Greater % increase in FM spots in match in last 4 years than in EM, can someone explain why the sky is falling for EM?

[wavecrasher111]

I'm an MS4 and am most likely applying EM but FM is still on the radar. Of course I'm a little spooked about entering the field after reading forums on SDN about the future outlook of the specialty. But everyone sites the fact that so many residency spots are opening up, but its the same thing for FM. Both are around 40% increase (43 for FM) since 2016 and its all sunshine and rainbows for future outlook for FM on their forum. I concede that 40% is a much larger increase than the match-wide increase of 23% since 2016, but with population increase and ER visits rising (not right now of course), is increasing residency spots by a couple hundred per year really going to destroy the outlook of the specialty to the point of equalizing wages between EM and primary care?
This table is from the NRMP match data

https://mk0nrmp3oyqui6wqfm.kinstacdn.com/wp-content/uploads/2020/06/MM_Results_and-Data_2020-1.pdf

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Members don't see this ad.

 

[clibby]

Supply and demand. ED visits may be up, but it isn't like they are building more hospitals for us to work at. We are tied to an ED; FM docs can open their own practice. Furthermore, there isn't the dearth of ED docs compared to primary care docs. Once every ED is staffed with an ED doc, where does an unemployed ED doc work?

So given this, as you increase the supply, people will work for less money just to have a job where they want. That is why pay is falling. We needed more EM residencies; we just didn't need this many and certainly don't need more unless PA/NPs go away completely and we see all the patients they have been seeing.

 

[ace_inhibitor111]

That data isn't completely accurate because it doesn't consider AOA spots before and after the merger. Here is a more accurate list IMO:

As far as FM being rainbows and butterflies, I didn't get that sense when I looked their forums. They got hit pretty hard by COVID

 

[Rekt]

How is this even a question? Realistically we only work in EDs aka hospitals. Sometimes FSEDs, but those are few and far between. Urgent care is dead from noctors/midlevels/FM. Pick any street and take a drive and count the outpatient clinics. We don't have that kind of practice mobility. We essentially work in the hospital and that's it. Fellowships make up an insignificant amount of practice variability. The fact that it's even close to FM (and actually more as above) is incredibly concerning.

 

[Brigade4Radiant]

FM can do colonoscopies and hospitalist medicine as well

 

[AMEHigh]

That data isn't completely accurate because it doesn't consider AOA spots before and after the merger. Here is a more accurate list IMO:

View attachment 318108

As far as FM being rainbows and butterflies, I didn't get that sense when I looked their forums. They got hit pretty hard by COVID

Thats interesting you say that because everyone on the forum is saying they’re pretty much at their usual volume now. I read an article that DPC doctors were actually doing better during covid.

I think the fact that FM can continue to work outside of a clinical setting (unlike anesthesia, surgery, etc) is a good thing, easy to adapt.

Plus can work in so many different settings.

 

[RustedFox]

Thats interesting you say that because everyone on the forum is saying they’re pretty much at their usual volume now. I read an article that DPC doctors were actually doing better during covid.

I think the fact that FM can continue to work outside of a clinical setting (unlike anesthesia, surgery, etc) is a good thing, easy to adapt.

Plus can work in so many different settings.

Dude.

You may catch some heat on this forum; but don't stop hanging with us.

I was an "upsetter" as well during my early days.
We will warm up to you.

I think you're spot-on with this logic.

I am getting out of direct ER work later this year. I'm just ferreting out details now.

I will make my bones to the forum when the time is right.

I will still work PRN in the ER because I like the procedures and the wild unpredictability, but I can identify four things that have burned me out hard.

When you said: "easier to adapt"...

That was you hitting a high fastball over the left-center wall.

 

[VA Hopeful Dr]

Dude.

You may catch some heat on this forum; but don't stop hanging with us.

I was an "upsetter" as well during my early days.
We will warm up to you.

I think you're spot-on with this logic.

I am getting out of direct ER work later this year. I'm just ferreting out details now.

I will make my bones to the forum when the time is right.

I will still work PRN in the ER because I like the procedures and the wild unpredictability, but I can identify four things that have burned me out hard.

When you said: "easier to adapt"...

That was you hitting a high fastball over the left-center wall.

Please do tell us all what you end up doing once it's up and running.

I'll miss your absolutely hilarious posts about working in the ED, but I think we'd all rather have a not burnt out RF even if we lose some of the humor.

 

[bravotwozero]

Dude.

You may catch some heat on this forum; but don't stop hanging with us.

I was an "upsetter" as well during my early days.
We will warm up to you.

I think you're spot-on with this logic.

I am getting out of direct ER work later this year. I'm just ferreting out details now.

I will make my bones to the forum when the time is right.

I will still work PRN in the ER because I like the procedures and the wild unpredictability, but I can identify four things that have burned me out hard.

When you said: "easier to adapt"...

That was you hitting a high fastball over the left-center wall.

Ah, guess it was 'no dice' with me suggesting academics.

Well, hope whatever it is you do makes you happy. Best of luck.

 

[RustedFox]

Thanks, amigos.

*I will make my bones to the forum when the time is right.*

 

[RustedFox]

Please do tell us all what you end up doing once it's up and running.

I'll miss your absolutely hilarious posts about working in the ED, but I think we'd all rather have a not burnt out RF even if we lose some of the humor.

I promise. Tell you what...

Tomorrow, you get a hilarious post.

It's not going to involve an ED visit, but it will be hilarious.

"So, my wife had her wisdom teeth removed...."

 

[Tipsy McStagger]

, ...but I can identify four things that have burned me out hard...

I’m going to guess: the patient, the patient, the patient annnnnnd the patient?

 

[RustedFox]

I’m going to guess: the patient, the patient, the patient annnnnnd the patient?

The patient is number four.

I will elaborate.

Later.

 

[Birdstrike]

Is there anyone that thinks that although increasing numbers of EM grads could drive down salaries, that overall the trend could make EM job satisfaction better and reduce burnout, by reducing the amount of shifts the average EP needs to work and increasing coverage?

 

[Birdstrike]

Is it possible that increasing numbers of EM grads could have no effect on salary, and no effect on ED coverage, because increasing the supply and availability of EM docs, may proportionally increase volume by the "If you build it, they will come" principle?

 

[Birdstrike]

...but I can identify four things that have burned me out hard..

For me it was,

1) Circadian-rhythm induced chronic dysthymia that invades all waking hours, including all days off work ("When you're off, you're off" in EM, was a lie in my experience).

2) Unrealistic demands placed by administration, ie, destruction of Emergency Medicine by replacing the "treat the sickest first" concept with "the customer is always right and all must be seen in less than 15 minutes regardless of acuity, impossibility and no matter how badly it destroys job satisfaction and peace of mind" concept.

3) Acuity and pace-induced stress at a level few other specialties or professions will never understand except for bomb defusers and other emergency/fire/police personnel.

4) Working life-destroying amounts nights, weekends and holidays to take care of people the vast majority of whom weren't sick and knew it, didn't have emergencies and were pathologically ungrateful and often openly hostile.

 

[RustedFox]

Birdstrike:

Add to that the "stockholm syndrome" of "not being able to hack it", when you know, in your soul, that there is no emergency to "fix". Now. Right now.

 

[Birdstrike]

Birdstrike:

Add to that the "stockholm syndrome" of "not being able to hack it", when you know, in your soul, that there is no emergency to "fix". Now. Right now.

Y E S

EM Stockholm Syndrome. I know it well.

"It's not Emergency Medicine, it's YOU!"

(Quick, tattoo 'burnout' on his forehead, label him 'flawed," "not born for this," and replace him with a warm body. Hurry, get one hot off the press!)

When in reality, EM has the fatal flaw, not you.

(Meanwhile, scramble, scrap, fight like sharks to get that clinical shift buy-down, establish a 'side hustle,' move to a different country or hemisphere or find any other way to get out before you stroke out while looking around, smiling, chin up, agreeing to protect the "Everything's Alright" party line.)

 

[RustedFox]

Y E S

"It's not Emergency Medicine, it's YOU!"

(Quick, tattoo 'burnout' on his forehead, label him 'flawed," "not born for this," and replace him with a warm body. Hurry!)

When in reality, EM has the fatal flaw, not you.

(Meanwhile, scramble, scrap, fight like sharks to get that clinical shift buy-down, establish a 'side hustle' or way to get out while looking around, smiling, chin up, agreeing to protect the "Everything's Alright" party line.)

I should say this via PM.

I left one of my job sites. Birdstrike is aware because we have spoken about this via PM.

After I left, two other docs left. I was the first pilgrim of the Exodus.

Now, I'm told... There's a guerilla "Bring Back Dr. RustedFox" movement at the hospital. The nurses, the techs, the medics... "Where is Fox?!"

"If RF were here, he would have had this patient out of here by now."

We shall see...

 

[Raryn]

I personally think it's a question of baseline. EM is, overall, a fairly young specialty. The first "emergency medicine" doctors came about in the 1960s, and the first EM program started in 1971. The board didn't exist until 1979.

Out of the total 47,192 people that have passed the EM boards from 1979 to 2019, half of them have been from 2005 and onwards. What that means is that if you finished EM training and passed the boards in 2005, there were, at most, 23,500 other EM boarded people *in the country* - that was the number of passes offered over the prior 25 years, the history of the specialty. And you were competing with only 1300 others for jobs.

Today, there are about 39,000 people actively board certified by the ABEM. Some proportion of them are retired and just haven't let their certification lapse yet, some proportion of them practice a different specialty, but the majority of them are in practice. In 2017 at least, the AAMC estimated there were 42,348 practicing emergency medicine doctors in the US - though obviously some of them must have not been boarded.

Regardless, the market is roughly 60-70% more saturated than it was in 2005. And instead of competing with 1300 others for jobs - you're competing with 2300 others.

You can imagine that while an EM doc graduating in 2005 could write their own ticket just about anywhere, the more popular markets are getting saturated today - both because of the # of graduates each year and the fact that the # of prior graduates has built up significantly over the last 40 years.

(The ABFM is also relatively young, with the board coming about in 1969, but I can't find comparable statistics for them and it's still a 10-year difference. In addition, the primary care market is very different from the EM one - with IM and old-school GPs being much closer to equivalent to FM than to EM.)

 

[deleted547339]

I was an "upsetter" as well during my early days.

Was? Lol.

 

[Siggy]

I'll add that the job options are different as well. Emergency medicine is going to be pretty much limited to the ED and urgent care. Family medicine has urgent care as well, but also sports medicine clinics, outpatient/primary care, nursing homes, and hospitalist work. The outpatient care can include peds and OB. Oh, and in rural areas there's also the ED as well (whether FM sans fellowship should and shouldn't are two separate questions. Whether the emergency fellowship for FPs should be a thing is a separate question as well).

 

[Groove]

Found out yesterday that yet another community hospital in our area will be going ABEM only due to the sudden glut of physicians in the area. That makes 4 hospitals out of 10'ish in our greater city area that have switched to bylaws requiring ABEM for all docs in the ED within the last 2 years. Craziness. What I'm currently noticing is a crazy level of anxiety from our local IM/FM docs who have been working in EM their entire career. They are flipping out and all are worried that they are going to lose their jobs within the next few years. A couple of the FM guys have bought into this ABPS EM certification which allows them to put (BCEM) on their name which I suppose they are hoping will allow them to fly under the radar with credentialing committees not really noticing that they are not ABEM. One of them is frantically studying for it right now. Emergency Medicine Board Certification | ABPS

This jogged my memory and we need to be vigilant about protecting our turf in the future. I can easily see ABPS making inroads into more states like this one to where the certification members can call themselves "board certified in EM". If anybody thinks that the IM/FM docs who have been working EM for 20 and 30 years are going to surrender their jobs willingly, they should think again. I predict more and more lobbying and suits filed against states that don't recognize ABPS or alternate EM certifying authorities so that their members can claim "board certification" without residency requirements.

ACEP Responds to Texas Ruling on ABPS—Certification Decision Questioned - ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

www.acepnow.com

 

[VA Hopeful Dr]

Found out yesterday that yet another community hospital in our area will be going ABEM only due to the sudden glut of physicians in the area. That makes 4 hospitals out of 10'ish in our greater city area that have switched to bylaws requiring ABEM for all docs in the ED within the last 2 years. Craziness. What I'm currently noticing is a crazy level of anxiety from our local IM/FM docs who have been working in EM their entire career. They are flipping out and all are worried that they are going to lose their jobs within the next few years. A couple of the FM guys have bought into this ABPS EM certification which allows them to put (BCEM) on their name which I suppose they are hoping will allow them to fly under the radar with credentialing committees not really noticing that they are not ABEM. One of them is frantically studying for it right now. Emergency Medicine Board Certification | ABPS

This jogged my memory and we need to be vigilant about protecting our turf in the future. I can easily see ABPS making inroads into more states like this one to where the certification members can call themselves "board certified in EM". If anybody thinks that the IM/FM docs who have been working EM for 20 and 30 years are going to surrender their jobs willingly, they should think again. I predict more and more lobbying and suits filed against states that don't recognize ABPS or alternate EM certifying authorities so that their members can claim "board certification" without residency requirements.

ACEP Responds to Texas Ruling on ABPS—Certification Decision Questioned - ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

www.acepnow.com

Wonder if they'll grandfather in some of the old timers.

 

[Groove]

Found out yesterday that yet another community hospital in our area will be going ABEM only due to the sudden glut of physicians in the area. That makes 4 hospitals out of 10'ish in our greater city area that have switched to bylaws requiring ABEM for all docs in the ED within the last 2 years. Craziness. What I'm currently noticing is a crazy level of anxiety from our local IM/FM docs who have been working in EM their entire career. They are flipping out and all are worried that they are going to lose their jobs within the next few years. A couple of the FM guys have bought into this ABPS EM certification which allows them to put (BCEM) on their name which I suppose they are hoping will allow them to fly under the radar with credentialing committees not really noticing that they are not ABEM. One of them is frantically studying for it right now. Emergency Medicine Board Certification | ABPS

This jogged my memory and we need to be vigilant about protecting our turf in the future. I can easily see ABPS making inroads into more states like this one to where the certification members can call themselves "board certified in EM". If anybody thinks that the IM/FM docs who have been working EM for 20 and 30 years are going to surrender their jobs willingly, they should think again. I predict more and more lobbying and suits filed against states that don't recognize ABPS or alternate EM certifying authorities so that their members can claim "board certification" without residency requirements.

ACEP Responds to Texas Ruling on ABPS—Certification Decision Questioned - ACEP Now

ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

www.acepnow.com

Does anyone know how this turned out? I can't seem to find an update to any final ruling and can't find another mention of it on ACEPs site.

 

[southerndoc]

@Groove My health system recently adopting to accept ABPS. I'm not supporting it for EM as a backdoor way of certifying. The argument was for those recertifying to have an additional option to recertify and not be a slave to the fee mill that the traditional boards require. Emergency medicine still requires emergency medicine residency training per our health system bylaws, and board certification (with either board) must be obtained within 5 years of finishing residency and must be maintained throughout career in order to maintain privileges.

Many hospitals are getting rid of non-EM trained physicians staffing their ER's because of ACS verification of trauma center designation. I think if you completed residency after 2016, you have to be EM-trained in order to staff an ACS verified trauma center. A lot of states are getting out of certifying trauma centers and are instead deferring to ACS to verify them. I know of one busy Level II that is staffed primarily by FP's that they train (their only residency). Some of the docs had to find jobs elsewhere.

As more EM trained physicians become available with the expansion of the residency programs, hospitals will probably get rid of non-EM trained physicians. This may become a reimbursement issue in the future. There is already talk of it amongst the insurance industry.

 

[cyanide12345678]

When i can only find just a few active jobs for the entire state of Texas, the second largest US state, the sky is falling.

Now you can be like "but there's all these only job listings" - go talk to a damn recruiter which i have done several times in the past 1 week. Almost all of them are shell listings right now. Usacs makes it sound like they have 20+ openings, when you talk to them on the phone, the recruiter is like "yeah i have nothing active right now. How about Oklahoma?".

Teamhealth - "yeah we just have one site. Used to be 36k volume, now 25k, single coverage, most days no MLP. It's a very difficult job".

I would have sworn that sound physicians would have something in port arthur (or was it vituity? Whatever, one of those cmgs that give you pretend partnership. Their recruiter said "yeah even that site is full. We have nothing".

All of these guys just have job postings up and aren't hiring, they don't mind getting resumes so they have a pool of candidates when they actually do hire.

Temple Texas has a posting up and pretend to be hiring, when you email them they say yeah maybe one spot but we have dozens of applicants for that spot so low chances.

IES pretends that they have several spots around Houston....i wouldn't know, because they seriously didn't even respond to my email or phone calls. The recruiter seriously has one job to do -_-

Envision pretends to be hiring for Lubbock and other smaller areas. Talked to Lubbock recruiter, she had nothing. The other areas like tyler Texas etc, the recruiter didn't respond at all. I've called twice and sent an email. No response. They probably aren't really desperate

So..... What happens when 100+ residents graduate next year? A lot of these people like to stay within the state. I don't even think Texas will have jobs for this year's class.

This isn't some small place.... This is the second largest state.

I'm just so damn tired of these posts. If you don't think the market is bad or want to rationalize and be in denial then you do you. Go pick up a phone, see if you can find something and then we can talk -_-

 

[cyanide12345678]

Ooooooo so many jobs with usacs on their website.... At least you would think -_-

NO. NOTHING AND I QUOTE FROM RECRUITER FROM A FEW DAYS AGO.

"Thank you for your note. As of right now, I don’t think I have anything for next summer open yet. We have our St. Francis System in Tulsa, OK if you were interested in that.


We have the Baptist Health System San Antonio which might have some needs in the spring but we are not sure yet. Happy to send your CV to a couple of the medical directors and talk next week if you would like?"

 

[AlmostAnMD]

Wonder if they'll grandfather in some of the old timers.

As much as I want protection, that's probably fair. Some of my best attendings in residency are so old they did their training before EM was an official thing. I'd hate to see them pushed out just for this. Although I do think they are protected, one told me ABEM grandfathered them in as BC for life, which must be nice. I would hope that doesn't change that.

Versus a new grad from an FM residency, yeah.

 

[Apollyon]

Wonder if they'll grandfather in some of the old timers.

They had their chance. That closed 31 years ago. Greg Daniel tried for 15 years after that to reopen it. Didn't work. However, I'm guessing that, when Daniel sold his group, Exigence, to TH in 2012, he made somewhere between 25 and 50 mil, just for him. That's not bad for "being denied opportunities due to not being ABEM boarded".

 

[VA Hopeful Dr]

They had their chance. That closed 31 years ago. Greg Daniel tried for 15 years after that to reopen it. Didn't work. However, I'm guessing that, when Daniel sold his group, Exigence, to TH in 2012, he made somewhere between 25 and 50 mil, just for him. That's not bad for "being denied opportunities due to not being ABEM boarded".

I didn't mean the board, I meant the hospital that's changing the bylaws. Seems a shame if you have someone not ABEM-boarded but who has practiced 100% in the ED for 20 years to be kicked out. That's all I'm getting it. They won't be unemployed at least as urgent care is still a thing (I wouldn't trust them in primary care at this point).

 

[bravotwozero]

When i can only find just a few active jobs for the entire state of Texas, the second largest US state, the sky is falling.

Now you can be like "but there's all these only job listings" - go talk to a damn recruiter which i have done several times in the past 1 week. Almost all of them are shell listings right now. Usacs makes it sound like they have 20+ openings, when you talk to them on the phone, the recruiter is like "yeah i have nothing active right now. How about Oklahoma?".

Teamhealth - "yeah we just have one site. Used to be 36k volume, now 25k, single coverage, most days no MLP. It's a very difficult job".

I would have sworn that sound physicians would have something in port arthur (or was it vituity? Whatever, one of those cmgs that give you pretend partnership. Their recruiter said "yeah even that site is full. We have nothing".

All of these guys just have job postings up and aren't hiring, they don't mind getting resumes so they have a pool of candidates when they actually do hire.

Temple Texas has a posting up and pretend to be hiring, when you email them they say yeah maybe one spot but we have dozens of applicants for that spot so low chances.

IES pretends that they have several spots around Houston....i wouldn't know, because they seriously didn't even respond to my email or phone calls. The recruiter seriously has one job to do -_-

Envision pretends to be hiring for Lubbock and other smaller areas. Talked to Lubbock recruiter, she had nothing. The other areas like tyler Texas etc, the recruiter didn't respond at all. I've called twice and sent an email. No response. They probably aren't really desperate

So..... What happens when 100+ residents graduate next year? A lot of these people like to stay within the state. I don't even think Texas will have jobs for this year's class.

This isn't some small place.... This is the second largest state.

I'm just so damn tired of these posts. If you don't think the market is bad or want to rationalize and be in denial then you do you. Go pick up a phone, see if you can find something and then we can talk -_-

@cyanide12345678 , we both know recruiters low ball and play all sorts of games. When I was applying for jobs in Houston in 2015, I had a TH recruiter telling me the 'job market is very tight' at a time when employers were begging you to work for them, for $500/hr in some places. So, I don't trust them.

Strongly suggest you start to cold call the hospitals and speak with the director. While the hospital EDs are definitely full, there's still room in the freestanding EDs. Pay is much lower, but you can still land a (less stressful) job.

 

[miacomet]

That data isn't completely accurate because it doesn't consider AOA spots before and after the merger. Here is a more accurate list IMO:

View attachment 318108

As far as FM being rainbows and butterflies, I didn't get that sense when I looked their forums. They got hit pretty hard by COVID

Urology isn't even listed. They keep that field locked down, tight.

 

[Raryn]

Urology isn't even listed. They keep that field locked down, tight.

They're not on that because it looks like the data is derived from the NRMP match. Urology has a separate match.

 

[Rekt]

@cyanide12345678 , we both know recruiters low ball and play all sorts of games. When I was applying for jobs in Houston in 2015, I had a TH recruiter telling me the 'job market is very tight' at a time when employers were begging you to work for them, for $500/hr in some places. So, I don't trust them.

Strongly suggest you start to cold call the hospitals and speak with the director. While the hospital EDs are definitely full, there's still room in the freestanding EDs. Pay is much lower, but you can still land a (less stressful) job.

I've done this and every place I've talked to has no plans on hiring anytime soon. Not to mention, the fact that a new grad starting their career at a FSED is essentially career ending unless you're able to grab enough prn shifts at a place with actual pathology.

 

[skougess]

I've done this and every place I've talked to has no plans on hiring anytime soon. Not to mention, the fact that a new grad starting their career at a FSED is essentially career ending unless you're able to grab enough prn shifts at a place with actual pathology.

This is my fear. I’m aware there will be SOME job for me. But honestly if you are starting out in some back woods free standing, that’s a one way street.

 

[GeneralVeers]

This is my fear. I’m aware there will be SOME job for me. But honestly if you are starting out in some back woods free standing, that’s a one way street.

I see a future where you get jobs based on your metrics which will follow you. National patient satisfaction scores will be on a database and tied to individual doctors. Low patient sat doctors can forget ever working at a decent job in city.

 

[skougess]

I see a future where you get jobs based on your metrics which will follow you. National patient satisfaction scores will be on a database and tied to individual doctors. Low patient sat doctors can forget ever working at a decent job in city.

So I guess dilaudid and benzos for everyone?

 

[bravotwozero]

I've done this and every place I've talked to has no plans on hiring anytime soon. Not to mention, the fact that a new grad starting their career at a FSED is essentially career ending unless you're able to grab enough prn shifts at a place with actual pathology.

My post was not directed to a new grad, but an experienced attending looking to slow down and relocate....

 

[GeneralVeers]

So I guess dilaudid and benzos for everyone?

It will just be a menu card. Check off what meds/studies you want. Also decide if you want yourself admitted/discharged at the end.

 

[miacomet]

It will just be a menu card. Check off what meds/studies you want. Also decide if you want yourself admitted/discharged at the end.

It's like this where I work. We don't have many addicts (any more). But I never say no. You get killed with pt satisfaction below the 90th percentile.

 

[beebermd]

I've done this and every place I've talked to has no plans on hiring anytime soon. Not to mention, the fact that a new grad starting their career at a FSED is essentially career ending unless you're able to grab enough prn shifts at a place with actual pathology.

this is a valid concern. as a medical director, my CMG wouldn't even consider you if your only work for greater than 2 years, was a FSED. BCEM or not. Their concern was skill set deterioration. I was heavy in the FSED workplace, but still worked in a traditional ED 3-5 shifts/mth because I was afraid i would lose my skills. When I went back FT in the traditional ER, I was AMAZED at how much I lost, even continuing to work a couple of shifts a month. I didn't realize it until I came back.

 

[sylvanthus]

this is a valid concern. as a medical director, my CMG wouldn't even consider you if your only work for greater than 2 years, was a FSED. BCEM or not. Their concern was skill set deterioration. I was heavy in the FSED workplace, but still worked in a traditional ED 3-5 shifts/mth because I was afraid i would lose my skills. When I went back FT in the traditional ER, I was AMAZED at how much I lost, even continuing to work a couple of shifts a month. I didn't realize it until I came back.

How does this work for those doing other stuff fulltime? Im currently ICU fulltime and my ED shifts have dried up. Am I gonna be hosed looking for ED spots in the future since Im not currently in the ED?

 

[bravotwozero]

How does this work for those doing other stuff fulltime? Im currently ICU fulltime and my ED shifts have dried up. Am I gonna be hosed looking for ED spots in the future since Im not currently in the ED?

ICU + freestanding. Now there's an idea for you!

 

[RustedFox]

ICU + freestanding. Now there's an idea for you!

Open a freestanding ICU.

 

[wamcp]

So how high was the earning potential during the glory days of EM supply shortage?

Better than surgical subspecialties?

This was posted during the midst of 2020 covid!

Otolaryngology Physician job in

Otolaryngology Physician job in

www.practicelink.com

$1 Million+ Potential VERIFIED, Hospital Employed, or Hospital-Supported Private Practice, Opportunity for ASC Ownership​

• $450,000-550,000 base salary dependent on experience
• 29 days PTO/ 6 holidays/ 9 days sick time/ 1 week CME + $5000 Allowance
• Executive-level benefits - 401K & deferred compensation plans
• Significant Sign-On Bonus!
• $100,000 in either Student Loan Repayment, or Home Purchase Assistance
• $15,000 Relocation Allowance

 

[sylvanthus]

In retrospect I shoulda done urology, ENT or some super subspecialty. I had the stats. I see clearly that those that bring money into the hospital are treated far better in all respects. Well maybe next life.

 

[wamcp]

In retrospect I shoulda done urology, ENT or some super subspecialty. I had the stats. I see clearly that those that bring money into the hospital are treated far better in all respects. Well maybe next life.

Even if you lack stats as a MS4, just do IM and then gun for GI. Seems to be on par. (if you prefer smelling poop all day)

Gastroenterology Physician job in Marshfield, WI

Gastroenterology Physician job in Marshfield, WI

www.practicelink.com

$700,000 2 yr Guaranteed Salary GI Opportunity at Flagship Hospital​

• Minimum of $700,000 2 year guaranteed salary, RVU based salary following
• Opportunity for competitive bonus
• 4 weeks vacation, 2 weeks CME to start
• $5,800 CME annual allowance
• Health, dental, life, disability, and occurrence-based malpractice insurance
• Fully funded retirement plan; 401(k) with match; 457(b)
• Fully funded relocation

 

[sylvanthus]

Midlevels doing colonoscopies now so GI not safe either.

 

[wamcp]

Midlevels doing colonoscopies now so GI not safe either.

Are there patients who happily agree to that..ffs... we will see colon ca rates skyrocket decade from now from the missed polyps