It's great to hear someone this positive about EM. But I think your last line misses a huge point. Yes, there area few "screw ups" that just picked the wrong profession. That happens in any profession. Regardless, outside of the world of physicians, it's normal to make major career changes more than once in a lifetime. Yet as a physician, you're supposed to pick your job at age 26, and not change it at all for thirty to forty years? That's a very hard thing to do, and especially hard to do in EM. Someone like you, 20+ years into it, that hasn't struggled with any significant burnout, is the exception to the rule. I feel like I picked the right profession in choosing EM. I feel that it was perfect for 10 years. Then life changed around me, I changed, and the fit was not so perfect anymore.