Job Advice

[HoosierdaddyO]

Ok so I’m very fortunate to be in this situation but I’m having the hardest of times trying to navigate which of these two options I should go with, and any help/advice would be truly appreciated.

Job 1: is in a city that I’ve grown to not really love… it’s a huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc. the job is ideal… they have me working 9 shifts a month, 10 hour shifts (1080 hours clinically). I do have administrative duties but they are totally manageable and even fun for me. The hospital is lower acuity, ancillary is good, pay is on par with the rest of the country, colleagues are enjoyable. I also have a sweet side gig that pays pretty well. The only caveat about this place is the city. I’m a solid 3 hours away from all my family and friends, I’m single, just broke up with my significant other (who took all the friends in the breakup lol🙄)… so besides it being a solid career with low stress work and amazing hours it’s the essential loneliness that is really throwing a monkey wrench in to what would be an ideal life set up. The job security at this place is essentially Fort Knox (tenured), and the patient population is some of the nicest peoples I’ve ever known, little spoiled but otherwise perfect.

Pro: job security, clinical hours, passionate side gig, no overnights, great hospital! Solid salary plus paid side gig. Plus admin hours

Cons: I essentially hate the city and feel alone lol!


Job 2: is in my hometown city, one of the biggest cities in the United States, has everything under the sun in regards to just everything lol. The biggest attraction here is just being back with my family and close friends who I am super tight with. The hospital is a huge public city hospital with all the headaches that come along with serving that kind of population. I would be working 10 shifts, 12 hours (1440 a year and this is the reduced hours for the admin position I would be having as well). I would be working day and overnight shifts. I would have to give up my paid side gig which is fun for me. But the only true net gain is just being near all my family. The headache that I’m giving myself is that worth giving up what is otherwise a pretty sweet Cush situation that I currently have but can’t stand the city. The salary is otherwise equal for both places.

Pros: just being close to family and old friends.

Words of encouragement or advice from some of the peanut gallery would really be appreciated. Both are w-2, both are secure jobs, the 2nd job has residents that does most of the scut. But the the acuity and level of work stress would be higher as well. Just trying to figure out if needing to suck it up… or getting a fresh start on things is worth losing all that job 1 has to offer. Thanks as always 😊!!!

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[Groove]

Here's ChatGPT's advice:

Based on the information provided, both job options have their pros and cons. Here's an analysis of each job and a suggestion based on the details provided:

Job 1: This job seems to offer a great work-life balance with low stress, ideal hours, enjoyable colleagues, and good pay. The hospital is lower acuity, and you have a passion for the side gig that pays well. However, the major downside is your dislike for the city and the feeling of loneliness. If you value career stability, a good work environment, and financial security, this job would be a solid choice. However, the aspect of feeling alone and disconnected from family and friends may affect your overall happiness and well-being.

Job 2: This job offers the opportunity to be close to your family and old friends, which seems to be a significant factor for you. The city has a lot to offer in terms of amenities and experiences. However, the hospital is a large public city hospital with potentially higher acuity and work stress. Giving up your paid side gig may also be a downside. If being near your loved ones and having a support system is a top priority for you, this job could provide the emotional fulfillment you seek. However, it's important to consider the potential challenges and stress that may come with a larger hospital setting.

Considering your preference for being close to family and friends, it seems that Job 2 holds a special appeal to you. The emotional connection and support system that come from being with loved ones can have a significant positive impact on your well-being. While Job 1 offers great professional perks, the sense of loneliness and disconnect you feel might hinder your overall satisfaction in the long run. Prioritizing personal relationships and finding joy in being near your family and close friends can often outweigh the advantages of a more ideal professional situation.

Ultimately, the decision is highly personal and depends on your individual priorities and values. It may be helpful to reflect on what truly matters to you in the long term and consider the potential impact on your overall happiness and well-being. Consulting with trusted friends, family, or mentors who know you well may also provide valuable insights and perspectives.

 

[Groove]

You didn't say whether job 1 requires overnights. If it doesn't, I'd take job 1 in a heart beat but that's because I'm used to long distance friendships.

I get the sense that being close to family and friends plays a huge part of your personal satisfaction and happiness, so just go with job 2.

 

[HoosierdaddyO]

Haha that chatGPT is no joke lol… better advice then my hypothetical therapist😂!

Yea job 1 has no overnights, Pph of 1.5 it’s 100% hourly and tenured.

But agree I’m incredibly close with my family and as everyone gets older the ability to be 15-20 min from everything/one is the only hurdle in having to give up all the job 1 offers.

 

[Groove]

Haha that chatGPT is no joke lol… better advice then my hypothetical therapist😂!

Yea job 1 has no overnights, Pph of 1.5 it’s 100 perfectly hourly and tenured.

But agree I’m incredibly close with my family and as everyone gets older the ability to be 15-20 min from everything/one is the only hurdle in having to give up all the job 1 offers.

I know right?! I've started asking it's advice on all types of things, lol.

Ugh, no overnights? Damn....I hate to say it but that would seal job 1 for me. That's just such a high priority item. Zero overnights for the foreseeable rest of your career? HUGE. You're going to have to think that one over long and hard. How about scheduling regular trips back home every 1-2 months to hang out with family and friends? 3 hours isn't that far.... My best friend and I have been long distance for most of my adult life and probably see each other only a handful of times a year, yet we talk on the phone almost daily. I live in the same city as my parents....yet I see them probably only once a month and might talk to them once a week. It's all relative but it really depends on your personal situation. I'm not particularly close to my family so that would play less of a role in my case. Good luck.

 

[Janders]

If job 1 has no nights… and your home city is only 3hr away… I might be tempted to keep on at job one and structure your schedule so you go back “home” for a long 3-4day weekend every month. Or a full week every-other-month.

Obviously not the same as being there. But perhaps a transitional plan for a year or two… try to take time and find a better job than job 2 back home?

 

[PianoMedic]

Residents also takes the sting out of job 2 some. It is 400 more hours a year, which can be significant since you’re adding overnights, plus you are losing more shifts with switching back and forth from days to nights. I estimate 1.5 lost days per block of overnight shifts (I have trouble with evenings not becoming overnights so I estimate the same for a block of evenings as well). So even though it’s only a little more hours per year in actual work, the fact you’re doing nights too means you will lose more time. If you also have admin work, you may not have a lot of time to spend with friends and family.

All that said, we moved from 10 hours from family to 4 hours away and that made a large difference for my wife and I. Biggest difference was family then moving to our town last year, and now we see them a lot which has been wonderful.

It’s a tough decision, maybe you can assist with convincing admin to hire or incentivize some nocturnists at job 2? If so, then it is an easier decision I think. Job 1 is a career longevity type job, and maybe you just need to give the town another chance. I’m from a town of 6k people, so anything has more amenities than we did. I’m happy in anything 40-50k or bigger, if it has a mall it’s a big town to me, so I’m easy to please that way. Job 2 is the family play, if you’re a close knit family and you’d rather spend time with them outside work than at your own home, it seems the better option.

Since you’re going through a breakup, that may be affecting things, making you yearn for the familiar. Don’t make any big or life changing decisions for at least a couple months post breakup (you didn’t say when it happened). You’re in a big city so you should be able to avoid prior SO. Get out in the sun, find some parks and walking paths locally, go fishing or biking if one of those are your thing. There might be an element of countertransference of your feelings from your ex-SO onto the city, and you might like the city more if you give it a chance. Or maybe not and I’m an idiot, but just make sure you’re giving the current city a chance and not rushing back to the “grass is greener” and familiar with your hometown.

 

[GassYous]

I feel like I spend more time with my friends and family when I go home than I do with my friends where I'm at

 

[Rekt]

Job one without any doubt it my mind. And I say this as a nocturnist. You’re only evaluating your situation due to the significant other issue and that will pass. 3hrs is so easy to go back home for a weekend. 400 extra hours, loss of side gig, worse patient population, flip flopping, etc. You’ll be miserable

 

[cyanide12345678]

You’re only working 9 days a month. Just go visit family a couple times a month and problem solved.

Also…. Try to grow your social circle where you are. Literally it sounds like a breakup is making you change your tenured job. Just go out more often, you’ll find people.

I’ve moved cities 6 times now. You just have to work on being social and give it time. Our last move was 1.5 years ago to a city where we knew 0 people, and now we have a social circle of 10 families with frequent game nights, poker nights, dinners etc. you just gotta work on it.

 

[Brigade4Radiant]

With an EM salary and good control of your money you are the prize. With both friendships and relationships. I would stay in Job 1 since you are it seems like you just make more $$$ and it isn’t like a CMG

If you plan on having kids moving close to family may be worth it if they will help significantly with child care.


Also with the time you have off you can just go somewhere else on your off days

 

[Mr. Vandemar]

Can I have job #1?

 

[gruemd]

I also drive 3 hours...to get on a plane, to then fly 3+ hours and then drive again to see family. I'm intentionally geographically arbitraging because $$$ but still. I'd probably take #1 and drive back every now and again, do it for a couple years, see how you like it if you can maintain good relationship with the hometown hospital. The no nights thing is pretty huge.

 

[Brigade4Radiant]

I also think it’s an interesting point that a lot of us are telling them to pick job one. But in another thread, we were talking about being on our deathbed and wanting to spend more time with family.

Even if you sent me back, I would still pick job one

 

[sloh]

I have trouble with evenings not becoming overnights so I estimate the same for a block of evenings as well). So even though it’s only a little more hours per year in actual work, the fact you’re doing nights too means you will lose more time. If you also have admin work, you may not have a lot of time to spend with friends and family.

Can you expand on the bolded part?

 

[FlaminHotER]

Take Job 1

The difference between 9 and 12 hour shifts might not seem significant but I promise you as you get older it definitely DOES make a huge difference

 

[Mount Asclepius]

You’ve gotten decent advice with not much for me to add. This is a personal decision based upon your gut feel. It’s also not a permanent decision. I’ll throw my hat in the job #1 ring. I won’t hold it against you if you pick #2.

 

[HemeOncHopeful19]

I can think of worse situations to be in than a newly single doctor working 9 shifts a month in a “huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc.”

 

[wook]

The answer is highly personalized. My thoughts match others suggesting option #1. Family/friend within 3 hours, is easily driveable for me (I just drove over 900 miles straight a couple of days ago). With that being said, that is my ideal, and may not be yours.

In the end, create a pro and con list for each place and weight them with what is most appropriate for you, then calculate. When I was young, overnights were not a big deal (longest shift I ever did was 41 hours straight without sleep....different occupation). Now nights are challenging.

Figure out what works best for you.


Wook

 

[cyanide12345678]

Ok so I’m very fortunate to be in this situation but I’m having the hardest of times trying to navigate which of these two options I should go with, and any help/advice would be truly appreciated.

Job 1: is in a city that I’ve grown to not really love… it’s a huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc. the job is ideal… they have me working 9 shifts a month, 10 hour shifts (1080 hours clinically). I do have administrative duties but they are totally manageable and even fun for me. The hospital is lower acuity, ancillary is good, pay is on par with the rest of the country, colleagues are enjoyable. I also have a sweet side gig that pays pretty well. The only caveat about this place is the city. I’m a solid 3 hours away from all my family and friends, I’m single, just broke up with my significant other (who took all the friends in the breakup lol🙄)… so besides it being a solid career with low stress work and amazing hours it’s the essential loneliness that is really throwing a monkey wrench in to what would be an ideal life set up. The job security at this place is essentially Fort Knox (tenured), and the patient population is some of the nicest peoples I’ve ever known, little spoiled but otherwise perfect.

Pro: job security, clinical hours, passionate side gig, no overnights, great hospital! Solid salary plus paid side gig. Plus admin hours

Cons: I essentially hate the city and feel alone lol!


Job 2: is in my hometown city, one of the biggest cities in the United States, has everything under the sun in regards to just everything lol. The biggest attraction here is just being back with my family and close friends who I am super tight with. The hospital is a huge public city hospital with all the headaches that come along with serving that kind of population. I would be working 10 shifts, 12 hours (1440 a year and this is the reduced hours for the admin position I would be having as well). I would be working day and overnight shifts. I would have to give up my paid side gig which is fun for me. But the only true net gain is just being near all my family. The headache that I’m giving myself is that worth giving up what is otherwise a pretty sweet Cush situation that I currently have but can’t stand the city. The salary is otherwise equal for both places.

Pros: just being close to family and old friends.

Words of encouragement or advice from some of the peanut gallery would really be appreciated. Both are w-2, both are secure jobs, the 2nd job has residents that does most of the scut. But the the acuity and level of work stress would be higher as well. Just trying to figure out if needing to suck it up… or getting a fresh start on things is worth losing all that job 1 has to offer. Thanks as always 😊!!!

But seriously…am i the only cold hearted person who thinks friends, bfs/gfs are just replaceable. Wife/husband replacement costs a little and aren’t as easily replaced.

Go on a few tinder dates or something.

As a side note, when we moved to this completely new city, my wife literally posted in a fb Muslim community group of our city declaring that we are new here and wanting to get to know people - she ended up a couple dozen messages with people inviting us to their homes. We started off by going to a few birthday parties, got to know dozens of other people at these birthdays and just developed a core group of friends.

Put in effort, download a dating app if you need to, go out to bars. Enjoy the freedom of the single life

 

[alpinism]

Yeah even with the 2-4 hours drive it should be easy to see the family at least 2-4 times a month with a chill schedule.

To be honest even back home it would be hard to see them more than a few times a month with a normal schedule.

 

[slchino]

Ok so I’m very fortunate to be in this situation but I’m having the hardest of times trying to navigate which of these two options I should go with, and any help/advice would be truly appreciated.

Job 1: is in a city that I’ve grown to not really love… it’s a huge metropolis city with anything imaginable in regards to food/culture/events/concerts etc. the job is ideal… they have me working 9 shifts a month, 10 hour shifts (1080 hours clinically). I do have administrative duties but they are totally manageable and even fun for me. The hospital is lower acuity, ancillary is good, pay is on par with the rest of the country, colleagues are enjoyable. I also have a sweet side gig that pays pretty well. The only caveat about this place is the city. I’m a solid 3 hours away from all my family and friends, I’m single, just broke up with my significant other (who took all the friends in the breakup lol🙄)… so besides it being a solid career with low stress work and amazing hours it’s the essential loneliness that is really throwing a monkey wrench in to what would be an ideal life set up. The job security at this place is essentially Fort Knox (tenured), and the patient population is some of the nicest peoples I’ve ever known, little spoiled but otherwise perfect.

Pro: job security, clinical hours, passionate side gig, no overnights, great hospital! Solid salary plus paid side gig. Plus admin hours

Cons: I essentially hate the city and feel alone lol!


Job 2: is in my hometown city, one of the biggest cities in the United States, has everything under the sun in regards to just everything lol. The biggest attraction here is just being back with my family and close friends who I am super tight with. The hospital is a huge public city hospital with all the headaches that come along with serving that kind of population. I would be working 10 shifts, 12 hours (1440 a year and this is the reduced hours for the admin position I would be having as well). I would be working day and overnight shifts. I would have to give up my paid side gig which is fun for me. But the only true net gain is just being near all my family. The headache that I’m giving myself is that worth giving up what is otherwise a pretty sweet Cush situation that I currently have but can’t stand the city. The salary is otherwise equal for both places.

Pros: just being close to family and old friends.

Words of encouragement or advice from some of the peanut gallery would really be appreciated. Both are w-2, both are secure jobs, the 2nd job has residents that does most of the scut. But the the acuity and level of work stress would be higher as well. Just trying to figure out if needing to suck it up… or getting a fresh start on things is worth losing all that job 1 has to offer. Thanks as always 😊!!!

I’d say job 2. Do you want to be a part of your family and friends lives and watch their kids grow up? Maybe you want your future kids to be Bffs with their kids and hang out with the aunties and uncles?

As you can tell I value family and money can’t buy time and relationships with family

20 yrs down the line
Job one gives you lots of Money to fly anywhere
Job 2 will give you lots of “remember when we…” and inside jokes with family and friends

 

[VA Hopeful Dr]

I’d say job 2. Do you want to be a part of your family and friends lives and watch their kids grow up? Maybe you want your future kids to be Bffs with their kids and hang out with the aunties and uncles?

As you can tell I value family and money can’t buy time and relationships with family

20 yrs down the line
Job one gives you lots of Money to fly anywhere
Job 2 will give you lots of “remember when we…” and inside jokes with family and friends

There's definitely truth in that.

But, with working 9 shifts per month it wouldn't be difficult to do 2 long weekends home every month and schedule a few days during the week for family things - birthdays, nieces'/nephews' sports stuff, recitals, whatever.

Over the years reading this forum, the things that seem to lead to burn out among you EPs boil down to a few main areas: circadian rhythm issues, frustrating patient populations, too many/too long shifts, issues with employer, or low pay.

Job #1 for the OP has none of those things and enough nonworking days to stay in fairly close contact with family within a very reasonable driving distance.

 

[PianoMedic]

Can you expand on the bolded part?

Our night shifts are 1700-0100 or 1700-0200. I have an hour drive from the site that goes to 0100, so it’s essentially always til 0200 at the earliest, I then usually eat and have to wind down a bit. It’s usually 0330 or 0400 when I get to bed and then awhile after to sleep. At that point, my body starts readjusting to it basically being an overnight and I struggle to flip back to days afterwards, and our scheduler gives less time to flip back after evenings because they’re “easier”. So I just work nights only now and have a consistent schedule. It sucks, but it’s consistent. If OP has that difficulty and one site requires evenings, that would increase their number of nights essentially. Hope that clears it up.

 

[GonnaBeADoc2222]

Job #1

Abd sabotage ex's relationships with the friends she stole.

...just kidding

...kinda

 

[Restart13]

I’m going to hijack this thread with my own dilemma possibly coming up.

I am about 80% of the way through partner track of a group I truly enjoy however, I live far from the main sites (~1 hr) and even farther from their rural sites, but 75% of my shifts are 1 hr there and 1 hr back. The medicine portion of the job is great, colleagues are great. Money-wise partners do well, however operations are fairly limited to EM, any other business has been locked to previous partners as separate LLC for partners at that point in time.

New group is very close to home, similarly long partner track, slightly more difficult medicine due to boarding/EMR etc. The group is very pro business, and has group wide ancillary income for all partners including incoming partners. It was my number #1 choice but due to other circumstances wasn’t available at that time. I think partners do similar money wise , maybe better with better long term contract stability.

My main concern is regretting leaving an almost sure fire thing (partner) where the medicine/hospital component is not bad for a closer job, that may be slightly more difficult, but way closer to home. I’m still very early in my career, so I’m not too invested in one route that will be that detrimental. my biggest fear is that I would be making a huge mistake leaving my current group and feel bad for all the relationships i have built thus far. However, the new group i think would offer the same if not better ability for future work relationships.

 

[JacobMcCandles]

A minimum 1 hour commute there and another 1 hour commute back would have been a non-starter for me. I assume you won’t have any committee and/or leadership roles or else that’ll just be more salt in the wound making that commute on your days off.

 

[bravotwozero]

Are you willing to relocate closer to your current gig?

 

[HemeOncHopeful19]

I’d also be curious with your current job

1) the nature of these exclusive deals
2) number of OG partners vs new partners

Basically in the event of a buyout offer or some other contractual stuff will they have wildly different motivations and can they outvote you new guys

 

[Restart13]

Are you willing to relocate closer to your current gig?

No due to family reasons…can potentially move to a site that is ~40 minutes away.

I’d also be curious with your current job

1) the nature of these exclusive deals
2) number of OG partners vs new partners

Basically in the event of a buyout offer or some other contractual stuff will they have wildly different motivations and can they outvote you new guys

every partner is equal (in both groups)…without getting into all the details, old guys ended up retiring now. However, I agree I am not a fan of the deals for some, but not for all

 

[gutonc]

I need some advice as well. I currently commute 50 minutes to work each way and make 275/hr (inclusive of bonuses). I need to relocate which would add roughly 30 minutes each way to my current drive. I have found an alternative site however I would make roughly 225/hr here (bonuses included). Drive would be considerably less around 20 minutes each way. Site seems fine in regard to expectations and consultants and ancillary staff.

What would you guys do if this were your situation? Everything is very smooth at my current site and the only drawback is the drive. I probably would have to start occasionally staying in town if I were to stay at my current site (hospital gives hotel allowance). It is a considerable pay cut and the thought of leaving an otherwise good gig makes me nervous. But I won't lie, the thought of a 20 minute drive and more time with my family sounds quite nice.

Thinking strictly about the dollars and cents, since the commute time delta is 2 hours between the jobs, add that to your shift length and current job (recognizing you don't get paid for those 2 hours) and do the math.

Assuming a 10h shift, $2750/12h (including shift time + commute time) = $229/h.

So you need to ask yourself if current job (with it's known good and bad qualities) is worth less time with family for what in the end is a $4/h difference in pay, compared to new site (with it's unknown good and bad qualities).

 

[TysonCook]

All things being equal when you factor in drive time, I'd go with the closer shop. Being close allows you to open yourself to being on a committee, directorship, community outreach etc, as opposed to GTFO because I have a 90min drive.

 

[JacobMcCandles]

Long commutes are a killer, especially if you live in a place where winter weather becomes an issue.

 

[WorkNoteEmergency]

Is part time, mix of the two an option? I worked 2/3 full time at a rural hospital 80 minute drive away which I didn’t mind while the pay was good ($280ish/hr) and job was OK but it became intolerable when the pay was cut and job worsened. I left a close by CMG and took the part time job as the pay was better at 2/3 full time (with benefits) than full time at the CMG. This was 8-9 shifts 10 hours per month. If you have a nice car and a good selection of podcasts/music, a long commute maybe 6-7 times per month can be tolerable.

I will add, I’ve had some pretty ****ty commutes in bad weather and snow on back country roads. Once it took me 3 hours to get to work in the snow.

 

[Mount Asclepius]

I don’t think you should commute more than 1 hour. I’ve seen a few do it over the years for a great job. A few have even stayed for quite a long time, but eventually the long commute became insufferable and they left for something closer to home.

It’s fair to factor in those extra unpaid hours into your hourly rate, but at the same time if you paid me over $200/hour to drive for 2 hours I might take that deal. However, I wouldn’t want to do that regularly for every shift. Too much time in a car. Effectively kills every day you work with no time before/after a shift other than in a car.

 

[bky3c]

I'd take the new job with the 20 minute commute. You can make more money, but you can't make more time. Maybe you can pick up an extra shift occasionally if necessary. I think most families would rather have you there at least for a little while each day rather than only in large chunks that are several days apart.

I've done very short commutes, 1-hour commutes, a 5-hour commute (3 shifts in a row, stayed in town, obviously, and it was a cool place that I got to enjoy during the day because I was working slow overnights and often got some sleep), and out-of-state locums. The 1-hour commute was the hardest because it turned a 10-12 hour shift into 12-14 or more, depending on whether I left on time. That means a day completely dedicated to working/driving, with very little hope of catching even part of whatever's going on with friends/family and very little time to recover (sleep/shower/eat) for the next day. Even locums shifts weren't as draining because I wasn't trying to juggle home and work on the same day.