Future job market

[Fox800]

Aaaaand this is just validating my decision to jump ship and work abroad.

---

Members don't see this ad.

 

[namethatsmell]

I feel bad for folks finishing now. Perhaps some of these soon-to-be-disaffected new grads will exit the dumpster fire, go to law school, and then come back and sue CMGs out of existence. And then they can get to work on the insurance companies. They'd not only be rich...they'd be damn heroes...

 

[watermanMD]

Aaaaand this is just validating my decision to jump ship and work abroad.

Where to?

 

[Groove]

I feel bad for folks finishing now. Perhaps some of these soon-to-be-disaffected new grads will exit the dumpster fire, go to law school, and then come back and sue CMGs out of existence. And then they can get to work on the insurance companies. They'd not only be rich...they'd be damn heroes...

Ever see Chain Reaction (1996) with Keanu Reeves where he discovers cold fusion and tries to "give it to the World" only to face off against an army of assassins sent by governments and fossil fuel corporations? Your post reminded me of that. Your guy/gal might need to hire a few body guards once the word got out!

 

[namethatsmell]

Ever see Chain Reaction (1996) with Keanu Reeves where he discovers cold fusion and tries to "give it to the World" only to face off against an army of assassins sent by governments and fossil fuel corporations? Your post reminded me of that. Your guy/gal might need to hire a few body guards once the word got out!

Haha, spot on.

There are so many cracks in the liability armor of the CMGs and insurance companies. A motivated EMdoc-turned-lawyer could find a lot of low hanging fruit to go after. But yes he/she may need a bodyguard to ward off the assassins. Maybe Denzel or Costner is available?

 

[RustedFox]

I've been watching a few select states on edphysician.com.
The *Number of jobs listed* keeps going down. And quickly.

 

[Fox800]

Where to?

TBD

 

[redpointmd]

It's interesting that people still want to work there, given the steep decline in quality of life. My understanding is that Midtown doesn't even exist anymore.

I mean honestly I don't understand the negativity towards NYC, it's a beautiful place with tons of great city life. I think midtown is still pretty nice and even thriving, and areas of brooklyn continue to gentrify. I understand, but maybe don't agree, but I understand the desirability of NYC. Most places with a low cost of living have a low cost of living because they suck.

 

[Torsion]

I mean honestly I don't understand the negativity towards NYC, it's a beautiful place with tons of great city life. I think midtown is still pretty nice and even thriving, and areas of brooklyn continue to gentrify. I understand, but maybe don't agree, but I understand the desirability of NYC. Most places with a low cost of living have a low cost of living because they suck.

I don't think anyone is necessarily advocating for young physicians to move to the lowest COL podunk town, just not move into one of the most expensive cities on planet earth. There are plenty of midsized American cities with medium COL that offer enough breweries and cocktail bars, ethnic cuisine, and greenways/outdoor activities to keep most single yuppy millennials busy. There are only so many hours in a day and so much money to go around. Actual New Yorkers aren't spending every waking minute taking in Broadway shows and eating at Gallaghers.

 

[DeadCactus]

I hate when people from the largest cities **** on the rest of the US like 95% of the country has nothing to offer but I also hate how people who want to live in NYC or LA get talked to like they're idiots. We all made a lot of sacrifices to go into medicine. One of the eventual benefits was to eventually live the kind of life we want to live. What's the point of more money and a cheaper cost of living if the life you actually wanted is to live in NYC? Once you've reached the point of being a physician, most people have made it. Income is not going to be what holds them back from happiness, even if they take a job that pays "trash". Now it's just a matter of prioritizing what you want most and not wasting money or time on nonsense you don't care about.

 

[Rekt]

I hate when people from the largest cities **** on the rest of the US like 95% of the country has nothing to offer but I also hate how people who want to live in NYC or LA get talked to like they're idiots. We all made a lot of sacrifices to go into medicine. One of the eventual benefits was to eventually live the kind of life we want to live. What's the point of more money and a cheaper cost of living if the life you actually wanted is to live in NYC? Once you've reached the point of being a physician, most people have made it. Income is not going to be what holds them back from happiness, even if they take a job that pays "trash". Now it's just a matter of prioritizing what you want most and not wasting money or time on nonsense you don't care about.

Agree, but the real issue at hand is those opportunities are disappearing on both sides. Needs to be addressed asap or you're not going feel like you "made it" when you can't find anywhere to work.

 

[sylvanthus]

I mean honestly I don't understand the negativity towards NYC, it's a beautiful place with tons of great city life. I think midtown is still pretty nice and even thriving, and areas of brooklyn continue to gentrify. I understand, but maybe don't agree, but I understand the desirability of NYC. Most places with a low cost of living have a low cost of living because they suck.

Duuuude I lived in Queens for 6 years, I can tell you from experience NYC is not "beautiful", the place is a hole. Ever walk down the sidewalk and get a random whiff of homeless man urine? , see the giant rats gracing the place with their presence? Trash blowing around in the wind? Terrible traffic, cost of living, and people, in general, are dicks. Soooooooooo glad im out of that hell hole. If salaries in nyc doubled, id still not live there. In before "but the food is great!!" If you have to drive in awful traffic, spend 45 min trying to find parking, walk by homeless people on the way to the awesome restaurant, then be surrounded by new yorkers, it kind of detracts from the dining experience.


/rant off

 

[GatorCHOMPions]

Recent graduate in Jun 2020 from a middle road EM residency program (community heavy mostly).
I signed for a sign before COVID but I know my contract is still being offered.
I took a very undesirable location, probably as undesirable of a location as you can get in the middle of the country.
I am anticipated to make approximately 700,000 in my first year.
You can make money if you sacrifice for a year or two and go somewhere you do not want to go. The market is tight and even my undesirable location has more applicants than they have ever had (we have 1 spot and 4 people applied just last month)
This isn't what i truly was looking for but I am glad i secured my contract for 3 years before COVID started because I could find nothing similar to this when I was looking around for other jobs tonight (mostly for fun...mostly)
my contract breakdown is
450K base
300/Hr for any extra shifts above the base (I pick up 4-5 per month)
20K yearly signing bonus (it was 60/3 years)
20K yearly RVU bonus/nightshift differential
50K yearly loan repayment/yr

Its not all doom and gloom. But be ready to given up a social life for a year or two if you want to pay off loans and get a savings.

Students and residents take note, this is NOT a great job. 700k sounds amazing, but let’s break this down a little more. Base rate of 450k is probably for at least 12-12 hour shifts per month. Over 1 year that’s $260/hour (450k divided by 1728 hours, or it’s worse if the base rate is for more shifts). Is this W2 work or 1099? This makes a significant difference as well. Working 4-5 extra shifts per month pushes those hours to unsustainable territory. Combined with the fact that this job is in BFE, you will come out after your 3 year contract burnt to a crisp if you keep at it. What’s your plan after 3 years?

You found decent compensation in BFE that was fairly commonplace in middle sized cities just a few years ago. And as you alluded to yourself, now there’s 4 spots for 1 job. Say goodbye to the extra shifts by the time your contract is done and the base rate of 450k is likely to drop after the 3 years. Finally, how ironclad is your contract, anyway? We sign contracts all the time with different clauses in there supposed to protect us, yet can be let go regardless.

 

[cyanide12345678]

Recent graduate in Jun 2020 from a middle road EM residency program (community heavy mostly).
I signed for a sign before COVID but I know my contract is still being offered.
I took a very undesirable location, probably as undesirable of a location as you can get in the middle of the country.
I am anticipated to make approximately 700,000 in my first year.
You can make money if you sacrifice for a year or two and go somewhere you do not want to go. The market is tight and even my undesirable location has more applicants than they have ever had (we have 1 spot and 4 people applied just last month)
This isn't what i truly was looking for but I am glad i secured my contract for 3 years before COVID started because I could find nothing similar to this when I was looking around for other jobs tonight (mostly for fun...mostly)
my contract breakdown is
450K base
300/Hr for any extra shifts above the base (I pick up 4-5 per month)
20K yearly signing bonus (it was 60/3 years)
20K yearly RVU bonus/nightshift differential
50K yearly loan repayment/yr

Its not all doom and gloom. But be ready to given up a social life for a year or two if you want to pay off loans and get a savings.

You are picking up a lot of shifts. Guessing you work 12 x 12 at baseline for the 450k?.

That's a pretty solid income though. But man... You're inviting burn out.

 

[EctopicFetus]

Recent graduate in Jun 2020 from a middle road EM residency program (community heavy mostly).
I signed for a sign before COVID but I know my contract is still being offered.
I took a very undesirable location, probably as undesirable of a location as you can get in the middle of the country.
I am anticipated to make approximately 700,000 in my first year.
You can make money if you sacrifice for a year or two and go somewhere you do not want to go. The market is tight and even my undesirable location has more applicants than they have ever had (we have 1 spot and 4 people applied just last month)
This isn't what i truly was looking for but I am glad i secured my contract for 3 years before COVID started because I could find nothing similar to this when I was looking around for other jobs tonight (mostly for fun...mostly)
my contract breakdown is
450K base
300/Hr for any extra shifts above the base (I pick up 4-5 per month)
20K yearly signing bonus (it was 60/3 years)
20K yearly RVU bonus/nightshift differential
50K yearly loan repayment/yr

Its not all doom and gloom. But be ready to given up a social life for a year or two if you want to pay off loans and get a savings.

How much do you have to work for 450k base. I would love to hear how you are doing after 12 more months. I guess you would have been there already for 3 months. How much are you working. Are you getting your hours?

Based on $300/hr you need to work over 2000 hours a year.. just some basic math for everyone. It is actually about 2333 hours if you average $300/hr. Or roughly 60 hours a week..

 

[Groove]

450K base
300/Hr for any extra shifts above the base (I pick up 4-5 per month)
20K yearly signing bonus (it was 60/3 years)
20K yearly RVU bonus/nightshift differential
50K yearly loan repayment/yr

Students and residents take note, this is NOT a great job. 700k sounds amazing, but let’s break this down a little more. Base rate of 450k is probably for at least 12-12 hour shifts per month. Over 1 year that’s $260/hour (450k divided by 1728 hours, or it’s worse if the base rate is for more shifts). Is this W2 work or 1099? This makes a significant difference as well. Working 4-5 extra shifts per month pushes those hours to unsustainable territory. Combined with the fact that this job is in BFE, you will come out after your 3 year contract burnt to a crisp if you keep at it. What’s your plan after 3 years?

Agreed, this is a ho-hum contract but not too shabby for a new grad looking to pay off loans.

Basically, $260/hr...meh...but I don't think this is too bad personally. I know @EctopicFetus would probably turn his nose up at this one but I probably wouldn't. 20K sign on...meh. 20K/yr night shift differential, which for 1728 hours comes out to $11 and some change per hour to work nights.(I'm assuming this is a nocturnist job?) 50K yearly loan repayment is actually pretty good. That's 100K on loans he/she can pay off just for working there a couple of years. I really like these big loan repayment offers being given to new grads and wish I had searched for something similar upon graduation.

I'd be interested to know the pph and acuity level. If you're seeing 2.5pph versus 1.8, then you're going to need a couple more B12 shots and monster drinks before tacking on the 4-5 extra 12's which would put you at ~204 hrs/month. I'm sorry but that's unsustainable and downright unhealthy, not only for you and your loved ones but also for your patients. That's a fast road to burnout, lawsuits and worse. It's honestly not a bad job...for nothing more than the 450K and loan repayment, especially in our current environment. Relax and take care of yourself during those first 2 years out. There's an enormous amount of continued growth and learning during that time period. The rest of your career is a marathon, not a sprint and you've got to pace yourself accordingly if you plan on crossing the finish line. Good luck to you. I'm glad you found a job!

 

[throwawaysteve19897]

My family medicine PGY3 wife who is also job hunting with me is having a pretty different experience right now. Recruiters contacting her like crazy with jobs, even in desirable cities with fairly decent salaries for family medicine.

FM attending who is searching for jobs here

A few yrs ago when applying for attending jobs out of residency the search was easy; it was a buyer's market.

Right now I'm looking to relocate to a relatively desirable area and pickings are super slim.

The jobs your wife is receiving may be very undesirable jobs unless in house recruiters are contacting her.

Most jobs represented by third party recruiters are not desirable due to work conditions, pay, or both.

Edit: typo

 

[deleted813736]

Students and residents take note, this is NOT a great job. 700k sounds amazing, but let’s break this down a little more. Base rate of 450k is probably for at least 12-12 hour shifts per month. Over 1 year that’s $260/hour (450k divided by 1728 hours, or it’s worse if the base rate is for more shifts). Is this W2 work or 1099? This makes a significant difference as well. Working 4-5 extra shifts per month pushes those hours to unsustainable territory. Combined with the fact that this job is in BFE, you will come out after your 3 year contract burnt to a crisp if you keep at it. What’s your plan after 3 years?

You found decent compensation in BFE that was fairly commonplace in middle sized cities just a few years ago. And as you alluded to yourself, now there’s 4 spots for 1 job. Say goodbye to the extra shifts by the time your contract is done and the base rate of 450k is likely to drop after the 3 years. Finally, how ironclad is your contract, anyway? We sign contracts all the time with different clauses in there supposed to protect us, yet can be let go regardless.

Ofcourse no contract is ironclad. I can be let go at anytime whenever they wish to cut me. There is a 90 day clause.
I work 10 hour shifts x 14 for the base compensation salary. It averages to around 50 hours a week.
I am a single individual/no kids. I planned on working as I am for only 1 year and either cut the contract in full or cut down to just base (with no extra shifts)
But you are all correct, I am inviting burnout and I know it.

 

[deleted813736]

How much do you have to work for 450k base. I would love to hear how you are doing after 12 more months. I guess you would have been there already for 3 months. How much are you working. Are you getting your hours?

Based on $300/hr you need to work over 2000 hours a year.. just some basic math for everyone. It is actually about 2333 hours if you average $300/hr. Or roughly 60 hours a week..

Yes that is correct, I average 200 hours a month (or 50 hours a week). I usually get 2 days off a week. Hours are a plenty in rural places.

 

[HemorrhagicShock]

Hours are a plenty in rural places.

How Rural/BFE are we talking because that sounds like a pretty solid deal given the kind of BS that's currently out there.

 

[JacobMcCandles]

Yes that is correct, I average 200 hours a month (or 50 hours a week). I usually get 2 days off a week. Hours are a plenty in rural places.

While I admire the hustle and the importance of socking away as much money as possible as early as possible, it's also important to be able to have the option to prolong your career. Making money early and getting burnt out early isn't necessarily a better plan than making less money but being able to work longer into your career.

 

[deleted813736]

How Rural/BFE are we talking because that sounds like a pretty solid deal given the kind of BS that's currently out there.

I am in a town of 150K with the surroudning area included. The nearest actual city is 2 hours away

How Rural/BFE are we talking because that sounds like a pretty solid deal given the kind of BS that's currently out there.

i am about 2 hours to the closest metropolitan city. We have one Walmart.

 

[cyanide12345678]

Yes that is correct, I average 200 hours a month (or 50 hours a week). I usually get 2 days off a week. Hours are a plenty in rural places.

What's your average patient per hour.

At some point the money isn't worth it. Once you are done with loans, reassess whether it is worth it. There's better things in life than being in the ER.

 

[deleted813736]

What's your average patient per hour.

At some point the money isn't worth it. Once you are done with loans, reassess whether it is worth it. There's better things in life than being in the ER.

Most of my colleagues average and myself are at about 1.8-2.0
And yes agree, this is a temporary job for me. I see it more as a 4th year of residency given I only went to a 3 year program. With a huge bonus on income

 

[Porfirio]

I viewed my first job after residency as continuation of residency hours and lifestyle - thank god I did. You will be better on the other side of this for making the sacrifice.

 

[emergentmd]

So $275/hr. Not a bad gig at all and the pph is decent. Whoever runs the group will get greedy and cut your pay b/c someone will take it for $225/hr and will start to overstaff to decrease overtime pay.

What you are doing is smart. Make 700K /x 3 yrs if you can, pay off all your debt. Invest the rest in passive income stuff and then work where ever you want.

I remember 5 yrs ago where I was making $275-325/hr in a Large city where I could easily have picked up 25 shifts a mo if I wanted to. I remember telling myself if I didn't have a family and single, I would just suck it up for 3 yrs make $1M/yr x 3 yrs and then coast.

 

[Alvarez13]

So $275/hr. Not a bad gig at all and the pph is decent. Whoever runs the group will get greedy and cut your pay b/c someone will take it for $225/hr and will start to overstaff to decrease overtime pay.

What you are doing is smart. Make 700K /x 3 yrs if you can, pay off all your debt. Invest the rest in passive income stuff and then work where ever you want.

I remember 5 yrs ago where I was making $275-325/hr in a Large city where I could easily have picked up 25 shifts a mo if I wanted to. I remember telling myself if I didn't have a family and single, I would just suck it up for 3 yrs make $1M/yr x 3 yrs and then coast.

I miss those days.

 

[miacomet]

It's interesting that people still want to work there, given the steep decline in quality of life. My understanding is that Midtown doesn't even exist anymore.

Midtown not existing is actually an improvement. But everything else is worse!

 

[TheTravelingShrink]

TBD

Where Can American Doctors Practice Abroad?

Just in case you need some inspiration. EM isn't recognized as a specialty everywhere else, but there are certainly some options.

 

[Splenda88]

While I admire the hustle and the importance of socking away as much money as possible as early as possible, it's also important to be able to have the option to prolong your career. Making money early and getting burnt out early isn't necessarily a better plan than making less money but being able to work longer into your career.

Compound interest is always your friend... One can even argue that making a lot more $$$ early on is better than having a steady stream of $$$. Of course, there should a balance in everything someone does.