D
deleted840740
delete
Last edited by a moderator:
- Joined
- Feb 21, 2017
- Messages
- 179
- Reaction score
- 312
Totally inexperienced opinion here so take what I say with a grain of salt. I once scribed for a doctor at a busy urgent care center. She was an EM attending at a lvl 1 trauma center for just 2 years and then decided to take a pay cut to work at the urgent care center which is open only 8am-8pm every day so no overnights ever. She makes considerably less than she did at the trauma center but said because she kept her student loan debt low and has a husband who also makes decent money they didn't even notice the pay cut.
Sent from my iPhone using SDN mobile
Sent from my iPhone using SDN mobile
- Joined
- Jan 5, 2007
- Messages
- 3,168
- Reaction score
- 12,356
In EM, in terms of scheduling, if you can think it up, it probably exists SOMEWHERE. A lot of groups have dedicated nocturnists who are paid more but only work nights. Not every group has them, however, so it all depends on where you want to practice. Ultimately if you can't do night shifts EM is probably not for you. But it's really not that much, if you can handle 3-5 night shifts a month go for it.
- Joined
- Nov 27, 2009
- Messages
- 1,182
- Reaction score
- 370
Where ever you do EM, you really can't escape nights or holidays. At some point, you have to do odd hours. Also, after the 3rd patient with psych issues or 4th sexual assault case, you would hate it. Most of the EM stuff is like running big family practice or urgent care. You would occasionally do resus, intubation etc but major trauma goes to trauma surgery. Money is good though.
Sent from my iPhone using SDN mobile
Sent from my iPhone using SDN mobile
- Joined
- Sep 8, 2009
- Messages
- 946
- Reaction score
- 733
Hi all,
undecided MS3 looking for advice on (possibly) entering EM, as I do not know many residents or attendings in the field
I am drawn to everything about the actual work of EM and found that I fit in with people in the field more than any other. My kryptonite is I hate overnights and changes in schedule. I am one that likes a regular routine schedule- not necessarily while at work (I like the randomness of the ER), but as far as when to go to work, sleep, and such. I also have concerns about family life with some of the horror EM schedules I hear of (never seeing kids), because having time for family is very important to me. My s/o is a peds resident and will therefore have normal hours. With that being said, as an undecided M3, everyone keeps telling me to "do what interests you the most" and "do the field you would be happiest in". When I sit back and think about the type of physician and work I would like to be doing, EM fits this perfectly in many ways- acuity, procedures, knowing a little about everything, helping to (directly) save lives, culture and people in ED... I even like the psych and drug overdose patients that so many in the field of EM complain about! I just dont know if i can live with such an erratic schedule for the rest of my career
I am not as concerned about pay as many others, so I would be happy to take a pay cut if I obtained more normal hours, but is this even possible right out of residency? Some people have told me you can work mainly day shifts after years of "putting in your time". I know I will have to go through this schedule during residency, which is fine and I believe i would handle it ok for 3 exciting years.
I guess my main question is: is it possible to have more "normal work hours" if i am willing to take a pay cut? I fear that the scheduling in the field will make me dislike it in the future and regret not going into something different, but at the same time i dont know if id have that feeling of accomplishment in another field. This concern is huge, so if it has that big of an impact on me, should I disregard EM?
As @Tenk said, it is possible to find such an arrangement somewhere, but to bank on this happening is a recipe for disaster. In addition, your training will certainly not be like this in any way. Urgent care, while the schedule may be better, is nothing like real EM. Everything fun has to get sent away. One of the things EM offers as a specialty is 24/7 access and availability. That means that you, as an EP, will also need to be able to offer that in some capacity, certainly during training, and likely for the duration of your career, although that varies. The erratic schedule is as much a part of EM as drunks and codes.
As others have already said, there is a possibility to find a position working only days, with a pay cut, but I wouldn't count on it. The reality is most EM docs I've met aren't in love with doing nights and flipping schedules, but it is simply a part of EM. Groups are looking to hire docs who are going to take on their share of the undesirable hours (nights/evenings/weekends/holidays). I would go into EM fully expecting to do a portion of those shifts for the majority of your career. You might get lucky, but expecting it and not finding it would make you very unhappy. Are you a rising third year or finishing up your third year? If you are a rising 4th year then you are kinda behind the 8-ball because you need to get SLOEs preferably in the beginning of your fourth year. Feel free to PM me if you have questions since I just went through the whole process. Best of luck.
C
cellsaver
Avoid EM like the plague.
"At 27%, EM physicians ranked fifth from the bottom in happiness at work (either very or extremely happy at work), and less content than they were in 2014 (36%)..."
Medscape Emergency Medicine Lifestyle Report 2016
Plus, as an EM, you are likely to be employed by a medical group, which means you are no better than a monkey on a chain. EmCare comes to mind - they are an evil company. Many medical groups are no better than Hospital Corporation of America: greedy, greedy, greedy businesses.
An ER physician friend told me something last year that really put it in perspective for me. He said it joking but it was too true: "We practice our ABCs: Airway, Breathing, CT Scan"
if the greed, jadedness and addiction won't kill you, the EM patient surveys skewering you, followed by admins running up to bend you over because of the poor patient surveys, will.
You asked
"At 27%, EM physicians ranked fifth from the bottom in happiness at work (either very or extremely happy at work), and less content than they were in 2014 (36%)..."
Medscape Emergency Medicine Lifestyle Report 2016
Plus, as an EM, you are likely to be employed by a medical group, which means you are no better than a monkey on a chain. EmCare comes to mind - they are an evil company. Many medical groups are no better than Hospital Corporation of America: greedy, greedy, greedy businesses.
An ER physician friend told me something last year that really put it in perspective for me. He said it joking but it was too true: "We practice our ABCs: Airway, Breathing, CT Scan"
if the greed, jadedness and addiction won't kill you, the EM patient surveys skewering you, followed by admins running up to bend you over because of the poor patient surveys, will.
You asked
D
deleted245139
You can cry doom and gloom all you want but you're describing medicines current state over all. Compensation is falling, work load is rising, hospital systems are consolidating and reimbursements are stagnant and may fall. I'm not talking for EM. I'm talking for all fields. Cruise ANY forum here.... anesthesia, path, derm, optho.... there is always some sky falling.
To the OP, no matter what you do in medicine you have to love it. I've said it before in posts and I'll say it again, ANY job is 10% amazing and reminds you why u love the job, 10% terrible and u question ever going in to it and 80% mundane day in and day out stuff that has to hold some meaning to you. The schedule stuff sorts itself out
Last edited by a moderator:
- Joined
- Apr 11, 2013
- Messages
- 1,497
- Reaction score
- 1,248
I agree with everything you said except the "have to love it part". What if you love no work out there? Then you don't work? I love my significant other, do I love work? F*** no.
Loving their work is only a phrase that really bodes well with like 10% of working people in general. It's ideal but not even close to being obtainable to everyone. in relation to your post, that 10% terrible needs to at least be bearable for the specialty you choose compared to other specialties of medicine.
D
deleted245139
You are pursuing a professional degree. Choose your synonym- if you're not passionate about your work it'll crush you. I guess I'd say if you don't feel that, you haven't found the right career. To use your analogy, it would be the equivalent of marrying the wrong person....
- Joined
- Jun 9, 2016
- Messages
- 2,589
- Reaction score
- 6,766
Make sure you check with the EM programs because this answer may differ between EM programs.
In general:
Most programs want 3 SLOES from EM faculty (e.g., EM Residency Program Director/Clerkship Director of EM rotation, or EM Department Chairperson, or board-certified EM faculty).
You can request a SLOE from each of your EM rotations.
EM residency programs put significant weight in SLOEs that they receive from other EM faculty.
Although it is highly advisable to have SLOES from EM faculty, an additional LOR may be obtained from a physician at a non-residency emergency program. Once again, it is very important to check with the EM program concerning the above..
C
cellsaver
The 2016 data reflect a different story:
Average salaries for primary care and other specialties continue to climb, including a 13 percent year-over-year increase for family medicine, according to the 2016 survey report(www.merritthawkins.com) by Merritt Hawkins, a Dallas-based health care recruiting agency. The report showed family physicians now earn an average of $225,000 annually, with some earning as much as $340,000 per year.
Source: AAFP: Family Physician Salaries Continue to Rise at Rapid Clip / 2016
Source: AAFP: Family Physician Salaries Continue to Rise at Rapid Clip / 2016
and
The move from value is reflected in doctor compensation, which increased by 18% among primary care doctors over the past five years. Meanwhile, compensation among specialists grew 10.7% since 2011, MGMA said.
Source: Forbes / 2016
Source: Forbes / 2016
and
Strong demand for both primary care and specialist physicians is pushing up average physician starting salaries. Starting salaries for 18 of the 20 specialties tracked in the 2016 Review increased year-over-year, including a 13% increase for family medicine, Merritt Hawkins’ number one search.
Source: Merritt Hawkins / 2016
and
Competition for new docs pushing pay higher
Source: Modern Healthcare / 2016
Source: Merritt Hawkins / 2016
and
Competition for new docs pushing pay higher
Source: Modern Healthcare / 2016
Bingo.
Doctors’ Work: Eulogy for My Vocation
"I, like so many of those who filled the first ranks of family practice, often described my career choice as a calling, a vocation, something more than a meal ticket. It was a source not only of pride and conviction but also resentment and resistance to change."
"I, like so many of those who filled the first ranks of family practice, often described my career choice as a calling, a vocation, something more than a meal ticket. It was a source not only of pride and conviction but also resentment and resistance to change."
C
cellsaver
Nope. Not even close.
More U.S. workers are satisfied with their jobs than at any time since 2005, the Society for Human Resource Management (SHRM) announced today.
- 88% of U.S. employees reported overall satisfaction with their current job, marking the highest level of satisfaction over the last decade.
Source: SHRM/2016
Employee Job Satisfaction and Engagement
Job Satisfaction by Generation
Baby Boomers > Generation X > Millennials in that order express job satisfaction
Source: SHRM/2016
Job Satisfaction by Generation
Baby Boomers > Generation X > Millennials in that order express job satisfaction
Source: SHRM/2016
Vocation, vocation, vocation....
- Joined
- Apr 11, 2013
- Messages
- 1,497
- Reaction score
- 1,248
Clearly we have different definitions of "love". I don't even know what you are trying to say with those surveys.
From my experience programs are going to want 3 letters, two of which must be SLOEs. The third can be a LOR, but honestly I'm not sure how much a Program director will care about a letter from a non-EM doc. From my understanding programs generally prefer SLOEs, and again you will need at least two SLOEs come ranking time (at least one SLOE for an interview, two of course is better). There was a good talk a few program directors did a little while back about applying, I'll see if I can find it. Do you have a home EM program? If not then you will need to do at least two aways and you really need to check out vsas today and start applying if you are seriously considering applying to EM. Your SLOEs are literally the most important part of your application (via the NRMP program director survey which showed PD's gave SLOEs an average rated importance of 4.9/5 vs 3.9/5 for step 1). So do not cut any corners on this part of your app as it will sink you.
http://www.nrmp.org/wp-content/uploads/2016/09/NRMP-2016-Program-Director-Survey.pdf
