redeeming qualities about ER?

[scoopdaboop]

Is ER residency much worse than ER attending life? because, as a student rotating in it with residents, who often stay from 7 am to 7 pm, have to work a revolving door of day shifts/ shifts from like 3 pm - 2 am, then 9 pm - 7 am, it feels awful. Then you add that you get talked down upon from some attendings, hell even some patients don't respect you and "want the ortho guy". Even some of the attendings were feeling bad for the residents talking about how the job market isn't what it used to be lmao. I don't see many redeeming qualities about EM tbh. Don't get me wrong, I do think ER attendings are awesome. When shifts get busy they have to manage and deal with a lot.

Is there anything I can't see on the surface that I'm missing?

Even hospitalist medicine is much better than this. can round very quickly, stay for admissions or leave if you don't think you're getting one in like 30 min - 1 hour because they go down the list for admissions throughout the day, and the pay is similar... albeit a little less.

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[watermanMD]

Nothing you said is too inaccurate.

 

[RustedFox]

Yep. It sucks.

 

[EctopicFetus]

Is ER residency much worse than ER attending life? because, as a student rotating in it with residents, who often stay from 7 am to 7 pm, have to work a revolving door of day shifts/ shifts from like 3 pm - 2 am, then 9 pm - 7 am, it feels awful. Then you add that you get talked down upon from some attendings, hell even some patients don't respect you and "want the ortho guy". Even some of the attendings were feeling bad for the residents talking about how the job market isn't what it used to be lmao. I don't see many redeeming qualities about EM tbh. Don't get me wrong, I do think ER attendings are awesome. When shifts get busy they have to manage and deal with a lot.

Is there anything I can't see on the surface that I'm missing?

Even hospitalist medicine is much better than this. can round very quickly, stay for admissions or leave if you don't think you're getting one in like 30 min - 1 hour because they go down the list for admissions throughout the day, and the pay is similar... albeit a little less.

I’ll chime in on the positive.

1) pay is much better than hospitalists.
2) hours are more intense
3) the hours depend on how much you work.
4) as an attending the “being talked down to” doesn’t happen if at all.
5) I’ve been at my current Ed for 5+ years. We had a vascular dude who tried this. I lit him up. He was complaining about me calling him for a vascular complication. He said something snooty. My response was “if you didn’t screw up all the time I wouldn’t have to call”. Then silence. Never another peep. I don’t get bullied.
6) the job CAN be interesting.
7) everything gets boring. How many knee replacements before they become mundane? How many social train wrecks upstairs the Hospitalist can’t dispo before it becomes annoying?

 

[GonnaBeADoc2222]

FINALLY. A smart medical student. Do ortho.

 

[Angry Birds]

Nothing you said is too inaccurate.

I dunno. I think it’s meant as a snide judgment of our field. But maybe I’m being sensitive

 

[scoopdaboop]

I dunno. I think it’s meant as a snide judgment of our field. But maybe I’m being sensitive

definetly being sensitive. every field in medicine is imperfect, other than maybe... CEO of the hospital.

 

[Angry Birds]

definetly being sensitive. every field in medicine is imperfect, other than maybe... CEO of the hospital.

You don’t get a vote here

 

[DOswag]

I worked in ER before med school and thought that's what I wanted to do all through school until like late 4th year. The constant change in shifts was making me exhausted. Seemed many ER docs I talked to were pretty unhappy with their jobs. Near everyone I had worked with pre-med school had been divorced at least once and was just working extra shifts to make extra money to pay off stuff, pay child support etc. They hated it. I thought I enjoyed it for a while but after taking a long hard look at myself, priorities, my preference for a regular schedule, I'm glad I didn't go into EM. This was actually after I applied and did not match military match the first time I applied. 2nd round, I knew it wasn't for me and applied to psychiatry (after I did some more rotations in psychiatry as a traditional rotating intern and fell in love with it). Very glad I did not reapply EM(not necessarily saying I definitely would've been accepted a second time but there were only like 2 programs in air force for psychiatry at the time I applied) but I'm happy where I'm at now.

I know some EM docs making 4-500K per year. They work for it though. Burnout seems pretty high but I don't remember the last time I saw actual numbers on burnout per specialty. I think I would've ended up miserable in EM.

I frequented this forum often when I was in med school so I come check in every once in a while to see what's happening in the EM world. Used to love one of the ongoing threads of "ER hall of fame" (or something like that) where people posted crazy lab values on patients that came in lol

 

[Mount Asclepius]

1) Ocean a mile wide even if only 3” deep. We have the broadest knowledge of the acute management of all conditions.
2) We work, and then we’re off to play. No call.
3) Reasonable number of hours. They suck - nights, weekends, holidays. We don’t work 50+ hours/week in perpetuity though.
4) Fast paced shifts. I feel exhausted after a busy shift, but it doesn’t drag while I’m there, which was how clinic or long OR cases felt as a student.
5) Compensation. In a decent EP job you will make towards the top of medicine in terms of money per hour.
6) Rarely, you will save a life. That’s powerful.
7) Cool stories, bro. They may involve dildos, but it’s better at a party than talking about the Kreb’s cycle.
8) Respect. There isn’t any as a resident. When you are an attending though, sub-specialists like that you manage all of their post-op complications at night and come running to you when someone is crashing.
9) Staff. A job is a job and patients are patients. After a while the relationships you develop with the staff in the ED are more meaningful than those in other areas of medicine in my opinion and one of my favorite parts of work. Only we understand each other’s dark humor.
10) Patagonia. Best dressed. Forget the white coat. We are one foot in medicine, and one foot in the real world. Allows us to escape back into society once we are burned out.

 

[EctopicFetus]

1) Ocean a mile wide even if only 3” deep. We have the broadest knowledge of the acute management of all conditions.
2) We work, and then we’re off to play. No call.
3) Reasonable number of hours. They suck - nights, weekends, holidays. We don’t work 50+ hours/week in perpetuity though.
4) Fast paced shifts. I feel exhausted after a busy shift, but it doesn’t drag while I’m there, which was how clinic or long OR cases felt as a student.
5) Compensation. In a decent EP job you will make towards the top of medicine in terms of money per hour.
6) Rarely, you will save a life. That’s powerful.
7) Cool stories, bro. They may involve dildos, but it’s better at a party than talking about the Kreb’s cycle.
8) Respect. There isn’t any as a resident. When you are an attending though, sub-specialists like that you manage all of their post-op complications at night and come running to you when someone is crashing.
9) Staff. A job is a job and patients are patients. After a while the relationships you develop with the staff in the ED are more meaningful than those in other areas of medicine in my opinion and one of my favorite parts of work. Only we understand each other’s dark humor.
10) Patagonia. Best dressed. Forget the white coat. We are one foot in medicine, and one foot in the real world. Allows us to escape back into society once we are burned out.

I’ll add we have a job in medicine where we can take a ton of time off. I’ve taken multiple week plus vacations this year. Hard to do in ortho. Also when I come back clinically speaking im not somehow way behind. Just plug and play. Outside of the CMG / corporatiza issue I think it’s the best job in medicine. That being said I would push hard to not have my kids do it because corporate control is real.

 

[emergentmd]

EM is not perfect but most fields complain constantly too.

When I did hospital work, these were much more miserable specialists who

1. Hospitalists -Miserable. Try doing 12 hr overnight call and getting 20 pts plus all the calls. Or 12 hr morning coverage spending your days tracking down labs, tests, placement. Yuk
2. Surgeons - Miserable group walking in at 2am for a bowel perf after a full day clinic plus full day tomorrow. Atleast after my 8-10 hr shifts, I am going home undisturbed
3. OB - Yuk
4. Anesthesia - 5am wake up to hospital for 1st case and watching a monitor all day long. Cut my wrist.

I can go on and on, but there are as many happy EM docs as there are in most fields.

 

[Prehealth1011]

Even hospitalist medicine is much better than this. can round very quickly, stay for admissions or leave if you don't think you're getting one in like 30 min - 1 hour because they go down the list for admissions throughout the day, and the pay is similar... albeit a little less.

Pay is not similar. EM makes quite a bit more

 

[EctopicFetus]

EM is not perfect but most fields complain constantly too.

When I did hospital work, these were much more miserable specialists who

1. Hospitalists -Miserable. Try doing 12 hr overnight call and getting 20 pts plus all the calls. Or 12 hr morning coverage spending your days tracking down labs, tests, placement. Yuk
2. Surgeons - Miserable group walking in at 2am for a bowel perf after a full day clinic plus full day tomorrow. Atleast after my 8-10 hr shifts, I am going home undisturbed
3. OB - Yuk
4. Anesthesia - 5am wake up to hospital for 1st case and watching a monitor all day long. Cut my wrist.

I can go on and on, but there are as many happy EM docs as there are in most fields.

As much as I complain about em it’s more the corporate side of it and less the clinical / patient care stuff. Yes lack of nurses and waiting room medicine sucks but overall it’s fine. I do my best. I make up stuff to keep the mundane interesting. Can I dispo this patient and have them be happy without doing labs or anything else. Can I keep my los way down. Residents help too. Having fun colleagues helps too. No one leaves my group but for retirement. Golden handcuffs are real. I am in a good location but 4-5 of my friends would likely move if the job changed especially cause they have very young kids. Once the kids hit a certain age moving is much tougher.

I’ll be honest that if I worked at a cmg this would be harder and would impact my enjoyment. That being said I can’t think of another specialty where I look at the whole of what they do and think “man I missed my calling”. Things are either way too boring (derm, rads, fp, Medicine etc.) or hours suck and I realized as a student I didn’t want to be in the OR. Now I’m not saying the fields above suck. They just don’t fit my personality and what I want my life to look like.

 

[emergentmd]

Every field has issues and when you pick a specialty you have to find joy in what you like about it and be able to blow off what you hate.

What I hate about EM
1. Shift work esp overnight - We had nocturnists and if not, I would pay someone until they cover it. I rather work an extra shift, use that money to avoid nights. But that is just me.
2. Drug seekers, psych pts, difficult pts - I will never see them again, they will never see me again, they are no different than meeting rude people in society. I don't let a rude walmart clerk get to me, so why have a rude drug seeker get to me esp when I am getting paid? I do not let this bother me
3. Admin/CMG/metrics/protocols - It sucks, but I just play nice/jump through hoops esp when it maybe takes 3-5 hrs out of a month.

Thinks I love
1. Shift work, create my own schedule 95% of the time. I almost never miss an important kiddie event b/c I either ask off or trade
2. Fun staff - typically EM docs are great people and staff typically young so never gets boring
3. Pay - I prob avg $250/hr when in the hospital, can't ask for more than this. I am efficient so rarely stay after/bring work home. Being efficient allows me to take lots of breaks, catch up on email, read the news. I would say in a 8 hr shift, I prob spend about 1-2 hrs a day doing non EM work.
4. 3 yr residency - need I say more
5. Job market - Great when I started, a few years of alittle down, and I feel like its going up again. We have FSER shifts that pays twice as much as hospital shifts doing 1/3 the work and its hard to find docs to cover shifts. This tells me all I need to know currently.

If you are getting burned out the best advice I can give you is to become efficient. Become more efficient than your partners. When you are top quarter efficient, you get much more leeway. I typically am a top 1-2 doc in efficiency. Be top 25% in pph seen, do it quicker than most docs will allow you to take as much breaks as you want, go get coffee when you want. No one will care if you spend the last 1-2 hrs of your shift just charting. No one is going to care if you go missing for 20-30 minutes when the board is covered with your name and your ppd is always tops. This may be difficult for many, but that should be your goal.

 

[Brigade4Radiant]

Yeah be efficient it seems that just being nice and seeing a lot of patients gives you a lot of job security in a non HCA job.

 

[thegenius]

EM is not perfect but most fields complain constantly too.

When I did hospital work, these were much more miserable specialists who

1. Hospitalists -Miserable. Try doing 12 hr overnight call and getting 20 pts plus all the calls. Or 12 hr morning coverage spending your days tracking down labs, tests, placement. Yuk
2. Surgeons - Miserable group walking in at 2am for a bowel perf after a full day clinic plus full day tomorrow. Atleast after my 8-10 hr shifts, I am going home undisturbed
3. OB - Yuk
4. Anesthesia - 5am wake up to hospital for 1st case and watching a monitor all day long. Cut my wrist.

I can go on and on, but there are as many happy EM docs as there are in most fields.

Ya I think that most doctors don't really enjoy day to day stuff. They get bogged down in it. I wonder why medicine is such a crappy field to go into. My dad is a retired doctor and he never seemed just generally down on a regular basis as doctors are these days.

For those who say universal health care is what's needed..i would cry and leave the field if we had universal health care. The amount of crap that would come into the ED would be many fold worse than it is now. People lining up outside to get "evaluated to get their knees replaced"

I really look forward to a different payment model where the govt gives a yearly lump sump to a hospital to take care of the community, and then (and only then) will the hospital support ER docs telling patients to GTFO when arriving for nonsense stuff.

 

[WilcoWorld]

Is ER residency much worse than ER attending life? because, as a student rotating in it with residents, who often stay from 7 am to 7 pm, have to work a revolving door of day shifts/ shifts from like 3 pm - 2 am, then 9 pm - 7 am, it feels awful. Then you add that you get talked down upon from some attendings, hell even some patients don't respect you and "want the ortho guy". Even some of the attendings were feeling bad for the residents talking about how the job market isn't what it used to be lmao. I don't see many redeeming qualities about EM tbh. Don't get me wrong, I do think ER attendings are awesome. When shifts get busy they have to manage and deal with a lot.

Is there anything I can't see on the surface that I'm missing?

Even hospitalist medicine is much better than this. can round very quickly, stay for admissions or leave if you don't think you're getting one in like 30 min - 1 hour because they go down the list for admissions throughout the day, and the pay is similar... albeit a little less.

What you see is accurate, there are also aspects that you are missing.

 

[TeddyBoomBoom]

I do, occasionally, get to do cool stuff.

I have good stories for parties.

I’m in the AC/not physical labor.

ER coworkers are generally cool.

When I leave work, I am 100% done with work.