r/emergencymedicine • u/RedditTemp2390 • 5h ago
Advice Regions with high proportions of democratic groups?
MS 3/4 here applying EM, and I've always heard that there's a good chance you stay where you do residency. Are there regions of the country that have higher proportions of democratic groups vs PE groups? Thanks!
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u/W0OllyMammoth ED Attending 5h ago
Democratic groups aren’t the promised land the way they once were.
I make much more as a hospital employee with better quality of life after leaving a democratic group.
My advice is pick where you want to live. The job will always be there and pay you well, live where you want to live.
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u/BodomX ED Attending 5h ago
To be fair there are some great SDGs. If you can break into them. A group I know very well easily clears 7-800k a year. The top earners make over a million.
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u/diniefofinie 5h ago
That’s usually the partners who have been there a long time, meanwhile the people on the “partnership track” are paid peanuts for 3 years in hopes of making it into the group.
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u/InitialMajor ED Attending 4h ago
It’s not what the top earners make, it’s what the bottom earners do. Rent seeking on the backs of new hires is not a great business model to join.
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u/zerotosixtyy ED Attending 4h ago
Would love more details on these numbers -like how many shifts they are working, coverage, part of the country etc. I do also think that jobs like this are not advertised and people never leave if it’s really the great balance of volume, pay, location, benefits. 10-15 shifts/month for $1M is a unicorn.
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u/bicyclechief 4h ago
Agreed. I work as a hospital employee and receive great benefits, the hospital backs us well as far as liability goes, and I make more and work less than the 3 friends of mine in democratic groups.
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u/YoungSerious ED Attending 1h ago
The trick with small groups is that each one different, sometimes drastically. I make notably more than the average in my area, with a very reasonable schedule (fte is 12). But we also have a phenomenal relationship with the hospital system we work in, strongly tied in with members on basically every hospital committee and med staff.
I agree with your advice, figure out where you want to live and go from there. It's not worth it at all to take a better paying job in a place you hate. You spend too much time not at work to hate where you live.
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u/Comprehensive-Ebb565 ED Attending 5h ago
The Midwest has large number of stable and quality democratic groups. Plus good pay and high quality of living.
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u/YoungSerious ED Attending 1h ago
Depends where. Several states in the Midwest are almost entirely run by cdgs
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u/heart_block ED Attending 5h ago
Big, "cool" urban centers attract PE/CMG's like flies to scat
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u/phattyh 5h ago
Exactly, because they know they can get fresh EM grads to work there because of the “cool city“, while underpaying them and treating them like crap. Unfortunately, these EM grads don’t realize that they could be getting paid 30% more and have a much better lifestyle and instead spend weekends traveling to these “cool cities“.
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u/Logical_Adagio_7100 5h ago
30% is a lot...but moving from Chicago to middle of nowhere for residency has made me appreciate exactly what I lost
Longterm is the paycut worth it? My dad sure doesnt think so. Will me and my partner probably move back to a major city on graduation anyway? Yes.
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u/phattyh 42m ago
The problem is people compare 'middle of nowhere' to places like 'chicago' - where they are going to get abused and beat up. There is SO much in-between this. There is a reason that many will even live in places like Chicago but commute 1 to 2 hours away for substantially better pay, treatment, and much better work lifestyle. If you look at outside the top 20 to 30 populated cities - you'll find places that actually value you, appreciate you - and know they can't just replace you with another fresh grad who is opining for the city life. When I keep in touch with residents who have moved to these types of cities - they tend to be happier than those who chose to go to a big city. Look - that all said, you have to make the call that is best for you and your family / etc. I respect my residents who say they are going to a big city shop because they have family there or just want to be in a big city but they appreciate / understand their work life is likely going to be miserable.
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u/EM_Doc_18 ED Attending 33m ago
Bingo. When people talk about geographic arbitrage, we don't mean go work in bumfu##, Mississippi, we mean choose an area where the COL and compensation aren't opposed to each other.
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u/ttoillekcirtap 3h ago
If there is a good job out there - there is 100% an administrator trying to make it shittier and pocket the difference.
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u/EM_Doc_18 ED Attending 32m ago
Don't forget hospital employed status. Beats the hell out of CMGs and probably a lot of SDGs.
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u/metforminforevery1 ED Attending 2h ago
California has a lot of Vituity but also a decent amount of SDGs in northern CA.
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u/AlanDrakula ED Attending 5h ago
Wherever you go, whatever you do, PE will be right there waiting for you