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  • EM job market implodes

    The EM job market has completely imploded due to residency expansion. I feel like an idiot for having picked such an unstable field.
    My job is OK (for now), but I doubt this career is viable for much longer. I'm a PGY-18 and doing another residency seems both impossible and daunting.
    Any thoughts from EM comrades?

  • #2
    I’m not in EM but I feel like there will always be room for competent, qualified ER docs. I have about 4-5 lazy, incompetent ones at my hospital that need to be out on the street ASAP...

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    • #3
      So you've been practicing for 14 yrs? If things didn't get bad until now, that's unfortunate and I feel your pain, but I'd say you had a pretty good run. If you lived the WCI life for this past decade and a half, you should be fine even with a bit of a pay cut. I can't imagine even considering another residency at this point. What assurance would you have that whatever happened to EM won't happen to that field.

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      • #4
        It has imploded? Has anything specifically changed about your job? What about your job do you feel like is going to make it non-viable in the near future? There isn’t a question that the number of residency spots has increased too drastically but I don’t think things are necessarily going to be as bad as many are making it out to be although the outlook isn’t positive. I think imploded is probably too drastic of a term.

        I do feel that HCA has no business in the residency game and the groups responsible for approving these residencies are largely ignorant to real world issues. SDN has been harping on this a lot recently. Nearly to the point of becoming unreadable. SDN was already chock full of pessimistic and burned out docs but this has really kicked them into overdrive. My guess is that 99% of them will still be working in EM in 5 years and so will you.

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        • #5
          I thought you hated your job and the hospital antics or am I thinking of another poster?

          Based on the number of cold calls and emails that I get daily, despite vigorous spam blockers, I would say there are still plenty of jobs, my internet friend. They just aren't at primo sites like ours.... But that hasnt changed either--i think we advertised one time a decade ago.

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          • #6
            More residency spots, more hospital corporations using more np/pa is all I read about on Reddit. Combine that with covid hiring freezes making it hard to find jobs.

            But I’m sure there will almost always be jobs available, just possibly not in the city you want to be in.

            Theres more of a distribution problem of doctors in the country.
            Last edited by Nysoz; 04-21-2021, 04:00 AM.

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            • #7
              “ I feel like an idiot for having picked such an unstable field. ”
              Brings up a learning opportunity for PGY1, PGY2 and PGY3:
              • How did you pick your field?
              • How would you pick your field now?
              • What mistakes can be eliminated?
              • What is the best choice now?

              From the outside looking in, looks like you are pretty well set for the next 15 years. Not sure “idiot” is the right word to be used. Do you like EM?

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              • #8
                I think everyone feels this way about their career at times, what dont you like about being EM , is it the work or is it that you are not making as much as you thought you would. At times, I felt on the bottom of the financial totem pole doing primary care over the last 20+ years, but some how you make it work and modify your career in the direction you want to go. It is hard to listen to someone complain , when there are people out there working 12 hour days of non skilled labor for little over minimum wage.

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                • #9
                  Yes, I'm OK financially and pay is still OK.
                  We are tied in compensation to the market, and will get a pay cut next year I think.
                  Thank you for all the insight.
                  I agree that I've had a decent run (new grads are in a tough spot) and appreciate that.

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                  • #10
                    What does 'implode' mean? Curious what actual numbers you are looking at?

                    If I had a dime for every time a doc said 'woe is me' regarding comp I'd be a rich individual!! Not to say I don't believe you but curious to hear actual "my comp went down" (outside of the obvious covid related changes that occured when EDs volume plummeted last year - or maybe thats what the reference is??)

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                    • #11
                      Originally posted by snowcanyon View Post
                      Yes, I'm OK financially and pay is still OK.
                      We are tied in compensation to the market, and will get a pay cut next year I think.
                      Thank you for all the insight.
                      I agree that I've had a decent run (new grads are in a tough spot) and appreciate that.
                      Serious question since you’ve been in the EM game longer than me but has their ever been a time where people weren’t worried about the future? I’ve been in and around EM for 11 years starting sometime in med school and there has only been a sky is falling attitude surrounding the specialty.

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                      • #12
                        Originally posted by East coast View Post
                        What does 'implode' mean? Curious what actual numbers you are looking at?

                        If I had a dime for every time a doc said 'woe is me' regarding comp I'd be a rich individual!! Not to say I don't believe you but curious to hear actual "my comp went down" (outside of the obvious covid related changes that occured when EDs volume plummeted last year - or maybe thats what the reference is??)
                        I believe there is a prediction that there’ll be 9000 excess ED docs by 2030 or thereabouts. If he/she works for a CMG then decreased compensation wouldn’t surprise me but that’s the name of the game for those groups no matter the situation. There’s always downward pressure on compensation for all specialties but that’s nothing new and likely will never change.

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                        • #13
                          Originally posted by snowcanyon View Post
                          The EM job market has completely imploded due to residency expansion. I feel like an idiot for having picked such an unstable field.
                          My job is OK (for now), but I doubt this career is viable for much longer. I'm a PGY-18 and doing another residency seems both impossible and daunting.
                          Any thoughts from EM comrades?
                          Looks like you are going through a mid life crisis and at the low point of the happiness curve.

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                          • #14
                            I think its a rare scenario though where you have residencies popping up left and right in the field with perverse incentives at these HCAs. When I was a student, EM was all the rage because of the flexibility, good compensation and high demand for jobs. Would have to think all 3 of those would be affected by excess amount of physicians. Obviously with a grain of salt as someone outside of the field. Also not sure how much ground docs are going to gain back on midlevels, I feel like once that ship sails it's going to be hard to win.

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                            • #15
                              Originally posted by CordMcNally View Post

                              Serious question since you’ve been in the EM game longer than me but has their ever been a time where people weren’t worried about the future? I’ve been in and around EM for 11 years starting sometime in med school and there has only been a sky is falling attitude surrounding the specialty.

                              They were right.
                              We had dozens of applications for a recent posting.
                              Plenty of out of work EM docs, including recent grads looking for a second residency.


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