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My goal is to be a successful, on-top-of-the-game, hard working emergency room physician. I will have to be a fast thinker, be efficient at problem solving, and be able to work well under stress. I will also need to have a general understanding of the medical field as a whole, because of all the situations I may be greeted with.

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Emergency room physicians are trained to work in an intense environment. They tend to be high-energy people. In the business, they're affectionately known as "adrenaline junkies."

This isn't the place for slow, methodical work. When the crunch comes, emergency room physicians have to make quick, educated guesses to save people's lives. But they also have to respond to the more mundane aspects of the emergency ward -- infants with high fevers, fingers accidentally severed in cooking accidents, children who have tumbled from jungle gyms.

In the U.S., there has been a tremendous strain on emergency rooms in the last 10 years, as the health-care profession tries desperately to cut costs.

Ian Cummings, president of the Association of Emergency Physicians, predicts that ER medicine will undergo a phenomenal amount of change within the next 10 years. As money becomes even tighter, he expects emergency rooms will develop better ways of diagnosing patients, and even methods of caring for them faster.

Typically, smaller communities haven't always looked for physicians certified in emergency treatment, but that trend too is changing. The greatest need, as with all areas of medicine, will continue to be care for rural communities.

Women continue to make up a minority of ER physicians, although that is changing, says Dr. Janet Nuth, an emergency physician.

Women are realizing that while stressful, ER work does offer benefits that a practice doesn't: regular work hours with no worries about being called out in the middle of the night.

"It's still a very male-dominated profession, but more and more women are going into it all the time. Ideally, it allows you to be at home with your own kids as much as possible," says Nuth. "You don't have to worry about being on call, or rushing to an emergency in the middle of the night."

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Emergency room physicians are trained to work in an intense environment. They tend to be high-energy people. In the business, they're affectionately known as "adrenaline junkies." This isn't the place for slow, methodical work. When the crunch comes, emergency room physicians have to make quick, educated guesses to save people's lives.

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Based on current statistics, the salary of an ER physician is growing every year. The American College of Emergency Physician's (ACEPnow) compensation report states, "when you add it into the trend of the past 10 years, it reflects a 34.5 percent increase for emergency physician salaries over the past 11 years." With this information, I would make an estimated $200-300 thousand per year. According to ACEPnow as well, the national norm is an average $200 per hour.

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The national average salary for emergency physicians increased again this past year, a full 3.5 percent. Not a stunning number, but when you add it into the trend of the past 10 years, it reflects a 34.5 percent increase for emergency physician salaries over the past 11 years.

How is it happening? States that have been chronically low-paying historically are starting to climb. In New York, for instance, starting salaries increased 25 percent this year. Even the West saw dramatic increases, with salaries up 32 percent in Nevada and 14 percent in New Mexico.

The Midwest continues to be all over the map, with increases in Michigan (11 percent), Minnesota (12 percent), and Ohio (14 percent) and a big decrease in Kansas of 18 percent. The Mid-Atlantic states experienced a 17 percent increase overall, including a 20 percent hike in the District of Columbia. The Pacific Northwest posted a 15 percent increase in Montana and 14 percent in Washington.

Another important number is the percentage of job opportunities open to physicians with primary care board certification (PC-BC). Currently, this is 43 percent! With nearly half the country's emergency medicine jobs open to physicians not trained in emergency medicine, we have further evidence of the location-driven supply and demand market in the specialty. I see this number increasing in the next five years. You can also visit ACEP's comprehensive archive of industry and EM-specific salary and compensation information.

Trends and developments this year include:

Urgent care salaries are creeping up and, in some cases, pay as much or even more than emergency physician incomes in some states.

Sign-on bonuses continue to grow, with $50,000 a norm and a high between $120,000 and $150,000 in geographically challenged areas.

Broad salary ranges continue in some states, such as $116-$300 an hour in Pennsylvania and $160-$282 an hour in Minnesota.

The highest dollars in emergency medicine occur in locum tenens offers, with the $300-$320 an hour appearing more frequently. I even found one location offering $350 an hour in North Dakota.

Only eight states provide no options for PC-BC physicians this year.

The following numbers are based on working 1,632 clinical hours a year and include incentive bonuses and relative value unit compensation, where applicable. Annual package numbers include basic benefits valued at $30,000. Sign-on bonuses, loan assistance, and other perks are not included. Rankings are based on state averages, not highs and lows.

The Southeast once again leads the country with a regional average of $236 per hour/$416,000 a year. It also nearly leads the country in opportunities open to physicians with PC-BC at 54 percent, up 26 percent from last year

South Carolina: Average: $253/hr., $444,000 ann.; 54% PC-BC; high of $500,000 ann.; Mississippi: Average: $265/hr., $463,000 ann.; 50% PC-BC; high of $300/hr.; up 7%
Florida: Average: $225/hr., $397,000 ann.; 25% PC-BC; high of $350/hr.; no change no change

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2018-2019 Compensation Report for Emergency Physicians - ACEP Now

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ACEP Now offers real-time clinical news, news from the American College of Emergency Physicians, and news on practice trends and health care reform for the emergency medicine physician. ACEP Now is an official publication of the American College of Emergency Physicians.

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In order to become an ER Physician, I would have to start off my journey by obtaining a bachelors degree. I can go for any major of my choice, but it's a smart idea to take science based courses those four years. After I finish four years of college, I have to apply to medical schools and take the Medical College Admission Test. If accepted, I then have to do four years of medical school, and then obtain a license by passing the United States Medical Examining Licensure test. Once that is done, I then start my residency and enter a fellowship, and I am all set.

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Licensing

Medical doctors must pass the United States Medical Licensing Exam (USMLE)

Experience

ER residency program is required

Key Skills

ER doctors must be able to work under pressure and have strong communication skills

Salary
$206,114 (2016 median for emergency room doctors)

Sources: U.S. Bureau of Labor Statistics (BLS), Payscale.com

An emergency room (ER) doctor treats and cares for patients admitted to an emergency room. Once patients arrive, an ER doctor is responsible for a number of duties, such as assessing their conditions and beginning treatment, ordering tests or X-rays, and/or providing medication. ER doctors stabilize a trauma patient or treat injuries like lacerations, broken bones, and sprains. If a specialist is necessary, an ER doctor will call them or admit the patient for further care.

ER doctors work very long, irregular hours, most of which are on their feet. It's a high-stress position that requires complex multi-tasking. There is also some risk for illness and injury while working in an emergency room, but the reward of saving someone's life is unparalleled. And according to PayScale.com, emergency room doctors earn a median annual salary of $206,114 as of January 2016.

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how to become an er doctor: career and education roadmap

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How to Become an ER Doctor: Career and Education Roadmap

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Licensing Medical doctors must pass the United States Medical Licensing Exam (USMLE) Experience ER residency program is required Key Skills ER doctors must be able to work under pressure and have strong communication skills Salary $206,114 (2016 median for emergency room doctors) Sources: U.S.

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Difference between ER Physician and Trauma Surgeon

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Difference between ER Physician and Trauma Surgeon

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Emergency Room Physicians and Trauma Surgeons may seem similar, but they are not the same. In general, ER Physicians do and treat every person that comes into the emergency room, but trauma surgeons only come into play when needed. They both start on the same pathway, but the trauma surgeon route takes longer and both careers have different skills required. Regardless, at the end of the day, each has one common goal, and that is to save lives.

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If I want to be an Emergency Room Physician, there are a few things to keep in mind. I have to be ready for ANYTHING. I will range from seeing patients with the flu to patients without gunshot wounds. I have to careful with my shifts because it is hard to switch them, and I have to be ready to be flexible with your work hours along with be on call for whenever i am needed. My priority should be to save the patient’s life, and sometimes that may involve extreme decisions and fast actions. I have to make sure I don’t let all the pressure get to me and keep calm, especially in emergency situations.

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Training to become an emergency room physician is not for the faint of heart: in addition to four years of college, and another four years of med school, you will also spend another three or four years as a resident in emergency medicine.

Add a prestigious two-year fellowship after residency onto that, and, if you graduated college at 22, you'd emerge from that process at about age 31 or 32-and that's if you didn't take any breaks, or get any other degrees in the process.

But along the way, you're saving lives, learning your field and preparing for a lifetime of making a real impact on people's health. As an emergency room physician, you work on the front lines, stabilizing patients before directing them to specialists who can take over their care.

According to the Centers for Disease Control and Prevention, more than 130 million people visited emergency rooms in the U.S. in 2013-about 42 in 100 people.

What does being an emergency room physician really entail? We spoke to three ER doctors across the country to get their thoughts:

(These interviews have been edited for length.)

Marlisa Mann, MD

The Ohio State University Wexner Medical Center
What are some common misconceptions about being an ER doctor?
One common misconception is that we only take care of critically ill patients, all the time. While this is a big part of our job, we also see lots of patients with chronic medical conditions, like high blood pressure and diabetes, without access to regular care. This means we often play the role of their primary care provider and take care of everyday problems as well.
What do you wish you had known before choosing your career?
I wish I had more insight into the difficulties of inadequate access to care. I also wish I had known how difficult it would be to switch from morning shifts to afternoon shifts to night shifts and back again, and not necessarily in that order. Even though we tend to work fewer hours than other hospital-based specialties, when you factor in time spent switching our sleep schedule around multiple times per month, we have less free time than it seems.
What is a typical shift like?
My typical shifts last for eight hours. This may be a morning, afternoon or night shift. When I come in, I receive a hand-off from the off-going doctor about the patients he or she is caring for who are still waiting on testing before being admitted or discharged. Then I start seeing new patients. We tend to be the most busy in the afternoons and least busy in the early morning hours.

Brandon Carr, MD

Arnold Palmer Hospital for Children
What are some common misconceptions about being an ER doctor?
Sometimes people think that working in the (emergency department) is like it is on TV shows, where they are constantly running in with patients that have been shot or run over and yelling out things like "STAT!" It is usually much more calm and controlled than this.
What is something most people wouldn't necessarily guess about your profession?
I hadno idea how much intuition would remain an important part of the job. Medical school teaches you how to think through problems in a systematic and methodical process. But there is still an element of intuition and gut instinct that comes with the territory. This gut instinct is not something that can be taught and it seems to grow with time and experience.

I can't tell you how many times I had this feeling that I should order a certain test or not discharge a patient, and ended up being right. It is very similar when a parent tells you, "Something's just not right." This is why even the best computer models and problem solving systems will never be able to replace a human being in the practice of medicine.
What is a typical shift like?
No shift is typical! They are all different. It depends on the time of year. During the winter months, we see more medical illnesses like influenza and respiratory viruses. During the summer, we see more injuries when children are outside playing. Fall brings in football and cheerleading injuries.

Theresa E. Tassey, MD, MS

University of Maryland, Mercy Medical Center
What are some common misconceptions about being an ER doctor?
Not every second in the (emergency department) is exciting.We see a lot of patients that could be treated by a primary care provider, but may not be able to get an appointment or have transportation that corresponds with office hours.

Also, (emergency care) providers and nurses do not know (or care) who has insurance.Sure, we want everyone to have insurance and access to health care, but when it comes to a patient's treatment in the ED, everyone gets treated the same, regardless of insurance. It does not affect our decision of whether someone needs admission.
What do you wish you had known before choosing your career?
You're going to make mistakes; it's unavoidable in every medical specialty, but you cannot let it ruin your shift, day, week or life. No one wants to harm a patient or miss a diagnosis, but it will happen. Have a solid group of people you can lean on, vent to your colleagues, learn from it and move on.

What is something most people wouldn't necessarily guess about your profession?
Emergency medicine physicians are part master of social services, part counselor and part tough-love parent. There is no doubt we see all walks of life in the emergency department. We are a haven for those that the rest of society forgets: the mentally ill, addicts, homeless, prostitutes, undocumented immigrants, the poor, demented and frail. We feed the homeless, allow the intoxicated to stay until they are sober enough to safely leave on their own, counsel victims of domestic abuse and sex trafficking and assist those that cannot go anywhere else for treatment.

Stephanie M. Bucklin

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Training to become an emergency room physician is not for the faint of heart: in addition to four years of college, and another four years of med school, you will also spend another three or four years as a resident in emergency medicine.

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The Day in a Life of an Emergency Room Physician 

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The Day in a Life of an Emergency Room Physician 

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The typical day for an ER physician is never the same. Things change everyday in this field. Shifts are usually around eight hours, but that isn’t set in stone. Depending on what you are dealing with, your shift can be much longer. You also never know what to expect, so you have to come in ready for anything. Usually you will be going from patient to patient,  and see at least ten patients per shift, if not more.

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5:50 am
Alarm goes off. I hit the snooze button and when it goes off again, I know it's time to peel my face off the pillow and get going.

7:03
Arrive at work and go put my stuff away. I pull out my bag of snacks (it gives me energy and motivation) and head to find a computer to set up shop. I sign in to our system, usually start by picking up the first two that are waiting to be seen. Before I go see them, I look through their electronic medical record to see how often they frequent the ED, what their medical problems are, etc. The first patient is an elderly gentleman with a ton of medical problems and abdominal pain. I go to see him but I'm pretty sure he's getting a CT scan (older people with abdominal pain=bad). The other pt is a young person with a headache and history of migraines. See them, place some orders in the computer and move on.

8:00
Charge nurse walks over and informs our team that we'll be getting a young male cardiac arrest. We gown up. The second year resident is airway, the third year resident usually runs the code and the intern gets the code central line. The patient arrives, he's intubated by EMS and we have no history. EMS was called by a friend who stated that he just passed out while watching TV. He is in PEA. We go through our ACLS protocols and were never successful in getting a pulse. This patient didn't make it and now the team leader must go break the news to his family. Was it drug overdose, a deadly arrhythmia from WPW, poisoning? We will never know. It's very unfortunate but we have to move on.

9:05

One of the day nurses asks for a resident to go and see the 84-year-old lady in bed one who's heart rate is 30. I walk over to the bedside thinking about the scenarios. Stable vs unstable. What will I do first? Does she have a blood pressure? It's a short walk so I get there and she's sitting up in bed talking to her daughter. Her blood pressure is normal and she tells me she was feeling fine but her PCP sent her here because her heart was "beating too slow." I grab her EKG and she has a complete heart block but she's been completely asymptomatic with it. The nurses have pacer pads on the patient before I even get a chance to ask. I'm glad she's stable and I can leave her bedside to call cardiology so that they can take her upstairs and place a pacemaker in her while she's stable.

Several more patients are seen throughout the day with the same basic premise in mind going in to see them. Are they stable or unstable? What are the life-threatening conditions that this person may have that are consistent with their complaints? What tests or studies that will help me determine the problem? Do I need any consultants immediately? After seeing several patients with complaints varying from vaginal bleeding to a newborn with a fever, to a finger laceration and finally you have made it to the end of your shift.

3:00 pm
It's that time and the relief is starting to trickle in which makes me very happy. At Baystate, the ED is always packed with patients and it's always busy. At the end of your 8 hours, you are quite ready for sign out. You finish wrapping up your patients. Getting them admitted or discharged and finishing the paperwork for the ones that you need to sign out.

3:30
Sign out for team A is announced overhead. Everyone gathers and we talk about our patients that are left.

4:15

The paperwork is finished and it's time to get home. It's time to go make some dinner for my husband and walk the dog...maybe go to the gym (only on a very ambitious day).

It's hard to describe one day because everyday is very different. As long as you come equipped with a great attitude and a stethoscope, everyday will be exciting with many opportunities to learn and develop your clinical skills.

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Day in the Life of an Emergency Medicine Resident

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5:50 am Alarm goes off. I hit the snooze button and when it goes off again, I know it's time to peel my face off the pillow and get going. 7:03 Arrive at work and go put my stuff away.

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I love emergency medicine and I want to be an ER physician, but it can be stressful, or maybe too easy and not enough. Incase I decide being an Emergency Room Physician isn’t for me or want to try something else in the same field, there are many jobs similar to it. These jobs include of, but are not limited to, trauma surgeon, emergency room nurse, emergency medical technician (EMT)/paramedic, flight surgeon, and fields in rescue medicine.

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Medical careers in emergency management will appeal to those who thrive in a fast paced work situation that demands quick thinking and efficient handling. Medical careers generally involve sustained work with patients, treating or assisting them through the period of illness until health is recovered. But emergency medical care focuses on handling the crisis quickly with minimal but necessary treatment, and transporting or transferring the patient to an appropriate medical service.

Resource: Top 10 Emergency Management Bachelor's Degrees Online 2016-2017

If the above description draws your interest, here are five medical careers in emergency management that you may wish to explore.

Emergency Medical Technician (EMT) and Paramedic

EMTs are health care providers with the training to provide quick medical service in emergency situations such as an accident, fire or natural disaster. There are three levels of training with increased coursework and length of training. EMT-Basic provides the first level of training and includes 120 to 150 hours of coursework covering patient assessments and handling emergency situations. Students learn how to provide basic life support for injured and critically ill patients, with skills such as CPR, airway management, controlling excessive bleeding, and treating for shock and poisoning. They also learn the proper use of field equipment and safe transport of patients.

EMT-Intermediate requires 200 - 400 hours of training and includes additional courses and skills training such as handling drug-related calls, behavioral crises, and emergency childbirth. The use of complex airway devices, giving intravenous fluids and providing medications are also included.

Paramedics receive more formal training of 1000 or more hours in six to twelve month programs with courses such as anatomy and physiology, cardiology, medical procedures and medications. Paramedic training is also offered in many community colleges in two-year programs, culminating in an associate's degree. Paramedics learn about procedures to follow in the full range of urgent and emergency care. These can involve strokes, heart attacks, cardiac arrest, spinal injuries and trauma.

Emergency Room (ER) Physician

Emergency medicine physicians work in the emergency room of a hospital or urgent care clinic. They are trained as MDs with the addition of a three- or four-year postgraduate residency training in emergency medicine, which is completed by taking the American Board of Emergency Medicine examination.

ER physicians must be prepared to handle any acute emergency condition that is presented, whether medical, surgical or psychiatric. They perform the procedures necessary to stabilize patients and then to refer them to the appropriate medical departments. In this process, they evaluate, order tests, diagnose and treat any acute physical injury as well as medical conditions such as strokes or heart attacks. They may perform invasive procedures, administer medication and use medical devices. They discuss the patient's condition with specialists or surgeons when a referral is indicated. They may educate patients on their conditions and help them to understand and accept what is necessary for recovery.

Neonatal Intensive Care Nurse

The critically ill newly born or premature infant needs the care of a specialist who is certified as a neonatal intensive care nurse. This nurse operates the technology that helps the neonate to breathe and to be fed intravenously. Working under the direction of a physician, the nurse cares for the newborn and educates the mother about the baby's condition and the care required, about breastfeeding and other questions the mother may have.

To become a neonatal intensive care nurse, an RN who has several years of neonatal nursing care experience takes and passes the Neonatal Nursing Certification exam through the American Association of Critical Care Nursing.

Neonatal intensive care nursing is only one of medical careers in emergency nursing. Other specializations include emergency room, ICU, acute critical care, cardiac care, pediatric intensive care, trauma nursing and life-flight care.

Flight Surgeon

Flight surgeons are primary care physicians with military status that are specially trained in aviation medicine. Each of the three branches of the armed services have their own parallel training program. Although referred to as "surgeons", they do not perform surgery. Instead, they provide clinical services in the air, and also conduct research and analyses to make recommendations for effective operational systems and environments for improved flight performance. Flight surgeons generally start as pilots who then undergo medical training and become pilot-physicians.

The training in the U.S. Air Force is an eight-week Aerospace Medicine Primary Course, followed by a three-year Residency in Aerospace Medicine (RAM). The Navy has a parallel program with a longer Flight Surgeon Primary Course followed by a RAM. The Army has a six week primary course followed by the three-year RAM.

Wilderness and Rescue Medicine

The beginning of wilderness medicine is seen as the addition of certain medical principles and procedures to Outward Bound first aid training in the early 1980s. The training focuses on teaching the ability to think and function during emergency situations in disasters or in settings where medical service is not available. These emergency situations may involve prolonged patient care, a difficult or dangerous environment, and improvised equipment.

Specialties in wilderness medicine include diving, tropical and travel medicine, high-altitude and mountaineering, expedition, rescue and evacuation, survival, general environmental medicine, improvised medicine, disaster and humanitarian assistance, and wilderness emergencies and trauma management.

The above five career areas give only a hint of the variety of specializations available in this engaging and challenging occupational field. If you're the outdoorsy type, or drawn to military service, or like the idea of rescue work during disasters, or would be at your best in a fast paced, demanding emergency situation in or out of the hospital, a medical career in emergency management may be the right field for you.

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5 Medical Careers in the Emergency Management Field

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Medical careers in emergency management will appeal to those who thrive in a fast paced work situation that demands quick thinking and efficient handling. Medical careers generally involve sustained work with patients, treating or assisting them through the period of illness until health is recovered.

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If it isn’t obvious, being an ER physician is stressfully. You have to work under high pressure and you have to work fast or else someone else’s life may be in risk. You also may have to work long hours or overnight and may not get as much time with your family or to yourself. I believe that although there is a lot to it, I will still enjoy this career. Out of 29 different specialties and 15,000 different physicians, with emergency being the third most, 58% of ER physicians said they are extremely happy outside of work, 26% said they are happy at work, but also 48% said they are burned out. The range varies greatly, but at the end of the day, I still believe it will be worth it.

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Medscape Emergency Medicine Physician Lifestyle Report 2018: Personal Happiness vs Work Burnout

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Medscape surveyed EM physicians and asked about their burnout and depression, as well as aspects of their lifestyles outside of the office.