EM LIFERS Episode 1: Getting Hired During a Pandemic

In the first episode of its new web series EM L.I.F.E.R.S., the ACEP Young Physicians Section and Online Education Committee hosted an interactive panel discussion about the challenges of getting hired during a pandemic. The full recording is now available in the ACEP Online Learning Collaborative and is free for all members.

Moderated by YPS Chair John Corker, MD; and Chair-elect Puneet Gupta, MD, the panel discussion kicks off with Natalie Wood, MD, talking about the contrast between her first job search out of residency in 2019, compared to her current search today as she and her partner, also an emergency physician, seek new jobs in another part of the country.

That set the stage for a panel discussion with emergency physicians Mike Abraham, MD, Greg Buehler, MD, and Ripal "Rip" Patel, MD, along with Tony Stadjuhar, president of Jackson Physician Search, about challenges the young EM physicians are facing this year.

The panelists answered the following questions during the webinar, and then we followed up with more questions from the audience afterward (see secondary list below). Scroll to the bottom for additional job-hunting resources.

1. How can EM physicians in the job market distinguish themselves during this unique and challenging time?
2. Who are we competing against? Is it primarily mid-career physicians looking to make a change, expanding residency pool or someone else? Has the competition changed because of the pandemic?
3. What locums opportunities are out there right now?
4. What are we seeing on the job trail right now? How has the recruiting pitch or applicant experience changed since the pandemic?
5. As you’re recruiting, are you seeing effects from the increase of APPs? How do we, as emergency physicians, differentiate ourselves in the market?
6. Are you seeing rural hospitals going to an APP-only model, or are we still seeing a lot of board certified, EM physician jobs in rural settings across the country?
7. Regarding contracts, what can we do to better advocate for ourselves and negotiate? What should we be looking for? Should we have someone available to look at a potential contract quickly?
8. How much more marketable are people who have an ACGME fellowship in their toolbelt for community or academic jobs? How can we set ourselves apart for academic jobs?
9. How honest do we need to be about our long-term goals when we’re looking at jobs?
10. When should we start applying, cold calling, emailing? And if we’re applying out of state from our residency, how do we figure out the market in that state?
11. Regarding locums: How do you handle the logistics of travel, childcare, etc?
12. What are some of the alternate career options for EM physicians other than “pit doc” we can get into that we may not be considering?
13. Where do you see this job market going? Is this the new normal?

After the webinar, we followed up with a few panelists directly to answer some of the audience questions:

1. How helpful or not is a non-ACGME fellowship (ultrasound, wilderness, undersea/hyperbaric) in making you more marketable?

Dr. Abraham and Dr. Buehler: I think the answer depends on where you are looking.  I would think that these positions are saturated in places where there is a program in place, so doing a non-ACGME fellowship and hoping to score a job in that institution might be tough. If you did do a non-ACGME fellowship, I would think that you need to take that expertise to a place where they may not have that but want to develop it. 

The other upside could be that by doing fellowship, that the job market may be completely different in two years.  Currently that market is tight, but in two years there may be a huge swing... One thing we have learned is that predicting the future is pretty tough.

2. We have heard that ACEP is advocating for ERs to staff ABEM/BE docs. What kind of progress is being made toward this? Are we seeing changes in this direction in hiring?

Dr. Corker: ACEP has always advocated for the gold standard of physician-led care by board-certified Emergency Medicine physicians.  Patients deserve physician-led care, and this model is both the safest and most cost-efficient for both patients and our health care system overall.  Please see our ACEP policy statement on this issue. Physician-led care continues to be the primary model espoused in the vast majority of locations nationwide, and this can be attributed in large part to ACEP's ongoing advocacy in this important area.

3. Dr. Patel, can you comment on the predominant model of 1099 and how you manage work that is not guaranteed or lack of benefits? Also, how do people with small children manage the travel required for locums work?

Dr. Patel: I could talk about this one forever and all the simple strategies to employ. You must have a sufficient emergency fund in case you cannot fill a week. I think it is advantageous to have PRN jobs close to home (that may not pay well, but still provide work) in case again work doesn't align. More importantly, book WELL IN ADVANCE so that you don't run into these hiccups, and if you do run into one you have time to prepare. Emergency Medicine can at times be dirty business with bad actors, and I've had medical directors cut my shifts 1-2 months before I am supposed to come (for cheaper staffing), despite my shifts being guaranteed. Don't get upset, angry, and threaten legal action: it won't get you anywhere really, and will ultimately impede you from ever working at that site again (the director will recommend to the CMO to not renew your privileges, seen it countless times). Even times that former has occurred, the hospital brought me back later for shifts. There are also ways to purchase insurance in case this happens (ie what happens to a venue when Coldplay can't perform because of COVID...the venue has insurance to pay employees, rent, etc). I could babble on, but anything else contact me through www.mercision.com to discuss further!

Resources:

• ACEP just launched a new Careers page where they put all of their career resources in one place, including the emCareers.org job board and an interactive map of job listings across the U.S.
• EMRA offers a host of career planning resources.
• The Spring Job Fair (virtual) hosted by ACEP, EMRA and emCareers.org is coming up May 20.
• Residents: Make sure to check out EMRA Match for Jobs.