Does anyone know what Las Vegas EM is like?

[Professor Deej]

I was thinking about settling down in Las Vegas after completing my residency. Can anyone offer any insight into the craziness that is Las Vegas? Pros and cons?

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[docB]

Vegas is a tough market. There are really only three groups in town. Medicine in Vegas is pretty dysfunctional. It is totally dependent on the EDs. For example all dialysis issues of any kind are routed through the ED. Direct admits are almost unheard of. The clinics fill the EDs every day at 4 and patients hold in the EDs forever. Specialty call is poor and transfers are difficult.

On the plus side the money is good and even though the cost of living is higher than it used to be it's still better than other places (particularly CA).

 

[GeneralVeers]

I was thinking about settling down in Las Vegas after completing my residency. Can anyone offer any insight into the craziness that is Las Vegas? Pros and cons?

As said by DocB it's not for everyone. If you want a lot of specialty support then it's not for you. If you want patients who participate in their own care it's not for you.

The pay is pretty good (relative to SoCal) and the cost of living is absurdly low at the moment with no state income tax, and bargain house prices.

 

[eagledriver]

How is the residency training there at UMC?

 

[Shorti3181]

I agree wholeheartedly with the above posts. Vegas is definitely a tough market in a very dysfunctional system. That being said, it's not a bad place to live given the 330 days of sunshine, low cost of living w/ no state income tax, and the fact that everyone comes to visit.

Having completed the residency program in Vegas, I can say it's a solid program. It's small, and still new, but certainly a standout program. As mentioned, you don't have much specialty support which actually enhances the learning environment. UMC is a county hospital, but support staff is good in the ED, even though the hospital is poor. Overall a great training program that I endorse and would certainly choose again.

 

[GeneralVeers]

As an attending who often works with the UMC residents I can say that their program is average. Certainly not stand-out, but they get decent training. My impressions are that the residents are not pushed as hard as they need to be by faculty to pick up patients, and many of the ones who rotate with us in their 2nd year are lacking in some core areas.

Still, the program is new, developing, and a great alternative for people who want to live in the CA/NV area.

 

[TrumpetDoc]

The above sounds spot on as for the EM life here. I have friends in other markets that have completely different lives.

As far as training there at UMC. As with any program it is an individual choice. You will get ALoT of serious pathology and manage a lot of really sick people from day one an throughout. The didactic program is pretty vigorous. There is definitely enough to see there.
The residency has a particular characteristic in that it is linked to a corporate EM group and does not have sovereign immunity like a lot of pure academic programs, hence the lack of total autonomy.
But the training opportunities are solid.

 

[EM_Rebuilder]

In Vegas, are there slot machines in the waiting room? Kind of like at the airport....?

Seems like it would help offset health care costs. We could do a study that I bet would show that the self pay are more likely to spend money in said slot machine...

 

[GeneralVeers]

In Vegas, are there slot machines in the waiting room? Kind of like at the airport....?

Seems like it would help offset health care costs. We could do a study that I bet would show that the self pay are more likely to spend money in said slot machine...

I have suggested this frequently but keep getting turned down. Our hospital is technically Catholic and it is "against our philosophy".

 

[docB]

In Vegas, are there slot machines in the waiting room? Kind of like at the airport....?

Seems like it would help offset health care costs. We could do a study that I bet would show that the self pay are more likely to spend money in said slot machine...

No. The gamble in Vegas is with primary care.

 

[GeneralVeers]

There's primary care in Vegas?

 

[Professor Deej]

Thanks guys.

Another question:
Would you discourage new doctors from coming there like i've known a lot of CA docs to do?

And do you feel that the patients are any better or worse since most of them are probably plastered tourists?

 

[GeneralVeers]

Thanks guys.

Another question:
Would you discourage new doctors from coming there like i've known a lot of CA docs to do?

And do you feel that the patients are any better or worse since most of them are probably plastered tourists?

I wouldn't discourage anyone. Most of our patients are not tourists. The typical patient is a low-skilled worker (usually stripper, or cocktail server, or bartender) who has no primary care access, and no ability to follow-up as an outpatient. There is also an exceedingly high number of narc-seekers, as you would expect in a town full of debauchery.

 

[morbo]

It really depends on the part of town. Along the main part of the city you see a lot of the more typical stress-related cardiac stuff, but in my experience most of the trauma is outside the main city where you don't really want to live anyway...

 

[EctopicFetus]

Arizona like most places isnt for everyone.

 

[GeneralVeers]

Just out of curiosity, why not Arizona? Cost of living is similarly low, although we do have income tax. Climate is similar, if not identical. Can't speak to the dysfunctionality of the system, but I know I've been direct admitted to PHX hospitals before.

I would have no problem with Arizona, though the state tax makes it less attractive. Also there's no comparison between Phoenix and Las Vegas for recreational opportunities.

 

[Professor Deej]

I wouldn't discourage anyone. Most of our patients are not tourists. The typical patient is a low-skilled worker (usually stripper, or cocktail server, or bartender) who has no primary care access, and no ability to follow-up as an outpatient. There is also an exceedingly high number of narc-seekers, as you would expect in a town full of debauchery.

Oh..that makes sense. Thanks.

What about autonomy over your schedule? I'm more of a night owl, and I would prefer to work 2-3 night shifts/week.

 

[EM_Rebuilder]

Oh..that makes sense. Thanks.

What about autonomy over your schedule? I'm more of a night owl, and I would prefer to work 2-3 night shifts/week.

I know nothing about Vegas Emergency Medicine, but typically a commitment to all night shifts may indeed give you a slight edge/advantage to landing a position regardless of the location you are looking...

 

[Reiko Rekceat]

On their website it states that they accept either comlex or usmle. Safe to assume DO friendly? Safe to assume comlex is all you need as in no usmle to get your foot in the door?

 

[Fox800]

On their website it states that they accept either comlex or usmle. Safe to assume DO friendly? Safe to assume comlex is all you need as in no usmle to get your foot in the door?

Considering the fact that EM is getting more and more competitive every year, forgoing the USMLE Step 1 and 2CK and applying ACGME EM would be a pretty foolhardy thing to do.

 

[Birdstrike]

I read this title as "Does anyone know what Lisa Vegas is like?" I was going to answer, but...

 

[GeneralVeers]

Their last program director of 5+ years was a DO (Epter) so that is why they were DO friendly. It's a good program in general, but you get a lot of hand-holding and not a lot of autonomy in the ED. Things in Vegas are looking to expand as we're finally on the verge of getting our own medical school, and additional residency programs.