Would you recommend EM?

[Twub13]

Very undecided third year medical student deciding what specialty to go into because I have found that I like A LOT

EM physicians what do you think about your work-life balance with shift work and salary compensation?

I am a women, who is interested in having a family so wanting to make sure I can still accomplish that.

I have heard a lot of mixed things about the burnout, but I find that in each of my rotations I find myself most intrigued by the high urgency/acute care cases. I love chaos and having to run around my entire shift (thanks ADHD). I can't help but feel like EM is meant for me but am just so worried about my life in residency and as a physician.

I am also really interested in access to healthcare and am aware of how many uninsured people (and unfortunately many people of color) use the ED for care, so I find that will be fulfilling (I am also of color). I also like continuity of care, and worry that I will miss that, but have been told that you often do see the same people over again.

The other thing I was debating was Psychiatry and found that I loved the Psych ED, but worry that I will miss the bread and butter of medicine. An attending at my university mentioned that they see A LOT of psych cases in the ED, so I feel like I'd still get exposure.

So long-winded to say, would you recommend EM ? Thoughts about your work-life balance with shift work and salary compensation? (I don't need to have 3 vacation homes, but will have a lot of loans and wish to never struggle with money despite childhood. But would like time to be able to enjoy having money as well lol)

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[namethatsmell]

Have you ever read this forum that you are posting on?

The answer you are seeking has been revealed approximately 4,956,772 times.

 

[RustedFox]

JESUS CHRIST, NO !

 

[RustedFox]

She's saying all the things, amigos.
ALL THE THINGS.

 

[sylvanthus]

Do I hate the person who is asking?

 

[Dr Mantis Toboggan]

Very undecided third year medical student deciding what specialty to go into because I have found that I like A LOT

EM physicians what do you think about your work-life balance with shift work and salary compensation?

I am a women, who is interested in having a family so wanting to make sure I can still accomplish that.

I have heard a lot of mixed things about the burnout, but I find that in each of my rotations I find myself most intrigued by the high urgency/acute care cases. I love chaos and having to run around my entire shift (thanks ADHD). I can't help but feel like EM is meant for me but am just so worried about my life in residency and as a physician.

I am also really interested in access to healthcare and am aware of how many uninsured people (and unfortunately many people of color) use the ED for care, so I find that will be fulfilling (I am also of color). I also like continuity of care, and worry that I will miss that, but have been told that you often do see the same people over again.

The other thing I was debating was Psychiatry and found that I loved the Psych ED, but worry that I will miss the bread and butter of medicine. An attending at my university mentioned that they see A LOT of psych cases in the ED, so I feel like I'd still get exposure.

So long-winded to say, would you recommend EM ? Thoughts about your work-life balance with shift work and salary compensation? (I don't need to have 3 vacation homes, but will have a lot of loans and wish to never struggle with money despite childhood. But would like time to be able to enjoy having money as well lol)

this may be of interest.

Female emergency physicians leave EM workforce >12 years b/f male EPs

Also: Two-thirds of 55 y/o+ EPs have been sued, TeamHealth’s debt, ED psych boarding is unconstitutional, & residents on strike.

emworkforce.substack.com

 

[Rekt]

no

 

[VA Hopeful Dr]

Continuity of care and wanting to help with underserved populations getting access to care?

Family medicine would like a word...

 

[Twub13]

Continuity of care and wanting to help with underserved populations getting access to care?

Family medicine would like a word...

LOL I feel like I have far too many loans for FM haha

 

[Twub13]

JESUS CHRIST, NO !


View attachment 379732

I am quickly realizing it was a mistake to ask this here lol

 

[valianteffort]

No. Do psych. My friends are making 400k working from home. markets hot

 

[kumatie]

The truth is very few people can have a life long career in EM, or even a couple decades long. You may have interest in it now, but let me tell you a decade of seeing vaginal discharge and MeMa’s that families refuse to take home wears on you. Yea, there are STEMIs and codes and central lines and chest tubes, but that is less then 5% of what I do. If am on honest with you, what EM docs do doesn’t matter for the majority of their time. You aren’t saving lives, you’re a waiter working at a ****ing restaurant.

A EM residency trains you for the 5% of what you will see. The rest of the 95% is complete and utter soul sucking bull****. Imagine training for a job 10+ years and only using your training less than 5% of the time. This specialty is a joke and an embarrassment and should not be terminated before poor souls like you get sucked into it.

 

[GatorCHOMPions]

I am quickly realizing it was a mistake to ask this here lol

Far from a mistake, but just search the forum and I bet you’ll find plenty of answers.

 

[RustedFox]

I am quickly realizing it was a mistake to ask this here lol

NO!

It was not a mistake.
This forum is full of hundreds of seasoned Emergency Physicians with literally thousands of years of practice under their belt.

You'd do well to listen.

It's a trap.

I guarantee you go to Reddit and you "like the things you hear over there better" and declare us all "burnt out".

Those redditards are mostly students, rezzies, and YOUNG attendings who really... REALLY don't know what they're talking about.

 

[AlmostAnMD]

I am quickly realizing it was a mistake to ask this here lol

It was a mistake to ask one of the few reliable web forums on earth where people who do what you're asking about for a living about if you should do EM? If you're taking any advice, don't keep asking this question until someone says what you want.

The mistake is EM

Not the forum

Be an -ologist/consultant only

I dont remember who posted this but it was a beautiful comparison: be the star player on the NFL team, not the hotdog vendor in the tunnels. One gets a complaint and is replaced, the other is nearly irreplaceable and the entire institution bends to their will

 

[Tipsy McStagger]

Not only is there no good reason to go into EM now, there is nothing to look forward to in the future.

 

[FlaminHotER]

No

 

[Franzd'Epinay]

LOL I feel like I have far too many loans for FM haha

You almost certainly don't.

Anyways, if you're serious about the acute care stuff, you should look into PulmCCM. This would also give you a nice way to wind down from the hospital if you feel like it.

As an aside, I really dislike it when people use an interest in underserved patients as a justification for pursuing certain specialties--underserved patients need physicians in every field.

 

[Brigade4Radiant]

Very undecided third year medical student deciding what specialty to go into because I have found that I like A LOT

EM physicians what do you think about your work-life balance with shift work and salary compensation?

I am a women, who is interested in having a family so wanting to make sure I can still accomplish that.

I have heard a lot of mixed things about the burnout, but I find that in each of my rotations I find myself most intrigued by the high urgency/acute care cases. I love chaos and having to run around my entire shift (thanks ADHD). I can't help but feel like EM is meant for me but am just so worried about my life in residency and as a physician.

I am also really interested in access to healthcare and am aware of how many uninsured people (and unfortunately many people of color) use the ED for care, so I find that will be fulfilling (I am also of color). I also like continuity of care, and worry that I will miss that, but have been told that you often do see the same people over again.

The other thing I was debating was Psychiatry and found that I loved the Psych ED, but worry that I will miss the bread and butter of medicine. An attending at my university mentioned that they see A LOT of psych cases in the ED, so I feel like I'd still get exposure.

So long-winded to say, would you recommend EM ? Thoughts about your work-life balance with shift work and salary compensation? (I don't need to have 3 vacation homes, but will have a lot of loans and wish to never struggle with money despite childhood. But would like time to be able to enjoy having money as well lol)

1. if you want a family how many kids will your spouse be working

2. Psych has more flexiability and is more life friendly no nights

3. Acuity meaning what? If you are in an academic hospital most of the high acuity gets run by other teams after tubing them

4. Liking a lot of medicine you should look into rads or do psych you'll make more and can choose where you want to live

What about anesthesia?

What are the highest paying contracts you’ve seen in the middle of nowhere?

Considering anesthesia and I’m needing some motivation to get through surgery rotations. I’m from the country and plan on working in a rural hospital? What are the best contracts you all have seen for working in the middle of nowhere ?

forums.studentdoctor.net

 

[cyanide12345678]

No. Don’t do EM.

Do psych.

 

[cyanide12345678]

I am quickly realizing it was a mistake to ask this here lol

You should not be looking for positive reinforcement.

When 80-90 percent of practicing attendings here essentially say ‘Stay away’ - this could be the best advice you ever got.

You know what’s almost impossible to have in emergency medicine? A reliable and fixed schedule.

Do you know what people need to have when they have kids and a family especially new mothers? A reliable and fixed schedule.

Let’s compare lives: i have a 3 year old and a 8 week old child. My wife is FM and in EM.

child care for an EM doc is so so so hard. One day you’re on a day shift, next day you might be on a night shift. Maybe you work Monday Tuesday Friday this week, maybe you’ll work Thursday Friday and Saturday next week. It is really really hard to balance motherhood with emergency medicine. No wonder all the data shows women are quitting EM in droves.

If something happened to my wife, i would have to quit my job as i literally wouldnt be able to work the times i work while having children.

My wife on the other hand works wednesday Thursday Friday. If i died tomorrow, she will continue dropping off our kids at day care at 7 am and go to work at 7:30 am and pick them up at 5 pm. If she had to work a day shift, then switch to night shift, then back to days, and have a new born to breastfeed through the night - she will go crazy.

Do psych. Listen to the dozens of attendings. The data is out there. the job outlook is terrible. By the time you graduate you’ll probably have to go work in the worst of places as well.

 

[RustedFox]

It was a mistake to ask one of the few reliable web forums on earth where people who do what you're asking about for a living about if you should do EM? If you're taking any advice, don't keep asking this question until someone says what you want.

The mistake is EM

Not the forum

Be an -ologist/consultant only

I dont remember who posted this but it was a beautiful comparison: be the star player on the NFL team, not the hotdog vendor in the tunnels. One gets a complaint and is replaced, the other is nearly irreplaceable and the entire institution bends to their will

It was Birdstrike who posted that. I'm almost damn certain of it.

That post hit young attending me like a brick between the eyes, once I learned to open them to the truth.

 

[RustedFox]

You almost certainly don't.

Anyways, if you're serious about the acute care stuff, you should look into PulmCCM. This would also give you a nice way to wind down from the hospital if you feel like it.

As an aside, I really dislike it when people use an interest in underserved patients as a justification for pursuing certain specialties--underserved patients need physicians in every field.

Yeah, I bristle when I hear that as well; because it's 100% feel-good virtue signaling nonsense. You absolutely don't give AF about served vs underserved when your feet are on the hospital floor. You don't have time for that.

The other thing that makes me bristle is: "but I'd still get psych exposure in the ER".

Hard stop. These are dangerous people. They brick the department and just love to complain to admin about anything and everything.

OP: READ THIS!

I was taken off the schedule for a week or 2 last year because crazypants patient accused me of putting her in an armlock and a forearm behind her head when she didnt get the validation and attention she wanted. She filed a police report. Cops came for me and everything. My director called me and said "pending investigation we have to do this" Good thing for me she was in a hallway bed with a camera on her the entire time. Completely confabulated.

Did they pay me for my time off? Nope. Just lost 2 weeks worth of shifts. I figure that was 18k gross pay. Not even an apology. "Eff you, RustedFox."

NO. Screw the psych patients in the ER. We need to be protected from their nonsense. When I said: "I want to press charges for a false police report", the hospital said: "no, that's not a good look for US", tacitly implying that me doing so would terminate my employment. Director said to me: "had it not been for the camera, I would have had to fire you, even if you didn't touch her at all."

Everything looks "interesting" to you when you're not responsible for it. Think that one through.

 

[cyanide12345678]

Very undecided third year medical student deciding what specialty to go into because I have found that I like A LOT

EM physicians what do you think about your work-life balance with shift work and salary compensation?

I am a women, who is interested in having a family so wanting to make sure I can still accomplish that.

I have heard a lot of mixed things about the burnout, but I find that in each of my rotations I find myself most intrigued by the high urgency/acute care cases. I love chaos and having to run around my entire shift (thanks ADHD). I can't help but feel like EM is meant for me but am just so worried about my life in residency and as a physician.

I am also really interested in access to healthcare and am aware of how many uninsured people (and unfortunately many people of color) use the ED for care, so I find that will be fulfilling (I am also of color). I also like continuity of care, and worry that I will miss that, but have been told that you often do see the same people over again.

The other thing I was debating was Psychiatry and found that I loved the Psych ED, but worry that I will miss the bread and butter of medicine. An attending at my university mentioned that they see A LOT of psych cases in the ED, so I feel like I'd still get exposure.

So long-winded to say, would you recommend EM ? Thoughts about your work-life balance with shift work and salary compensation? (I don't need to have 3 vacation homes, but will have a lot of loans and wish to never struggle with money despite childhood. But would like time to be able to enjoy having money as well lol)

Why emergency medicine is a dying specialty- The thread all Med students should read

Ok med students - I'm going to make this easy for you guys and explain to you really the details of what you don't experience as a med student and why EM is just a terrible specialty. I'm 3.5 years out of training. I wish someone sat me down and slapped some sense into me 7-8 years ago. But here...

forums.studentdoctor.net

Shameless plug for my own thread/post somewhere else on this forum. I think you should go through every post by attendings.

 

[Cinclus]

I was between EM and psych. I did EM. I recommend doing psych. Do not underestimate the value of having autonomy.

 

[RustedFox]

Why emergency medicine is a dying specialty- The thread all Med students should read

Ok med students - I'm going to make this easy for you guys and explain to you really the details of what you don't experience as a med student and why EM is just a terrible specialty. I'm 3.5 years out of training. I wish someone sat me down and slapped some sense into me 7-8 years ago. But here...

forums.studentdoctor.net

Shameless plug for my own thread/post somewhere else on this forum. I think you should go through every post by attendings.

If I remember correctly, you posted it to Reddit and it was removed because it didn't fit the narrative that they want.

 

[cyanide12345678]

If I remember correctly, you posted it to Reddit and it was removed because it didn't fit the narrative that they want.

Yup. I was just trying to educate and inform students.

I got suckered in 9 or so years ago - there was so much hype about EM then. It’s just not the same specialty i applied to back in 2015.

Every attending i talked to then couldn’t stop bragging about all the 300/hr job opportunities they have and the hundreds of recruiter emails. 10 years later, things have truly changed. It’s just a mediocre specialty

 

[VA Hopeful Dr]

LOL I feel like I have far too many loans for FM haha

Nonsense. Lots of FM jobs have pretty sweet loan repayment as part of the contract.

Plus, FPs make more than is generally appreciated. I'm hospital employed and every single doctor in my office is going to break 400k this year, several by a good bit.

 

[DOswag]

Nonsense. Lots of FM jobs have pretty sweet loan repayment as part of the contract.

Plus, FPs make more than is generally appreciated. I'm hospital employed and every single doctor in my office is going to break 400k this year, several by a good bit.

Didn't know FP's were making that much! To the OP, agree with what others have said above. I was a naive 3rd year once who was interested in EM and even worked in an ER for several years before med school as a tech. I heeded the advice of many on this forum and ended up going psychiatry. One of the best decisions I've ever made. I would've been absolutely miserable in EM as so many are. Do psych or FP (I'm a little biased toward psych though ), so many settings you can work in, work/life balance is great, money can be pretty lucrative. I recently separated from the military and started my first civ gig. With the bonus/rvu structure it is possible to clear 400+at my current job with some psychs making 5-$600K. I work 4 days per week Mon-Thurs, 40 hours, get a 3 day weekend every weekend, no nights, weekends, holidays, no call. I am a male, married with 4 kids and get to spend ample time with my family.

 

[Arcan57]

OP, my answer isn't really different from the above. Do EM if you have to do EM. If you don't have a burning passion that makes life unthinkable if you don't become an EM doc, stay the hell away. As my other posts have mentioned, our student rotations are a damn lie that have nothing to do with what being an emergency physician is about. But worse than that, EM destroys your ability to care about the things you mention as reasons for wanting to go into EM. Burnout is ubiquitious and hardcoded into the current system. When you're truly burned out, you can't experience empathy and noble goals of helping the underserved gets drowned in the noise of your own misery. There are people that don't burnout because of some quirk to their psychology but those are really rare. A lot of the other "happy" attendings in EM that learners encounter are happy because they're 2-3 steps removed from the grind of being a fulltime pit doc.

Going into EM in 2023 if you're lukewarm about it or for the usual "$$$, altruism, time off" trifecta is a bad idea. And it's probably going to sting even harder because you had choices and you deliberately chose the worse one.

 

[Mtbk]

OP,
I haven’t posted on here in a while, but you should heed these warnings. Everything posted above is absolutely true. The future of EM looks very bleak.

I’ve been out of training for over 10 years. The majority of people that I know want to get out of this field. Many of those docs will probably grind it out and be ok. Anyone starting training now will not be. The workforce issues are very real. In 5 years time you may not even be able to get a job anywhere.

Workforce issues aside, there are a million reasons to stay away from EM. Most jobs are with a CMG, which are owned by venture capitalist goons. This CMG will treat you like ****, cut your hours whenever possible, and pay you based upon market forces, ie as little as possible. You will have zero due process.

Unreasonable consultants and hospital administrators. Constant circadian rhythm shifts. Nursing shortages post-covid. The list goes on.

There are still a few good jobs out there, mainly with private groups. These jobs will be full long before you finish residency. Do something else.

 

[Brigade4Radiant]

Also EM wants you to have away rotations and a SLOE there will be a lot of unfilled programs

Also where do you want to live in some areas EM makes less than FM

 

[bky3c]

Everything looks "interesting" to you when you're not responsible for it. Think that one through.

THIS. I wish someone had said this to me when I was a med student. The Fox is right (as usual). Truly think about that one.

Signed, a female emergency physician who got the F out four years ago after 10 years as an attending. If I had chosen a different specialty, I might still be practicing. I do more for the underserved in my volunteer work these days than I ever did in the ED. AND I get to be home for Christmas. All 24 hours of it.

 

[GonnaBeADoc2222]

There's a couple positives/paths forward:

1) true portability if you plan on leading a nomadic life.

2) Easier to go part-time if you have a partner who can support you

3) easier to take vacation whenever you want

That being said, I would heed the above and not go in to EM.

If you can find a job w no nights and no expectations, it might be sustainable, but this is difficult.

At the core of it, the job sucks. I love a good hip reduction, intubation, chest tube, but this is not the core of what I do. Pure emergency medicine is awesome. Even the worried well and kiddie colds I don't mind so much. It's nice to reassure parents that their kids are OK.

The work has been bastardized however by hospital systems, and CMGs. I've worked for both. The CMGs truly don't care about you and will cut you or your hours at the drop of a hat. I was cut from a CMG schedule out of nowhere because I refused to place a central line in someone who didn't need it. I have friends who were cut to 80 hrs a month during COVID. The "not for profit" hospital systems are worse in some ways as they pretend to care but actually do not, but gaslight you along the way. We were heroes during COVID. We saw all comers while the specialists did virtual consults and admins jerked off at home. We intubated COVID patients with little to no PPE sometimes. Now, we are trash.

My expertise and behavior are constantly questioned by patients, other physicians, nurses, chaplains, you name it, and even the most innocuous "incidents" get you dragged to the principals office. Everyone second guesses, until it's time to "just send them to the ED." We are regarded as loss leaders, instead of profit generators, as dimwit bottom of the class administrators disregard how our work leads to downstream revenue generation from Ortho, spine, cards, radiology, etc.

Violence is rampant. Admin does little to protect us. We begged for years for metal detectors before finally getting one. Everytime a combative patient presents I am forced with the decision to not sedate the patient and risk nursing complaints, or sedate them and risk accusations of whatever "-ism" du jour the patient wants to throw out that day. Both can end my career.

I haven't even talked about midlevels.

TLDR: the field could be great, but sucks secondary to greed, American exceptionalism, and loser non-physician interference.

 

[RustedFox]

Someone post a link to this thread on Reddit.

Redditards will remove it because feelings.

 

[NYEMMED]

Nope, Cannot recommend. I think the average ER doc lasts <10 years from what I remember.

I’m done with it, lasted 10 years. I’m out

 

[RustedFox]

Nope, Cannot recommend. I think the average ER doc lasts <10 years from what I remember.

I’m done with it, lasted 10 years. I’m out

10 years here and I'm down to 4-5 shifts a month while parlaying myself into something else. No, I won't talk about it until next year.

 

[Twub13]

You almost certainly don't.

Anyways, if you're serious about the acute care stuff, you should look into PulmCCM. This would also give you a nice way to wind down from the hospital if you feel like it.

As an aside, I really dislike it when people use an interest in underserved patients as a justification for pursuing certain specialties--underserved patients need physicians in every field.

So I am also a person of color, which is the only reason I feel comfortable saying that. They absolutely need physicians in every field, but what I meant is often times POC have difficulties with access to care and often times leads to a lot of them seeing ED for care or using clinic urgent cares and I find it fulfilling to help patients in that situation not just the ones with the privilege of seeing specialists and continuity of care.

 

[Twub13]

Nonsense. Lots of FM jobs have pretty sweet loan repayment as part of the contract.

Plus, FPs make more than is generally appreciated. I'm hospital employed and every single doctor in my office is going to break 400k this year, several by a good bit.

that's very good to know. I guess I have heard that a lot of FM docs make in the 100ks

 

[Twub13]

Didn't know FP's were making that much! To the OP, agree with what others have said above. I was a naive 3rd year once who was interested in EM and even worked in an ER for several years before med school as a tech. I heeded the advice of many on this forum and ended up going psychiatry. One of the best decisions I've ever made. I would've been absolutely miserable in EM as so many are. Do psych or FP (I'm a little biased toward psych though ), so many settings you can work in, work/life balance is great, money can be pretty lucrative. I recently separated from the military and started my first civ gig. With the bonus/rvu structure it is possible to clear 400+at my current job with some psychs making 5-$600K. I work 4 days per week Mon-Thurs, 40 hours, get a 3 day weekend every weekend, no nights, weekends, holidays, no call. I am a male, married with 4 kids and get to spend ample time with my family.

Wow that sounds like the life

 

[Twub13]

Everyone has been super helpful, I think I kept wondering if the bad stories I was hearing about EM was just outliers and that it would be different for me and worth it, but it really does seem like it is not a sustainable career path and considering I can see myself doing something else and being happy, that is something I will strongly think about.

 

[DeadCactus]

SDN has by far the most negative view of emergency medicine and, while many of the criticisms of the field here have a factual basis, the overall negativity is amplified here. That being said, your post doesn't really sound like someone who wants to do emergency medicine physician but rather someone who thinks being an emergency medicine physician is just the chill medical student experience but with a six-figure salary.

Every specialty serves underserved populations and many others are in a better position to do something more substantial than the emergency department. Plenty of places where opening a clinic or being the lone sub-specialist in X will do more good than any amount of emergency department work could ever do.

Most of emergency medicine is not high-acuity chaos; it's trying to squeeze in time to take care of the one acutely ill patient around discharging or updating 9 other people with social, psychiatric, or primary care issues yet are more demanding of your time.

Seeing a lot of patients with psychiatric diseases in the emergency department is not the same as treating psychiatric illness.

The flexible schedule is great but the circadian rhythm disruption for years and years is just hard to adequately convey.

The job market seems decent right now, particularly if you are geographically flexible. There is a lot of concern about the future; partly because the golden era set unrealistic expectations and partly because of legitimate concerns about the rate at which emergency physicians are being produced and the increased utilization of NP's and PA's to handle emergency department volume.

Everyone has financial and family concerns. This is an issue of job selection more than specialty selection.

 

[Arcan57]

Everyone has been super helpful, I think I kept wondering if the bad stories I was hearing about EM was just outliers and that it would be different for me and worth it, but it really does seem like it is not a sustainable career path and considering I can see myself doing something else and being happy, that is something I will strongly think about.

The other thing to take into consideration is that EM wasn't always like this. The golden age for EM varied by region but basically coincided with the hospitals in that region realizing that EM trained docs provided better, cheaper, and faster care and that they needed to make it rain to attract docs. Once all the docs are EM, we become commodities and people stop thinking of us positively but instead we become just anther fixed labor cost to "right size". Combined with temporal trends around bans on balance billing, PE involvement in EM, and residency expansion and the golden age is over for most of the country that people want to live in. So docs that are 10-15 years out are going to have an outlook on their career that is significantly better than the class of 2022.

 

[alpinism]

So to be honest the only way I'd recommend EM nowadays is if you hated all the other fields and would be completely geographically flexible.
There are still good high paying jobs available but these are few and far in between and in less than ideal locations like rural Texas rather than cities like Dallas, Austin, or Houston where everyone wants to live after residency.

 

[watermanMD]

I interviewed for psychiatry and EM. And I wish I had done psychiatry every day. I also have a very good, unicorn-ish EM job. Do psychiatry and enjoy life.

 

[GonnaBeADoc2222]

I interviewed for psychiatry and EM. And I wish I had done psychiatry every day. I also have a very good, unicorn-ish EM job. Do psychiatry and enjoy life.

I was told in medical school that I would make I great psychiatrist. I should have listened.

 

[Tipsy McStagger]

You know how surgeons say "if there is even the smallest part of you that could be content (not even happy, just content) doing anything other than surgery, then you should not go into surgery." Well EM is the same way now.

Another thing to consider is that you're at an academic institution right now. You'll learn quickly that is not representative of reality. They're basically paid to be hopelessly enamored with the specialty. I have a lot of respect for some of the academic EM docs I know, but I do think they're unrealistic about where the field is going. Listening to the perspective of a solely academic EM doc is setting yourself up for a skewed perspective as a whole on the field.

It's a hard job. One of the hardest in medicine. There's basically no barrier to entry now, where even 10 years ago it was quite competitive. The absolute bottom line, is that it's not what you think it is. Nothing is, but EM sure seemed like a bait and switch specialty to me. If I had it to do all over again I'd do PCCM. I'm grateful for my training in EM, but it leaves you with no exit strategy, and if you end up not liking the ED you have very few viable options.

 

[cyanide12345678]

that's very good to know. I guess I have heard that a lot of FM docs make in the 100ks

FM salary requires patience.

You start in the 200-250 range. Then you build your practice over time. Once you have a large patient panel, you start getting progressively larger bonuses for the size of panel you have.

The group my wife is with, i think there’s a 70k bonus if her panel has some 200 or so Medicare advantage patients. I don’t know the exact number - but once you have a big panel, especially a lot of Medicare advantage patients, it’s a different level of compensation.

 

[InternistDO]

that's very good to know. I guess I have heard that a lot of FM docs make in the 100ks

If you make less than 250k as a PCP it's because you deliberately chose a lower paying job, and certainly there are jobs that pay more than 250k especially with RVU or quality bonuses.

 

[Birdstrike]

I recommend any specialty in Medicine where you don’t have to work nights, weekends, holidays, or take call. EM isn’t one of those.

All the specialties that require any of those four things are a heavy cross to bear after the initial interest becomes routine. No amount of money or imagined prestige, can make up for the weight you’ll carry, at work, and even more so, at home.