Job market for EM (future)

[Strider_91]

May come off as crazy because I am still a student but I am 99% sure I am going into EM.

Basically, my brother, and best friend is a police officer and needs to apply for police jobs in a state soon because his pension depends on it. It has always been our dream to live near each other in a state with mountains (he is also my climbing partner). The only two states that pay their state police officers anything decent seem to be Colorado and Washington. I know that neither of them are low COL, but no low COL states pay their police officers well.

 

How difficult is it for an east coast student to get a job in either of those states and how can I maximize my chances of getting a job out there? If he gets offered a job for the state police in both states would one be easier/ better for me to get a job than the other? He is going to be a state police officer so I do not care about living near one of the big cities, and he will have mobility once he was in the state.

 

 

 

 

[White.Beard.Doc]

EM jobs are fairly wide open at the moment, in most areas of the country.  However, there are specific locations or types of jobs that might be harder to come by. Many of the residents from east coast training programs take jobs out west.

Say you decide you want an academic job at a major medical center in Colorado.  If that were the case, it might be more challenging to land a spot.  However, you could plan on doing a residency that would help you develop a niche that might help you with that specific type of job search, such as particular research niche, or do a fellowship at an institution of interest or in an area that would help a specific targeted institution build their academic program.

The other future employment risk in EM is that the ED has become the provider of conveneience for all sorts of non-emergency medical and societal ills.  The insurance companies are starting to push back harder on patients going to the ED.  If our health and insurance system succeeds in diverting lots of care out of the ED (a big if), then the huge demand for emergency physicians and the job market could potentially change in a substantial way.  I am beginning to see some changes in well insured patients in my area being diverted away from the ED, and our volume is down somewhat for the first time in many years.

[Zaphod]

Strider_91 wrote:

May come off as crazy because I am still a student but I am 99% sure I am going into EM.

Basically, my brother, and best friend is a police officer and needs to apply for police jobs in a state soon because his pension depends on it. It has always been our dream to live near each other in a state with mountains (he is also my climbing partner). The only two states that pay their state police officers anything decent seem to be Colorado and Washington. I know that neither of them are low COL, but no low COL states pay their police officers well.

 

How difficult is it for an east coast student to get a job in either of those states and how can I maximize my chances of getting a job out there? If he gets offered a job for the state police in both states would one be easier/ better for me to get a job than the other? He is going to be a state police officer so I do not care about living near one of the big cities, and he will have mobility once he was in the state.

 

 

 

 

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If you're a competitive student you should be able to go anywhere. I think Colorado would be more fun all around (less grey/rain), though am from Washington so I'd of course pick where I havent lived and is also cool, so obviously just my opinion.

[Strider_91]

White.Beard.Doc wrote:

EM jobs are fairly wide open at the moment, in most areas of the country.  However, there are specific locations or types of jobs that might be harder to come by. Many of the residents from east coast training programs take jobs out west.

Say you decide you want an academic job at a major medical center in Colorado.  If that were the case, it might be more challenging to land a spot.  However, you could plan on doing a residency that would help you develop a niche that might help you with that specific type of job search, such as particular research niche, or do a fellowship at an institution of interest or in an area that would help a specific targeted institution build their academic program.

The other future employment risk in EM is that the ED has become the provider of conveneience for all sorts of non-emergency medical and societal ills.  The insurance companies are starting to push back harder on patients going to the ED.  If our health and insurance system succeeds in diverting lots of care out of the ED (a big if), then the huge demand for emergency physicians and the job market could potentially change in a substantial way.  I am beginning to see some changes in well insured patients in my area being diverted away from the ED, and our volume is down somewhat for the first time in many years.

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Thank you for the insight. From what I have heard, I would prefer to work for a democratic group where I can have stake in the company instead of working for a CMG, but I know these are becoming more rare.

 

It is interesting to think about the future of EM and how insurance companies are diverting people from the ED,as well as CMG's taking over small groups. Conversely, I have seen hospitals advertising low wait times for ED's and it seems that going to the ED has become more of a norm. Urgent cares are popping up all over the place and it seems that jobs are abundant.

I have also started reading about free standing emergency departments and they seem to be popping up all over the place and an excellent way for EM physicians to make a killing if you can get ownership. It seems impossible to predict the future of EM, or really any specialty but it does seem that right now, the field is booming and there are significant entrepreneurial pursuits if you are in the right place at the right time from Urgent cares to FSED's. Its just a shame that EM seems to attract people that want to live in the good outdoor locations and take all the good jobs =/

[Strider_91]

Colorado definitely has better weather but I think Washington has better mountains for mountaineering. They are technical as all ************************ and you just cant beat the north cascades imo. I would be happy as could be with either state.

[lernd]

What's the saying?  Lifestyle, Location, Salary.  Pick two.

If you want to reside in Colorado, doing residency there would certainly help facilitate a job after residency as there are likely many alumni in the area and academic faculty with professional contacts.

[Strider_91]

lernd wrote:

What’s the saying?  Lifestyle, Location, Salary.  Pick two.

If you want to reside in Colorado, doing residency there would certainly help facilitate a job after residency as there are likely many alumni in the area and academic faculty with professional contacts.

 

I get the jist of what this is saying but what would a high salary job in a place I want to live in but a poor lifestyle look like? Does that mean that in order to make good money in a high desirable location I would have to work a lot of shifts?

Cause if it just meant a group I couldn't be an owner at but I still had a fat salary in a place I wanted to live that doesn't sound so bad lol

[SPlum]

A friend of ours works as a ER physician in Pueblo, CO, 30 minutes south of Colorado Springs. Lives in the Springs, so a great town and commutes to Pueblo. Partner. Great set up as Pueblo is"underserved" so better pay differential. Most ER docs in the area NOT from Colorado. And just look up "Epic local pass".

[MPMD]

If you're still a med student you really don't need to be worrying about the job market in specific regions of the country. Focus on figuring out your specialty choice and find a good fit at a residency program.

I say this as someone who advises med students a lot on things like this and I'm a residency APD. Focusing on something like this can cloud your judgement on more important aspects of your future. Feel free to PM me if you want to talk more.

That said, Denver is a tougher market for EM than many cities of similar size/scope. These things fluctuate wildly over periods of years though.

The thing about EM is that you can always get a job somewhere no matter what market you're in, if not right where you want to live than a reasonable commute. But EM jobs are HIGHLY variable and not always what they seem, in many ways the salary is the least helpful thing to look at esp in more desirable areas. In Chicago there are places that pay <$300k/year that have totally stable groups and places where you could crack $400k that can't beg borrow or steal docs to cover.

[ENT Doc]

Are you married, kids?  If not, you've got medical school and residency to find someone and have your life and plans completely altered.  Things change.  Also, give some other specialties a chance.  You're just starting out, no?

[adventure]

Strider_91 wrote:

The only two states that pay their state police officers anything decent seem to be Colorado and Washington.

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So, this isn't true. Seems like your bother will have more choices.

Strider_91 wrote:

I know that neither of them are low COL, but no low COL states pay their police officers well.

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This depends on where in the state you live. This data (page 6) is from 2013, but reflects the point being made here. If you want to live in downtown Denver, yeah, that's not a low cost of living, I'd agree.

Strider_91 wrote:

How difficult is it for an east coast student to get a job in either of those states and how can I maximize my chances of getting a job out there?

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Plenty of EM jobs in Colorado. And in most places. ... Just apply! (they might not pay what you'd like though.... and might pay a lot less than midwest locales.) I agree with MPMD:

MPMD wrote:

The thing about EM is that you can always get a job somewhere no matter what market you’re in, if not right where you want to live than a reasonable commute. But EM jobs are HIGHLY variable and not always what they seem, in many ways the salary is the least helpful thing to look at esp in more desirable areas.

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CO/WA are places where most students "think they want to go" when they want to go west, but don't like California. You drove through Idaho, it seemed pretty beautiful...Cost of living is pretty ideal. Perhaps that's a better place for outdoor fun, living, policing, etc. There are plenty of ways to live well in Denver or Seattle too. Maybe you two should buy a duplex and each live in half! Point is, the overall picture matters, if you'd rather live in the mountains than in the cities, the changes in cost of living, the short commute to climbing might make life pretty ideal for both of you. Think of a place like Durango, CO, or Wenatchee, WA. Far enough off the beaten path they have some cool character, still need skilled folks to live/move there, but aren't as crazy as downtown city life. Overall picture here, not just salary.

If I were you, I'd make a list (export it from here, I think) of all EM residencies, put it in a spreadsheet, and start taking notes on whats important. Things like # of years, elective opportunities (aka program traits) or  #miles from climbing/hiking/coffee/etc (lifestyle) should go on the list for you to ponder!

[Strider_91]

ENT Doc wrote:

Are you married, kids?  If not, you’ve got medical school and residency to find someone and have your life and plans completely altered.  Things change.  Also, give some other specialties a chance.  You’re just starting out, no?

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Thank you all for the helpful and informative responses. This forum really has a special group of helpful and wise people compared to many other forums on the internet. I will consider all of the information.

@ENTDoc yes I am just starting out but I went into med school between surgery and EM but have pretty much ruled out surgery for many reasons and have realized I am the exact stereotype of emergency medicine physicians which has got to count for something. I am trying to keep an open mind though! I am dating the girl I am going to marry hopefully and have been very clear about my intentions to move to a better location and she says "she will be happy going anywhere with me" but that may change once we say "I do" lol. obviously her opinion will ultimately matter more to me about the future location than my brother...but overall she's great and gets it.

 

@adventure that data is awesome, and you have a good memory. I would LOVE to live in boise but it is the only police department in the state that my brother would work at and its not exactly ideal. He has always wanted to be a state trooper over a local department and id rather see him be happy and have some pride than live in a place where I can do super well. Its bad enough when we meet people and they find out im in med school and get all excited/ impressed and then he tells people he's a police officer and no one cares. Kills me inside every time.

[MPMD]

Strider_91 wrote:

 

@ENTDoc yes I am just starting out but I went into med school between surgery and EM but have pretty much ruled out surgery for many reasons and have realized I am the exact stereotype of emergency medicine physicians which has got to count for something.

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It does not.

[Strider_91]

MPMD wrote:

Strider_91 wrote:

 

@ENTDoc yes I am just starting out but I went into med school between surgery and EM but have pretty much ruled out surgery for many reasons and have realized I am the exact stereotype of emergency medicine physicians which has got to count for something.

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It does not.

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Forgot to mention I like being in the ED and I am an EMT. which is obviously different than being an attending, but either way I WILL keep an open mind.

 

I sent you a PM asking for some guidance on how to get more exposure to the field.

[GXA]

You will be able to find a decent EM job in either of those states - though if you limit yourself to a specific city, you may have to deal with less favorable circumstances (less pay, more hours...).  There are lots of jobs out there and at least in my neck of the woods (midwest), pay has been going up quite a bit over the last several years.