviewing.

but more concerning some REALLY REALLY ****ing suck ass programs that I know about filled 100%. Which is terrifying. Well known name brand programs have openings but HCA bumble**** community hospital filled its 5 residents per year???? THey adjusted *very* well and we will suffer for it.

Here's the unbelievable thing about HCAs: their residents tend to be US-educated. Mostly DOs, but you'll find the odd US MD in the mix. Meanwhile, there are some good EM residencies (places that have been around for decades, have in-house fellowships, have great alumni networks, are level 1 trauma certified) that are 50% IMGs this year.

I would've said that it's cos people wanna go to Florida ... except most Florida HCAs aren't even in nice areas, and the handful that are pay awful salaries, and the non-Florida HCAs filled fine this year too. So I'm really stumped as to how HCAs keep poaching American medical students who could've done so much better.

 

[Splenda88]

EM is the new FM

IMGs have been duped

Probably worse based on N=1 experience.

My friend who graduated in 2017 or ?2018, failed step 1/2 and was working as a scribe matched into EM last year. He had applied FM every year and did not match.

IMG are not being duped. You are talking about people who are having a hard time getting into residency, so anything will do.

The difference between getting a medical license vs. not getting one is ENORMOUS. I have seen a good friend of mine graduated from a carib school who could not get into a US residency struggled as he was working as a patient care technician making < $15/hr from 2011-2014 in NJ.

He then found a 1-yr unaccredited ACGME internship in Puerto Rico, which allowed him to get a license there after a year. Fast forward. He has been working for Indian Health Service in the mainland making 200k+/yr plus 25k/yr student loan payment. He is already a millionaire in less than 10 yrs.

That is the difference between having ANY medical license vs. not having one.

 

[sylvanthus]

Ya this was predictable. Programs still fill, quality of applicants goes down, next the pay will drop more. EM is in the ****ter, sorry dudes this sucks ass. For those in residency, consider your fellowship options, but be careful, critical care is next.

 

[RustedFox]

Yep.
I hate this "specialty".

Ever notice something?
When the psych patient is in the psych office (or floor) and they act crazy, the default administrative attitude is to presume: "patient is crazy, psychiatrist is right".
But when it's in the ER, it's: "we have to presume that there's a legit complaint until we're convinced that there's not".

Eff you, admins.

 

[betamale]

https://www.cordem.org/resources/residency-program-openings/

Harvard with open spots? people just fed up with working in the hospital armpit or what

 

[southerndoc]

https://www.cordem.org/resources/residency-program-openings/

Harvard with open spots? people just fed up with working in the hospital armpit or what

They may have booted people out.

 

[CoolDoc1729]

EM is the new FM

IMGs have been duped

One of our PGY3 family practice rotators is graduating this year.

She’s excited to be doing an ER fellowship after graduation.

I was like WHY?!

I think she thought I was joking.

I guess at least she’s only wasting one year of attending salary and then she can still do FP.

 

[HemorrhagicShock]

Ya this was predictable. Programs still fill, quality of applicants goes down, next the pay will drop more. EM is in the ****ter, sorry dudes this sucks ass. For those in residency, consider your fellowship options, but be careful, critical care is next.

Critical care next? Tell me more...

I know the field is full of midlevels, and it's hospital-based, but it seems too complex and too high risk to let in a bunch of under-qualified candidates.

Also what about the variety of post-operative patients that need ICU-level care, and depend on CCU/TICU docs to manage since they're all busy operating?

Institutional outcomes and metrics also depend on a lot of (actual) high-quality critical care being practiced.

I'm very interested in whether critical care is at risk of going down the same path since it appears many EM residents are choosing to train in the subspecialty as a way to escape the perils of EM...

Very interesting hypothesis!

 

[BoardingDoc]

They may have booted people out.

People quit from the BWH and MGH programs with some frequency. I've spoken with several people that trained at either program and they have all said that on average, at least one person drops out of each class during training. Frequently it's to go into business or switch specialties. One time it was to go be an astronaut. I haven't heard about anyone getting booted out. That said, those programs do seem to select for people that don't actually want to be an ER doc. The want to use the pedigree to go be something else.

 

[Splenda88]

Critical care next? Tell me more...

I know the field is full of midlevels, and it's hospital-based, but it seems too complex and too high risk to let in a bunch of under-qualified candidates.

Also what about the variety of post-operative patients that need ICU-level care, and depend on CCU/TICU docs to manage since they're all busy operating?

Institutional outcomes and metrics also depend on a lot of (actual) high-quality critical care being practiced.

I'm very interested in whether critical care is at risk of going down the same path since it appears many EM residents are choosing to train in the subspecialty as a way to escape the perils of EM...

Very interesting hypothesis!

You don't think EM is complicated!

Radiology arguably is one of the most complex non surgical specialities is starting to get infiltrated by midlevels according to thread in the rad forum.

You think these people with the help of admins will stop!

There is a nurse in the step-down floor who just finished his online NP and he already got hired to work in our ED. I don't want be mean here by saying he is not a stellar RN. Our PD did not want to even hire him to do hospital medicine.

Every non surgical specialty except for pathology is fair game.

 

[TroutMD]

Wow, what a rabbit hole this AM. Was curious how the match went and what programs went unfilled. Ended up over here at SDN and I see that many of you are still the same. Haven’t seen many of these names in forever!!

 

[Siggy]

Critical care next? Tell me more...

I know the field is full of midlevels, and it's hospital-based, but it seems too complex and too high risk to let in a bunch of under-qualified candidates.

Also what about the variety of post-operative patients that need ICU-level care, and depend on CCU/TICU docs to manage since they're all busy operating?

I honestly thing that the high level post operative care is one of the best uses for the PLPs. The vast majority of post-op patients, like CABG patients, follows the same script... and it should be easy enough to key the surgeon in if a patient moves off the well trodded path.

That's different than the more generalist fields (primary care, EM, hospitalist, medical critical care) where each patient and presentation has a decent risk of either not being a standard presentation or having comorbidities that complicates the workup and management.

 

[the messenger]

Critical care next? Tell me more...

I know the field is full of midlevels, and it's hospital-based, but it seems too complex and too high risk to let in a bunch of under-qualified candidates.

Also what about the variety of post-operative patients that need ICU-level care, and depend on CCU/TICU docs to manage since they're all busy operating?

Institutional outcomes and metrics also depend on a lot of (actual) high-quality critical care being practiced.

I'm very interested in whether critical care is at risk of going down the same path since it appears many EM residents are choosing to train in the subspecialty as a way to escape the perils of EM...

Very interesting hypothesis!

You didn't ask me, but this is something I've been thinking about. The pressures I see in critical care to control cost and potentially reduce physician staffing are 1) hospital leadership not caring about census caps and instead adding mid-levels to cover the increased volume while maintaining the same number of intensivists, which will slow intensivist job growth even as ICUs increase their volume, and 2) the potential for the norm in community/rural ICUs to be run by in-house mid-levels with a virtual intensivist, similar to tele stroke. One virtual ICU doc can cover several community ICUs sitting in a call room, staffing admissions and providing remote guidance overnight. There will be even less jobs if this spills over into daytime coverage. This is obviously not the standard at tertiary referral centers but is happening in the more peripheral hospitals due to inadequate staffing. If its implementation becomes widespread before intensivists take jobs at these satellite hospitals, it can create a standard of care that will make it difficult for intensivists to financially justify creating in-house positions to hospital leadership, assuming outcomes remain the same.

There are some good opposing pressures for the first one. The goal is to finish rounds in the morning so that procedures, family meetings, discussion with consultants, and new admissions can be handled in the afternoon, so there will be a lot of pushback from intensivists if rounds routinely cuts into the afternoon due to higher volumes (at least in the places I've worked and trained). I imagine the threshold is also lower for bad press and bad outcomes in an understaffed ICU compared to an understaffed ED, where the majority of patients aren't critically ill. So I imagine as volumes go up with the aging population, staffing should increase. I don't see much slowing down virtual ICUs, though--nobody wants to work nights, and everyone wants to be close to a city. I could even see contracted vICU groups start popping up similar to those teleradiology groups. I shudder to think of private equity jumping into it. But even then, with virtual services they couldn't exploit the training pipeline for cheap resident labor as they did with EM. They could, however, market their cost savings to hospitals nationally and proliferate that way.

One potential problem I haven't seen is a ballooning phenomenon of fellowship programs in CCM like there was in EM by private equity staffed programs. The staffing landscape is a bit different in CCM, I'd like to think.

And I'd like to think in CCM we're not completely misleading trainees as to what it is--it's harder to hide from a resident what a fellowship specialty is like compared to a med student. The decision to go into CCM is a bit more resistant to the rose tinted med student glasses many of us wore as we went into EM.

I do see that staffing is getting saturated, though. The available positions will increasingly become further from the cities and/or nocturnist, assuming the hospital doesn't adopt overnight vICU coverage.

 

[Splenda88]

Critical care next? Tell me more...

I know the field is full of midlevels, and it's hospital-based, but it seems too complex and too high risk to let in a bunch of under-qualified candidates.

Also what about the variety of post-operative patients that need ICU-level care, and depend on CCU/TICU docs to manage since they're all busy operating?

Institutional outcomes and metrics also depend on a lot of (actual) high-quality critical care being practiced.

I'm very interested in whether critical care is at risk of going down the same path since it appears many EM residents are choosing to train in the subspecialty as a way to escape the perils of EM...

Very interesting hypothesis!

One of the PCCM doc was complaining the other day about job availability for intensivist where I work. He does not think midlevels are the issues. He actually thinks open ICU in most community hospital where hospitalists are managing a bunch of these patients is the issue.

I think he might be exaggerating things but could see where he is coming from since hospitalists manage more than half the of ICU patients where work.

We have been pushing them to close the ICU but our PD told administration would never do it because they would have to hire 2 new intensivists.

 

[alpinism]

Heh don't worry PE backed companies have started to come for ICUs too since COVID.

Sound has an entire Tele-ICU with NPs service they've been marketing to community hospitals.

Link: Critical to care: Telemedicine continues to bridge gaps in ICUs across the U.S. | Sound Physicians

 

[BoardingDoc]

Heh don't worry PE backed companies have started to come for ICUs too since COVID.

Sound has an entire Tele-ICU with NPs service they've been marketing to community hospitals.

Link: Critical to care: Telemedicine continues to bridge gaps in ICUs across the U.S. | Sound Physicians

I just told my wife about this. She literally started yelling what the f***, punctuated by a few moments of silence, followed by more "what the f***!"

I concur with her assessment of the situation.

 

[Splenda88]

EM is the new FM

IMGs have been duped

I just got a N =2

This person graduated in 2017 (I graduated in 2018). We were acquaintance as we were living in the same apartment complex and we used to carpool sometimes. His issue was he could not pass CS because his typing was horrible. He did pass step 1/2CK with no issue.

He matched a VERY good university program in NYC this year. I just don't want to say the name of the program. He was not out of medicine completely as he was practicing as an AP (Associate Physician) in Missouri for the last 2+ yrs.

I have a feeling that programs are starting to be weary of IMG from Asia because of the USMLE cheating scandal and are taking more chances on US students and IMG (not FMG) with some blemish on their applications.

For instance, my hospital has a small IM program and the other day I was talking to the PD about the USMLE cheating scandal. He told me there were 2 applicants they interviewed and they were very suspicious about them. These 2 applicants transcripts have multiple failure while both score 260+ in all the steps. Needless to say that they did not rank them.

Also, one of my best friends SOAPED into FM after multiple failures in CS/CK and step 3. He is an IMG from a Caribbean school.

 

[TooMuchResearch]

Heh don't worry PE backed companies have started to come for ICUs too since COVID.

Sound has an entire Tele-ICU with NPs service they've been marketing to community hospitals.

Link: Critical to care: Telemedicine continues to bridge gaps in ICUs across the U.S. | Sound Physicians

Holy ****

Tele-ICU + resident: Support, supervision, and training for residents in your hospital who care for critically ill patients.


Look you don't even need intensivists in your training program anymore.

 

[RustedFox]

I just got a N =2

This person graduated in 2017 (I graduated in 2018). We were acquaintance as we were living in the same apartment complex and we used to carpool sometimes. His issue was he could not pass CS because his typing was horrible. He did pass step 1/2CK with no issue.

He matched a VERY good university program in NYC this year. I just don't want to say the name of the program. He was not out of medicine completely as he was practicing as an AP (Associate Physician) in Missouri for the last 2+ yrs.

I have a feeling that programs are starting to be weary of IMG from Asia because of the USMLE cheating scandal and are taking more chances on US students and IMG (not FMG) with some blemish on their applications.

For instance, my hospital has a small IM program and the other day I was talking to the PD about the USMLE cheating scandal. He told me there were 2 applicants they interviewed and they were very suspicious about them. These 2 applicants transcripts have multiple failure while both score 260+ in all the steps. Needless to say that they did not rank them.

Also, one of my best friends SOAPED into FM after multiple failures in CS/CK and step 3. He is an IMG from a Caribbean school.

the ... what?

 

[Splenda88]

the ... what?

USMLE Finds Pattern of Suspicious Results From Nepal

Impacted examinees have had step 1, 2, and/or 3 examinations invalidated

www.medpagetoday.com

Judge Won't Overturn Invalidated USMLE Scores

Court documents reveal medical graduates from Nepal outperformed every country in the world on the USMLE and that examinee volume at Nepal's single test center tripled.

www.medscape.com

 

[RustedFox]

USMLE Finds Pattern of Suspicious Results From Nepal

Impacted examinees have had step 1, 2, and/or 3 examinations invalidated

www.medpagetoday.com

Judge Won't Overturn Invalidated USMLE Scores

Court documents reveal medical graduates from Nepal outperformed every country in the world on the USMLE and that examinee volume at Nepal's single test center tripled.

www.medscape.com

Thanks for the links.
The following is not an argument, or is any way pointed at you, bro:

Is anyone else sick of kids and their "reaction videos"? I can read. Give me an article. I don't want to watch two smug millennials give each other handies about a niche topic for 27 minutes. Grow up, virgins.

 

[DoctorMD1]

You don't think EM is complicated!

Radiology arguably is one of the most complex non surgical specialities is starting to get infiltrated by midlevels according to thread in the rad forum.

You think these people with the help of admins will stop!

There is a nurse in the step-down floor who just finished his online NP and he already got hired to work in our ED. I don't want be mean here by saying he is not a stellar RN. Our PD did not want to even hire him to do hospital medicine.

Every non surgical specialty except for pathology is fair game.

we pretty much have mid levels (in radiology) doing only simple procedures, like lp, thoras, arthrograms etc

 

[betamale]

we pretty much have mid levels (in radiology) doing only simple procedures, like lp, thoras, arthrograms etc

I 2nd that. I was a radiology resident once and we had Rad Techs w/ masters degrees who worked as RPAs and they did some procedures but I never saw them dictate any studies. But as with other non-radiologists like GI, Cards, Vasc, non-MDs also generated their own reports like podiatrists, dentists, speech pathologists...

 

[CoolDoc1729]

I know a surgical PA who is moonlighting doing prelim reads on neuro MRIs

 

[sylvanthus]

we pretty much have mid levels (in radiology) doing only simple procedures, like lp, thoras, arthrograms etc

For now.

 

[Janders]

I know a surgical PA who is moonlighting doing prelim reads on neuro MRIs

Whaaaat?!

I know some great surgical PAs, great use for PAs if they have an establish program with support, training, etc.

But they don’t know the ass end of a Neuro MRI from a hole in the ground. Hell, I consider myself a very excellent ED Doc-Radiologist, and MR skills are very primitive.

 

[Janders]

https://www.cordem.org/resources/residency-program-openings/

Harvard with open spots? people just fed up with working in the hospital armpit or what

I’d put cash the open spots are either:
(1) the outgoing residents ARE Harvard-smart, and found a new specialty early
or
(2) They are going to business/industry

I’ve interviewed a few new grads from that program for jobs. They very openly said they wanted a short-term 4-6 shift / month gig as they tried to get their private equity / biotech startup / weird foreign government funded mega-capitalist-non-clinical-thing going. Had significant scheduling needs/concerns (limited overnights d/t daytime business needs, etc). Anyway, not a good match for what we needed at the time…

 

[vm26]

Whaaaat?!

I know some great surgical PAs, great use for PAs if they have an establish program with support, training, etc.

But they don’t know the ass end of a Neuro MRI from a hole in the ground. Hell, I consider myself a very excellent ED Doc-Radiologist, and MR skills are very primitive.

MRI complicated?! C'mon man!...it's all just like different signal intensities/abnormalities on different sequences which need to be correlated with anatomy and patient history in order to produce some semi-useful clinical info etc

All joking aside, the whole mid-level encroachment seems to be grassroots effort locally at the state level, likely enabled by certain lobbies (HC systems, PE). Most physicians/people are simply unaware or wake up too late