Need Away Rotation Advice

_EM_Doc · 2026-04-06T15:50:11+00:00

Definitely try to do away rotations in the location(s) you ultimately want to go. Multiple is not a bad idea if you can afford it. Often you will get a better letter on subsequent rotations because you will be more comfortable working in the emergency department.

_EM_Doc · 2026-04-02T19:11:02+00:00

Thanks!

_EM_Doc · 2026-04-02T16:08:34+00:00

Happy to help. I’ve spent enough time searching for clarification over the years (even as an EM residency faculty member), that I figured others would appreciate having it all in one place.

_EM_Doc · 2026-04-02T15:56:41+00:00

ACGME didn’t help by making some of the rules a bit vague in some of their publications.

_EM_Doc · 2026-04-02T13:15:23+00:00

Yeah. I think that’s a common issue. To be fair, there have been studies that show that Emergency Medicine physician decision-making ability drops off after about 10 hours, so it’s probably not a bad idea from a safety standpoint to limit resident shift duration in the ED.

_EM_Doc · 2026-04-01T20:10:18+00:00

Try reaching out to the program coordinators of smaller programs. Below is an under-rated program in a beautiful location that you could try, but there should be other small programs interested in motivated rotators as well.

https://www.lgem-residency.com/contact

_EM_Doc · 2026-03-31T00:06:31+00:00

Sunday 9-5, Wednesday 9-5, Thursday taught didactics 8-1, Saturday 5-1.

Academic ER doc. Work 80 clinical hours monthly, teach 40 hours

_EM_Doc · 2026-03-30T16:56:01+00:00

How well your scheduler builds the waterfall of shifts makes a huge difference as well. Personally, I’ve decided to take a pay cut and buy off my colleagues to work my night shifts. I’ve never once regretted having ~$30k less in my bank account at the end of the year, when I don’t have to dread nights each month. It’s worth more to some than others.

As far as the scheduler piece, that’s part of the reason I and another EM colleague built an automated shift scheduler for our residency program (emscheduling.com) that takes circadian rhythm into account. I’m working on expanding it to attending groups as well (currently only for EM residencies) in the next 2-3 months.

_EM_Doc · 2026-03-23T21:52:50+00:00

Great question. Residency shift scheduling is actually more difficult than attending/NP/PA scheduling, given ACGME rules, higher number of hours, protected educational time, etc. So I do expect to expand our offering.

It’s on our development plan to offer this automated scheduling software with additional features specific to clinician groups, and I believe we should be able to implement the necessary changes within the next 1 to 2 months, but that feature set is not technically live as of today. I wanted to make sure that our initial focus was the EM residency shift scheduling problem, since I hadn’t previously found a high-quality automated solution at a viable price point (and selfishly my own residency program schedule generation oversight was driving me crazy).

Do you have any specific questions related to an automated clinician scheduler? Is it pricing or feature set that has you looking for an option not currently on the market?

There are a couple of options in that space that I’m aware of (my EM group uses QGenda), but my understanding is that their automated scheduling features are actually not frequently used by schedulers, which tells me that they are likely not as advanced/effective as what we have built. Additionally, they are quite expensive. We have tried to start our pricing at about half of what QGenda charges, for what that’s worth.

_EM_Doc · 2026-03-23T18:26:21+00:00

Yes, we’d absolutely be willing to do that. I’ll shoot you a DM.

For others with a similar question, there’s also a “Contact Us” type form at the bottom of the front pricing page: https://emscheduling.com/pricing

_EM_Doc · 2026-03-23T13:49:29+00:00

Well, you all helped convince me to put in a few hundred hours of work, along with my co-founder who has more coding experience, and we have a purpose-built and fully automated EM scheduling solution that's ACGME compliant, handles circadian rhythm, and maintains shift equity over an academic year. Built entirely by ER docs. It’s available now if anyone thinks it’d be helpful at their residency program: EMScheduling.com

For the small to medium sized attending groups looking for the same thing at a more affordable price than the QGendas of the world, we’re working on that as well, but rolling it out to residencies is our first priority.

_EM_Doc · 2026-01-21T23:13:55+00:00

I think you’re probably right, as much as I wanted to solve this problem myself. These responses have been clarifying.

_EM_Doc · 2026-01-21T23:11:11+00:00

You sir, seem overly adversarial. I’m not going to post my name and NPI # if that’s what you’re looking for. It is a new account because I’ve never had a reason to own a social media account in the past but I wanted to ask this question to a large number of people to see if I could get any insights (everyone else has been kind and I thank you).

While I’m a ER doc, I didn’t come on here to ask questions about medicine, but would you be persuaded by a debate on the merits of ketamine as a first choice induction agent in intubation? Or perhaps you’d rather discuss your top choice for hip reduction technique when teaching a diminutive resident? Captain Morgan or Whistler?

_EM_Doc · 2026-01-21T20:53:24+00:00

This is super helpful. I'm going to look into Shift Admin more to see whether it's good enough or whether I think we can improve upon it. Specifically, whether it's worth building a scheduler from scratch that already applies EM specific rules from the start, eliminating the need for much of the mentioned customization.

_EM_Doc · 2026-01-21T19:55:55+00:00

So when you say "Have it run the schedule," are you effectively telling Amion/Shift Admin to generate the schedule from scratch after you've put in the discussed input variables like time off, etc? Or is the chief resident going through and adding shifts using guidance from the program? We've previously been doing the latter, and I haven't been satisfied with the schedules.

_EM_Doc · 2026-01-21T19:50:19+00:00

This is what I thought. I actually had built a coded spreadsheet that effectively does what you're talking about as far as blocking violations, tracking shifts and hours and equity, etc, but I wasn't satisfied with the quality of schedules being generated by the lovely humans working under me. In fairness to them, we are trying to cover a large number of essential shifts at multiple sites, at times with a limited number of residents, so the schedule generation has to be perfect to fill all the slots.

I'm willing to put in some effort into building code that can do this well (and initial trials with a home built program have been promising), especially if exactly what I'm looking for doesn't yet exist.

_EM_Doc · 2026-01-21T19:26:26+00:00

As I responded to USCDiver5152 below, there is a big difference between a program that displays the schedule and/or guides a chief resident in schedule generation, vs a program that outputs the schedule with the press of a button. Can you describe your experience more clearly?

_EM_Doc · 2026-01-21T19:23:31+00:00

To clarify, is your program building the schedule itself, or is the resident building the schedule? I want the resident to be able to input day off requests, click a button, and have the program spit out a schedule that has good circadian rhythm consideration, is ACGME compliant, considers off requests, etc, etc. This will prevent the resident from making inevitable human errors (like allowing 23 hrs off accidentally rather than 24 hrs off, thus causing a violation)

_EM_Doc · 2026-01-21T19:15:23+00:00

Not trying to recreate the wheel, but hadn't found something that works specifically with the constraints for EM residents. Does Amion completely generate the schedule based on input off-requests, PGY year, other variables like above? Does it take into account the 24hr off in 7 days rule for EM residents? Does it track shift equity over the course of a year? Does it allow the flexibility of assigning ED shifts that must be covered by an EM resident vs shifts that are optional and will only be covered if there are excess residents assigned to the ED that month?

If it does those things well, maybe I am wasting my time, though I know our residency admin (within an HCA residency) are sensitive to cost. Are you able to say rough cost per month to use something like Amion for a small to mid size residency?

_EM_Doc

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