For Fooks Sake Gents!

[Consigliere]

AAEM/RSA Statement of Concern for Graduating EM Residents and the Current Job Market | AAEM Resident and Student Association

The American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA) is a non-profit professional association for emergency medicine residents and medical students.

www.aaemrsa.org

And I thought we had it bad in anesthesia. My condolences to the future emergency medicine warriors.

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[namethatsmell]

AAEM/RSA Statement of Concern for Graduating EM Residents and the Current Job Market | AAEM Resident and Student Association

The American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA) is a non-profit professional association for emergency medicine residents and medical students.

www.aaemrsa.org

And I thought we had it bad in anesthesia. My condolences to the future emergency medicine warriors.

Welcome to the party.

One fun way to describe our respective current job markets is

Anesthesia : Ketamine

EM : Kayexalate

 

[Consigliere]

Welcome to the party.

One fun way to describe our respective current job markets is

Anesthesia : Ketamine

EM : Kayexalate

Ummmmmm.....ok buddy......sure, sure. (Slowly backs out of room).

 

[Rekt]

AAEM/RSA Statement of Concern for Graduating EM Residents and the Current Job Market | AAEM Resident and Student Association

The American Academy of Emergency Medicine Resident and Student Association (AAEM/RSA) is a non-profit professional association for emergency medicine residents and medical students.

www.aaemrsa.org

And I thought we had it bad in anesthesia. My condolences to the future emergency medicine warriors.

I saw a thread in your group that mirrors ours from a couple years ago. Don't worry. You'll be here soon.

...and ignoring it just like most of the EM docs until we both end up like rad/onc.

 

[Arcan57]

A little confused though, there are too many EM residents now and we're worried as a consequence that fewer med students will choose to do EM which would lead to... fewer EM residents?

 

[Consigliere]

I saw a thread in your group that mirrors ours from a couple years ago. Don't worry. You'll be here soon.

...and ignoring it just like most of the EM docs until we both end up like rad/onc.

I couldn't care less. I'm outta the game!

 

[deleted547339]

A little confused though, there are too many EM residents now and we're worried as a consequence that fewer med students will choose to do EM which would lead to... fewer EM residents?

No. Med students are stupid. The only way is to cap the number of spots.

 

[HemorrhagicShock]

Holy hell are medical students stupid. I reflect back on all the brilliant advice I received as a medical student, and how I decided to ignore 99% of it because I thought I knew better and/or "that doesn't apply to my situation."

It's tragic to see how many MORE medical students are applying to EM this year than last. Idiots.

 

[Groove]

I kind of expected a more detailed analysis from AAEM. They're great at pointing out the obvious but unfortunately lack any real clout or ability to do anything about it. Not that anyone could do anything about it.

 

[deleted547339]

I kind of expected a more detailed analysis from AAEM. They're great at pointing out the obvious but unfortunately lack any real clout or ability to do anything about it. Not that anyone could do anything about it.

What, do you expect USACS, I mean ACEP, to say anything?

That’s kind of AAEMs role. The crazy cousin who says what everyone is thinking but no one else has the balls to say.

 

[Groove]

What, do you expect USACS, I mean ACEP, to say anything?

That’s kind of AAEMs role. The crazy cousin who says what everyone is thinking but no one else has the balls to say.

Totally fitting analogy. I support AAEM from a philosophical point of view but I can't help but feel a sense of despondence every time they point something else out that we all knew without any solutions and with nobody else in the field willing to echo the same sentiments. Meanwhile, for all our talk, most EM docs keep trudging through the snow..head down, ambling toward our retirement goals, all major issues out of sight, out of mind. All of us just doing what we're told and happy to be making 6 figures. All of us longing for the day we can say it's somebody else's problem.

ACEP? Please. Like they could ever or would ever say anything with their CMG mistress holding their testicles with one hand and a sharp knife with the other.

 

[namethatsmell]

Ummmmmm.....ok buddy......sure, sure. (Slowly backs out of room).

Heh, I think I was feeling the full effect of the Ledaig when I wrote that.

Put another way...the anesthesia market, while still with its shortcomings, is surprisingly good right now. While the EM market is, well, $hit.

 

[Consigliere]

Heh, I think I was feeling the full effect of the Ledaig when I wrote that.

Put another way...the anesthesia market, while still with its shortcomings, is surprisingly good right now. While the EM market is, well, $hit.

I figured a more intelligent individual would interpret accordingly. Thanks for explaining it to my dumb a_ss.

 

[Rekt]

A little confused though, there are too many EM residents now and we're worried as a consequence that fewer med students will choose to do EM which would lead to... fewer EM residents?

I'm not sure why anyone would be unhappy to see that. I would love to see zero medical students chose EM. The more we soap the better. Then we can start closing tons of these mediocre programs.

 

[deleted547339]

I'm not sure why anyone would be unhappy to see that. I would love to see zero medical students chose EM. The more we soap the better. Then we can start closing tons of these mediocre programs.

All programs are great, don’t you know the party line?

 

[clibby]

I'm not sure why anyone would be unhappy to see that. I would love to see zero medical students chose EM. The more we soap the better. Then we can start closing tons of these mediocre programs.

That makes no sense. As long as there are spots, they will fill. You can fill them with the Match or the SOAP, but they will fill. If US grads don't fill them, IMGs will. If we want respect in the medical world, we want our specialty to attract the best and the brightest, not the leftovers.

We need to advocate for higher RRC requirements to become and maintain a residency program so that the low tier programs that can't meet them actually are forced to close.

 

[HemorrhagicShock]

These new programs won't close any time soon. There will always be a steady stream of new blood to fill ANY open residency slot in the US.

In the short-term, they bring physician-level services at less than midlevel costs. In fact, they actually get paid by CMS per resident (something like $100,000 per resident per year or something absurd like that). It's an incredibly straightforward business decision for a CEO/hospital board to start up a residency.

The CMGs love "training" them too. Residents will work slave hours, generate RVUs, and expose themselves to the kool-aid of that specific CMG in order to get a job. After all, they have to pay off those quarter-to-half million in loans.

In the long-term, the residency expansion will continue. The top-tier medical students and high achievers will wise up quickly and not choose EM. Your average American medical student will take a lot longer to open their eyes to the reality nearly guaranteeing a continued labor pool. Especially as the denominator of medical students increases due to rapid medical school expansion as well. Now perhaps on the decade time frame, if those medical students really stop going into EM en masse, that will open the door for the international grads or physicians who would sell their soul, first child, and their own mother for an American residency spot.

 

[Fox800]

ACEP? More like USACEPS...can't tell the difference any more.

Med students and IMGs will literally eat a steaming plate of yak dung to SOAP into a spot at the crappiest CMG-sponsored residency program in Florida. Good luck pulling accreditation, ACGME keeps rubber stamping all of these dumpster fire programs.

 

[deleted126335]

ACEP? More like USACEPS...can't tell the difference any more.

Med students and IMGs will literally eat a steaming plate of yak dung to SOAP into a spot at the crappiest CMG-sponsored residency program in Florida. Good luck pulling accreditation, ACGME keeps rubber stamping all of these dumpster fire programs.

Med students:

 

[maxxor]

These new programs won't close any time soon. There will always be a steady stream of new blood to fill ANY open residency slot in the US.

In the short-term, they bring physician-level services at less than midlevel costs. In fact, they actually get paid by CMS per resident (something like $100,000 per resident per year or something absurd like that). It's an incredibly straightforward business decision for a CEO/hospital board to start up a residency.

The CMGs love "training" them too. Residents will work slave hours, generate RVUs, and expose themselves to the kool-aid of that specific CMG in order to get a job. After all, they have to pay off those quarter-to-half million in loans.

In the long-term, the residency expansion will continue. The top-tier medical students and high achievers will wise up quickly and not choose EM. Your average American medical student will take a lot longer to open their eyes to the reality nearly guaranteeing a continued labor pool. Especially as the denominator of medical students increases due to rapid medical school expansion as well. Now perhaps on the decade time frame, if those medical students really stop going into EM en masse, that will open the door for the international grads or physicians who would sell their soul, first child, and their own mother for an American residency spot.

They are only paid directly if these are CMS funded spots, which most are not (if the Hahnemann hospital residency auction teaches us anything). I'm actually not sure if these new residencies get the indirect CMS payments, which is still substantial.

The real reason these residencies are getting created is that the physicians are now directly or indirectly employed by the hospitals and a cost-center. Bean counters are gonna do anything they can to reduce those costs. PAs/NPs are too expensive. It's cheaper for them to fund a residency even without the CMS direct payments than to pay for PA/NPs (who work a lot fewer hours, get paid more, and have better benefits).

 

[EctopicFetus]

They are only paid directly if these are CMS funded spots, which most are not (if the Hahnemann hospital residency auction teaches us anything). I'm actually not sure if these new residencies get the indirect CMS payments, which is still substantial.

The real reason these residencies are getting created is that the physicians are now directly or indirectly employed by the hospitals and a cost-center. Bean counters are gonna do anything they can to reduce those costs. PAs/NPs are too expensive. It's cheaper for them to fund a residency even without the CMS direct payments than to pay for PA/NPs (who work a lot fewer hours, get paid more, and have better benefits).

Not only are residents cheaper but eventually simple supply / demand economics will come into play and pay will rapidly drop.

 

[AlbinoHawk DO]

A little confused though, there are too many EM residents now and we're worried as a consequence that fewer med students will choose to do EM which would lead to... fewer EM residents?

Those spots will happily be taken by unmatched applicants and IMGs