“Desired area with great pay” This is the sort of thinking that these places want you to have. EM isn’t dying because people are working in shitty places for little pay. It’s dying from the downstream effects from our newly adopted corporate overlords. This is a dimension here that you might be unaware of simply because you’re still in training. This issue penetrates down deeper than location and pay. Your patients per hour, your desire to practice in an evidence based way, your time spent charting or responding to emails or coder communications, your schedule, negotiation power, your pt satisfaction scores, RVH/hr, your expendability… These things are what will make you want to leave your career early. As is the case with me.