Bored of EM

[SeekerOfTheTree]

So haven’t posted as actively as I would like in a while. The doom and gloom of ER is true and I am seeing it around me. I am lucky as I have had a unicorn gig here that had paid me really well and isn’t going to change in the foreseeable future. The problem is I have been doing this for awhile and I am really bored. Everyday coming to work I am so bored. Every shift I am just waiting for it to end. The money is good, I don’t work many hours at all. I work less than 130. What can I do to get some happiness back. I use to be one of those idiots that was like I can’t do anything but EM. I had good enough scores to pick any other specialty at the time. Now most shift I want to be left alone and just do my job. This leads me to my second question. Would you ever consider a second residency? Is that dumb? I was thinking radiology because it was something I liked. How hard would it be to go back or get into it. Just looking for some perspective. Maybe I am just crazy and need to chill. Just looking from input from others that might be in my shoes.

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[Crabbygas]

Anesthesia not EM but I could have pretty much written this exact same thing. Maybe it's a high quality problem being able to make good money doing something that isn't absolutely horrible. Doesn't matter. I am feeling the same lack of fulfillment. Some people would say just take the money and find a meaningful hobby. I hope that works for them. It won't for me. I would consider another residency butting getting too old and there's the risk that it wouldn't really be any better. I'm trying to come up with some other idea. If you figure something out let the rest of us know.

 

[Dr Mantis Toboggan]

So haven’t posted as actively as I would like in a while. The doom and gloom of ER is true and I am seeing it around me. I am lucky as I have had a unicorn gig here that had paid me really well and isn’t going to change in the foreseeable future. The problem is I have been doing this for awhile and I am really bored. Everyday coming to work I am so bored. Every shift I am just waiting for it to end. The money is good, I don’t work many hours at all. I work less than 130. What can I do to get some happiness back. I use to be one of those idiots that was like I can’t do anything but EM. I had good enough scores to pick any other specialty at the time. Now most shift I want to be left alone and just do my job. This leads me to my second question. Would you ever consider a second residency? Is that dumb? I was thinking radiology because it was something I liked. How hard would it be to go back or get into it. Just looking for some perspective. Maybe I am just crazy and need to chill. Just looking from input from others that might be in my shoes.

I feel you. What I have done a lot is focus on my procedures and try to learn new things as much as I can (hematoma blocks for trimalls, loop drains for abscess, difficult airway adjuncts, peripheral nerve blocks guided by U/S etc). It’s a broad enough field I find I can always learn something new to work on/practice. Hell even if it’s a slow procedure day sometimes I’ll start my own IVs and draw my own blood just to do something with my hands. Something about just pushing buttons really bores me as well. If I have an interesting CT or radiograph I’ll go look at it with the radiologist etc. Also a lot of my enjoyment at work comes from hanging out with the staff and my partners etc. being with friends is always somewhat enjoyable.

 

[SeekerOfTheTree]

Glad I’m not alone. I’ve tried traveling which helps a little but not much. Ive tried a ton of hobbies but it’s the work itself that I feel I don’t enjoy. To me it is like I am working at that drive thru flipping burgers. At least there you can say go to school and do X or Y and you will be happier to the drive thru worker. With medicine what is our it will get better if you do this. Doing that second residency seems tempting but god I hate residency

 

[hundreddaysoff]

So haven’t posted as actively as I would like in a while. The doom and gloom of ER is true and I am seeing it around me. I am lucky as I have had a unicorn gig here that had paid me really well and isn’t going to change in the foreseeable future. The problem is I have been doing this for awhile and I am really bored. Everyday coming to work I am so bored. Every shift I am just waiting for it to end. The money is good, I don’t work many hours at all. I work less than 130. What can I do to get some happiness back. I use to be one of those idiots that was like I can’t do anything but EM. I had good enough scores to pick any other specialty at the time. Now most shift I want to be left alone and just do my job. This leads me to my second question. Would you ever consider a second residency? Is that dumb? I was thinking radiology because it was something I liked. How hard would it be to go back or get into it. Just looking for some perspective. Maybe I am just crazy and need to chill. Just looking from input from others that might be in my shoes.

Have you looked into FIRE? Timeline/potential barriers?

I worked a lot more the past few years, like 150--180 hours/mo, because FIRE lit a, um, fire under my butt. I am very happy I put in that extra time as now I have a paid off house and no other real debt. I only need ~110 hours/mo and spend a lot more time w/ family.

If nothing else, working more might alleviate the boredom? 🙂

 

[emergentmd]

I have a Unicorn job with excellent pay, relaxed ER, slow paced, and bread and butter EM stuff. Every shift I leave where I am refreshed taking care of tap ins all day is a great day.

Past had shifts that was sick pts and codes after codes in the ER then run up to the floor and running more codes.

Trust me, any boring shifts is a great shift where you can go home refreshed. All fields get boring which is not bad. I catch up on to do lists and work on my other businesses when there are no pts to be seen.

Give me a day with zero procedures and bunch of healthy med pts over a busy day full of life/death procedures.

 

[Fox800]

I have a Unicorn job with excellent pay, relaxed ER, slow paced, and bread and butter EM stuff. Every shift I leave where I am refreshed taking care of tap ins all day is a great day.

Past had shifts that was sick pts and codes after codes in the ER then run up to the floor and running more codes.

Trust me, any boring shifts is a great shift where you can go home refreshed. All fields get boring which is not bad. I catch up on to do lists and work on my other businesses when there are no pts to be seen.

Give me a day with zero procedures and bunch of healthy med pts over a busy day full of life/death procedures.

I feel the same way. Current gig is 1-1.5 PPH, good coverage, good pay, nice patients. Mainly medical problems. Little trauma/peds/OB.

gonna be hard to go back to a typical busy/dumpster fire place.

 

[SeekerOfTheTree]

Have you looked into FIRE? Timeline/potential barriers?

I worked a lot more the past few years, like 150--180 hours/mo, because FIRE lit a, um, fire under my butt. I am very happy I put in that extra time as now I have a paid off house and no other real debt. I only need ~110 hours/mo and spend a lot more time w/ family.

If nothing else, working more might alleviate the boredom? 🙂

I have done the FIRE for past five years and set myself on the path pretty well. I could go down to 60 hours a month and be fine but my place has a bare minimum and I am pretty much there. Working is the problem for some reason. Showing up to work and trying to motivate myself to be remotely content doing the work lately seems to be the problem. It's all so boring. Regardless of the medical complexity of the patient it just seems like labs, imaging, procedure, admit...

I have a Unicorn job with excellent pay, relaxed ER, slow paced, and bread and butter EM stuff. Every shift I leave where I am refreshed taking care of tap ins all day is a great day.

Past had shifts that was sick pts and codes after codes in the ER then run up to the floor and running more codes.

Trust me, any boring shifts is a great shift where you can go home refreshed. All fields get boring which is not bad. I catch up on to do lists and work on my other businesses when there are no pts to be seen.

Give me a day with zero procedures and bunch of healthy med pts over a busy day full of life/death procedures.

The clock ticks so slowly on all these days when I have my shift. Its not that the day is slow, it's that the work feels like a drag. I have days where I am super busy vs dead days and both days I leave feeling the same as I came in. It just doesn't feel satisfying anymore. I stick to it because after spending this much time getting here I don't want to walk away from the invested time and the money to be made for the time sacrificed getting here. I wish it was easier for us to jump specialties like it is for NPs and PAs. Would be nice to do CC without doing another fellowship and giving up your income to be in training again.

In ten years I could have exit out of medicine but the problem is I will still be young and don't want to give up all that training and earning potential. At the same time I don't want to do another residency (3-4 years). What do I do? I am bored with EM. I am not sure how to fix this and get through atleast the next 10 years.

 

[HoosierdaddyO]

This is such a common situation. I would even consider myself to be in this situation from time to time along with plenty of colleagues. Besides up and quitting emergency medicine… is there a certain fellowship that you’d might enjoy. As opposed to redoing a whole new residency, maybe taking a year and redirecting your ER career to some other path might be useful. When I get like this I always think the grass is greener, I can assure you it’s not.

 

[deleted77919]

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[Birdstrike]

Glad I’m not alone. I’ve tried traveling which helps a little but not much. Ive tried a ton of hobbies but it’s the work itself that I feel I don’t enjoy. To me it is like I am working at that drive thru flipping burgers. At least there you can say go to school and do X or Y and you will be happier to the drive thru worker. With medicine what is our it will get better if you do this. Doing that second residency seems tempting but god I hate residency

I got the same way. So I did a second residency. It just happened to be the only 1 year “residency” I could find: Pain fellowship (interventional). Although it’s technically not a residency, it brings a skill set adequate to practice a completely new specialty, but in only 1 year.

The change didn’t completely eliminate boredom. My clinic days can be boring (procedure days are not). But it eliminated the chronic circadian rhythm dysphoria which made any boredom intolerable (I have Derm-hours now). Now, if I feel bored, it doesn’t distress me in any meaningful way. That makes Pain sustainable whereas EM was not for me.

That’s one thing about EM I didn’t realize fully until it was about 6 weeks since my last ED shift; that the chronic circadian-rhythm dysphoria bled into every waking moment of me non-working life, without me even realized it. So much so, that about six weeks post-EM, my wife said, “Your personality has changed since you left EM. You’re calmer, happier, and less argumentative. You seem content.” That’s held steady for 10 years. YMMV.

 

[emergentmd]

OP, I would bet 90% of the EM and most specialties would kill to have your job/work life. Most I know would kill for a good pay, good work environment, slow paced ER. I know I am much happier and just as fulfilled b/c I still make a difference in people's lives.

Resus of a GI bleed, reduce shoulder, or Bronchitis treatment still improved pts lives and they are just as thankful.

There is a reason people call work - work. Its to make money so you can enjoy life outside. But to enjoy life outside, work should not be stressful.

 

[Dr Mantis Toboggan]

OP, I would bet 90% of the EM and most specialties would kill to have your job/work life. Most I know would kill for a good pay, good work environment, slow paced ER. I know I am much happier and just as fulfilled b/c I still make a difference in people's lives.

Resus of a GI bleed, reduce shoulder, or Bronchitis treatment still improved pts lives and they are just as thankful.

There is a reason people call work - work. Its to make money so you can enjoy life outside. But to enjoy life outside, work should not be stressful.

You’re not wrong but his/her feelings are not invalid. My struggle is to be appropriately grateful without stuffing down/suppressing all my negative emotions regarding my work life in EM.

 

[namethatsmell]

@SeekerOfTheTree -- sorry you're going through this.

A question worth closely exploring is: what would make the work satisfying? And then ...is there a way to make this happen while staying employed at your current ED? Or while still staying in EM? Or do you need to move to a different area of medicine? Or leave clinical medicine to find what you're looking for?

It's pretty common for things professionally to get "boring" over time in many lines of work. Once you've learned the ropes at a given shop you can often turn on autopilot and feel like you're simply moving widgets down the line. Kinda like an air traffic controller. I know I've felt similarly in the past. Any of that ring true for you? If so, some things that have helped me along the way:

-adding in PRN shifts at a completely different type of shop which pushed me out of my comfort zone with new challenges and logistics and patient populations to keep things fresh

-focus on connecting, really connecting with 1-2 patients per shift. I'd intentionally sit and talk with a patient for 3-5 minutes longer than I'd "have to" and learn about their job, hobby, whatever etc. Corny as it may sound, it brought in a new dimension to my work day.

-appreciate the fact that a boring EM day...is in many ways an amazing thing. So much less draining this way and in many ways liberating because you can leave work at work. And it allowed me to be more present for the rest of my life when I wasn't at work--my wife still tells me this lol.

If need be, branching out into another field can be great, but I wouldn't make any moves until you know what it is you're looking to get out of it that you don't get with your current gig or can't find in EM in general. Once you have a few well-defined "wants" in a new job/field, have a way to make a potential transition work with your personal/family life, than jump in with both feet and go after it. There's no guarantee it'll be a slam-dunk, but nothing ventured, nothing gained. And far better to go for it than feeling trapped and always wondering "what if?" I ended up doing a fellowship and am happy I took that leap, but there are many roads that lead to Dublin. Be honest and kind with yourself, and you'll find yours.

 

[emergentmd]

You’re not wrong but his/her feelings are not invalid. My struggle is to be appropriately grateful without stuffing down/suppressing all my negative emotions regarding my work life in EM.

You are right. I understand there is dissatisfaction/unhappiness in all situations. I have no clue what stage they are in their life and I went through something similar as an early attending. I thought about switching to radiology and sounded like a great idea back then. Glad I never switched and with more wisdom, grateful I did not put myself/my family through this.

Just trying to send some wisdom b/c you definitely gain more when you get older.

 

[Franzd'Epinay]

I don't know you and only have your posts on this thread to go on, so take this opinion with a grain of salt.

That being said, it sounds like switching specialties would be the wrong move for you. You don't describe the typical reasons that make people leave the specialty--it seems to me that you are just bored of your routine. In 10 years you will be well into a new routine in radiology and then what? Will you do a third residency?

 

[GeneralVeers]

I'm super bored with EM too. I hate procedures now too. For years it's been widgets in a factory for me, which is fine, as most jobs people do are mind-crushingly repetitive. Now with the boredom comes the constant worry of job loss, salary decrease, and increasingly demanding patients who present for petty nonsense.

Hopefully if my significant other's main project works out I can put in my 90-day notice and just work my part time rural job.

 

[gamerEMdoc]

I definitely was there, 3 years out of residency. I didn't think I could do it anymore. Wasn't hard. Just bored by the cookie-cutter assembly line nature of the day to day aspect of the job. I actually wrote about it in EM news this past year. Here's an excerpt of what I had written:

"Ironically, it wasn't a bad case that nearly ended my EM career but the complete opposite. Three years after residency, I started to become bored. Seeing the same things over and over made me feel more like an assembly line worker than a physician. Even the sick patients became easier, and as the challenge left, I began to lose enjoyment.

The job also became much more socially isolating than it was in residency because you are just working. There's no attending or resident with whom to work. No weekly conference to get together and share stories. It's just you and the virtual chart rack. As the shifts went on over several months and I began to lose interest, I started getting more and more anxious about my career decision. Did I make a mistake? My anxiety ate at me, and I got more and more burned out, and I really thought my career in emergency medicine was on the brink of imploding only a few years out of residency.

But I loved my time in residency, and I desperately missed working within the social and academic structure of one, so my last hope was academics. It was something I had always wanted to do, but I couldn't because the Navy had other plans after residency.

At the height of my burnout, after my time with the U.S. Navy was up, however, I took a job in a residency program. Everything changed for me. I began to see cases through the eyes of a learner again. Working with residents and students rejuvenated me. I quickly moved up the academic food chain and got into program leadership. I can honestly say, eight years later, I still don't feel burned out. I still love to teach, learn, socialize, laugh, and challenge the residents and students on every shift.

Academics brought back my love of emergency medicine, and I will be forever grateful for that."

Here's a link to the article. I reference SDN in it. Haha.

First Person: Students and Residents Saved My Career, and I ... : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

 

[NicMouse64]

I definitely was there, 3 years out of residency. I didn't think I could do it anymore. Wasn't hard. Just bored by the cookie-cutter assembly line nature of the day to day aspect of the job. I actually wrote about it in EM news this past year. Here's an excerpt of what I had written:

"Ironically, it wasn't a bad case that nearly ended my EM career but the complete opposite. Three years after residency, I started to become bored. Seeing the same things over and over made me feel more like an assembly line worker than a physician. Even the sick patients became easier, and as the challenge left, I began to lose enjoyment.

The job also became much more socially isolating than it was in residency because you are just working. There's no attending or resident with whom to work. No weekly conference to get together and share stories. It's just you and the virtual chart rack. As the shifts went on over several months and I began to lose interest, I started getting more and more anxious about my career decision. Did I make a mistake? My anxiety ate at me, and I got more and more burned out, and I really thought my career in emergency medicine was on the brink of imploding only a few years out of residency.

But I loved my time in residency, and I desperately missed working within the social and academic structure of one, so my last hope was academics. It was something I had always wanted to do, but I couldn't because the Navy had other plans after residency.

At the height of my burnout, after my time with the U.S. Navy was up, however, I took a job in a residency program. Everything changed for me. I began to see cases through the eyes of a learner again. Working with residents and students rejuvenated me. I quickly moved up the academic food chain and got into program leadership. I can honestly say, eight years later, I still don't feel burned out. I still love to teach, learn, socialize, laugh, and challenge the residents and students on every shift.

Academics brought back my love of emergency medicine, and I will be forever grateful for that."

Here's a link to the article. I reference SDN in it. Haha.

First Person: Students and Residents Saved My Career, and I ... : Emergency Medicine News

An abstract is unavailable.

journals.lww.com

FYI, idk if you want everyone to know your true identity.....

 

[Porfirio]

Anyone with a unicorn job that is bored just PM me. Let’s trade - you will not be bored at my current place.

Hourly has to be $250 or more. I work 160+ hrs a month.

 

[emergentmd]

Doesn't every job become cookie cutter and monotonous after awhile. I trained in one of the busiest Gun/Knife clubs. I would guess my training was one of the busiest/sickest. We just didn't have an ER. We had a surgery ER separate from the medicine ER separate from the Psych ER separate from the OB ER and the Pedi ER across the walkway.

After residency, I did not want to see another trauma pt again. People think it is exciting but how is Undress, intubate, chest tube, central line, Pan scan, pan labs, IV fluids exciting? Its cookie cutter like everything else.

People always asks me that it must be stressful/exciting in the ER and I say I get very little excitement or stress from the job. I may see something remotely new or exciting once every 6 months.

I used to like procedures, now I avoid them like the plague b/c they are boring and puts me behind on my other pts. I am sure surgeons are the same. Other than money, why would you want to do the 100th gallbladder?

I just put a cargo rack carrier on my car last night and that was more exciting than anything I have done in the ER for the past year. Doubt I would be excited if this was my 100th rack installation.

 

[bravotwozero]

I work at some low volume places that people would get 'bored' at. However, I'm not, because I just find something else to occupy myself with in the meantime. Remotely getting errands done, CMEs, charting, important phone calls etc. I'll even squeeze in a workout if it's super slow. If it's busy, then I don't really have the time to be 'bored'. How is it possible for someone to be busy and be bored at the same time?

 

[Mount Asclepius]

I don’t think I’m as far along in my career as emergentmd, but have been doing this for a while. Emergentmd doesn’t seem to enjoy taking care of sick patients, and perhaps never did. The only aspect that sustains my interest in EM is the handful of critically ill patients I see every shift, or perhaps maybe even just that pretty good case I get every other month or so. I find a good critical care resuscitation invigorating. Some of them are boring, but far more interesting to me than the healthy patients. If EM was entirely the 70-80% of discharged worried well, I’d have quit and moved on to something else long ago. I don’t think I’d ever really enjoy working solely in a slower FSED, and I know because I do it occasionally. While I don’t do as many procedures as I used to (and no longer find the thousandth central line or intubation as exciting), I still also enjoy the variety procedures can occasionally add to a shift. EM is a wide tent that attracts people to the specialty for various reasons. See if you can find what attracted you to it in the first place and try to get back to that. The grass isn’t usually greener on the other side. I often feel similarly to the OP, but not sure another residency is the answer as I worry I’d ultimately end up back in the same place eventually with a few years of poorly compensated training and lots of extra work disrupting my family after they already made that sacrifice once. For now, I’ll stick with my fairly high acuity, busy hospital based shop and try to enjoy what I can about EM for as long as I can.

 

[SeekerOfTheTree]

There are a variety of fellowships that only take one year that can diversify your work life. Think pain, palliative, or undersea and hyperbaric medicine.

There’s an option to try to get a job in academics. Teaching residents provides some much needed intellectual stimulation for me.

Academics also tends to allow for more admin roles - here are some of the things my colleagues have done - head of medical informatics/IT,section chief, department chair, head of simulation, head of ultrasound for medical students, head of the transfer center. These admin jobs all come with clinical buy downs.

Best of luck getting out of your rut.

Thanks man. I did academics for a little and hated it. I think the IT and informatics side might be better but not really sure how to get into that.

 

[SeekerOfTheTree]

I work at some low volume places that people would get 'bored' at. However, I'm not, because I just find something else to occupy myself with in the meantime. Remotely getting errands done, CMEs, charting, important phone calls etc. I'll even squeeze in a workout if it's super slow. If it's busy, then I don't really have the time to be 'bored'. How is it possible for someone to be busy and be bored at the same time?

The work feels like being on autopilot. That's the problem. It's like when you go for a run; you're working hard but your mind is just on cruise control.

I don’t think I’m as far along in my career as emergentmd, but have been doing this for a while. Emergentmd doesn’t seem to enjoy taking care of sick patients, and perhaps never did. The only aspect that sustains my interest in EM is the handful of critically ill patients I see every shift, or perhaps maybe even just that pretty good case I get every other month or so. I find a good critical care resuscitation invigorating. Some of them are boring, but far more interesting to me than the healthy patients. If EM was entirely the 70-80% of discharged worried well, I’d have quit and moved on to something else long ago. I don’t think I’d ever really enjoy working solely in a slower FSED, and I know because I do it occasionally. While I don’t do as many procedures as I used to (and no longer find the thousandth central line or intubation as exciting), I still also enjoy the variety procedures can occasionally add to a shift. EM is a wide tent that attracts people to the specialty for various reasons. See if you can find what attracted you to it in the first place and try to get back to that. The grass isn’t usually greener on the other side. I often feel similarly to the OP, but not sure another residency is the answer as I worry I’d ultimately end up back in the same place eventually with a few years of poorly compensated training and lots of extra work disrupting my family after they already made that sacrifice once. For now, I’ll stick with my fairly high acuity, busy hospital based shop and try to enjoy what I can about EM for as long as I can.

That is the reality. I gotta stop thinking that the grass is greener. Just need to stop being bored.

Doesn't every job become cookie cutter and monotonous after awhile. I trained in one of the busiest Gun/Knife clubs. I would guess my training was one of the busiest/sickest. We just didn't have an ER. We had a surgery ER separate from the medicine ER separate from the Psych ER separate from the OB ER and the Pedi ER across the walkway.

After residency, I did not want to see another trauma pt again. People think it is exciting but how is Undress, intubate, chest tube, central line, Pan scan, pan labs, IV fluids exciting? Its cookie cutter like everything else.

People always asks me that it must be stressful/exciting in the ER and I say I get very little excitement or stress from the job. I may see something remotely new or exciting once every 6 months.

I used to like procedures, now I avoid them like the plague b/c they are boring and puts me behind on my other pts. I am sure surgeons are the same. Other than money, why would you want to do the 100th gallbladder?

I just put a cargo rack carrier on my car last night and that was more exciting than anything I have done in the ER for the past year. Doubt I would be excited if this was my 100th rack installation.

This is exactly what describes how I feel. I have done academics, locums, trauma centers, remote chart review crap...at the end of the day I am just very bored.

 

[SeekerOfTheTree]

I don't know you and only have your posts on this thread to go on, so take this opinion with a grain of salt.

That being said, it sounds like switching specialties would be the wrong move for you. You don't describe the typical reasons that make people leave the specialty--it seems to me that you are just bored of your routine. In 10 years you will be well into a new routine in radiology and then what? Will you do a third residency?

That's true. Thanks for putting it so nicely.

 

[SeekerOfTheTree]

I got the same way. So I did a second residency. It just happened to be the only 1 year “residency” I could find: Pain fellowship (interventional). Although it’s technically not a residency, it brings a skill set adequate to practice a completely new specialty, but in only 1 year.

The change didn’t completely eliminate boredom. My clinic days can be boring (procedure days are not). But it eliminated the chronic circadian rhythm dysphoria which made any boredom intolerable (I have Derm-hours now). Now, if I feel bored, it doesn’t distress me in any meaningful way. That makes Pain sustainable whereas EM was not for me.

That’s one thing about EM I didn’t realize fully until it was about 6 weeks since my last ED shift; that the chronic circadian-rhythm dysphoria bled into every waking moment of me non-working life, without me even realized it. So much so, that about six weeks post-EM, my wife said, “Your personality has changed since you left EM. You’re calmer, happier, and less argumentative. You seem content.” That’s held steady for 10 years. YMMV.

I think the circadian-rhythm dysfunction does play a role into some of this for me. It definitely changes your personality. I didn't realize this as a younger man but I definitely do as a middle aged one.

 

[emergentmd]

I don’t think I’m as far along in my career as emergentmd, but have been doing this for a while. Emergentmd doesn’t seem to enjoy taking care of sick patients, and perhaps never did. The only aspect that sustains my interest in EM is the handful of critically ill patients I see every shift, or perhaps maybe even just that pretty good case I get every other month or so. I find a good critical care resuscitation invigorating. Some of them are boring, but far more interesting to me than the healthy patients. If EM was entirely the 70-80% of discharged worried well, I’d have quit and moved on to something else long ago. I don’t think I’d ever really enjoy working solely in a slower FSED, and I know because I do it occasionally. While I don’t do as many procedures as I used to (and no longer find the thousandth central line or intubation as exciting), I still also enjoy the variety procedures can occasionally add to a shift. EM is a wide tent that attracts people to the specialty for various reasons. See if you can find what attracted you to it in the first place and try to get back to that. The grass isn’t usually greener on the other side. I often feel similarly to the OP, but not sure another residency is the answer as I worry I’d ultimately end up back in the same place eventually with a few years of poorly compensated training and lots of extra work disrupting my family after they already made that sacrifice once. For now, I’ll stick with my fairly high acuity, busy hospital based shop and try to enjoy what I can about EM for as long as I can.

Yeah I have done this for 20 yrs and always love the job, still loved my job to the last day in the hospital. I think I enjoy it more due to the people I get to work with, relationships you build, control over medical decisions, and helping people. More the people than actual patient care.

I never thought I would leave the hospital but once I got my new gig, there was no way I wanted to go back for a pay cut. What I didn't enjoy was admin control, metrics, rules detrimental to the provider/pts, and segregation of job security. Add on that noncompliant pts, violent patients, short/revolving door nursing staff with zero control in your environment. Even with this I still enjoyed the job.

Now I get to control patient medical decision making without metrics and admin control, compliant pts that are more appreciative, and a staff that almost never turn over. I get to sit down and actually get to know the staff. They are essentially family now. I think we lost 2 full time staff in the past 3 years.

 

[emergentmd]

The work feels like being on autopilot. That's the problem. It's like when you go for a run; you're working hard but your mind is just on cruise control.


That is the reality. I gotta stop thinking that the grass is greener. Just need to stop being bored.


This is exactly what describes how I feel. I have done academics, locums, trauma centers, remote chart review crap...at the end of the day I am just very bored.

I have essentially done it all too and look at it as work that pays the bills so I can provide for my family, work less, and be home for the kids.

I too have done admin, trauma, rural, community, chart review, telemedicine, medical director, MEC, Q&A committee. I was offered a National CMO CMG Job a few years ago and VP status which is probably the only thing I have not done. Now that would have been a job I would have hated.

 

[GeneralVeers]

I think the circadian-rhythm dysfunction does play a role into some of this for me. It definitely changes your personality. I didn't realize this as a younger man but I definitely do as a middle aged one.

It absolutely does. I've been switched non-voluntarily to night shifts the past 2 months, my old shift was always a 3PM-11PM shift, and it's accelerated my burnout and discontent by a factor of 1000. If they put me on nights again in August, I will likely give my resignation.

I worked nights only for 5 years, and it burned me out. The only reason I did it was I got to pick the number of shifts, and dates I worked. Now I'm stuck on nights and have none of that control.

Note to directors: Put people on nights involuntarily at your own risk. You will enhance their burnout and exacerbate existing personality issues.

 

[BoardingDoc]

It absolutely does. I've been switched non-voluntarily to night shifts the past 2 months, my old shift was always a 3PM-11PM shift, and it's accelerated my burnout and discontent by a factor of 1000. If they put me on nights again in August, I will likely give my resignation.

I worked nights only for 5 years, and it burned me out. The only reason I did it was I got to pick the number of shifts, and dates I worked. Now I'm stuck on nights and have none of that control.

Note to directors: Put people on nights involuntarily at your own risk. You will enhance their burnout and exacerbate existing personality issues.

I'm sorry what? They just made you a nocturnist without any say in the matter?

 

[GeneralVeers]

I'm sorry what? They just made you a nocturnist without any say in the matter?

For May and June yes. July is better, and hopefully it doesn't extend past that. As I've stated before the group is actively trying to get rid of the lowest seniority docs, so giving them worse schedules can accomplish that.

 

[emergentmd]

I voluntarily did a nocturnist stint for one summer thinking it would give me schedule flexibility and more time with the kids. It gave me flexibility, worked less shifts, and had more POOR quality time with the family. A year of that and my kids would not want to be around me. Talk about a zombie.

 

[alpinism]

To be honest I feel like almost everyone starts to get bored within a few years after finishing residency.

I made a deal to work all nights in exchange for working all my shifts in the critical care section.

 

[Mount Asclepius]

Yeah I have done this for 20 yrs and always love the job, still loved my job to the last day in the hospital. I think I enjoy it more due to the people I get to work with, relationships you build, control over medical decisions, and helping people. More the people than actual patient care.

I never thought I would leave the hospital but once I got my new gig, there was no way I wanted to go back for a pay cut. What I didn't enjoy was admin control, metrics, rules detrimental to the provider/pts, and segregation of job security. Add on that noncompliant pts, violent patients, short/revolving door nursing staff with zero control in your environment. Even with this I still enjoyed the job.

Now I get to control patient medical decision making without metrics and admin control, compliant pts that are more appreciative, and a staff that almost never turn over. I get to sit down and actually get to know the staff. They are essentially family now. I think we lost 2 full time staff in the past 3 years.

Fair. I enjoy the interactions with the people I work with often just as much as the job itself. I enjoy the nuances of complex medical care though more than the majority of patient interactions. As @RustedFox has said (paraphrasing), the problem with medicine is the patient. Perhaps surgery or radiology would have been better fits for me, although I needed the variety more than the monotony. Also my younger self was a bit naive to my older self’s interests instead being overtaken by the hot ride EM appeared to be as a premed and med student. I connect with a patient or two most shifts, but I don’t enjoy the majority of patient interactions. The great work relationships with colleagues, nurses and staff on the other hand make shifts better.

To be honest I feel like almost everyone starts to get bored within a few years after finishing residency.

I made a deal to work all nights in exchange for working all my shifts in the critical care section.

Agree. I also made the same compromise in order to tailor the job to my preferences.

 

[Kryptocoin]

Find a new challenge. I'm exploring new avenues outside of medicine.


As doctors, we are Type A and goal oriented. Premed-->med school-->residency--->attending----> then what? Nothing else to look forward to. The FIRE movement is just an escapist hobby and not a true outlet.

Finding a new challenge can be going back to school, learning a new skill, opening up a business, fitness coaching etc. Stay away from daytrading though. You'll lose all your money and back to working nights.

 

[DeadCactus]

People in medicine are goal oriented and frankly probably have some underlying personality disorder that leads to discontentment. I don't say that to disparage us but there is something in our personalities that makes us so unsatisfied with what we could have had with just an undergraduate degree or trade school that we push forward through over a decade long endeavor. The point is EM has no inherent outlet for that part of our personality. There is no practice to build, no relationship with a community to develop, no increasing responsibility, no new challenges. You have to find that next professional goal that's worth it for you whether that is in EM, in some other area of medicine, or in a new pursuit.