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Soul crushing AND unsustainable.Is it if they are making $275+/hr? Is 15 days/month (12 hrs) soul crushing in EM?
Soul crushing AND unsustainable.Is it if they are making $275+/hr? Is 15 days/month (12 hrs) soul crushing in EM?
EM doesn’t work like other fields. Few people are going to be able to sustain a 40 hour week average. I say average because nobody in EM works 40 hours every week.Sorry this may be incorrect math on my part but does this mean if you worked 40hr a week youd gross like $544,000?
But the math was correct? Sorry for the stupid questions.EM doesn’t work like other fields. Few people are going to be able to sustain a 40 hour week average. I say average because nobody in EM works 40 hours every week.
Sorry this may be incorrect math on my part but does this mean if you worked 40hr a week youd gross like $544,000?
Ahhh that’s where I got messed up, I assumed you were getting $40k quarterly (I was kinda in shock lol).Nope.
Full time is 13 x 12 hr monthly shifts.
So 375k from hourly. Plus 50k annual bonus for full time (i thought it was 40k but i was off). So 4 x 12.5k quarterly payments.
Gross = 425k
Kind of getting an extra 25k/yr for the next 3 years because they are incredibly low staffed and are attempting to retain people.
So limited time gross = 450k if i worked 1872 annual hours.
Plus cme, and the usual w2 benefits.
Wouldn't go that far. I'd rather work a 12 seeing 1.2 pph then a 8-10hr shift seeing 2+ pph. Plus I get more days off working 12s.
Do you feel you could work more at another facility during the other 2 weeks you have off or another side gig if you wanted?Nope.
Full time is 13 x 12 hr monthly shifts.
So 375k from hourly. Plus 50k annual bonus for full time (i thought it was 40k but i was off). So 4 x 12.5k quarterly payments.
Gross = 425k
Kind of getting an extra 25k/yr for the next 3 years because they are incredibly low staffed and are attempting to retain people.
So limited time gross = 450k if i worked 1872 annual hours.
Plus cme, and the usual w2 benefits.
Lol spoken like a med student.Do you feel you could work more at another facility during the other 2 weeks you have off or another side gig if you wanted?
Do you feel you could work more at another facility during the other 2 weeks you have off or another side gig if you wanted?
Haha. Thank you!Lol spoken like a med student.
NO.
I’m going part time starting October to 10 shifts per month. Taking roughly a 90k pay cut.
So no I’m not interested in working on my days off. Absolutely not. I don’t ‘love’ work. There are better things in my life than work.
No, the amount of money isn’t the draw towards EM. It’s the once in a while actual emergencies that you can actually make a difference and save a life.If your motivation for EM is how much money you’ll make, then pick orthopedic surgery, dermatology, anesthesiology, ophthalmology, ent, or urology.
No, the amount of money isn’t the draw towards EM. It’s the once in a while actual emergencies that you can actually make a difference and save a life.
Oh I know. I think out of my 5 years we had less than 10 actual emergencies.True emergencies are surprisingly rare in emergency medicine
I feel like they’ve been ever rarer on IM service though 😂True emergencies are surprisingly rare in emergency medicine
If acuity is your thing, you’re much better off doing critical care…Oh I know. I think out of my 5 years we had less than 10 actual emergencies.
If acuity is your thing, you’re much better off doing critical care…
Do you feel you could work more at another facility during the other 2 weeks you have off or another side gig if you wanted?
Seems to be the same consensus with my mentors in the field. Was just curious hahaI can answer that for him.
Jesus, man. No.
You have zero bandwidth left for much of anything.
Figure out what the day to day job is for any field you're interested in and see if you like that. Utterly ignore the cool 5% that any field does, as that crap doesn't happen day to day.I feel like they’ve been ever rarer on IM service though 😂
Noted, I just feel the same "Meh" patients the ED gets the Hospitalists see as well. I like the bread and butter so far of IM just wish there was more acuity in it. Who knows. Thank you to everyone who responded to me. I didnt mean to turn this post into something it wasnt intended for.Figure out what the day to day job is for any field you're interested in and see if you like that. Utterly ignore the cool 5% that any field does, as that crap doesn't happen day to day.
Do you hate handing out B Blockers? Don't go into cards.
Do you hate giving vaccines and treating URIs with overly anxious parents? Don't go into peds.
Do you hate dealing with chronic non emergencies presented by the bottom 10% of humanity? Don't go into EM.
Etc etc.
I have only done about 10, 12 hr shifts my whole career and they are soul crushing.Any amount of 12 hour shifts in the ED is soul-crushing.
My predicament is that I feel IM is going to deal with some of the same bullcrap going on in EM and there has been less acuity on my IM rotation. I enjoy thinking on my feet and the few cases of actual emergent cases that came into the ER during my 5 years as a scribe.
Yea, thats the consensus I have seen on IM. No one seems thrilled with their job. There is a privately owned group that I scribed for that the CEO is a very close friend who has already told me they would hire me post graduation (not counting eggs before they hatch).Outpt IM/hospitalists is more soul crushing than EM. Disagree, but there are more hospitalist zombies than any other hospital specialty.
But to your question, makin 500K/yr as an EM doc is not difficult.
I know of a job around the Houston area that pays 350/hr and still can't fill spots. If you can do 40hr/wk x 52 then you are at 725k/yr. They do bonuses too. Get close to a million if you do part time and them pick up all the bonus shifts.
I have been out of the pit for about 5 yrs. I worked in a functional hospital, probably a top tier functional hospital. Even with this, the happiest hospital specialty was EM compared to the on call docs.Yea, thats the consensus I have seen on IM. No one seems thrilled with their job. There is a privately owned group that I scribed for that the CEO is a very close friend who has already told me they would hire me post graduation (not counting eggs before they hatch).
I dont know that I want my quality of life to be terrible just to make a boat load lol.
Yea I am between a few (GS, Neuro, IM, and EM) and will narrow it down in the next few months. The doom and gloom of EM has it as the last on my list though LOL.I have been out of the pit for about 5 yrs. I worked in a functional hospital, probably a top tier functional hospital. Even with this, the happiest hospital specialty was EM compared to the on call docs.
Hospitalist, GS, OB were all miserable b/c they had to come to the hospital. The ones that can tag IM over the phone were overall pleasant which is obvious b/c its a phone call then back to their lives. These other schmucks who had to drop everything and come in a 11p-5am, were all miserable.
The level of unhappiness was by far the hospitalists. They were always busy. From 7pm, they were single coverage for the whole hospital. I remember starting my consult off by saying, "sorry man, but I have another", knowing they are already 5 behind.
Interesting.I have been out of the pit for about 5 yrs. I worked in a functional hospital, probably a top tier functional hospital. Even with this, the happiest hospital specialty was EM compared to the on call docs.
Hospitalist, GS, OB were all miserable b/c they had to come to the hospital. The ones that can tag IM over the phone were overall pleasant which is obvious b/c its a phone call then back to their lives. These other schmucks who had to drop everything and come in a 11p-5am, were all miserable.
The level of unhappiness was by far the hospitalists. They were always busy. From 7pm, they were single coverage for the whole hospital. I remember starting my consult off by saying, "sorry man, but I have another", knowing they are already 5 behind.
I’ve noticed this and it’s why I am considering IM. Literally the shift is from 7a-7p the attending gets there at 8 and leaves by 2.Interesting.
I am a hospitalist and on my week, there are 3 hospitalists that think hospital medicine is better than even sliced bread.Their attitude is that "chest pain" call card; GI bleed, call GI. Patient is going bad, dump him/her into the intensivist lap..
For the most part, the people I work with like hospital medicine. Two of them even went as far to say they are overpaid (350k) for what they do. These two guys are quick and usually done by 1-2pm and spend the rest of their time on the computer watching the stock market.
When it comes to lifestyle, I think hospital medicine (HM) is great. We have a guy who just transitioned from outpatient M-F to HM after doing outpatient for 4-5 years. He keeps saying every day what took him so long.I’ve noticed this and it’s why I am considering IM. Literally the shift is from 7a-7p the attending gets there at 8 and leaves by 2.
Another reason IM is higher than EM is the option to do a fellowship to become a specialist.
Yea one of my preceptors does week on week off and has a side gig where he does 3 hours of work on his off week an makes an extra $50,000 lol.When it comes to lifestyle, I think hospital medicine (HM) is great. We have a guy who just transitioned from outpatient M-F to HM after doing outpatient for 4-5 years. He keeps saying every day what took him so long.
Yea one of my preceptors does week on week off and has a side gig where he does 3 hours of work on his off week an makes an extra $50,000 lol.
I like the lifestyle but I dont know if I would be okay with the acuity of patients. My preceptor said that sometimes they feel like the grunt of the hospital. So thats something I have to see.
I think high acuity just fits my personality well. I am very calm and collected in high stress situations. I know there can be those in many specialties though. My naiveness is glaring the further this conversation goes on and I am well aware of that lol.What's funny is that here I am, wishing I got the complexity of IM.
Acuity is cool at first, yeah. It gets very easy, very fast.
I think high acuity just fits my personality well. I am very calm and collected in high stress situations. I know there can be those in many specialties though. My naiveness is glaring the further this conversation goes on and I am well aware of that lol.
I think high acuity just fits my personality well. I am very calm and collected in high stress situations. I know there can be those in many specialties though. My naiveness is glaring the further this conversation goes on and I am well aware of that lol.
Do IM. More flexibility.
Can just be a hospitality. Can further specialize into better specialties (gi, cards, oncology etc).
Can always have a chill life and do outpatient clinic as well.
Much more flexibility. EM has no flexibility. You are pretty much a pit doc unless you do a fellowship to get out, and most fellowships then make less than what a hospitalist makes except pain fellowship.
IM is a better choice. It just took me too many years to recognize that.
The issue with medicine is that most people who go into medicine did not see it as a job until reality hits them in the face.Hey, at least you're mature enough to admit: "maybe dozens of EM attendings with collectively hundreds of years of experience may know something that I don't", instead of the usual response of "you guys are ALL wrong, Im just different, you're burned out and can't handle it" that we so commonly get on here.
The issue with medicine is that most people who go into medicine did not see it as a job until reality hits them in the face.
I am not ashamed to say that I went into medicine primarily for financial security. For some strange reason, I just happen to like hospital medicine. Maybe it's because of 350k/yr and the 7days on/off working form 7:15 am to ~5pm (on average). Lol
Yea, a lot of people fail to realize the knowledge that can be had if you shut up and take in the knowledge that others are so willing to give.Hey, at least you're mature enough to admit: "maybe dozens of EM attendings with collectively hundreds of years of experience may know something that I don't", instead of the usual response of "you guys are ALL wrong, Im just different, you're burned out and can't handle it" that we so commonly get on here.
Yea, a lot of people fail to realize the knowledge that can be had if you shut up and take in the knowledge that others are so willing to give.
I am not ashamed to say that I went into medicine primarily for financial security. For some strange reason, I just happen to like hospital medicine. Maybe it's because of 350k/yr and the 7days on/off working form 7:15 am to ~5pm (on average). Lol
The issue with medicine is that most people who go into medicine did not see it as a job until reality hits them in the face.
I am not ashamed to say that I went into medicine primarily for financial security. For some strange reason, I just happen to like hospital medicine. Maybe it's because of 350k/yr and the 7days on/off working form 7:15 am to ~5pm (on average). Lol
I’m going to second that. I went into medicine because of financial security. And if you grow up in a Pakistani household, either you are a doctor or an engineer, otherwise you are a disappointment 🤣
Emergency medicine 3 year residency seemed like an attractive choice, highest paying 3 year specialty with the most number of days off. I didn’t think i would burn out like everyone else. I thought id be the exception - i mean i moved here with 2 suitcases as an immigrant for college. I’ve seen some rough days when i moved. Survived on ramen noodles and no money in college. I shouldn’t be burned out!!! My life is incredible compared to what it was 10-15 years ago. But for whatever reason that i cannot fully understand, I’m burned out.
Would i be happier in some other specialty? I don’t know.
Some people are born happy, some not. I know roofers, construction workers, cafeteria workers who are truly happy even working in the heat. They have what they need, they deal with what they have not, they have their health/family. There are docs making 5x what these people make, working in AC places, with more time off than they can imagine, but still not satisfied.But I think an argument can be made that a lot of the EM burnouts would be burned out in many if not all the specialties for one reason or another.
Your rhetorical question is what I think might be a key discussion point for EM burnout. Is it the the specialty, the person, or both? My hunch is it’s a little of both, probably something like a 70-30 split in favor of the specialty. But I think an argument can be made that a lot of the EM burnouts would be burned out in many if not all the specialties for one reason or another.
Any amount of 12 hour shifts in the ED is soul-crushing.
I mean.... I have worked 48 hours a week for the last 6 years (and was above that for a chunk of peak covid). And I'm not the only one.EM doesn’t work like other fields. Few people are going to be able to sustain a 40 hour week average. I say average because nobody in EM works 40 hours every week.
>48 hours every week (as in you haven't taken any vacations longer than 3 days for a calendar week?) or averaged 48 hours every week? There's a difference but you'll also be in the vast minority so it's important to point that out for those lurking.I mean.... I have worked 48 hours a week for the last 6 years (and was above that for a chunk of peak covid). And I'm not the only one.
I know it sounds like humblebragging and its hard to get intent online. I'm just saying it because I think we are maybe a bit *too* gloom and doom on SDN and we forget that people do exist who enjoy doing this and haven't burned out yet. And I'm not the only one (though I do know we are a minority. we aren't a *rare* minority)
edit: technically >48 hours a week for the last 10 years, since I was obviously doing that much (and more) in residency too.
To add another perspective … I didn’t mind 12’s either before I had kids. But now there isn’t enough time in a day for me to spend time with my family and also do the housekeeping things I need to do (I don’t mean literal housekeeping, but like .. making sure all the papers and lunches make it to school, stop to buy milk on the way home, etc).. if I work a 12 I either am away from home ALL DAY except for half an hour before bed, or I can’t be home for dinner and bedtime.disagree.
Give me *full* days on and *full* days off every time and dont eat up my whole week with shifts that are too long for me to enjoy the rest of my day but still shorter than they could be. If I'm in for a penny, I'm in for a pound. If i can't spend my whole day doing what I want, let me make all the money I can and work as many hours as they will let me at once.
To add another perspective … I didn’t mind 12’s either before I had kids. But now there isn’t enough time in a day for me to spend time with my family and also do the housekeeping things I need to do (I don’t mean literal housekeeping, but like .. making sure all the papers and lunches make it to school, stop to buy milk on the way home, etc).. if I work a 12 I either am away from home ALL DAY except for half an hour before bed, or I can’t be home for dinner and bedtime.
Also, approaching 40 I’m starting to feel noticeably less sharp around hour 11.
Yea I am between a few (GS, Neuro, IM, and EM) and will narrow it down in the next few months. The doom and gloom of EM has it as the last on my list though LOL.