Lifestyle of county hospitals?

[Symmetry11]

I know this is early and will probably change but I want a life of caring for indigent populations which I hear are the norm for county hospitals. If I get that far I know I won't care much about pay because as a non trad I will only get to practice a few years, so I will live conservatively by doctors standards for retirement.

How hard are the hours? How difficult would it be to get a job at Parkland Memorial (UTSW) or any other county hospital? How many hours do docs work in county hospitals?

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[shoal]

wow bro... google is your friend

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[BoardingDoc]

I know this is early and will probably change ....

Probably

If I get that far I know I won't care much about pay because as a non trad I will only get to practice a few years, so I will live conservatively by doctors standards for retirement.

If you have loans to pay off, you'll care about pay. Especially with a shortened career.

How hard are the hours? How difficult would it be to get a job at Parkland Memorial (UTSW) or any other county hospital? How many hours do docs work in county hospitals?

Regarding the hours, this thread has excellent information and has addressed this question in multiple places: http://forums.studentdoctor.net/threads/emergency-medicine-faq.758725/
Regarding how hard it is to get a job at (insert any place in the world here): get into medical school first. Then you can worry about residency. You won't know what your odds are until you get to that point. If you do well in med school, it will be easy. If you do ****ty, you won't get in.

 

[DeadCactus]

He's asking about jobs not residency.

 

[The White Coat Investor]

If I get that far I know I won't care much about pay because as a non trad I will only get to practice a few years, so I will live conservatively by doctors standards for retirement.

It's bizarre to me why you think a shorter career would mean you would care less about pay. Did your previous career make you independently wealthy or something?

 

[Symmetry11]

It's bizarre to me why you think a shorter career would mean you would care less about pay. Did your previous career make you independently wealthy or something?

No. I feel like I can make it very comfortably on 80-120k. Making 250k would leave me more than enough for savings working 10-15 good years. I also live in Texas where med school is cheap and there are plenty of moonlighting opportunities during residency.

 

[goodoldalky]

No. I feel like I can make it very comfortably on 80-120k. Making 250k would leave me more than enough for savings working 10-15 good years. I also live in Texas where med school is cheap and there are plenty of moonlighting opportunities during residency.

Do the math, there's no way you can retire in that timeframe at that pace. -Texan

 

[Symmetry11]

I'm honestly not worried about retiring with 2-3 mil in the bank. I just want to fulfill my life's dreams as cliche as that sounds. I've lived just fine off of 40-50k pre tax and would have no problem doing that for a while.

Also, on a related note: do other attendings look at your lifestyle when determining partnership?

 

[Brahnold Bloodaxe]

It's bizarre to me why you think a shorter career would mean you would care less about pay. Did your previous career make you independently wealthy or something?

No. I feel like I can make it very comfortably on 80-120k. Making 250k would leave me more than enough for savings working 10-15 good years. I also live in Texas where med school is cheap and there are plenty of moonlighting opportunities during residency.

Nevertheless, it's still bizarre that you brought up a shorter career as a reason why you'd be less concerned about money. Your "explanation" above merely tries to defend the feasibility of making enough to save for retirement despite a shorter career. In other words, you yourself just admitted that a shorter career is an obstacle to be overcome, not an enabler, in having a mindset that places less emphasis on annual earnings.

 

[Symmetry11]

Could someone please answer my original questions? I just want to know what life is like at a county hospital. I've looked online and couldn't find much. I'm just not up to speed on the financial aspect of medicine right now but i know it is important. I want to apologize if I sounded like some holier-than-thou figure. I really just want to learn and practice medicine right now without concerning myself with the financial aspect too much. Doctors earn every penny they get paid but it's not that high on my priority list because I am just beginning the process. Just looking for future goals to think about.

So how hard is it to get a job at a county hospital? What are the hours like? How tough are the cases on a daily basis?

 

[shoal]

cases are very tough. they are the hardest. its impossible to be hired at a county hospital. you must work 100 hours weekly. good luck

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[alpinism]

Could someone please answer my original questions? I just want to know what life is like at a county hospital. I've looked online and couldn't find much. I'm just not up to speed on the financial aspect of medicine right now but i know it is important. I want to apologize if I sounded like some holier-than-thou figure. I really just want to learn and practice medicine right now without concerning myself with the financial aspect too much. Doctors earn every penny they get paid but it's not that high on my priority list because I am just beginning the process. Just looking for future goals to think about.

So how hard is it to get a job at a county hospital? What are the hours like? How tough are the cases on a daily basis?

It really depends on the hospital.

The jobs aren't that hard to find as long as you're willing to relocate.
Most attendings working full time in the ED average around 45hrs per week.
The cases are usually BS primary care complaints except for the occasional sick patient every few hours.

 

[Symmetry11]

cases are very tough. they are the hardest. its impossible to be hired at a county hospital. you must work 100 hours weekly. good luck

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It really depends on the hospital.

The jobs aren't that hard to find as long as you're willing to relocate.
Most attendings working full time in the ED average around 45hrs per week.
The cases are usually BS primary care complaints except for the occasional sick patient every few hours.

Oh so it's not high acuity patients at least once every couple of shifts? Are county hospitals like Parkland not where all of the major trauma go? I use Parkland as an example because that has been considered a top hospital almost every year. I assumed this was because it is a county and so level 1 trauma center.

 

[The White Coat Investor]

You don't need to go to a county hospital to take care of indigent patients. You'll do that at nearly every ED in the country.

The hours aren't any different from anywhere else. The cases aren't all that much tougher than anywhere else, you just get less resources to take care of them with.

It's not that hard to get a job at a county hospital either. Many are academic centers though, so you might need a fellowship. That will eat up one of those ten years in your ten year career that is somehow supposed to magically build you that $2-3M nest egg you'll need to support your $80-120K retirement spending.

In case the reason why people are pointing that out to you still eludes you, the math looks like this:

Gross $250K
Net $175K
Live on $120K
Assuming no student loans, that leaves you $55K to save per year.
$55K at 5% for 10 years grows to $692K
You can spend ~ 4% of that a year, so that will support a lifestyle of something like $28K a year, plus whatever you get from SS.
Thus, it's a good thing you're happy with $40-50K a year pre-tax, because that's what you'll have.

But keep this in mind. Many of us at your stage of the game thought we'd practice medicine for decades even if it only paid us $50K a year. But I don't know a single doc who would do that now. You should probably ask yourself why that is and why you are different from everybody else in medicine. What are the odds, right?

 

[Janders]

I think part of the problem is your term "county hospital".

What do you really mean? Do you mean a big level 1 trauma center in an inner city that serves as a safety net hospital? Parkland, Grady, Charity before the hurricane, Shands Jacksonville, Cook County, etc? If so many of these are, of course, large residency training sites meaning your job will be academic.

Remember, while a lot of these places see amazing pathology, they also see a TON of patients, meaning they see a lot of disenfranchised people with limited PCP access, limited insurance, and limited healthcare literacy who use the ED for convenience care or as a last resort safety net. Granted, every ED in the country sees this to some degree. But I point this out to demonstrate that while you might have a shift in the acute side where you spend 8 hours doing crazy critical care, your next two might be in fast track trying to sort through the masses with hypertension and no PCP...

Anyway, I think the real question is what brings you satisfaction vis-a-vis practicing EM? Are you trying to find a job with lots of severe pathology? Are you trying to find a job serving the underserved? Do you want to work at the "best" hospital?

 

[Symmetry11]

You don't need to go to a county hospital to take care of indigent patients. You'll do that at nearly every ED in the country.

The hours aren't any different from anywhere else. The cases aren't all that much tougher than anywhere else, you just get less resources to take care of them with.

It's not that hard to get a job at a county hospital either. Many are academic centers though, so you might need a fellowship. That will eat up one of those ten years in your ten year career that is somehow supposed to magically build you that $2-3M nest egg you'll need to support your $80-120K retirement spending.

In case the reason why people are pointing that out to you still eludes you, the math looks like this:

Gross $250K
Net $175K
Live on $120K
Assuming no student loans, that leaves you $55K to save per year.
$55K at 5% for 10 years grows to $692K
You can spend ~ 4% of that a year, so that will support a lifestyle of something like $28K a year, plus whatever you get from SS.
Thus, it's a good thing you're happy with $40-50K a year pre-tax, because that's what you'll have.

But keep this in mind. Many of us at your stage of the game thought we'd practice medicine for decades even if it only paid us $50K a year. But I don't know a single doc who would do that now. You should probably ask yourself why that is and why you are different from everybody else in medicine. What are the odds, right?

Thank you for the info! I have bought your book but haven't gotten a chance to read it. And I stated earlier that I DONT expect or need 2-3 mil in the bank at retirement. But I am aware that medicine is no easy gig, so their must be an incentive for working so hard.

I live in Dallas and would love to stay here. Do you know how tough it is to get into a place like Parkland here or anywhere else? Also what kinds of duties do academic doctors fulfill? Do they do presentations and research? I'd much rather do shift work then go home.

Using Parkland as another example, why would you have less resources to work with if it is affiliated with UTSW? I don't understand.

Also, how much more difficult is EM then any other non-surg specialty? (just asking for speculation). EM scares me but I am also excited by the good you can do on each shift!

 

[Symmetry11]

I think part of the problem is your term "county hospital".

What do you really mean? Do you mean a big level 1 trauma center in an inner city that serves as a safety net hospital? Parkland, Grady, Charity before the hurricane, Shands Jacksonville, Cook County, etc? If so many of these are, of course, large residency training sites meaning your job will be academic.

Remember, while a lot of these places see amazing pathology, they also see a TON of patients, meaning they see a lot of disenfranchised people with limited PCP access, limited insurance, and limited healthcare literacy who use the ED for convenience care or as a last resort safety net. Granted, every ED in the country sees this to some degree. But I point this out to demonstrate that while you might have a shift in the acute side where you spend 8 hours doing crazy critical care, your next two might be in fast track trying to sort through the masses with hypertension and no PCP...

Anyway, I think the real question is what brings you satisfaction vis-a-vis practicing EM? Are you trying to find a job with lots of severe pathology? Are you trying to find a job serving the underserved? Do you want to work at the "best" hospital?

Thank you for the response!

Well, I like the fact that EM requires knowledge of every other specialty (including psych unlike radiology) and that you impact the underserved on a daily basis. Whether it's severe pathology or PCP visits.

I am assuming that academic doctors are the brightest of the bunch and I don't see myself as that kind of doctor. So I probably won't get accepted there. What other options are there for someone like me? I worked in a local ER and all I remember is people complaining about was EMTALA. I wan't to constantly be reminded how valueable and necessary our services are to our communities (even if they don't show it).

 

[goodoldalky]

Your cart is so far in front of the horse on this whole thread that it's hard to give serious responses to your questions. It's great that you have an eye toward the future but your time thinking about these questions now is probably time wasted. Do yourself a favor and put all of this on the back burner, get into medical school, focus on working hard and then focus on residency, and come back to this in about 7-10 years.

 

[The White Coat Investor]

And I stated earlier that I DONT expect or need 2-3 mil in the bank at retirement.

No. Here's what I'm saying. You actually DO need $2-3M in the bank if you wish to live on $80-120K a year in retirement. That's what it takes to produce that kind of income for decades.

If you think you'll be fine living on $40K a year in retirement, perhaps you're right, but it's VERY UNLIKELY given what most people do with their lifestyles once finishing residency.

 

[Angry Birds]

OP, White Coat Investor has written a book on the topic, and is literally an expert on the issue. Heed his advice.

 

[canigetawhatwhat]

I don't think the topic creator has any clue about anything.

*looks back into his older posts*

Yep. Hes a college kid.
Heres a suggestion. Get off this forum and use your time productively. Focus more on passing your classes, getting life experience, making friends, than looking into "county hospitals and retirement."

-Hova

 

[MSmentor018]

I know this is early and will probably change but I want a life of caring for indigent populations which I hear are the norm for county hospitals. If I get that far I know I won't care much about pay because as a non trad I will only get to practice a few years, so I will live conservatively by doctors standards for retirement.

How hard are the hours? How difficult would it be to get a job at arkland Memorial (UTSW) or any other county hospital? How many hours do docs work in county hospitals?

is it sicker pts you're wanting by working in the county hospital? i work at a level 1 trauma/training center, level 2 inner city community (almost all medicaid) and level 3 rural area hospital (only 40% medicaid). in 6 yrs, by far the most bizarre and sickest pts have been in the rural area. I don't know if the full moon empties out the trailer park or if the insured finally gives up on their pcp who's been holding the disease at bay until now. but either way, you'll get sick, poor people almost everywhere. I think the stigma of "county" hospitals being for the poor and private community hospitals for the rich is a myth of the past.

trust everyone on here, you'll care a lot about pay. let's face it, none of us are red cross volunteers. being a older non trad myself my time is also cut short so getting the most pay with life balance is even more important! the time I had to be productive for retirement has been burned already. not sure what "conservatively by doctors standards for retirement" are. only 1 bmw car, 1 range rover suv and boat in the garage? just kidding, you'd rent a boat slip/lift instead. seriously, with repeated groups being "acquired", hospital corporations gaining more control, big govt squeezing everyone with their ridiculous guidelines, just getting a job and surviving comfortably without blowing your brains out will be more important than population

 

[Symmetry11]

No. Here's what I'm saying. You actually DO need $2-3M in the bank if you wish to live on $80-120K a year in retirement. That's what it takes to produce that kind of income for decades.

If you think you'll be fine living on $40K a year in retirement, perhaps you're right, but it's VERY UNLIKELY given what most people do with their lifestyles once finishing residency.

You are far more knowledgeable then me so let me ask you if joining the military makes any financial sense? (not why I want to do it, if i get in) But my plan is to serve a few years then move on to PP. I've read that the military has great retirement plans for docs, is that true?

 

[Symmetry11]

OP, White Coat Investor has written a book on the topic, and is literally an expert on the issue. Heed his advice.

I bought his book and do not want to be confused as someone who THINKS they know more than him. I just thought he made an honest mistake. No disrespect.

 

[Symmetry11]

I don't think the topic creator has any clue about anything.

*looks back into his older posts*

Yep. Hes a college kid.
Heres a suggestion. Get off this forum and use your time productively. Focus more on passing your classes, getting life experience, making friends, than looking into "county hospitals and retirement."

-Hova

I just want something to think about. Did you never look way into the future and plan the next book, tv show, article to read with your future goals in mind?

 

[Symmetry11]

is it sicker pts you're wanting by working in the county hospital? i work at a level 1 trauma/training center, level 2 inner city community (almost all medicaid) and level 3 rural area hospital (only 40% medicaid). in 6 yrs, by far the most bizarre and sickest pts have been in the rural area. I don't know if the full moon empties out the trailer park or if the insured finally gives up on their pcp who's been holding the disease at bay until now. but either way, you'll get sick, poor people almost everywhere. I think the stigma of "county" hospitals being for the poor and private community hospitals for the rich is a myth of the past.

trust everyone on here, you'll care a lot about pay. let's face it, none of us are red cross volunteers. being a older non trad myself my time is also cut short so getting the most pay with life balance is even more important! the time I had to be productive for retirement has been burned already. not sure what "conservatively by doctors standards for retirement" are. only 1 bmw car, 1 range rover suv and boat in the garage? just kidding, you'd rent a boat slip/lift instead. seriously, with repeated groups being "acquired", hospital corporations gaining more control, big govt squeezing everyone with their ridiculous guidelines, just getting a job and surviving comfortably without blowing your brains out will be more important than population

I'm basing my thoughts about how I feel now about money. I know this will change as I start to feel drained by medicine. But I also don't want my mind to solely shift to money considering EM docs see what poverty can do to someones health. I would think people take that home with them.

I'd imagine that level 1 trauma centers make more then lower levels because of the acuity of the patients, is that true?

 

[racerwad]

I'm basing my thoughts about how I feel now about money. I know this will change as I start to feel drained by medicine. But I also don't want my mind to solely shift to money considering EM docs see what poverty can do to someones health. I would think people take that home with them.

I'd imagine that level 1 trauma centers make more then lower levels because of the acuity of the patients, is that true?

No. It doesn't matter the acuity because, almost by definition, underserved patients are poor. And certainly, by definition, poor people do not have money. No money means no means to pay the bill you will send the patient.

Community hospitals with a good payor mix (a euphemism for more well insured pts than not) tend to have better reimbursement rates. Moreover, the county places you have named are academic training sites which also pay less than non-academic practice.

Finally, trauma designation, whether state or actual American College of Surgeons, does not necessarily mean that they will see higher acuity pts of all types (although this is often the case).

 

[Symmetry11]

No. It doesn't matter the acuity because, almost by definition, underserved patients are poor. And certainly, by definition, poor people do not have money. No money means no means to pay the bill you will send the patient.

Community hospitals with a good payor mix (a euphemism for more well insured pts than not) tend to have better reimbursement rates. Moreover, the county places you have named are academic training sites which also pay less than non-academic practice.

Finally, trauma designation, whether state or actual American College of Surgeons, does not necessarily mean that they will see higher acuity pts of all types (although this is often the case).

I'm more interested in serving the poor. What skills should one have when treating this population? I live in Texas so I would think that spanish is a must and what else could I add?

 

[Symmetry11]

What kind of skills do you wish you had related to EM before entering medical school?

 

[racerwad]

I'm more interested in serving the poor. What skills should one have when treating this population? I live in Texas so I would think that spanish is a must and what else could I add?

If you want to be a doctor, you should get some doctoring skills.

What kind of skills do you wish you had related to EM before entering medical school?

None. Med school and residency teaches you the skills related to EM you need.

I feel like I am being trolled.

 

[The White Coat Investor]

You are far more knowledgeable then me so let me ask you if joining the military makes any financial sense? (not why I want to do it, if i get in) But my plan is to serve a few years then move on to PP. I've read that the military has great retirement plans for docs, is that true?

The military may or may not make financial sense depending on the cost of the education and the specialty chosen. However, it is not a financial decision. If you want to be a military doc, join the military. If not, don't. It really is that simple.

The military does not have a special "doc retirement plan." A military retirement isn't bad, but generally requires 20 years of service, which you don't seem to have with a 10-15 year career. The retirement pay is based only on base pays, not your allowances or your special pays though, so I would argue it is worse for docs than everyone else.

 

[Symmetry11]

Nope seriously just a twenty something premed. Do you have any good book recommendations? Written in novel like style for EM.


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[MSmentor018]

Nope seriously just a twenty something premed. Do you have any good book recommendations? Written in novel like style for EM.


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iserson's guide to getting a residency. I think all med students should have read this book before and during. get the 2 cents old version on amazon

 

[MSmentor018]

I'd imagine that level 1 trauma centers make more then lower levels because of the acuity of the patients, is that true?

I make the least at level 1, most at level 3. the more rural the area, the less back up you have.
usually the less desirable the area, the better the pay

 

[canigetawhatwhat]

Do people not drink and stay up all night eating pizza and playing video games with friends in college anymore?

 

[Symmetry11]

Do people not drink and stay up all night eating pizza and playing video games with friends in college anymore?

Not after they realize this could only lead to an empty life. I'm ready to turn things around! And I believe it starts with the way you think and plan.

 

[dchristismi]

Fair enough, but seriously, you can make a difference anywhere.

"County hospitals" are not inherently bad, but there are sick people everywhere. And they do tend to have poor ancillary staff, which is a huge "resource."

I see plenty of crazy pathology at my "little" not-quite-rural-not-quite-surburban shop.
Yes, cart before horse. Keep an open mind - who knows? You could get into your rotations and realize that you are meant to be a surgeon. Or a nephrologist. Or a pediatrician. Or something else.

And FWIW, there is something to be said for enjoying college. I thoroughly enjoyed college, and you should too. Eat the pizza. Stay up late. Embrace it. And definitely embrace the silliness of some of it. Life can be too serious, and sometimes, too short.

 

[Symmetry11]

Fair enough, but seriously, you can make a difference anywhere.

"County hospitals" are not inherently bad, but there are sick people everywhere. And they do tend to have poor ancillary staff, which is a huge "resource."

I see plenty of crazy pathology at my "little" not-quite-rural-not-quite-surburban shop.
Yes, cart before horse. Keep an open mind - who knows? You could get into your rotations and realize that you are meant to be a surgeon. Or a nephrologist. Or a pediatrician. Or something else.

And FWIW, there is something to be said for enjoying college. I thoroughly enjoyed college, and you should too. Eat the pizza. Stay up late. Embrace it. And definitely embrace the silliness of some of it. Life can be too serious, and sometimes, too short.

All I am saying is that I have experienced that and i am done with it.

Why is poor ancillary staff a huge resource?

 

[BoardingDoc]

All I am saying is that I have experienced that and i am done with it.

Why is poor ancillary staff a huge resource?

You misunderstood. The ancillary staff is a huge resource. Not having it sucks. You wind up putting in a ton of your own IVs, pushing your own patients to the CT scanner, you do your own discharges instead of having an RN do it, there's no tech to irrigate wounds etc etc etc. CAN you do all of these things yourself? Of course you can! But it is eating up time that you should be spending elsewhere, like seeing an additional patient.

 

[gutonc]

I'm more interested in serving the poor. What skills should one have when treating this population?

Mad cooking skills using only ramen noodles and 50% off expiring veggies at the warehouse store.

 

[bravotwozero]

Mad cooking skills using only ramen noodles and 50% off expiring veggies at the warehouse store.

Expiring veggies? Pfft. They'd rather go to church's chicken!


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[gutonc]

Expiring veggies? Pfft. They'd rather go to church's chicken!


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I was talking about the docs treating them. They need to eat too.

And Popeye's or GTFO.

 

[IH8ColdWeath3r]

Look OP, I will tell you straight up.

I am from your neck of the woods, used to work at the old Parkland hospital. There are no guarantees. I had nearly a 4.0 in undergrad but struggled on one section of the MCAT. Didn't get into medical school in Texas, but did get in OOS. There is no guarantee that you will get into medical school, just because you are a Texas resident. A lot goes in to it. Right now, I am borrowing 45K per year at 6.9% interest for tuition, and another 25K a year at 7.9% interest for living expenses. Add that up and you will have accumulated a LARGE debt after medical school that will eat away at a substantial amount of your income.

Second, it is difficult to get residency at Parkland. I am applying for residency soon and their spots filled up quickly and they have over a 500 person wait-list. Maybe after you become an attending, you could practice there. But, to train there, is very difficult because a lot of medical students want to train in a county setting or a pseudo county-community program that gives them access to high patient acuity and good pathology. It is very specific of you to ask and use Parkland as an example. You should worry about doing well in your classes, passing the MCAT, and then revisit this topic at a later time. First thing you should actually do is to decide whether medicine is really for you. I know a lot of my classmates who, if they could go back now, would not go into medicine just because of the changes that are occurring with healthcare, the time spent away from family, the sacrifices, the debt that you accumulate, the countless hours of charting after work, etc. etc.

Find some doctors to shadow and decide if this is really for you. Then, hit the books and do well on your classes and the MCAT. If after you get into medical school and you feel strongly about EM, apply and see where it takes you. EM is becoming increasingly more competitive. Gluck.

 

[Psai]

Look OP, I will tell you straight up.

I am from your neck of the woods, used to work at the old Parkland hospital. There are no guarantees. I had nearly a 4.0 in undergrad but struggled on one section of the MCAT. Didn't get into medical school in Texas, but did get in OOS. There is no guarantee that you will get into medical school, just because you are a Texas resident. A lot goes in to it. Right now, I am borrowing 45K per year at 6.9% interest for tuition, and another 25K a year at 7.9% interest for living expenses. Add that up and you will have accumulated a LARGE debt after medical school that will eat away at a substantial amount of your income.

Second, it is difficult to get residency at Parkland. I am applying for residency soon and their spots filled up quickly and they have over a 500 person wait-list. Maybe after you become an attending, you could practice there. But, to train there, is very difficult because a lot of medical students want to train in a county setting or a pseudo county-community program that gives them access to high patient acuity and good pathology. It is very specific of you to ask and use Parkland as an example. You should worry about doing well in your classes, passing the MCAT, and then revisit this topic at a later time. First thing you should actually do is to decide whether medicine is really for you. I know a lot of my classmates who, if they could go back now, would not go into medicine just because of the changes that are occurring with healthcare, the time spent away from family, the sacrifices, the debt that you accumulate, the countless hours of charting after work, etc. etc.

Find some doctors to shadow and decide if this is really for you. Then, hit the books and do well on your classes and the MCAT. If after you get into medical school and you feel strongly about EM, apply and see where it takes you. EM is becoming increasingly more competitive. Gluck.

Why 6.9%? Are you taking private loans?

 

[IH8ColdWeath3r]

Why 6.9%? Are you taking private loans?

No, that is the standard interest rate now offered by the gov. 6.9% on the first 45K and 7.9% is for grad plus on any additional costs, which is cost of living.

 

[CoolWhipp]

Could someone please answer my original questions? I just want to know what life is like at a county hospital. I've looked online and couldn't find much. I'm just not up to speed on the financial aspect of medicine right now but i know it is important. I want to apologize if I sounded like some holier-than-thou figure. I really just want to learn and practice medicine right now without concerning myself with the financial aspect too much. Doctors earn every penny they get paid but it's not that high on my priority list because I am just beginning the process. Just looking for future goals to think about.

So how hard is it to get a job at a county hospital? What are the hours like? How tough are the cases on a daily basis?

You don't even know for sure if you will actually like emergency medicine. You are asking a question that is not going to help you. The only question you should ask yourself is whether or not you like medicine. If you do, then focus your efforts in getting into medical school. Just because you like the subject of a specialty subject does not mean you will like the workflow or the people or the patients. Knowing the answer to your questions at this point of your career is zero help to you, in fact you are wasting your time. Most people change their specialty choice by the end of third year, some even change in residency.

Strongly consider PA school too.

 

[Psai]

No, that is the standard interest rate now offered by the gov. 6.9% on the first 45K and 7.9% is for grad plus on any additional costs, which is cost of living.

https://studentaid.ed.gov/sa/types/loans/interest-rates#rates

Says 5.31 and 6.31
I'm not sure why there is a discrepancy, there hasn't been a huge increase in the rate for 10 year treasury bonds

 

[FootballFoot]

But keep this in mind. Many of us at your stage of the game thought we'd practice medicine for decades even if it only paid us $50K a year. But I don't know a single doc who would do that now. You should probably ask yourself why that is and why you are different from everybody else in medicine. What are the odds, right?

Why do you think that is? Do you think this experience is magnified in EM specifically? Do you happen to feel similarly, and if you don't mind, why?

EM seems very amazing, but there are a lot of firsthand accounts on here that make me wary. Unfortunately, I don't see any other specialty being as attractive in terms of work hours or remuneration (other than derm).

 

[namethatsmell]

Why do you think that is? Do you think this experience is magnified in EM specifically? Do you happen to feel similarly, and if you don't mind, why?

EM seems very amazing, but there are a lot of firsthand accounts on here that make me wary. Unfortunately, I don't see any other specialty being as attractive in terms of work hours or remuneration (other than derm).

Sometime between the first and second time a group/hospital administrator tells you how to handle something that you think adversely impacts patient care, your views will change.

Sometime between the first and fifth times a patient says "I'm gonna sue you all if I don't get ___" you're feelings on the doctor-patient relationship will probably change. Doesn't mean you'll hate all your patients (no should it), but it will likely impact you.

The more and more you are asked to do things with your clinical time that have nothing to due with patient care (like charting exessively for coding purposes), you will feel less warm and fuzzy about the game.

Don't get me wrong, EM and medicine has a lot of redeeming factors and helping somebody truely in need is incredibly rewarding but make no mistake the job is hard and stressful in many different ways. You deserve to be paid fairly and working too much in it will ruin you.

 

[MSmentor018]

Sometime between the first and second time a group/hospital administrator tells you how to handle something that you think adversely impacts patient care, your views will change.

Sometime between the first and fifth times a patient says "I'm gonna sue you all if I don't get ___" you're feelings on the doctor-patient relationship will probably change. Doesn't mean you'll hate all your patients (no should it), but it will likely impact you.

The more and more you are asked to do things with your clinical time that have nothing to due with patient care (like charting exessively for coding purposes), you will feel less warm and fuzzy about the game.

Don't get me wrong, EM and medicine has a lot of redeeming factors and helping somebody truely in need is incredibly rewarding but make no mistake the job is hard and stressful in many different ways. You deserve to be paid fairly and working too much in it will ruin you.

excellent post!