How's the job market in desirable cities/coastal cities (NYC, SF, LA, etc)?

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Also interested for those with pain fellowships and for those without fellowship.

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There’s literally almost endless discussion available if you use the search function. My program director once told me it’s a lot easier to help someone achieve their goals when they’re able to articulate what those goals are. I would recommend some introspection.
 
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I think nyc is tough market I would start looking early. My friends with a pain fellowship had trouble finding pain jobs in nyc they are doing mostly anesthesia. Ie anesthesia first few years or anesthesia through out the week with limited pain days in a month.
 
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Why do you find those places desirable
 
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Why do you find those places desirable

• LA has great taco trucks?

• NYC has great halal chicken rice?

• SF has a disproportionate number of “wealthy” single men (living with a bunch of other “wealthy” single men in houses with bunk beds)?
 
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It does. I miss some things about southern California. I grew up in Encinitas. I don't miss the weather enough to compensate for the factors that keep me from ever moving back though. :)
Gun control, traffic, taxes, COL. :D
 
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I have close friends (and family) who live in LA/SF/Dallas/NYC/DC/Miami etc

there is a lot of pros and cons with each city.
NYC/SF proper in general suck for medical services pay wise vs housing cost. I have friends who live inside the city.

DC job market sucks as well. Most live in suburbs but suburbs jobs suck as well. Traffic sucks

Miami sucks for pay. It’s not that great of a real city. Don’t believe all the pictures. It’s certainly cheaper with no state income taxes. But beaches/super humidity can get old (winters are great in south florida )

LA proper market is brutal. Traffic is notorious bad. In my opinion. The best weather

Dallas is great housing cost vs pay . But opportunities are getting less and less. It’s also too hot in Dallas at times. Not as bad as Houston humidity.

Figure out what your expectations are. You can rent a 600 square foot mid town manhattan apt for roughly $3000/3500 with no washing machine inside ur apt. You have to go to another floor to do your own laundry. And get paid $350-400k. And pay 11% city plus New York taxes. If you are ok with that

you can get a little more value living in Brooklyn PLUS IN APARTMENT washer. Lol
 
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Totally agree. More of a tongue in cheek post. However, Coming from an East coast environment where summers were regularly mid 90s plus very high humidity, I much prefer North Texas summers. As I get older, I find I can't tolerate cold winters anymore (Acquired Raynauds?). So the weather is perfect for me. If I was in Houston or San Antonio, it would be a different story
I am a Texan, and these summers ain't no joke.
Beats the cold, but I wish we didn't have five months of the year with 90+ degree weather and three months of 100+.
If one's a scorpion.
 
I have close friends (and family) who live in LA/SF/Dallas/NYC/DC/Miami etc

there is a lot of pros and cons with each city.
NYC/SF proper in general suck for medical services pay wise vs housing cost. I have friends who live inside the city.

DC job market sucks as well. Most live in suburbs but suburbs jobs suck as well. Traffic sucks

Miami sucks for pay. It’s not that great of a real city. Don’t believe all the pictures. It’s certainly cheaper with no state income taxes. But beaches/super humidity can get old (winters are great in south florida )

LA proper market is brutal. Traffic is notorious bad. In my opinion. The best weather

Dallas is great housing cost vs pay . But opportunities are getting less and less. It’s also too hot in Dallas at times. Not as bad as Houston humidity.

Figure out what your expectations are. You can rent a 600 square foot mid town manhattan apt for roughly $3000/3500 with no washing machine inside ur apt. You have to go to another floor to do your own laundry. And get paid $350-400k. And pay 11% city plus New York taxes. If you are ok with that

you can get a little more value living in Brooklyn PLUS IN APARTMENT washer. Lol

What kind of area do you live in then? Just curious. Some people (especially if young and single) prioritize living in a fun city over banking a few extra g’s. At our salaries, we can live comfortably no matter where we choose to live.
 
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What kind of area do you live in then? Just curious. Some people (especially if young and single) prioritize living in a fun city over banking a few extra g’s. At our salaries, we can live comfortably no matter where we choose to live.
Until Covid gets a cure or vaccine, what kind of fun is there to really have without worrying about getting sick these days? Just wondering.
 
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What kind of area do you live in then? Just curious. Some people (especially if young and single) prioritize living in a fun city over banking a few extra g’s. At our salaries, we can live comfortably no matter where we choose to live.
I’ve worked in proper NYC, SF area, mid Atlantic and south.

Honestly. I loved the Bay Area proper. Just too freaking expensive. By proper. I mean literally 10 min in/out of SF. Not the 45 min away.

if you are young and single. Almost any big city will work. There are more educated people in the urban west coast and northeast Areas in general.

I’ve been based in the south the past decade. Where i have saved the most. Just cheaper cost of living. Not a massive urban area. But 2-3 million people in the surrounding area. My definition of major urban area is population 5 plus million by the way.
 
Why do you find those places desirable
A lot of my family is in New York.

But I was also curious to ask about other famous desirable places.
 
A lot of my family is in New York.

But I was also curious to ask about other famous desirable places.

i think job market in nyc is okay. not great. but there are jobs. some people have left due to coronavirus and probably not coming back. we have a few ~70 yr olds who got essentially sent to retirement. however its super costly to be here and salaries usually around 300-400 depending for about 50-60 hrs of work including calls
 
i think job market in nyc is okay...

its super costly to be here and salaries usually around 300-400 depending for about 50-60 hrs of work including calls

Your "okay" is my "miserable".

I'm originally from NY and lived in NYC for several years as well. I loved living there, back when I was younger. But no way in hell I'd work those hours for that pay, not even in a low cost of living area, let alone NYC.
 
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Show me the money
LOL


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I have close friends (and family) who live in LA/SF/Dallas/NYC/DC/Miami etc

there is a lot of pros and cons with each city.
NYC/SF proper in general suck for medical services pay wise vs housing cost. I have friends who live inside the city.

DC job market sucks as well. Most live in suburbs but suburbs jobs suck as well. Traffic sucks

Miami sucks for pay. It’s not that great of a real city. Don’t believe all the pictures. It’s certainly cheaper with no state income taxes. But beaches/super humidity can get old (winters are great in south florida )

LA proper market is brutal. Traffic is notorious bad. In my opinion. The best weather

Dallas is great housing cost vs pay . But opportunities are getting less and less. It’s also too hot in Dallas at times. Not as bad as Houston humidity.

Figure out what your expectations are. You can rent a 600 square foot mid town manhattan apt for roughly $3000/3500 with no washing machine inside ur apt. You have to go to another floor to do your own laundry. And get paid $350-400k. And pay 11% city plus New York taxes. If you are ok with that

you can get a little more value living in Brooklyn PLUS IN APARTMENT washer. Lol
This is a pretty accurate post.
 
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If we exclude places like NYC, Boston, Chicago, and Philly, we can all agree that in general "desirable" means great (warm/hot) weather most of the year or at least some resemblance of readily available cultural activities, which many of us have our own definition.

You can absolutely find low/lowish cost of living in California and Florida and generally get what people call "desirable" for those areas but you just won't be in Miami, LA or SF. For some people being in or very near those cities or near the beach is the very definition of living in those states.

You get California weather by living in Fresno or even Bakersfield and there are absolutely jobs in those places but many people have to be convinced to lived in those locations. As I get older my priorities have definitely changed and what I once looked at as desirable, may not be exactly that anymore.

I'm approaching "desirable" as a 4 bd/3 bth reasonably priced home in a safe place with a tolerable climate and moderate politics.
 
You get California weather by living in Fresno or even Bakersfield and there are absolutely jobs in those places but many people have to be convinced to lived in those locations.

Living in Fresno or Bakersfield is stupid. You are paying the CA taxes with none of the benefits of living in CA. You’d be better off in AZ or NV or OR or well you get the point.
 
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If we exclude places like NYC, Boston, Chicago, and Philly, we can all agree that in general "desirable" means great (warm/hot) weather most of the year or at least some resemblance of readily available cultural activities, which many of us have our own definition.

You can absolutely find low/lowish cost of living in California and Florida and generally get what people call "desirable" for those areas but you just won't be in Miami, LA or SF. For some people being in or very near those cities or near the beach is the very definition of living in those states.

You get California weather by living in Fresno or even Bakersfield and there are absolutely jobs in those places but many people have to be convinced to lived in those locations. As I get older my priorities have definitely changed and what I once looked at as desirable, may not be exactly that anymore.

I'm approaching "desirable" as a 4 bd/3 bth reasonably priced home in a safe place with a tolerable climate and moderate politics.
Come to Texas!! We have cheap nice houses all the way to overpriced McMansions depending on where you want to live. It's a Red State, but the major cities lean liberal with plenty of minorities. No state income taxes, but high real estate taxes so be careful of how much you pay for your house and the neighborhood because that could get expensive.
However, we got plenty of CRNAs, although if doing cardiac you may not have to work with them.
 
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Living in Fresno or Bakersfield is stupid. You are paying the CA taxes with none of the benefits of living in CA. You’d be better off in AZ or NV or OR or well you get the point.
If I had known better coming out of residency I would've avoided California on taxes alone. Now I've gotten used to the weather it's pretty hard for me to go back to long winters. I think my grand point was that if people want to live in the CA they dream about they better be ready to pay for it. I know in your neck of the woods you can find some value but then the battle becomes finding a good job. I know they're out there, but you have to know somebody that knows somebody that surfs with someone.
 
Come to Texas!! We have cheap nice houses all the way to overpriced McMansions depending on where you want to live. It's a Red State, but the major cities lean liberal with plenty of minorities. No state income taxes, but high real estate taxes so be careful of how much you pay for your house and the neighborhood because that could get expensive.
However, we got plenty of CRNAs, although if doing cardiac you may not have to work with them.
I could see myself as a Texan.....
tenor.gif


The problem is I'm tired of applying for licenses. I have SIX. Granted two are regional because there was an area where it benefited you to have two bordering state licenses, well let's not be coy, a "district" and a state. That's just dumb. I'm considering letting a few lapse because Im tired of doing the state required CME requirements for renewal. If a good job in Austin or maybe San Antonio popped up I would maybe consider it if they wanted me to join.
 
I know they're out there, but you have to know somebody that knows somebody that surfs with someone.

Pretty much. That’s what I tell everyone interested in coming here with no connections.
 
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Living in Fresno or Bakersfield is stupid. You are paying the CA taxes with none of the benefits of living in CA. You’d be better off in AZ or NV or OR or well you get the point.
My buddy is from originally from Los Angeles. Worked at kern (Bakersfield) and made 500-550k with 10 weeks off for a long time before somonia stole the contract in 2007.

moved back to LA proper Settled for mid 350s as w2 hospital employee with generous benefits.

ain’t no one gonna to work at kern for 350-375k when somonia took over a long time ago. I know they finally changed the pay structure but it took them 3 plus years to figure it out.
 
New York City metro has jobs. I get emails left and right from recruiters about NYC jobs. You just have to be ok making 300-350k and taking in house call possibly covering OB and trauma. I know there are outliers but that's my general sense of NYC. If start heading out out of the city and away from Metro North you can probably pull more and quite honestly if there weather wasn't so extreme a house on a lake in Upstate NY doesn't sound horrible. Most people should just forget SF unless you do your residency at Stanford or UCSF, make some connections, and have a little luck. Expensive areas mean people need to work to live their expensive lifestyle and many practices are willing to run thin in order to do so. If there's an opening in the Bay Area it's usually a retirement, death, or some problem with the practice. My sense of LA is that it's a lot of 1099 work or if you do find a W2 position it's usually for like 350k. In order to afford a home you're doing to need to be able to tolerate traffic.

If you're young and single, have at it. YOLO. If you're married and have children, really evaluate if "desirable city" is what you want. You WANT somewhere you can afford to live and to possibly send the kids to a good public school system or if not, have enough of an income to comfortably send them to private school.
 
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Won't happen any time soon.
Yah, those days are gone. Been gone in Austin and recently gone in San Antonio.

I'm looking to move back in 2 years and this does not bode well :/
Either dallas/houston/SA would be great, but hopefully the surrounding towns would still have decent PP gigs (thinking Georgetown/Round Rock/ Boerne/ Sugarland/Plano)
 
I'm looking to move back in 2 years and this does not bode well :/
Either dallas/houston/SA would be great, but hopefully the surrounding towns would still have decent PP gigs (thinking Georgetown/Round Rock/ Boerne/ Sugarland/Plano)
Then get ready to say Hello to USAP. They aren’t too bad I hear. Austin has been bad for over a decade.
 
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It's hard to get in in LA. Also have heard Seattle is saturated af and the city only keeps getting more and more people - one of, if not the fastest growing city in the nation.
 
It's hard to get in in LA. Also have heard Seattle is saturated af and the city only keeps getting more and more people - one of, if not the fastest growing city in the nation.

I hear they’re hiring in the CHAZ.
 
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Then get ready to say Hello to USAP. They aren’t too bad I hear. Austin has been bad for over a decade.
I wonder if a group of anesthesiologists could band together and make a bid for a contract to one of their hospitals. Like 15-20 anesthesiologists that could staff one of their hospitals.
 
I wonder if a group of anesthesiologists could band together and make a bid for a contract to one of their hospitals. Like 15-20 anesthesiologists that could staff one of their hospitals.

A lot of risk and start up capital needed.
 
I have a good sense of the NYC market. Everything above is definitely accurate. You can expect 325k-400k working 50 hours a week in academics and a little more money/hours in PP. There are jobs, especially with people leaving after covid. Most people who want to do academic pain start with some or all anesthesia for a year or two.

At the moment, some academic centers have temporary pay cuts but I am not fully aware of how long those are in place and how it affects new hires.
 
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New York City metro has jobs. I get emails left and right from recruiters about NYC jobs. You just have to be ok making 300-350k and taking in house call possibly covering OB and trauma. I know there are outliers but that's my general sense of NYC. If start heading out out of the city and away from Metro North you can probably pull more and quite honestly if there weather wasn't so extreme a house on a lake in Upstate NY doesn't sound horrible. Most people should just forget SF unless you do your residency at Stanford or UCSF, make some connections, and have a little luck. Expensive areas mean people need to work to live their expensive lifestyle and many practices are willing to run thin in order to do so. If there's an opening in the Bay Area it's usually a retirement, death, or some problem with the practice. My sense of LA is that it's a lot of 1099 work or if you do find a W2 position it's usually for like 350k. In order to afford a home you're doing to need to be able to tolerate traffic.

If you're young and single, have at it. YOLO. If you're married and have children, really evaluate if "desirable city" is what you want. You WANT somewhere you can afford to live and to possibly send the kids to a good public school system or if not, have enough of an income to comfortably send them to private school.

Agree with what you (and most other posters above) said about NYC. Most NYC gigs are in the $300-400k range, but I know of some people pulling in $500-550k. They're working 50-55 hrs/week to get there, though.
 
I applied to both academic and PP jobs in highly desired west coast cities. Fellowship trained. Overall, I found the interview process for academic gigs time consuming (required multiple essays like a diversity statement and mission statement), slow to respond to applications, and disorganized with what they are looking for or the trajectory of the department. In contrast, PP groups were a quick “meet and greet” phone call after reaching out, reasonably timed interview, and a clear picture of what they needed. I’m a path of least resistance kinda guy so you can guess where I ended up. Just figured I’d share my experience (n of 1) to those who are thinking about jobs in the near future. Connections start the process but your skill and personality finishes the job (and sometimes can’t control a connection that’s bigger than you).
 
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