A funny thing happened on my way to retirement. Putting it as a mathematical equation: weight loss x energy gain + boredom = back to work! 

Having done my usual job market research, I can tell you there is little to no change in the market for emergency physicians from last season. Last year, it showed 1,700 jobs; this year it was 1,701. This creates an interesting situation. There are not enough jobs for the number of residency graduates (not to mention experienced physicians looking to make a move), and yet many employers say there aren’t enough docs to fill the openings.

It all boils down to supply and demand — the standard state of the market in emergency medicine.  Emergency medicine residency-trained docs are picky. For them it’s all about location, location, location — and money! Salaries are back to, and even exceeding, pre-pandemic levels, and not-so-geographically-desirable locations are offering sign-on bonuses as high as $100,000 to $150,000 for multi-year contracts!

On that note, it’s important to realize that the job search process has become tougher and more competitive. Online job searching focuses on two main websites: EDPhysician.com preseason lists a total of 979 positions nationwide, and ACEP’s EMCareers.org reports 2,605 emergency physician jobs. Looking closer to the latter, however, I discovered that 74 percent of the jobs listed are either locum or other specialties like pulmonology and critical care, leaving 945 actual full-time equivalent emergency physician jobs.

The listings are also quite repetitive, often having the same job listed by multiple agencies. There is little overlap between the two sites with EDPhysician.com heavily featuring national groups whereas ACEP’s EMCareers features smaller groups, plus hospital employee and academic jobs.

With between 65-68 percent of jobs available with large, national groups and nearly 46 percent of all jobs open to primary care physicians, here is the regional breakdown:

Southeast

The 12 states of the Southeast represent 36 percent of the nation’s job openings, 85 percent of which are with national groups. Jobs are quite literally everywhere, especially in Florida, Tennessee, and North Carolina where the Research Triangle has a few rare openings. Look for increased activity in Birmingham, Alabama, Nashville, and the D.C. metro area of Virginia.

Southwest

The nine states of this region with 21 percent of U.S. jobs are seeing heightened activity in Phoenix, Las Vegas, and all over Texas including Austin/San Antonio, El Paso, Dallas, and even Houston. California has jobs in the big cities, including a few in San Diego. You can even expect to find a few positions in Denver as well, but at wages under $200 an hour.

Midwest

Regarding positions in the Midwest, I asked my good friend, Jenifer Stevenson, MD, FACEP, in Michigan to weigh in on the topic. “Compared to years past, there are jobs in the Midwest,” she said. “There’s greater opportunity in rural and mid-tier settings; however, jobs exist in urban and suburban communities. As expected, compensation is more competitive in rural communities and less lucrative in urban/suburban. Indiana and Ohio present the most opportunity. Despite the prediction that we’d see a shortage of jobs in the specialty, burnout, corporate consolidation, and APP staffing have resulted in more [jobs] than expected.”

These 12 states represent 19 percent of U.S. jobs, with Ohio way out in front. The major cities including Chicago, Detroit, Kansas City, and Omaha, Nebraska, are predominantly quiet.

Northeast

One of my favorite emergency medicine recruitment specialists, Shawn Teed of Teedco, is the pro in this region, although his crew works positions all over the country. I asked him what he is seeing in the market now. He said, “We will continue to see emergency physician shortages for years, mostly due to the pandemic and the medical schools pushing students into specialties less affected. Many of the residency slots remain unfilled even though residency matching has become very competitive. Many physicians are leaving the specialty or eager to do [that] so much earlier than pre-pandemic years. Physicians setting up their own corporations for working locums is a rising trend in many parts of the country.”

New York leads the way with five times more openings than other states in the region.  Don’t look for much of anything in Rhode Island or Vermont, but Massachusetts has a decent amount with a few near Boston.

Middle Atlantic

It’s all about Pennsylvania with 66 percent of the region’s openings, but very little in Pittsburgh or Philadelphia. Maryland has a good amount with D.C. metro areas, but the District itself is slow as usual. Opportunity is low in New Jersey, but there were 22 ads for travel physicians for big groups.

Pacific Northwest

Finally, these six states are extremely quiet in all but the more rural and suburban areas.  None of the big cities are on the radar for opportunity right now. Washington has quite a few suburban and rural slots, as do Oregon and Montana. Alaska and Wyoming are off the grid.

Barbara Katz, a graduate of West Virginia University, has been working exclusively with emergency medicine physicians since 1991 in the recruitment, consulting, and education arenas.