EM Future

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Members do not see this ad.
skougess said:
First off, nobody blamed med students for this problem.

Second, any US MD/DO who passed their classes/steps and isn’t full blown autistic will eventually find a spot in some specialty somewhere. I feel terrible for those people who didn’t match, but they will still eventually find a spot as an attending if their expectation match reality. To say the solution is expand residencies to an unsustainable level (i.e. so they won’t have a job, or will have a terrible one after the grueling years of residency), I think it’s fair to say that is a misguided thought in a moment of frustration.
Click to expand...
Agreed on all counts.

I don't think anyone here wants residency spots to expand unchecked. But most of us also have the emotional intelligence required to not call med students who just went through the match "snowflakes".

I guess, to use your language, even "full blown autistic" people can come out the other end of the process just fine and on time to kick med students while they're down.
 
Franzd'Epinay said:
Agreed on all counts.

I don't think anyone here wants residency spots to expand unchecked. But most of us also have the emotional intelligence required to not call med students who just went through the match "snowflakes".

I guess, to use your language, even "full blown autistic" people can come out the other end of the process just fine and on time to kick med students while they're down.
Click to expand...
Fair. But again that wasn’t me that posted about med students in the first place.
 
bravotwozero said:
If HCA is opening up EM programs, what is to stop them from starting a urology, plastics, FM, derm, or ortho program? Or fellowships?
Click to expand...
Even if they open new FM programs they can’t harm existing FM doctors you can’t just fire a FM doctor. The patients follow the doctor, they want to be seen by a particular doctor that they trust. They want the continuity of care.
 
Last edited:
Franzd'Epinay said:
Yeah, let's take out our frustrations on the med students who just went through match week and either didn't match or have close friends who didn't match. They are definitely to blame for the increase in medical school seats and HCA residencies.

I bet you're the type of person who complains about kids who received participation trophies. Yes, the kids are definitely to blame there.
Click to expand...

Should every med student get the exact spot they want? Pretty simple. Should we open 2000 IR spots? Another 2000 derm spots? Why don't we just expand slots at harvard. 500 people per IM class.


Use your brain.
 
Franzd'Epinay said:
"Why would medical students who don't match (or who have friends who don't match) complain? Don't they realize that my depressed wages are more important than their ability to get licensed and practice medicine? Why can't they take one for the team and go into crushing debt without the ability to pay it back so that I can make $400/hr?"

Yeah, they're the snowflakes...
Click to expand...

That just doesn't make sense. If you are one of the 6.3% US MD graduates that didn't match in 2021 (which has been the same every single y ear, historically 6% of US MD don't match), then chances are very very high that it was due to an issue that was within your control and not the fault of the 'system'.
 
wamcp said:
That just doesn't make sense. If you are one of the 6.3% US MD graduates that didn't match in 2021 (which has been the same every single y ear, historically 6% of US MD don't match), then chances are very very high that it was due to an issue that was within your control and not the fault of the 'system'.
Click to expand...
Should we create a path so at least some of these people can still practice medicine? The AP license

One of my friends (AMG) failed to match for the 3rd time, albeit he has a few red flags (had to take both step 1 and step 2 twice). It's pailnful to watch.
 
Splenda88 said:
Should we create a path so at least some of these people can still practice medicine? The AP license

One of my friends (AMG) failed to match for the 3rd time, albeit he has a few red flags (had to take both step 1 and step 2 twice). It's pailnful to watch.
Click to expand...
As painful as that is to imagine, should a person who has proven a pattern of not being able to pass step exams be allowed to practice medicine? I’m not sure his failure to match is a failure of the system.
 
skougess said:
As painful as that is to imagine, should a person who has proven a pattern of not being able to pass step exams be allowed to practice medicine? I’m not sure his failure to match is a failure of the system.
Click to expand...

Should someone who shadows a random doc in a random clinic for 500hours and do no residency practice medicine?
 
skougess said:
As painful as that is to imagine, should a person who has proven a pattern of not being able to pass step exams be allowed to practice medicine? I’m not sure his failure to match is a failure of the system.
Click to expand...
Not sure about that. People (NP/PA) who arguably are less qualified than him are practicing medicine. I am not advocating for him to have an unrestricted license, but he should be able to 'practice' medicine in some capacity.

I think physicians are shooting themselves in the foot on that one...
 
Splenda88 said:
Not sure about that. People (NP/PA) who arguably are less qualified than him are practicing medicine. I am not advocating for him to have an unrestricted license, but he should be able to 'practice' medicine in some capacity.

I think physicians are shooting themselves in the foot on that one...
Click to expand...
So someone who failed in the process of becoming a physician is more qualified to practice medicine than someone who excelled in a PA/NP program? Sorry....Medicine is medicine. Maybe if they passed a PA-style board exam I might feel more comfortable with that. Our (PA) national board exam is based on step 2/3 USMLE so if they failed those they would probably fail ours as well.
 
Did anyone read the article by the ACEP clown?

So many questions: what is "paramedicine"?
Paranormal medicine?

Away from "brick and mortar"? This isn't retail sales. A physical exam is pretty critical to what we do.

How high is this guy?
 
Emedpa said:
So someone who failed in the process of becoming a physician is more qualified to practice medicine than someone who excelled in a PA/NP program? Sorry....Medicine is medicine. Maybe if they passed a PA-style board exam I might feel more comfortable with that. Our (PA) national board exam is based on step 2/3 USMLE so if they failed those they would probably fail ours as well.
Click to expand...
Excelled in NP program! You can not be serious! Have you look at these programs? I was a RN. These programs are part of the reason I decided to go to med school.

I don't know about PA board to be honest, but I have a hard believing it's as hard as step1/2/3 even if it is based on step2/3. If you don't believe that someone who attended US med school that has 3000+ clinical hours is more qualified than someone who attended University of Phenix online, I don't think there is anything I can say to convince you.
 
Splenda88 said:
Excelled in NP program! You can not be serious! Have you look at these programs? I was a RN. These programs are part of the reason I decided to go to med school.

I don't know about PA board to be honest, but I have a hard believing it's as hard as step1/2/3 even if it is based on step2/3. If you don't believe that someone who attended US med school that has 3000+ clinical hours is more qualified than someone who attended University of Phenix online, I don't think there is anything I can say to convince you.
Click to expand...
Fine. Take NP out of the mix. That is another ball of wax entirely. Our PA exam is not USMLE, but it isn't a walk in the park either. Florida used to allow FMGs to take it(Ancient history at this point) . Guess what? They ALL failed. 100% of them.
Here is another option:
azure.edu

Foreign MD to RN Program to Start working in Medical Profession

To mark your feet in the medical profession, you need to take up the foreign MD to RN program at the Azure College. Learn more about it. Contact us now!
azure.edu azure.edu

Even the AAFP is concerned about the assistant physician concept:
www.aafp.org

Study Reveals Troubling Test Scores of Assistant Physicians

Researchers found that a new category of medical licensure in Missouri drew individuals with lower pass rates on standard licensing exams and did not adequately address the problem of medically underserved areas.
www.aafp.org www.aafp.org
 
Last edited by a moderator:
Emedpa said:
Fine. Take NP out of the mix. That is another ball of wax entirely. Our PA exam is not USMLE, but it isn't a walk in the park either. Florida used to allow FMGs to take it(Ancient history at this point) . Guess what? They ALL failed. 100% of them.
Here is another option:
azure.edu

Foreign MD to RN Program to Start working in Medical Profession

To mark your feet in the medical profession, you need to take up the foreign MD to RN program at the Azure College. Learn more about it. Contact us now!
azure.edu azure.edu

Even the AAFP is concerned about the assistant physician concept:
www.aafp.org

Study Reveals Troubling Test Scores of Assistant Physicians

Researchers found that a new category of medical licensure in Missouri drew individuals with lower pass rates on standard licensing exams and did not adequately address the problem of medically underserved areas.
www.aafp.org www.aafp.org
Click to expand...
That's what the AP license was created for... It's mostly for people who could not get into residency because of red flag(s) on their application (eg., failing boards etc...). It's not for people who got 240+ on the steps. Not surprised by the AAFP article; they have stake in the game.

I have no issues with PA as there are standards to PA school and the PA profession. My problem is with NP. As I said, I was (or am) a RN and it takes a lot for a nurse who was making 45-50k/yr working 2 days/wk (24 hrs) to go to med school since NP would have made a lot more sense financially.
 
skougess said:
Man screw this guy. Talking about job fairs as a fix to the job market. Yes, definitely, the problem right now is that physicians and employers just can’t find each other!
Click to expand...
He is a dildo. If he says anything other than everything is awesome and the future is bright then he would actually have to do something to address the disaster that is going on. Much easier to suck the CMG **** and get that diamond sponsorship and shrimp tower. F him.
 
RustedFox said:
Did anyone read the article by the ACEP clown?

So many questions: what is "paramedicine"?
Paranormal medicine?

Away from "brick and mortar"? This isn't retail sales. A physical exam is pretty critical to what we do.

How high is this guy?
Click to expand...
The article overall shows how delusional ACEP leadership is.

The first and foremost issue is regarding the propaganda put out by midlevels that they fill the void in rural environments where physicians don't want to work. Yes, because of course every single midlevel that graduates from the University of Phoenix is really excited about the prospect of living in the middle of nowhere. The current job situation has shown that new residency grads are having difficulty finding work even in rural communities, so I think it's pretty dumb for physicians to support midlevels as saints for working in rural areas. And furthermore, the majority of midlevels don't want to live in the sticks, they want to live in Denver or Portland like everyone else, but those markets were saturated by physicians for decades and so they went elsewhere historically and realized they could market themselves as "defenders of rural America".

The comment on paramedicine was somewhat odd. I'm not sure if he's referring to community paramedicine AKA Mobile Integrated Healthcare, which is an offshoot of EMS where a patient calls 911 because they have asymptomatic hypertension. The medic makes them take their home BP med, or their insulin, or their lasix, or whatever and then goes back and checks up on them to keep them out of the hospital. I know there's multiple different variations of these types of programs, some aimed to keep system abusers out of the ED, others to help those with substance use/psychiatric issues etc find some help. I overall support these programs because they are patient centered and reduce my burnout from having to see that kind of crap in the ED.

But yes, I think if this joker believes that transitioning away from emergency department AKA brick and mortar based care to telehealth, community paramedicine, etc is going to save our specialty and the collapsing job market he's definitely missed the mark.
 
wamcp said:
That just doesn't make sense. If you are one of the 6.3% US MD graduates that didn't match in 2021 (which has been the same every single y ear, historically 6% of US MD don't match), then chances are very very high that it was due to an issue that was within your control and not the fault of the 'system'.
Click to expand...

1.
Even if someone fails to match due to circumstances completely under their control, are they not allowed to complain or vent their frustrations? If a Neurosurgery resident complains about being sleep-deprived, is the best response really something along the lines of "suck it up, snowflake, you knew what you got yourself into"?

2.
Putting aside the issue of students complaining or being "snowflakes", you bring up the role of the "system", which I think is actually a really interesting line of thinking (which you just sort of ignored):

Saying that 6% of people didn't match and that number has been stable for a while doesn't really address the health of the system. Let's put aside the people who apply poorly (e.g., someone who has really low step scores but shoots for Derm), because eventually those people likely make it into a residency program better suited to their competitiveness.

Is it reasonable to expect that someone who graduates from a US medical school should be capable of practicing medicine competently? I would say yes. If schools are graduating people who they know are incapable of practicing medicine, then that would definitely qualify as a system problem.

Is it reasonable to expect that someone deemed capable of practicing medicine should have the opportunity to become licensed and then practice medicine? I would also say yes. Obviously you will never have a perfect 1:1 ratio of capable graduates to residency spots, but from a societal standpoint, it would be ideal to get this as close to even as possible. Is 94% as close as possible as we can get it? Maybe; I don't know, it does seem like it could be a bit higher.

In any case, someone saying that a 6% unmatched rate is a system problem seems not unreasonable to me. We could 1) be graduating students who should not be graduating, 2) be matriculating too many students, 3) not have enough residency spots, or 4) any combination of the above. Before I get straw-manned again, my personal feeling is that IF we are to consider this a systems issue, then it is due to a combination of 1 and 2, NOT 3.
 
GeneralVeers said:
What's he going to say? These guys of course know what the problem is, yet they are beholden to their CMG "Diamond donors" and can't rock the boat.
Click to expand...
Did anyone else notice this gem in the follow-up article:

"I’m not sure what a contract management group is. So I can’t say that it’s good or bad because I don’t even know what it is."
 
Emedpa said:
So someone who failed in the process of becoming a physician is more qualified to practice medicine than someone who excelled in a PA/NP program? Sorry....Medicine is medicine. Maybe if they passed a PA-style board exam I might feel more comfortable with that. Our (PA) national board exam is based on step 2/3 USMLE so if they failed those they would probably fail ours as well.
Click to expand...
"I practice healthcare"
 
turkeyjerky said:
Did anyone else notice this gem in the follow-up article:

"I’m not sure what a contract management group is. So I can’t say that it’s good or bad because I don’t even know what it is."
Click to expand...
1616337132729.png
Rosenberg with the cmgs
 
Franzd'Epinay said:
This honestly should be a thread on its own. What a joke.
Click to expand...
Reality is the interviewer should have followed up with names. Envision usacs team Schumacher app. But the interviewer lacks balls. Wants to be on the acep teat
 
miacomet said:
Pain is great.
Do EMS, aerospace, and CCM have job options?
Click to expand...
I'm finishing up EMS fellowship this year. I applied to only academic places, because I was begrudgingly accepting of less money for slightly more job stability compared to working for TeamHealth/Envision/USACS. I would say as a fellowship trained graduate in the academic world, I had a leg up above the competition. However, I think if I applied in the CMG dominating community practice world, nobody would have cared about further fellowship training. The really competitive and desirable SDGs sure as heck don't even care about fellowship training either.

Can't comment on aerospace since it seems like a real niche area. In terms of CCM, can definitely confirm that friends/colleagues who went that route are having a very difficult time finding jobs, especially if they are looking for dual EM/CCM appointments. In a sense it almost seems more competitive and challenging because you often require two separate groups/departments at one site to hire you on for your respective practice in each specialty.
 
Emedpa said:
So someone who failed in the process of becoming a physician is more qualified to practice medicine than someone who excelled in a PA/NP program? Sorry....Medicine is medicine. Maybe if they passed a PA-style board exam I might feel more comfortable with that. Our (PA) national board exam is based on step 2/3 USMLE so if they failed those they would probably fail ours as well.
Click to expand...
Dude the PANCE is a joke. I could pass that after a moderate happy hour.
 
You know why many people go into administration and take high profile EM-organization leadership jobs?

Because they hate working EM shifts as much or more than anyone else. It cuts their clinical shifts to near zero. Then they can pretend they care about someone else's problem. It's their way of 'getting out' and the only difference between us on this thread and them, is they're afraid to admit it. They're trying to keep up a certain social image within EM. They can remain the EM poster boy, while others get branded with the 'burnout' label.

They have no intention of ever "fixing" EM. If they were going to make any meaningful effort to fix EM, they'd have to lead a massive, outsider Rebel Force push against all things EM-Establishment and they know the likely end result is that the aligned forces would destroy them and any last chance of them riding out their last few years to save enough money to retire.
 
GeneralVeers said:
I'm writing a complaint letter to ACEP pointing out how stupid he is. I think we all should.
Click to expand...
It's too bad ACEP isn't doing on site conferences right now. That would be a perfect target for disaffected EPs and new grads to wreak havoc.
 
sylvanthus said:
My wifes a PA, doesnt currently work, when she recerts, she studies for a couple weeks and passes without a problem. Pretty sure USMLE is far harder.
Click to expand...
If it was hard then it would be difficult to churn out scores of marginally qualified "providers".
 
I do think we should write letters to acep. That’s a great idea. Those idiots might not realize the degree of tone deafness exhibited.
 
I suspect acep wouldnt care. What will prob happen is they will start paying some attention to the issues when EMRA members are having issues finding jobs and bring it up at council. Until then, I doubt it would matter how many letters we write.
 
GeneralVeers said:
If it was hard then it would be difficult to churn out scores of marginally qualified "providers".
Click to expand...

in the past id do what I could to support PAs, after all they are far better trained than NPs, have a legit exam, have national standards, etc.

That all ended with the push for independence and name change.

Now im against all midlevels, period. When my future job prospects are on the line because midlevels want to play doctor and be independent, the gloves are off.
 
Another incredible quote from that article:

And you know what? Many of my colleagues and friends who “sold out” to some of these larger groups, whether they were private independent groups making a lot of money are now privately independent or retired. It’s wonderful. That is the American way.
Click to expand...

The ACEP president, everybody.
 
That whole follow-up article is surreal. I have about as much idea as what he's trying to get at half the time as I do when Biden prattles on nonsensically.

"I can't get to two more; what's wrong? So I push harder."

"Healthcare disparities with Covid... robble-robble D-I-V-E-R-S-I-T-Y....."

This is pretty much what he did:

 
turkeyjerky said:
Did anyone else notice this gem in the follow-up article:

"I’m not sure what a contract management group is. So I can’t say that it’s good or bad because I don’t even know what it is."
Click to expand...

Such a sublimely asinine attempt to dismiss concerns via petty distractions.

Might as well start teaching the tactics of our dear leaders to our interns ...

Intern: "Hi Mr. Patient, how can I help you today?"

Pt: "Well doc, I came to the emergency room becau..."

Intern interjects: "Ooooooops sorry you're in the wrong place! We're an emergency department and a place of may rooms...mwah mwah mwah. So, when you say "emergency room" I don’t even know what that is. But no worries, I'll d/c you now to not delay you further on your quest to find this mythical room. I hope you had a 5 star experience and wish you good luck! PS gawbless our American Way!!"
 
EctopicFetus said:
I do think we should write letters to acep. That’s a great idea. Those idiots might not realize the degree of tone deafness exhibited.
Click to expand...

Why ACEP? Why not the people in charge of accrediting these residencies? Have they put out a statement?
 
bravotwozero said:
ACEP is supposed to advocate for our interests. The RRC/ACGME crew has no such obligation. We should all target ACEP and burn it to the ground.
Click to expand...

We should just stop being a part of it.

Why can't we even come together and save money by not being part of acep? I never joined. I have better use for my money.
 
You must log in or register to reply here.

Similar threads

B
EM Alliance
Replies
1
Views
1K
RustedFox
RustedFox
E
Houston EM forum
Replies
3
Views
2K
HemeOncHopeful19
H
Boatswain2PA
Best EM podcasts?
2
Replies
64
Views
5K
Janders
J
D
EM at the VA, future career advice
Replies
23
Views
5K
GBR0321
GBR0321
G
EM Match 2025
2
Replies
90
Views
12K
RustedFox
RustedFox
Top