What should I do after

[gomavs]

I’m a year and a half out making pretty solid money at an rvu shop with no debt. I have good days and bad days but like all of you I can see where this is going. The prospect of further medical training to me though sounds not very enjoyable. We’ll see how things go but I could see myself not practicing in about 10-15 years. Does anyone know what it’s like to work for med tech/device companies? I’d be ok with doing some school if I had to do an mba or something.

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[cyanide12345678]

My personal solution:

10 shifts a month.

 

[RustedFox]

My personal solution:

10 shifts a month.

I already work 10.
They're 12 hour shifts.
I wanna work 8. Maybe 7.

 

[cyanide12345678]

I already work 10.
They're 12 hour shifts.
I wanna work 8. Maybe 7.

That’s step 2 after 3M in assets. 8 shifts. Just enough for full benefits.

 

[emergentmd]

Working 6 shifts making 200K sounds way better than going back for a 3 yr residency or go back to an unrelated career starting out at 80K/yr.

If you can't do 6 ER shift, then go do UC or if in Tx, FSER making 150-200/hr.

Unless you really have a passion for something, the grass is not greener.

 

[RustedFox]

That’s step 2 after 3M in assets. 8 shifts. Just enough for full benefits.

Lol.
What are these "benefits" you speak of?
Where do you get those?

 

[EctopicFetus]

You can work for med device making 200-250k. Need some business or legit medicine smarts.

 

[cyanide12345678]

Lol.
What are these "benefits" you speak of?
Where do you get those?

My w2 gig pays for a 401k match, health insurance, dental insurance, life insurance, disability insurance, cme and quarterly bonuses. You get pretty much full benefits at 0.6 FTE.

So yeah… 4-5 ish more years of 10 shifts starting next year then im coasting down to 8.

 

[GonnaBeADoc2222]

I’m a year and a half out making pretty solid money at an rvu shop with no debt. I have good days and bad days but like all of you I can see where this is going. The prospect of further medical training to me though sounds not very enjoyable. We’ll see how things go but I could see myself not practicing in about 10-15 years. Does anyone know what it’s like to work for med tech/device companies? I’d be ok with doing some school if I had to do an mba or something.

After considering MBA and talking to multiple advisors, I came to the conclusion that it's not really necessary and also doesn't really help you all that much.

The MD/MBA space is already saturated.

No one will really even take you seriously unless you have an MBA from one of the "big 5."

Agree w above about not bailing out unless there is something you're truly passionate about. The grass is brown everywhere.

My personal solution is to save and invest as aggressively as I'm comfortable with in order to eventually go PT and then eventually quit and become a park ranger or something.

 

[WilcoWorld]

Only half kidding:

Go back to school and study writing, then write a book about the rot of the house of medicine.

 

[RustedFox]

My w2 gig pays for a 401k match, health insurance, dental insurance, life insurance, disability insurance, cme and quarterly bonuses. You get pretty much full benefits at 0.6 FTE.

So yeah… 4-5 ish more years of 10 shifts starting next year then im coasting down to 8.

I hope you realize how awesome this is. Health insurance alone costs me 2K a month. Then there's life/disabiliy. Quarterly bonuses? Lol, I work for HCA; those go to inner party members and not proles like me.

 

[alphaholic06]

I already work 10.
They're 12 hour shifts.
I wanna work 8. Maybe 7.

This is the way.

 

[miacomet]

I worked about 80 hours a month at my last gig. The constant Press-Ganey, unlimited visitors (like 15 people in an exam room), the endless emails about nothing...it was still too much

 

[Mount Asclepius]

SDG. More control provides more satisfaction in the short term and leads to more power in the long term. Increased compensation allows you to eventually talk with your feet. This job is hard though in any environment. Very few do more than 15-20 years in the community. If after 10-15 years you’ve built up a sizable nest egg then you can better transition to whatever’s next. That could very well be part time or semi-retirement. I didn’t know 10 years ago what I would like now. If I guessed then, I wouldn’t be completely right. Nor am I sure I’ll know what I like best 10 years from now. The key is to have independence and options.

 

[thegenius]

I think we have several concurrent threads about this very topic on Page 1 of this forum.

 

[Rekt]

I think we have several concurrent threads about this very topic on Page 1 of this forum.

I wonder why

 

[TooMuchResearch]

I think we have several concurrent threads about this very topic on Page 1 of this forum.

Man, there's only three of us here, saying the same things over and over. The fun part is figuring out everyone's alts. (Sarcasm, sort of)

 

[FlaminHotER]

Man, there's only three of us here, saying the same things over and over. The fun part is figuring out everyone's alts. (Sarcasm, sort of)

Well that latest match drama brought alot of us out of the wood work and dust off our account.

I know it did for me because I am fired up about this freakin nonsense of unbridled expansion of residencies, CMG take over, usucks non sense, and acep’s ineptitude

 

[thegenius]

Man, there's only three of us here, saying the same things over and over. The fun part is figuring out everyone's alts. (Sarcasm, sort of)

Yea it's too bad. Even I'm getting sick of reading the same thing over and over here. I still like EM and recognize all it's problems, but I still find it generally fun. Maybe one day I won't. But that day hasn't arrived yet. We used to spend a little bit of time discussing patient care admist all the negativity, but now it's just all negativity. We even have ER docs who 7-10 years ago and non ER docs regularly chime in on the current state of affairs. it's constant whack-a-mole these days

 

[collegestud2013]

I’m a year and a half out making pretty solid money at an rvu shop with no debt. I have good days and bad days but like all of you I can see where this is going. The prospect of further medical training to me though sounds not very enjoyable. We’ll see how things go but I could see myself not practicing in about 10-15 years. Does anyone know what it’s like to work for med tech/device companies? I’d be ok with doing some school if I had to do an mba or something.

If anything an engineering background and skillset would be more useful than an MBA for getting into medical development. That and networking/connections. Even then, as an employee doing engineering work will probably involve big paycut on a per hourly basis than doing ED shifts. Would need some ownership and business interest as well if you want to end of financially comparable.

 

[GonnaBeADoc2222]

If anything an engineering background and skillset would be more useful than an MBA for getting into medical development. That and networking/connections. Even then, as an employee doing engineering work will probably involve big paycut on a per hourly basis than doing ED shifts. Would need some ownership and business interest as well if you want to end of financially comparable.

MBA for a medical professional is a merit badge, like ACLS or ATLS.

Kinds useless, except this one takes 2 years and is a lot more expensive.

 

[3rdJob]

On a semi-related note, I have a question for I think everyone. What is the _maximum_ age y'all can see still practicing clinically? Probably near the end of my own rope, but curious as to when most folks hang it up. Not necessarily retire, but quit working clinically. I apoologize if this is the wrong thread for this question.

 

[bravotwozero]

On a semi-related note, I have a question for I think everyone. What is the _maximum_ age y'all can see still practicing clinically? Probably near the end of my own rope, but curious as to when most folks hang it up. Not necessarily retire, but quit working clinically. I apologize if this is the wrong thread for this question.

I am hoping work in a high acuity hospital ED becomes optional to me by age 50, and working towards that end currently.

Beyond that, I could see myself working at some low volume freestanding or urgent care, probably into my 60s.

 

[odoreater]

After considering MBA and talking to multiple advisors, I came to the conclusion that it's not really necessary and also doesn't really help you all that much.

The MD/MBA space is already saturated.

No one will really even take you seriously unless you have an MBA from one of the "big 5."

Agree w above about not bailing out unless there is something you're truly passionate about. The grass is brown everywhere.

My personal solution is to save and invest as aggressively as I'm comfortable with in order to eventually go PT and then eventually quit and become a park ranger or something.

This is just complete misinformation and should not be taken as gospel at anyone who is interested in the MD/MBA option.

If anyone is actually interested in the realities of MD/MBA options in Emergency Medicine and medicine in general and not this level of nonsense feel free to DM me.

 

[Brigade4Radiant]

So what are the benefits of an MBA in Emergency Medicine? I’m curious since what other jobs are opened that a regular MD can’t do?

 

[RustedFox]

If all goes according to plan, I'll be doing 3-4 shifts/month by year's end and transitioning to a different item altogether.
I'm 41. I've had quite enough of this circus.

 

[JacobMcCandles]

So what are the benefits of an MBA in Emergency Medicine? I’m curious since what other jobs are opened that a regular MD can’t do?

If you want to be the CMO of a decently sized hospital then you’ll likely need an MBA. I obviously can’t speak for every hospital but it’s at least common in the areas I’m familiar with.

 

[Brigade4Radiant]

If all goes according to plan, I'll be doing 3-4 shifts/month by year's end and transitioning to a different item altogether.
I'm 41. I've had quite enough of this circus.

Like clinical stuff?

I want to do part time by mid 40s at least

 

[Brigade4Radiant]

If you want to be the CMO of a decently sized hospital then you’ll likely need an MBA. I obviously can’t speak for every hospital but it’s at least common in the areas I’m familiar with.

I see but that’s a lot of politics usually you need to be doing admin stuff for a few years but I would need something that I can immediately jump into if I spent 60-100k and two years

 

[JacobMcCandles]

I see but that’s a lot of politics usually you need to be doing admin stuff for a few years but I would need something that I can immediately jump into if I spent 60-100k and two years

If you're not going into admin then your time and money would be better spent learning more/becoming better at whatever it is you want to do. You should really have a goal with what you want to do with an MBA first rather than get an MBA and then try to figure out what you want to do.

 

[Apollyon]

Like clinical stuff?

I want to do part time by mid 40s at least

I was 49 and UPMC almost killed me. (Literal)

 

[cyanide12345678]

On a semi-related note, I have a question for I think everyone. What is the _maximum_ age y'all can see still practicing clinically? Probably near the end of my own rope, but curious as to when most folks hang it up. Not necessarily retire, but quit working clinically. I apoologize if this is the wrong thread for this question.

Part time at age 35 - already set the wheels in motion. January 2024 onwards, 10 monthly shifts. 4.5 years out of training by then.

~ 40 age is my tentative retire early age. So 5.5 years left. I don’t think I’ll be 100 percent jobless, but i think I’ll have transitioned to some version of online remote clinical or non clinical practice or even might continue EM in a part time fashion if I’m still happy. I haven’t figured out what I’ll do when i hit my FIRE number in 5 years.

Every move I’ve made in the last 4 years, I’ve progressively taken a pay cut in return for quality of life and happiness. 2019 - 2021 made 450k. 2021 - now making 400k. January 2024 onwards $300k. I think if I’m making 150k in 5 years in a part time 20-25 hours a week capacity, i will be happy with it since i fully expect a portfolio worth 3-4M by age 40 (if not more). A 10 percent return from my portfolio should make up the deficit from my lost income. My wife is also going to part time starting January 2024 to 3 days per week (27 weekly hours), so her income will also drop $60k.

So yeah…. Another 160k pay cut coming in 7 months for our family income. Money is becoming less and less relevant.

 

[RustedFox]

Like clinical stuff?

I want to do part time by mid 40s at least

Tell you when it happens.

 

[DetroitERDO]

If all goes according to plan, I'll be doing 3-4 shifts/month by year's end and transitioning to a different item altogether.
I'm 41. I've had quite enough of this circus.

I'm right there with you the thrill of the ER is no longer there and would much rather work banker hours and see my family more. It makes me sad to come home at night and see my kids sleeping. I'm a women doc so I feel like I'm missing out on critical time where they still want me around

 

[Dr Mantis Toboggan]

I'm right there with you the thrill of the ER is no longer there and would much rather work banker hours and see my family more. It makes me sad to come home at night and see my kids sleeping. I'm a women doc so I feel like I'm missing out on critical time where they still want me around

Yup my oldest is graduating high school this week. It flies by let me tell you. She’s closer to her mom and likely always will be. But hey, I got to save all those lives right? 🙄

 

[TooMuchResearch]

Tell you when it happens.

Can't wait. Insert soooo excited meme

 

[DetroitERDO]

Yup my oldest is graduating high school this week. It flies by let me tell you. She’s closer to her mom and likely always will be. But hey, I got to save all those lives right? 🙄

Yes it hard to think about especially all the time spent in med school, resident, and beyond. The working odd hours really has gotten to me recently. And your right the "days are long but the years are short" rings so true

 

[WorkNoteEmergency]

I am in my mid 50's, a 2 time "late bloomer" , so have been a physician for 20 years, EM boarded for 12. I have been 2/3 full-time, 90 hours per month, for 4 years now. Over these 4 years I've made some efforts to break out to something different with no success. I went from a salary of $400k at high acuity, high volume ED to $250k currently. The money is fine, we live comfortably, though not extravagantly, and I carry a mortgage on an expensive hose and have put one kid though college out of pocket at a UC school out of state tuition. I wouldn't be as comfortably situated now though if I hadn't socked away money when I was making more in a LCOL area.

Incidentally, I quit my $400k job when I started getting some burnout and the first stages of employer craps on doctors emerged. I tried out a CMG, full time for $240k and it was horrible, quit in less than a year.

In my first few months I did that, before pandemic, I thought it was the answer for a living for 8-10 years until full retirement but between my advancing age and the repeated toilet swirlies our specialty is subjected to, I've had enough and I quit. I work my last two night shifts ever later this week. After that I will work prn a couple shifts per month but hope to be out of EM entirely by the end of the year, if not the summer. I have a line on non EM clinical work and hopefully business development work but will keep mum, sorry, until its a sure thing.

OP, you are wise to lay groundwork for an exit early. I am at the point where I'm convinced the job is shortening my lifespan and there is probably a number where I would continue at my current schedule but it's not one anyone now would be willing to pay. I considered MBA but did not want to make that kind of financial outlay and I think anyone past age 40 would not likely get a good enough return on that investment if self-funding. The Pharma/med tech industry is tough to break into in our specialty, but if you start early, I would think that holds promise. Medical monitor jobs via CRO (contract research orgs) abound, don't pay all that well, but are a way to get a foot in the door. Some Pharma companies have fellowships geared toward turning early career doctors onto the Big Pharma lifestyle. Medically oriented financial/VC jobs are pretty much impossible for grunt level guys/gals, with a lot of competition for that work amongst the C-suite types.

If I was younger and a more traditional pathway, I would focus on getting my med school debt paid off (I did HPSP scholarship) then make liberal use of FIRE calculators to find a number where the retirement nest can grow from and then as quickly as possible get to part time work, cutting out night shifts as quickly as possible.

 

[medninja]

Yea it's too bad. Even I'm getting sick of reading the same thing over and over here. I still like EM and recognize all it's problems, but I still find it generally fun. Maybe one day I won't. But that day hasn't arrived yet. We used to spend a little bit of time discussing patient care admist all the negativity, but now it's just all negativity. We even have ER docs who 7-10 years ago and non ER docs regularly chime in on the current state of affairs. it's constant whack-a-mole these days

I ask myself how I became so unsatisfied previously having liked EM. For me it was like Hemingway’s bankruptcy quip: slowly then all at once. The all at once has been the post pandemic state of EM.

I have chosen terribly too. I started at an exploitative sdg that had an 5yr partnership track and left after two. I liked my cmg job but it paid nothing. I loved my current w2 job at first, but over 6 years, I think my pay is no higher and likely lower than when I started. I have 2 pph shifts, with pay that’s targeted for volumes we saw when I started, which are now 30% higher.

I’m a saver but I have so much more of this to go. I hated my inept residency attendings that never could have excelled at any of my jobs. It was a plurality of them. Now I wish I had joined them. No procedures, slow pace, endless ability to consult, minimal documentation, all in the name of teaching.

 

[DoctorJDO]

I ask myself how I became so unsatisfied previously having liked EM. For me it was like Hemingway’s bankruptcy quip: slowly then all at once. The all at once has been the post pandemic state of EM.

I have chosen terribly too. I started at an exploitative sdg that had an 5yr partnership track and left after two. I liked my cmg job but it paid nothing. I loved my current w2 job at first, but over 6 years, I think my pay is no higher and likely lower than when I started. I have 2 pph shifts, with pay that’s targeted for volumes we saw when I started, which are now 30% higher.

I’m a saver but I have so much more of this to go. I hated my inept residency attendings that never could have excelled at any of my jobs. It was a plurality of them. Now I wish I had joined them. No procedures, slow pace, endless ability to consult, minimal documentation, all in the name of teaching.

Couldn't have said it better

 

[TooMuchResearch]

I ask myself how I became so unsatisfied previously having liked EM. For me it was like Hemingway’s bankruptcy quip: slowly then all at once. The all at once has been the post pandemic state of EM.

I have chosen terribly too. I started at an exploitative sdg that had an 5yr partnership track and left after two. I liked my cmg job but it paid nothing. I loved my current w2 job at first, but over 6 years, I think my pay is no higher and likely lower than when I started. I have 2 pph shifts, with pay that’s targeted for volumes we saw when I started, which are now 30% higher.

I’m a saver but I have so much more of this to go. I hated my inept residency attendings that never could have excelled at any of my jobs. It was a plurality of them. Now I wish I had joined them. No procedures, slow pace, endless ability to consult, minimal documentation, all in the name of teaching.

I would take a reasonable pay cut to have two EM residents on every shift. I practice adjacent to my residency program, but the line to get in the door is longer than my career.