salary in EM

[xaelia]

Give kid IM ketamine, go see someone else, go back do procedure on kid etc etc.

Ah, eh, as much as I love ketamine and it's safety profile, I wouldn't stray far from the bedside during procedural sedation. Everyone's practice environment allows them different flexibility, of course.

As far as salary goes, as in everything in life, your ability to be happy is all internally generated as a response to the stimuli you receive. Life as an attending does not produce a great deal of negative stimuli, and it is very easy to have a positive outlook on life - and the number of negative inputs can be easily modulated depending on the individual situation.

In residency, I made ~$48k, had a $500/mo. apartment, and lived like a king in rural NC. Now I make 4.5x that as an academic attending and the townhome my wife and I rent is 6x more, plus the mortgage from her old house. Would more money make me happier? It would make some things easier and I could have one of those pieces of hotness they feature on Top Gear, but, for the most part, it wouldn't really change my life.

Even as a lowly Assistant Professor, I still have plenty of money left over to the point where I never worry about it for everyday things - but I also need very little to be happy. I'm quite content with my VW Golf, I don't concern myself with exotic vacations when there are so many beautiful places in the U.S. I haven't visited, I can afford the $80-100 scotch instead of the $50 kind, we can support a second cat, and I have the means and time to make the people most important in my life a little happier. My job is hardandisuckatitbutgoodandiwouldntwantitanyotherway, my family is healthy, and nothing of any consequence is inconveniencing me. Again, and I cannot emphasize this enough, happiness and satisfaction is completely under your own control and how you respond to the world.

Choose the specialty and job that makes you happy. EM is great for some, not for everyone, but there are also a zillion niches for different people. When I'm not working in the department, I'm getting a Master's degree in Biomedical Informatics supported by an AHRQ Training Program, I blog, I write angry letters to Annals about obnoxious TPA literature, and I chip in with departmental needs. Toxicology, ultrasound, palliative care, rural critical access, upscale community - there's something in EM for everyone.

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[deleted109597]

Combined, my wife and I make roughly 5 times what we made in residency. Of course, after she becomes partner, we will make 6 times what our lowly resident salaries were. It does allow us to afford pretty much anything a sane person would like. No, I can't drive a Bentley or put 28s on it, but I could take my pick of most cars. I still drive my Wrangler, and will until it I start losing things through the rust holes in the floorboards. She drives a Patriot, but is looking to upgrade. We did just buy our "attending" house, so it will take a little time before the slush fund is restored, as downpayments are a bitch.
However, the difference between xaelia and I is, while I earn more, he has no student loan debt, and we have $300K. The prior mortgage anchor isn't great either. My total housing expenditures went up 5x. I certainly don't fret about buying groceries. More money would make me either spend more, or invest more. With a young child, I don't travel much now, but will do so in the future.

And, like Ectopic mentioned, if I could sail for a week every month, I would.

 

[UnderwaterDoc]

Sobering, to say the least.

Any job anywhere, in the world, in the entire history of jobs, will get boring and annoying after enough time. So what do you have left when the job is no longer exciting? The lifestyle that your job allows you to have, in that regard, EM is still very close to the summit.

 

[DreamingTheLive]

Xaelia and Dr. McNinja,

Thanks for the insight. Again, it really helps for those of us who perhaps haven't fallen in love with any one particular field, but instead like several aspects about a lot of different areas of medicine.

-How did you guys winnow down your list to EM? Was it love at first site? Did you dislike everything else? Jack of all trades?
-Looking back so far, has EM been what you thought it would be when you first set out as a PGY-1?

 

[DreamingTheLive]

Any job anywhere, in the world, in the entire history of jobs, will get boring and annoying after enough time. So what do you have left when the job is no longer exciting? The lifestyle that your job allows you to have, in that regard, EM is still very close to the summit.

I had always thought that being able to spend ample time with family/friends or pursuing other ventures was one of the real draws of EM. However, I'm a bit conflicted as I've recently came across a bunch of posts espousing that the shift work/odd hours can be so taxing, that it literally takes most of that off-time just to recover/normalize, and that you can't truly utilize/enjoy this time like originally believed (i.e., as a M3 or M4). Thoughts?

 

[UnderwaterDoc]

I had always thought that being able to spend ample time with family/friends or pursuing other ventures was one of the real draws of EM. However, I'm a bit conflicted as I've recently came across a bunch of posts espousing that the shift work/odd hours can be so taxing, that it literally takes most of that off-time just to recover/normalize, and that you can't truly utilize/enjoy this time like originally believed (i.e., as a M3 or M4). Thoughts?

I think you were right when you previously stated that EM is a polarizing field. First and foremost you have to love the ED to want to work in the ED, and the only way to know if you do or not is to expose yourself to the field with rotations.

As has been previously discussed on these threads ad nauseum, if your primary draw to EM is the lifestyle then you are making the wrong choice, because if you do not truly enjoy being in the ED then you will burn out.

I disagree about the shift work being so terrible that you need days to recover, but that is something that you will have to experience for yourself. To me, the positives of EM far outweigh the negatives, Birdstrike is in the process of leaving the field, so he represents the other end of the spectrum as far as EM satisfaction goes.

In the end of the day, nothing we can tell you here will compare with you going through it on your own, do a rotation and see how you feel about it.

 

[deleted109597]

-How did you guys winnow down your list to EM? Was it love at first site? Did you dislike everything else? Jack of all trades?
-Looking back so far, has EM been what you thought it would be when you first set out as a PGY-1?

I worked in an ED in undergrad. I really never liked anything else. Even then I knew some of the downsides (I worked nights while going to school during the day), saw the admission arguments, the waiting room times.
At the same time, the Jack of all trades concept is pretty spot on. I like getting the chance to do different stuff every day. I like how I can work at pediatric hospitals, geriatric hospitals, and everywhere in between. I also like how much I get paid.
Is it everything I thought it would be? Well, considering I did a year of surgery before EM residency, and still stuck with going into EM, I would say it's been pretty accurate. Attending life is much better than residency life as far as what you do at work. I don't have to ask permission before I decide to do something novel. It is pretty refreshing.

 

[Apollyon]

Well, considering I did a year of surgery before EM residency, and still stuck with going into EM, I would say it's been pretty accurate.

Shouldn't you qualify this for the person to whom you are responding, though, namely, that doing a year of surgery wasn't your intention? That is just the same as me doing a year of IM, which wasn't my intended plan.

 

[danielmd06]

I had always thought that being able to spend ample time with family/friends or pursuing other ventures was one of the real draws of EM. However, I'm a bit conflicted as I've recently came across a bunch of posts espousing that the shift work/odd hours can be so taxing, that it literally takes most of that off-time just to recover/normalize, and that you can't truly utilize/enjoy this time like originally believed (i.e., as a M3 or M4). Thoughts?

This (the definition of "freedom" and free time) is relative. It changes as you age, get married, and have children. Your financial needs change, too.

Hence, the different (and honest) angles of opinion as you progress through EM and medicine in general.

 

[deleted109597]

Shouldn't you qualify this for the person to whom you are responding, though, namely, that doing a year of surgery wasn't your intention? That is just the same as me doing a year of IM, which wasn't my intended plan.

Wasn't trying to be obfuscating. Yes, I did a year of surgery purgatory as punishment for not matching. Even with the heinous bitch who tried to ruin my career working in EM I still went into it.

 

[emergentmd]

ED docs are well paid/hr. You can't compare ED docs yearly salary with other specialists.

If a doc makes 200k a year, it may seem low but what if they are part time and only work 20 hours a week?

If an ED doc works what a typical specialist works, I would say we are well paid.

Let me run some numbers from surgeons I know.

Surgeon works 8 hrs/day, on call every 4 day. Lets say he gets called in to do surgery 2 times a month or about 8 hrs of his life. So about 170 hrs a month, or 2000 hrs/yr.

Even if I get paid on the low end of being a board certified EM at 190/hr, that 2000 hrs would be equivalent to 380k a year.

For anyone who says that an EM doc works harder than a surgeon, I think this is not true.

The 190/hr I quoted is for friends I knw that works in freestanding EDs with volumes of 15-20 per day. Most are Quick care type pts also. So at nights, you sleep making 190/hr.

Just looking at this, I would say ED docs are overpaid compared to many other fields.