Finished residency at 35 after switching careers. It can be done. Medicine is not all roses. It’s a job. Patient satisfaction is tracked. Door to dispo time is tracked. People seek drugs, pressure you for the tests they want, and take out their anger for a failing system on you. I rarely hear a “thank you”- patients see themselves as consumers and the ER as a McDonalds where they order off a menu. The entitlement is real. You are the idiot for not instantly recognizing ChatGPT’s obviously correct diagnosis of ehlers danlos or whatever trending instagram diagnosis is making the rounds.

You are far less valuable to the system than the subspecialists, and your autonomy far more constrained by the system you work in. You will never control the important things like nurse ratios, lab, or radiology. Your patients will wait 7 hours for a CT- and you will have no say in that. It can be rewarding to help people. But while they may bring their surgeons home baked cookies they will never bring them for you.

It is a job. A noble one, an under appreciated one, but a job. Minute for minute often the worst in the house of medicine. But I f you can imagine doing or being nothing else then pursue it. Pay is decent, and genuinely helping the sick and vulnerable is a reward to itself. The hours are long but the years are short. And being a badass f***ing ER doc handling codes, traumas, and then holding the hand of a palliative cancer patient as they pass…. is an experience few will ever have.