Em overcrowding

[Rekt]

Getting real tired of this forum constantly sh**ing on new grads or medical students like it is our fault the current market is the way it is or it is their fault for attending a new program that never should have existed in the first place. How about chasing the root cause of the problem and advocating for stricter ACGME accrediting standards that would shut down or prevent these lower quality training sites from existing in the first place. How about we address the fact that there is a large number of non- EM boarded docs working in EM across the nation or a rise in midlevel presence in EM. Can we stop fighting amongst ourselves and put our energy towards worthwhile causes? Because at the end of the day if I am at a shop where my colleague is a Caribbean grad who is HCA trained I don't give a sh** he/she is still my colleague who I will treat with respect.

I'm sorry, but there's a point that these incredibly inferior programs are going to produce less than mediocre physicians. Still better than any MLP, but you won't get the education you need. Some of the CMGs got a foothold at some decent programs, but if you're going to any of these BFE programs or even random small suburban programs, you need to be worried. Not only for your education, but as the market continues to become incredibly tight, you will be passed over for jobs easily for someone who went to a residency that's been established or isn't run by a CMG. Our faculty has already noted they do not hire anyone from HCA residencies.

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[12jas]

I'm sorry, but there's a point that these incredibly inferior programs are going to produce less than mediocre physicians. Still better than any MLP, but you won't get the education you need. Some of the CMGs got a foothold at some decent programs, but if you're going to any of these BFE programs or even random small suburban programs, you need to be worried. Not only for your education but as the market continues to become incredibly tight, you will be passed over for jobs easily for someone who went to a residency that's been established or isn't run by a CMG. Our faculty has already noted they do not hire anyone from HCA residencies.

I'm not disagreeing with you. I was simply pointing out that I feel the hate is misguided. I don't plan to train at any of these programs if I can avoid it. I am saying we should advocate for stricter ACGME standards so that these places where you "won't get the education you need" don't keep popping up everywhere. I also think we need better lobbying and legislation in place that prevents non-EM boarded docs from working a job they are not trained to do. I am just trying to point out that there are better outlets for our frustrations towards the current outlook of EM than our colleagues.

 

[turkeyjerky]

I'm not disagreeing with you. I was simply pointing out that I feel the hate is misguided. I don't plan to train at any of these programs if I can avoid it. I am saying we should advocate for stricter ACGME standards so that these places where you "won't get the education you need" don't keep popping up everywhere. I also think we need better lobbying and legislation in place that prevents non-EM boarded docs from working a job they are not trained to do. I am just trying to point out that there are better outlets for our frustrations towards the current outlook of EM than our colleagues.

I guess it depends on where in your career you are. I really, really feel for current residents--it f'ing sucks. They were sold a bill of goods and now they have limited options. (Some of this is covid-related, but it's really a very small part) Any students currently applying though? Let's just say you were warned.

Also, CMGs and HCA don't care that the new residencies suck. They're counting on it.

 

[deleted966164]

So... what y’all are saying is...if I am rather towards the beginning of medical career, I can kiss my dreams of EM good bye?

 

[Dr Mantis Toboggan]

So... what y’all are saying is...if I am rather towards the beginning of medical career, I can kiss my dreams of EM good bye?

no, but it ain’t as sweet as it used to be. we are in a transition now so hopefully by the time you make your choice things have settled out and you know exactly what you’d be getting into.

 

[DO3]

Is the EM world all roses right now? Absolutely not, however, I worked about 90 hours and made close to $22k last month. That’s a lot of people’s yearly salary. There aren’t many jobs where you can do that. I’ll take it.

 

[Aquaman29]

Is the EM world all roses right now? Absolutely not, however, I worked about 90 hours and made close to $22k last month. That’s a lot of people’s yearly salary. There aren’t many jobs where you can do that. I’ll take it.

OK DO3, so things are so great for you right now...what is your number then when you quit, salary hit 15K per month? Will you still do it? Are you just gonna stay with academics and ride easy street forever while everyone else suffers?

 

[DO3]

OK DO3, so things are so great for you right now...what is your number then when you quit, salary hit 15K per month? Will you still do it? Are you just gonna stay with academics and ride easy street forever while everyone else suffers?

All I’m saying is that with all the doom and gloom on this board, there is another side people experience too.

And, I’m not in academics. I’m in the community pit just like most everyone else. Also an IC for a big CMG like most everyone else.

Are things perfect? No. Do I want to fight for our profession and make things better and rid the world of CMGs?Absolutely. The reality is I need a job. My family needs to be supported. The job I have right now, while not perfect, is manageable, and I can comfortably support my family working less than 100 hrs a month, which you cannot do in most professions.

 

[deleted941485]

Latest Baylor Scott & White deal is for new med school campus

The new Baylor College of Medicine campus, slated to open in fall 2023, is part of Baylor Scott & White push to expand the physician workforce in Texas and build a pipeline of physicians practicing at its system.

www.modernhealthcare.com

Overcrowding to continue

They don’t even hide it. We want a pipeline of physicians to just work for us.

What is the deal with Texas

 

[Rekt]

Latest Baylor Scott & White deal is for new med school campus

The new Baylor College of Medicine campus, slated to open in fall 2023, is part of Baylor Scott & White push to expand the physician workforce in Texas and build a pipeline of physicians practicing at its system.

www.modernhealthcare.com

Overcrowding to continue

They don’t even hide it. We want a pipeline of physicians to just work for us.

What is the deal with Texas

Everybody only cares about themselves at each level. The people starting medical schools know seats will fill no matter what for years and years to come with guaranteed tuition. Residencies know spots will fill because all these graduates need somewhere to go. Fellowships will open and fill because the market is significantly declining for non-fellow trained so they're looking for an out. Both residency and fellowships are free labor for the hospital systems. CMGs can dump all these excess program graduates they're starting into their healthcare systems and others, driving down salaries and positions, all the while filling as many spots as possible with low-level providers that claim they provide better or equal care with 1/100th the training. Eventually there won't be anything left to fill, but no one cares because everyone else is getting their piece.

Welcome to medicine.

 

[blue.jay]

Everybody only cares about themselves at each level. The people starting medical schools know seats will fill no matter what for years and years to come with guaranteed tuition. Residencies know spots will fill because all these graduates need somewhere to go. Fellowships will open and fill because the market is significantly declining for non-fellow trained so they're looking for an out. Both residency and fellowships are free labor for the hospital systems. CMGs can dump all these excess program graduates they're starting into their healthcare systems and others, driving down salaries and positions, all the while filling as many spots as possible with low-level providers that claim they provide better or equal care with 1/100th the training. Eventually there won't be anything left to fill, but no one cares because everyone else is getting their piece.

Welcome to medicine.

^^ This

Perfectly said. The golden age of medicine where older doctors had fame, prestige, $$$ is over. Every year is getting tougher and very competitive to get in to residency, fellowship and good jobs in spite of bleak future.

 

[Dr.K124]

^^ This

Perfectly said. The golden age of medicine where older doctors had fame, prestige, $$$ is over. Every year is getting tougher and very competitive to get in to residency, fellowship and good jobs in spite of bleak future.

Every 5 years I hear someone say the golden age of medicine has just ended. This is false.

Things are different, and different specialties are in different positions, but as a whole medicine is better off now than it was 20 years ago. Inflation-adjusted, our incomes are mostly the same, and yet as a whole physicians are working fewer hours.

Yes, some changes have occurred. Some of the fame and prestige has gone, but that's happened in every single profession. Being a doctor is still THE most prestigious job in the United States, and doctors are the second most trusted profession, with nurses being first (I don't see nurses staying #1 forever).

The only genuine argument one could make in regards to medicine as a whole being worse off than before would be the shift away from private practice and full autonomy. But many specialties (such as Ophthalmology, in which I am a sub-specialist) still have a very majority/significant presence in private practice.

I'm praying for you EM docs and hoping things end up better than it seems.