In your experience, what speciality has the most unhappy/regretful attendings?

  1. I asked my young EM attending where the older ones are at and he said either in the grave early or retired cause they couldn’t take it anymore. Lol

  2. Are any of the people saying this actually in EM? I am and I know tons of EM attendings in their 50s and 60s. None of them want to do urgent care because that's even more obnoxious. They just usually step away from the big trauma centers and work in the nice medium volume, medium acuity community sites.

  3. Seems like part of the problem is that a lot of specialties have escape routes to where you can scale back or shift focuses. For EM, pretty much none of the subspecialties truly gets you out of the ER and gets you better hours/salary. I’ve seen some go palliative for better hours, or Crit care to get out of the ER, but doesn’t get you the rest.

  4. Patients are showing up in record numbers with innumerable complaints. The sick don’t want to be healthy and the healthy want to be sick. Patients are more complex than ever. There is a psychiatric emergency in our nation that is being ignored.

  5. Well, they have an impending problem with saturation. It sucks that people are burning out but maybe that will help the overall problem they expect to have in 5-10 years.

  6. EM sucks and I can say that as an ED attending. It’s soul draining and miserable. The only thing worse than the patients are your fellow physicians being non stop jerks to you

  7. Where are you located? Here in Canada I would say about 20-25% of my attending are over the age of 50. My PD (though he just stepped down last year) is his late 60s, now he doesn't do PD anymore and just works emerg.

  8. You gotta understand that historically ppl overemphasis went into EM bc they wanted more time off work than on and a flexible schedule, which EM offers. So we have a high threshold for what we consider a good work life balance. Those who leave EM at 50 would have left in patient medicine by 35 lol.

  9. Surprised nobody had said neurosurgery, I’ve seen some older attendings throw cauteries and catheters all over the place when things weren’t going well.

  10. Neurosurgery are made different. They are the people who like to torture themselves. By the time they are an attending, they had been through so much of self-torture that it does not bother them anymore. And of course, 5 years after residency they retire. :p

  11. Don’t mistake the unacceptably poorly controlled rage for regret, most neurosurgeons couldn’t imagine doing anything else. Those throwy types are just immature egomaniacs who were never forced to grow up, and thankfully (very gradually) becoming rarer in the field.

  12. Same with psychiatry. You see a lot of old psychiatrists because it’s not a too demanding field where you can easily work until past retirement age.

  13. I'm a neurosurgery resident, and I spent several years closely involved in EM before as I was considering EM before med school. The neurosurgeons may be tired and grumpy, but most of them derive a good degree of fulfillment from their job. I've never run across a group of people who, on average, seemed to openly hate every minute they are clocked in until they are clocked out as EM docs, despite some of them working maybe only thirty hours in that same week. Some of them enjoyed it for the most part but, but most of them didn't. (These are usually mid career 35-55 year old private practice attendings at a mix of semi rural and upscale suburban ER's). Now, would I rather be completely burnt out 30 hours a week or have a fulfilling job 80 hours a week? That's a question I'm still wrestling with, because I am still very burnt out with these hours. But, it didn't seem that extra 50 hours of free time saved their sanity which is saying something.

  14. Just because you throw your bipolar in frustration doesn’t mean you’re frustrated with your life choices. Same as a tennis player throwing a racket.

  15. People talk a lot about how anesthesia is a "lifestyle" specialty, but it's really not depending on where you work. There are life threatening situations that come up regularly which can be stressful af. That being said, it's mostly shift work so hours-wise it is much better than any surgical specialty

  16. I love anesthesia and while I agree with the general gist of your comment, anesthesia tends not to be an old man’s game. There are exceptions, but the great majority of us are done by early 60’s.

  17. Lol I’ve seen younger attendings do it. Although we didn’t have something he needed to put a drain in (can’t remember exactly, maybe not the right size catheter?) so I kinda get it.

  18. Also, a lot of older EM attending retired at the start of Sars-CoV2. This country does not learn its lessons. We are lucky that the mortality of Covid was what it was. If it was like Ebola and the public acted the way it did, I would have also walked away too. If I was older and more vulnerable I would walk away too.

  19. Yeah not like us glorious DOs. One round of amygdala directed lymphatic pump and we're good to go for the next CRI cycle

  20. What city if you don’t mind me asking or region. All the trauma attendings ive met are the friendliest and funniest of the general surgery attendings

  21. I have yet to meet a happy trauma surgeon. I'm sure there out there but the odds must be poor.

  22. I’ll never forget being told by a 60+ yo trauma attending who operated on Reagan when he was shot, tell me that he regretted his career choice and would have liked to spent more time with friends and family.

  23. I feel like it’s all the old pcp docs who are grumpy. Probably because of technology. All the young pcp around me love their jobs. I think the old docs are just not efficient.

  24. I’ve never met a happy or even slightly pleasant interventional cardiologist. I’m pretty sure they only take residents who can prove they were abused as children.

  25. damn, i cold-emailed an IC when I was in undergrad and he was the happiest, most genuine guy I've ever met. Hes one of the big reasons why I wanted to go into the field.

  26. Guess I’m fortunate that the sassy deadpan hilarious interventionalist is one of my favorite people at the hospital.

  27. At my intern program there was a few interventional cardiologists that were amazing people, such good teachers and so fun to work with but they were also miserable. One of them switched to gen cards half way through my intern year, and he was so much happier. He said if he could go back and switch 8 years earlier he would have.

  28. EM, my friends in that field are telling me that it’s getting unreal. Job offers so low you would’ve been better off as a midlevel (seriously), so much patient volume I get nauseous just hearing about it, lack of resources and support, ridiculous patient complaints etc. Idk if most places are doing ok and just my region is going to shit but I don’t think EM as a physician specialty will be sustainable if this keeps up…

  29. Our hospitals are >50% midlevels. They pan scan everyone, order lytes/urinalysis/metabolic labs on everyone… then either consult, discharge, or admit. Most of the imaging ordered isn’t indicated… it’s getting bad so bad. Often our techs get a better history than the midlevels.

  30. I agree I think a big reason for burnout across ALL specialties has to do with our healthcare system… despite being in my field of choice, I wouldn’t walk the same path solely due to this

  31. I've found that most of the general surgeons with whom I've worked are pretty happy and relaxed. Certainly not the stereotype I had bought into.

  32. Lol... most general surgeons I've seen are pretty happy these days. The days of being always on call is going away, with midlevels to take the call burden and increasingly acceptable punting of anything emergent at 2AM to the local university hospital for "higher level of care".

  33. I am a rad who changed to ER. You people gotta understand that ER us not just medicine, it is a sport

  34. IM Hospitalist/EM. Hospitals are going to shit. Pandemic and poor management has made them crispy AF.

  35. This was one where the guys still seemed pretty happy, but like half the age 50+ women seemed utterly miserable. But some of the women seemed really happy still.

  36. I always see this on Reddit for some reason but the OBs and OB residents at my institution are actually very pleasant people to work with. They definitely work their asses off, esp the residents, but they seem happy overall. Maybe I'm just lucky

  37. Some hospitals it seems like they’re just Which Doctors. Deciding which specialty their going to do the admit and discharge for

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  39. Being very vocal about something and expressing your opinion and someone taking you the wrong way

  40. Fwiw Im am em pgy-4 and it does not seem that doom and gloom. I enjoy my work, I like my colleagues and I get satisfaction out of patient interactions. I'm applying for attending jobs that pay ~350k/ year working 13 8 hour shifts a month.

  41. Lmao ya, how sad that they sit there counting all that money while us surgeons work… you don’t know what the fuck you’re talking about…

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