Work as few shifts in the Emergency Department as possible, preferably < 120 per month. Also, work as few night shifts as possible. Seeing that helps. If you're at less than 120hr per month, and working few or no night shifts and still hate your job, you need to change jobs. If it still persists beyond more than 2 or 3 job changes while working <120 hr per month and few if any nights, then you may need to get out of the ED, period. Your tour of duty in EDs may have run its course. This is not a bad thing, not a sign of weakness or failure, and not a state easily fit into a box and easily labeled as "burnout" as it is popular to do. It can be completely healthy. There are ways to do this without "throwing it all away." There is no incontrovertible law of the Universe stating you must work around the clock, 24/7/365 in an emergency department to be happy, fully productive and fulfilled as a doctor and human being. Heresy, I know, but true.