MediMike

No OT differential is...ridiculous. Onboarding time seems good, I'd ensure you have the ability to extend that if necessary. 401k looks god PTO could be better but...shift work CME is definitely low. North of $2k is kind of standard these days (in my experience) Malpractice/Insurance etc sounds great Trash the noncompete if possible. If not possible and you have other options I'm willing to bet you can score a better offer elsewhere.

PNW, Critcare with large system. $2500 CME, professional membership + DEA + License provided outside of this.

Interesting, what makes an ED provider more able to determine the ethics, need and/or legality of treating an individual?

Yeah, those are the situations you memorize the anoxic injury rates for...Was it hypoxia driven bradycardia? You thinking PE? Mentioned tPA...

There are a select few where a big difference can be made. It's normally the young, otherwise healthy individuals who have a sudden precipitous event. Septic shock from PNA, arrest from a channelopathy, massive PE...these folks will often recover. The remainder? There's a lot more prolonging death than there is extending life. But it's still fun! Physiology is great. Procedures. Unending learning. And I suppose that what I consider "making a difference" could very well be much different than what someone else may think. Boats, family just insistent on continued efforts?

Wander over there and say you're interested in a position, see what they say!

If you have interest in ortho then experience as an AT will be invaluable. Many positions want experience OR an AT background, some will only hire prior ATs or at least have significant preference for them. I'd stick it out and get some experience, doubt your clinical hours will count.

Yeah I totally agree. Just sticking up for us few BS'ers left and was feeling slightly argumentative, sorry about that. I can definitely tell you that when I do pursue a master's though there's no way I'll be getting in in "PA Studies" or whatever the going degree designation is

One shop my wife works at has no cares what her legal name is as long as her license/NPI/NCCPA all match. Other shop made her get EVERYTHING changed which was a little rough.

Quick Google shows the requirements for PA cosign in PA (heh) is time dependent initially then based on an agreement between PA/MD/DO

Likely region dependent. I graduated with my BS in 2015, remain heavily recruited, no issues finding positions. In the PNW.

One thing to remember (*insert standard thread hijack apology*) is that higher acuity doesn't mean making a difference in someone's life. It oftentimes is the complete opposite. I went from 10yrs off/on in EMS to working critical care right out of school with that same thought process. My wife (who works in the ED, sees mainly 3s-5s, some 2s) had similar thoughts as you the other day. To relay our conversation I had to let her know that the testicles she untorsed last week made a hell of a lot more difference in an individual's life than the VAST majority of high acuity super sick patients that I see on a daily basis. Remember, everything you do makes a difference for someone, they're there to see you for a reason. It may not be a good one to you, but to them it's important, and there's a lot to be said for that.

Per diem rates vary considerably and I've never found a good source for comparison. Academic critical care I was pulling between $125-150/hr Non-academic critical care $80 The academic position reimbursed us at the same rates as fellows/residents picking up shifts which was really nice.

I think I'm going to take a different tack on this one. Look, I'm far from a "pull yourself up by the bootstraps" kind of guy, hell I don't even know what a bootstrap is, but there is a certain level of coping and interpersonal skills that need to be developed here. There are crappy people in every field whether you are slinging rebar (done it), pushing a button in a lumber mill (been there), fixing power lines or fixing people. Mitigating people's stupidity. Prolonging death. Whatever you want to call it. You seem to have a reason to not seek out a variety of positions and seem to have a tendency to generalize and stereotype entire hospital models (such as the inner-city or city-owned facilities mentioned above). You are going to run into physicians, PAs and NPs with "cold eyes" whether you're in outpatient pulmonary, family practice, pediatric gastroenterology or WHEREVER you go. I think you need a bit of a frame shift and take the initiative to work on your communication skills, self esteem and some confidence building exercises. Completely agree with the suggestion for counseling as above. Addendum: Just re-read your last post regarding a lack of interest in any type of residency based training...Sounds like you've thrown in the towel Sam. And that's fine, medicine isn't necessarily for everyone, I'm not sure what HCE you had prior to school but I'd consider looking into a different field. Your ability to respond to every suggestion with an excuse or a reason for why it's a bad one is borderline trolling. Good luck.

And as a sidenote coming from one who work(ed) in a Uni system, make sure there isn't a noncompete buried in your contract. In my experience academia is a jealous %$#^ and doesn't like to let you play outside the relationship.