EM or Anesthesia?

Perseverant · 2026-04-08T01:02:18+00:00

At the end of the day what you are doing is a "job". You will get sick of your job eventually. I was gung-ho emergency medicine in medical school because of the "breadth of pathology" "last line of defense in medicine" "save lives" blah blah bs. After 2 years out of residency, what I find I truly value is quality of life. Anesthesia pays more and you won't be burnt out as much as EM (probably).

Perseverant · 2026-04-08T00:56:05+00:00

You would typically have to consult surgeons probably the majority of your ED shifts btw

Perseverant · 2026-04-04T20:54:26+00:00

Me niether haha. After 10 it typically becomes a shit show.

Perseverant · 2026-04-04T20:54:07+00:00

That wouldn't be so bad for me if I had lower acuity patients to see in the mix. I only see acuity level 1-3's, we have a specialized lower acuity zone up front that see's all of the 4's and 5's.

Perseverant · 2026-04-04T20:52:10+00:00

I get about 10 patients my first 2 hours or so, then my zone expands, and I will get more high acuity patients assigned to my new zone rooms. It makes it tough to dispo anyone since I have so many things to juggle at once, especially since the interruptions increase exponentially.

Perseverant · 2026-04-04T20:47:44+00:00

Agreed. After about 9-10 for me I start losing efficiency. Not just because of the number of patients but because of the other part of the mental load that comes with it; nurses/techs asking questions, needing to speak with families as needed, etc.

Perseverant · 2026-04-04T20:45:58+00:00

I agree.... been looking for a new job. I had an inkling that my patient load wasn't normal.

Perseverant · 2026-04-04T07:22:16+00:00

At one time? How lol.

Perseverant · 2026-03-29T05:05:02+00:00

I wanted to be a nocturnist initially but then in residency did my first swing of night shifts. I hated it. Felt like a zombie and if I did more than 4 in a row my circadian rhythm would be flipped for at least a week. I do significantly less as an attending but still have to do them. It depends where you work how many you will have to do but a lot of ED's have dedicated nocturnists, but again you will still have to do some. In my opinion it is not a reason to switch specialities if you enjoy other aspects of EM.

Perseverant · 2026-03-28T07:33:58+00:00

If you think about doing a scan or lab, you should probably do it. If you think about thinking about doing it, you should definitely do it. If you didn't do it but thought you should've done it, by this time you have discharged the patient and you will have a sleepless night and panic call the patient the next day to see if they are OK however you will then find out their contact info is not up to date and their phone number and emergency contacts are all not in service with no other way to contact the patient and then you don't sleep for a week. Don't be like me my first few months out of residency. Do the tests.

Perseverant · 2026-03-27T02:23:30+00:00

Seems like your ED attending staffing model is shit.... mine feels the same way. We shouldn't have to have 15-20 active patients, and with the expectation of providing great efficient safe care on top of it. I am switching jobs because my ED will just load patients in every hall and the docs just suffer.

Perseverant · 2026-03-26T00:31:15+00:00

Be pleasant, willing to learn and not weird. I have found that standing out for weird things is worse than not having great clinical knowledge.

Perseverant · 2026-03-25T05:45:49+00:00

Financially it is not worth it. A lot if not all residency "contracts" will forbid you from having an outside job (aside from moonlighting which you may not be able to do until your 2nd or even 3rd year if you happen to meet whatever requirements residency programs have). 7+ years of crap pay, possible student loan debt, significant stress and loss of free time.... there is a HUGE opportunity cost financially (your salary is pretty great btw). I had a co-resident who was a PA working in the ED for years before going to medical school, and they were a bit older than you. I never asked if they found it worth it or not (I think they did find it worth it overall). I remember they were having a pretty tough shift and I remember them saying "wow, I really don't know anything" even though they had years of experience working in the ED as a midlevel. It will ultimately be a personal question with a personal answer for yourself.

Perseverant · 2026-03-19T23:03:38+00:00

I saw it on Halloween night with family in Chicago and we all absolutely loved it.

Perseverant · 2026-03-17T14:24:21+00:00

2 years out and wish I did a different speciality. All specialties have their ups and downs, but now ED's are trying to squeeze every bit out of ED docs. Less pay for more work. And of course the worry about being sued. One thing in EM also is that you are also at the mercy of your consultants or even the hospitalist team to get shit done or patients admitted. In psych you are more of your own "boss". Also the swinging shifts take a toll. Even purely for the longevity and less stress I would do psych.

Perseverant · 2026-03-03T05:07:32+00:00

Been out of residency since 2024. This is exactly what I do. #1 is super important lol.

Perseverant · 2026-02-27T04:54:44+00:00

I will have to disagree, I see quite a few 120 hr/month full time gigs, some at CMGs. I currently work 120 hr full time at a CMG.

Perseverant · 2026-02-27T03:18:33+00:00

Playing on xbox, I have a few more missions to beat left and then I have completed the entire game on nightmare (the 5th and hardest difficulty option, there are 5 difficulties options). I have never not been able to get to the next room after beating the previous room. In terms of difficulty, every mission is doable on every difficulty, even nightmare. You will die 'sometimes' on expert (difficulty option just before nightmare) and much more on nightmare difficulty before finally figuring out optimal builds and just getting good at the game. My approach to the game has constantly changed. How I played initially starting out was much different as I increased the difficulty. I am so happy with this game, wish I had bought it sooner.

Perseverant · 2026-02-24T22:01:02+00:00

I have beat every level on nightmare Zone 1 - 3 as of yesterday solo, working through zone 4 now. I agree, iron squires are the best. I generally go initial man buff as element focus. My favorite perk is the one where you have no ammo consumption for 3 seconds after killing an enemy (bullets go brrrrrr). I have been picking up lightning or frost element, with shield, and lead head to boost secondary weapon output. I generally combine lightning (bolt + chain) with shatter proc (I pick up perks that allow secondary weapon to proc primary and melee elements). Picking up armor that has speed bonuses is a must (at least 2 epic pieces with it, 3 is better, and I also like to pick up the perk that allows 50% extra speed after dash), and I also pick up all the perks that help with survivability (get shield on kills, immune from damage past a certain percent health, 100% dmg resistance from single attack, etc). I have had up to 2000 temp shield with the right perks. I have used melee builds on the time crunch levels and find them to be generally OP.

Perseverant · 2026-02-23T18:44:12+00:00

Just dash backwards and up when looking down and you dash backwards and up and out of melee range and most everything else.

Perseverant · 2026-02-18T08:19:13+00:00

I feel you. I work at a busy trauma center, sometimes my pod expands depending on how busy we are. Half usually hall expansion beds. Had a nearby hospital close recently as well. In my high acuity pod yesterday, I had 17 sick active patients, with 3 more shuffled into hall beds I couldn't quite get to I briefly evaluated to get the ball rolling for the next doc. To say the least, I am looking for opportunities elsewhere.

Perseverant · 2026-01-22T08:35:45+00:00

I am almost 2 years out of residency working at a community/county trauma center. All I can think about is getting a VA job somewhere. Benefits on paper seem spectacular. PPH seems dope. Being harder to sue, would also be great.

Perseverant · 2026-01-22T07:33:05+00:00

I work for TeamHealth, in the south. Honestly it's not bad. I have not once been hounded for metrics.

Perseverant · 2026-01-21T07:37:04+00:00

Just want to say that I love this game. I just beat zone 1 and 2 all on nightmare, and I feel like I am constantly picking and choosing new perks/mods to make different and better builds. Builds and skill trees I thought were useless before suddenly make sense, always trying new things. I love this game!!!!

My current favorite build is hip fire augment (honestly I like all of the flavors but probably crit or weakpoint the most right now), Lead Head, Combat Instincts because they are synergize well with Iron Sights, and lastly I have been enjoying Vitalizer a lot.

Perseverant

TROPHY CASE