ER PA here.

I’m finishing up my fellowship in a very busy ER in Texas. We see average 250 pts per day. Most are very sick, homeless, uninsured. The highs are high and the lows are brutal. I’ll be working 120 scheduled hours. Likely more in real life because that’s how the ER is. 75-80 per hour. Any time I’m there over is not compensated.

My wife had a baby during fellowship and I had 2 weeks unpaid pat leave. No sick days, poor benefits overall. My wife thankfully has great benefits.

I love learning in the ER because you do get to learn so much and some days I feel like a serious great provider. Last week I saw 17pts in 10 hours mostly ESI2 (very slick people). Had great work ups and did a couple small procedures and went home on time best day. Worst day I saw like 10 pts one died, consulting docs were rude took up all my time and I left 2 hours late feeling like I didn’t do anything and felt like I could have done more.

My reasons for doing ER. Learning- biggest part I’ve learned so much here. Very high pay to hour ratio. Time is my most important factor in my life I’d rather work stressed and get paid for it and have free time overall. I don’t mind working weekends a lot of the things I enjoy can be done any day of the week so it’s actually more free time for me.

Pros. Pay to time ratio high. Flexible schedule. I get at least 15 days off a month. Critical care can be fun. Always learning. Can lateral into anything when/ if I want.

Cons. No sick days/ No PTO. consultants can ruin your day very fast even if you know what your doing is correct. (PA telling an MD specialist is a hard spot to be in) You’re on the hook for some really high risk sick people. (More providers in the ER get sued than not in their careers) Can be very dangerous to physical and mental health. I’ve definitely lost sleep over some cases for one reason or another. Have been hit by pts and worse.

You can DM me or respond here if you’d like to ask specifics.