EM->Critical care fellowship vs IM->CC/PCCM

[Doc Doc Doc Goose]

Yaaa it is pretty damn hard to find a split position. Best ive done is 1/2 or fulltime IcU with working in the ED as a gun for hire. Honestly the best,imo, plan is to work fulltime IcU in a W-2 position at a nonprofit (for PSLF purposes), form an LLC, work ED shifts as an independent contractor for the solok, and other tax writeoffs.

Problem is now, finding ED shifts is difficult.

What does this do for you in particular?
And to clarify: full-time being 7 on 7 off, “12-hour shifts”?

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[okudasai]

Yaaa it is pretty damn hard to find a split position. Best ive done is 1/2 or fulltime IcU with working in the ED as a gun for hire. Honestly the best,imo, plan is to work fulltime IcU in a W-2 position at a nonprofit (for PSLF purposes), form an LLC, work ED shifts as an independent contractor for the solok, and other tax writeoffs.

Problem is now, finding ED shifts is difficult.

Do you find that the mix of EM/CC is something that is enjoyable/sustainable for you? My thinking is that I would enjoy ICU but would miss the ED, hence my desire to find some kind of mix. My concern is that this might not really help with the burnout issue being that the ICU and the ED are both stressful environments to be in. Have you felt like burnout/excessive stress has been in an issue in working in both environments?

 

[sylvanthus]

Do you find that the mix of EM/CC is something that is enjoyable/sustainable for you? My thinking is that I would enjoy ICU but would miss the ED, hence my desire to find some kind of mix. My concern is that this might not really help with the burnout issue being that the ICU and the ED are both stressful environments to be in. Have you felt like burnout/excessive stress has been in an issue in working in both environments?

I think it is more sustainable to do both. You burn out in different ways. When you get sick of the drug seekers, quality metrics, customer servicr,admission pushbacks, etc in the ED, you get a bit of a break from that nonsense in the ICU. Also have time to eat, and chill for a bit.

Then, when youre sick of the vented gomers and families that “want everything done” for the 95 yo bedbound, poor quality of life gomer because “hes a fighter” you can go back to the ED for a bit.

It spreads the suck out a bit doing both.

 

[sylvanthus]

What does this do for you in particular?
And to clarify: full-time being 7 on 7 off, “12-hour shifts”?

Ya I am 7 on 7 off 12’s. But I have vacation time also, so ill have 3 weeks off, every 3 months or so which is a nice break.

 

[okudasai]

Ya I am 7 on 7 off 12’s. But I have vacation time also, so ill have 3 weeks off, every 3 months or so which is a nice break.

Did you find it difficult to find a mixed sort of setup (part time ED work/full time ICU)? Also, do you do your ED shifts during your 7 off week?

 

[sylvanthus]

Did you find it difficult to find a mixed sort of setup (part time ED work/full time ICU)? Also, do you do your ED shifts during your 7 off week?

I was doing some per diem shifts on my off weeks at a few different EDs but hours dried up. Im looking at a per diem gig in the ED at the same hospital im currently at. Will see once the contract is completed.

 

[okudasai]

I was doing some per diem shifts on my off weeks at a few different EDs but hours dried up. Im looking at a per diem gig in the ED at the same hospital im currently at. Will see once the contract is completed.

Gotcha, so in a sense it's like having two jobs. Do you know in general how difficult/what obstacles you might face in trying to split time between the ED and the ICU? How has it been negotiating your current contract, for example?

 

[sylvanthus]

Gotcha, so in a sense it's like having two jobs. Do you know in general how difficult/what obstacles you might face in trying to split time between the ED and the ICU? How has it been negotiating your current contract, for example?

Its hard to find ED shifts as they are drying up all over the place. I havent seen the current contract for the ED per diem shifts yet.

 

[The kitchen sink]

Its hard to find ED shifts as they are drying up all over the place. I havent seen the current contract for the ED per diem shifts yet.

Drying up due to ?

 

[turkeyjerky]

Drying up due to ?

Massive oversupply of EM grads combined w/ lingering decreased ED volumes combined w/ increased reliance on midlevels

 

[sylvanthus]

Massive oversupply of EM grads combined w/ lingering decreased ED volumes combined w/ increased reliance on midlevels

What he said. EM is hosed.

 

[ShowtimeKaner88]

I wish they would update this information. It's 3+ years old. There are newer programs that aren't on that list, and some that should be removed.

I'm actually leading a team working on this update as we speak. I've integrated all of that excel sheet into a new one and have added all of the new programs. It will take some time to get everything updated, but it is in the works!

 

[Hamhock]

I'm actually leading a team working on this update as we speak. I've integrated all of that excel sheet into a new one and have added all of the new programs. It will take some time to get everything updated, but it is in the works!

Your work is appreciated.

Thank you...even from CCM docs who are far from fellowship.

HH

 

[Doctor Bob]

I'm actually leading a team working on this update as we speak. I've integrated all of that excel sheet into a new one and have added all of the new programs. It will take some time to get everything updated, but it is in the works!

Oh yay