Young ER doctors risk their lives on the pandemic’s front lines. But they struggle to find jobs.

[elementaryschooleconomics]

https://www.washingtonpost.com/health/2021/01/04/er-doctors-covid-jobs/

Obviously, this makes the news because ER docs are on the COVID frontlines. I find their situation to be abhorrent and certainly worse than the oversupplied RadOnc issue.

I post this here only because the oft-repeated argument of the "RadOnc Job Market is FINE" crowd is that "unemployment is low". They say that we shouldn't be pointing at things like inability to find jobs in certain locations, inability to find/sign contracts "early" in the final year of training, increase in fellowships, etc, as evidence that the job market in Radiation Oncology is bad. We're wrong for raising these points! There's no data!

However, all of these points seem to be newsworthy for Emergency Medicine.

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Members don't see this ad.

 

[drewdog1973]

Well, it’s the people in our field; they are particularly thick headed. These #radoncrocks folks would rather we hit 400 grads a year and have people literally collecting unemployment rather than admit there is an issue. EM people never felt like they were gods gift and there wasn’t this entitlement about “well, if I went to a top program I deserve to live in X city”. You did an ED residency, you wore your university branded fleece with scrubs, and you walked into whatever job in whatever region you wanted. Now, it’s changing and they can admit it and try to fix it. Not us, though. Our leaders sit there and contort themselves to say it’s all good, and that it will sort it self out.

 

[Neuronix]

Despite all that, the 29-year-old doctor cannot find a company in his hometown of Houston ready to hire him when he graduates next year.

I laughed out loud at this. Rad onc grads can't find jobs in half the country when they graduate. If someone comes in this forum and says they have to be in a specific city when they graduate, they would be considered totally unreasonable.

Rad onc is such a small specialty and unrelated to COVID, so we fly under the radar on stories like this.

 

[elementaryschooleconomics]

I laughed out loud at this. Rad onc grads can't find jobs in half the country when they graduate. If someone comes in this forum and says they have to be in a specific city when they graduate, they would be considered totally unreasonable.

Rad onc is such a small specialty and unrelated to COVID, so we fly under the radar on stories like this.

"But it's just like any other white collar job, quit being so entitled"

 

[fiji128]

I spent some time going through the ED forums over the past few months. Their job market has rapidly deteriorated over the past several years so its shocking for them to see it happen over such a short time frame but it is not as bad as ours yet. Their issues stem from crazy rapid expansion of residency positions/programs (private HCA hospitals are now even opening programs with very low quality) and a national professional organization that denies this is an issue that needs to be addressed (sound familiar). On top of that they have issue with increasing usage of mid levels that are seeing more and more patients but a system (cooperate private practice groups and hospitals) that use the MD's license as a liability shield for this cheaper labor. They also have significant issues with increasing corporate ownership of private practice groups that will tend to pay less and give physicians less say about the their work life with no path to partnership. All of this with decreasing ED utilization overall during COVID. ED docs also have a the same problem as rad oncs in that they have no generalist training to fall back on if you can't find an acceptable job.

The sense I get is 5 or 10 years ago an ED doc could probably get a job anywhere but maybe not in the ideal practice setting, this is no longer the case. Now you must be willing to go rural to have a chance of finding fair and equitable opportunities.

 

[fiji128]

https://www.washingtonpost.com/health/2021/01/04/er-doctors-covid-jobs/

Obviously, this makes the news because ER docs are on the COVID frontlines. I find their situation to be abhorrent and certainly worse than the oversupplied RadOnc issue.

I post this here only because the oft-repeated argument of the "RadOnc Job Market is FINE" crowd is that "unemployment is low". They say that we shouldn't be pointing at things like inability to find jobs in certain locations, inability to find/sign contracts "early" in the final year of training, increase in fellowships, etc, as evidence that the job market in Radiation Oncology is bad. We're wrong for raising these points! There's no data!

However, all of these points seem to be newsworthy for Emergency Medicine.

"Since 2008, the number of emergency doctors in the United States has grown from 40,000 to almost 50,000; there are fewer of these specialists per person, though, particularly at rural hospitals. In that same period, the number of doctors enrolled in emergency residency programs grew from about 4,500 to nearly 8,000."

To listen to many of the academic rad oncs (they know who they are) this type of expansion should have no effect on employment. You got a job that should be enough for you.

 

[fiji128]

https://www.washingtonpost.com/health/2021/01/04/er-doctors-covid-jobs/

Obviously, this makes the news because ER docs are on the COVID frontlines. I find their situation to be abhorrent and certainly worse than the oversupplied RadOnc issue.

I post this here only because the oft-repeated argument of the "RadOnc Job Market is FINE" crowd is that "unemployment is low". They say that we shouldn't be pointing at things like inability to find jobs in certain locations, inability to find/sign contracts "early" in the final year of training, increase in fellowships, etc, as evidence that the job market in Radiation Oncology is bad. We're wrong for raising these points! There's no data!

However, all of these points seem to be newsworthy for Emergency Medicine.

Some residents have opted to apply for emergency medicine fellowships, which provide additional expertise in toxicology, ultrasounds, wilderness medicine or other subjects at academic centers.

“All fellowships have become more competitive this year,” Sontag said. Opting for a fellowship also has financial consequences; the pay in a fellowship is closer to a resident’s salary — an average of about $59,000 — than it is to a full-time attending physician’s salary, an amount in the six figures.

 

[seper]

These issues in ER are real. I have a relative who is emigrating to New Zealand with an ER job offer there.

 

[DoctwoB]

I spent some time going through the ED forums over the past few months. Their job market has rapidly deteriorated over the past several years so its shocking for them to see it happen over such a short time frame but it is not as bad as ours yet. Their issues stem from crazy rapid expansion of residency positions/programs (private HCA hospitals are now even opening programs with very low quality) and a national professional organization that denies this is an issue that needs to be addressed (sound familiar). On top of that they have issue with increasing usage of mid levels that are seeing more and more patients but a system (cooperate private practice groups and hospitals) that use the MD's license as a liability shield for this cheaper labor. They also have significant issues with increasing corporate ownership of private practice groups that will tend to pay less and give physicians less say about the their work life with no path to partnership. All of this with decreasing ED utilization overall during COVID. ED docs also have a the same problem as rad oncs in that they have no generalist training to fall back on if you can't find an acceptable job.

The sense I get is 5 or 10 years ago an ED doc could probably get a job anywhere but maybe not in the ideal practice setting, this is no longer the case. Now you must be willing to go rural to have a chance of finding fair and equitable opportunities.

They also carry the problem that it is a relatively recent development to have board certified ER doctors staffing all ERs, where previously it was a lot of FM, IM, etc. Similar to any field where the standard of care has changed (e.g. CCM staffing all ICUs, neuro IR for strokes etc), there is a huge shortage initially and jobs are plentiful because the marketplace isn't in equilibrium. Over long term, things equilibrate and you need the number of new grads to equal the number of retirees + demand for new positions. However, it is very tempting to continue to expand in the short term because the demand is there, even if in the long term the market can't sustain that many graduates.

 

[radsisrad]

These issues in ER are real. I have a relative who is emigrating to New Zealand with an ER job offer there.

This seems excessive. Surely there were other factors at play...?

 

[taserlaser]

This seems excessive. Surely there were other factors at play...?

Sounds about right to me. I was looking at RO jobs (but more likely a locum for a year just because a working year there would be fun) as an alternative when I was hunting around. QoL is good in NZ. That will work for a select few, but it is not an escape valve for more than that in such a small field.

 

[seper]

Poor job security/bargaining power at home; relative ease of credentialing for an American MD in NZ; comparable take home pay; good pandemic management in NZ

Sounds about right to me. I was looking at RO jobs (but more likely a locum for a year just because a working year there would be fun) as an alternative when I was hunting around. QoL is good in NZ. That will work for a select few, but it is not an escape valve for more than that in such a small field.

 

[OTN]

QOL is fantastic in NZ, as is their culture, outdoor opportunities, etc. I have a friend from med school who is an ER doc there, and she and her family loved it. I briefly looked into it when I was graduating, as I love all that outdoor stuff. Pay was ~$150k/year (US dollars) for a radonc.

 

[seper]

QOL is fantastic in NZ, as is their culture, outdoor opportunities, etc. I have a friend from med school who is an ER doc there, and she and her family loved it. I briefly looked into it when I was graduating, as I love all that outdoor stuff. Pay was ~$150k/year (US dollars) for a radonc.

Is RadOnc there pure radiation, or one has to give cisplatin etc.?

 

[OTN]

Is RadOnc there pure radiation, or one has to give cisplatin etc.?

Ooh, good question. Looking at their website for their national health service, it appears as if it's just RT alone:

Radiation Oncologist

Find out about radiation oncologist pay, training requirements and job opportunities in New Zealand.

www.careers.govt.nz

 

[thecarbonionangle]

I guess 150k in NZ is much better than 150k in Salina KS if you are lucky when the breadlines come

 

[RadOncDoc21]

I guess 150k in NZ is much better than 150k in Salina KS if you are lucky when the breadlines come

Yea but what kind of bread are they serving?

 

[thecarbonionangle]

Yea but what kind of bread are they serving?

Stale bread from the shelter which was not eaten with a Vegemite spread

 

[medgator]

Yea but what kind of bread are they serving?

They cook it on the barbie?