It's September, and that means another round of predictions. Last year, the South did rise again (though there were no reported sightings of Rhett, Scarlet, or Aunt Pittypat), and it looks like that region is going to continue to rule the job market again this season but not by much. The Midwest will rival the Southeast for good job opportunities followed by the Western states, with Texas and California dominating that region.
The most important news for job seekers — residency graduates and experienced EPs alike — is that the spring emergency medicine job market has risen from the ashes like a mythical bird! The five months from January through May were jumping with new and surprisingly good jobs for the first time in nearly 10 years. This bodes well for the job market as a whole and for candidates who don't like to get their feet wet until after the New Year. By breaking down the market by regions reveals the state of the market across the country.
Job seekers will benefit from new and surprisingly good jobs for the first time in nearly 10 years
Florida will lead this 10-state region, providing 29 percent of the jobs, with 76 percent of them being offered by national contract groups like Team Health/InPhyNet, EmCare, and the Schumacher Group. Less than 11 percent will be offered by democratic private groups, and most of the positions will be available in interior sections of the state, with about 20 percent along the two coasts. Georgia will have about 15 percent of the jobs, with very few in the Atlanta area and about 36 percent in rural areas. Rural areas are defined as those hospitals with patient volumes under 14,000 a year.
About 60 percent of jobs will be offered by national contract groups, with 34 percent open to physicians board certified in primary care with emergency medicine experience. North Carolina will have a healthy hiring season in the interior region and around Charlotte, but there are no signs of activity in the Raleigh/Durham area at this time. Less than 20 percent of North Carolina jobs are in rural areas or open to doctors boarded in primary care. Tennessee also will offer strong opportunities, particularly among the national contract groups (82%), with a smattering of spots in Nashville and 20 percent in the rural areas, which may explain the whopping 41 percent of jobs open to physicians boarded in primary care.
Look for good levels of opportunity in West Virginia, Alabama, and South Carolina (but forget Charleston), with eight percent each. Average hiring levels will occur in Arkansas, with 50 percent open to primary care physicians via national contract groups. Fifty percent of Mississippi's jobs also will be open to physicians boarded in primary care, though less than 15 percent of them will be in rural areas. Surprisingly, Louisiana has the fewest job opportunities in the Southeast this year. New Orleans has little to no opportunities looming at all. I imagine the restructuring of health care and hospitals after Hurricane Katrina is retarding the job market in the state, but those interested in investigating the area should be patient and persistent. Just don't expect the previously high pre-Katrina incomes Louisiana was becoming known for.
The 13 states in the Midwest will provide 28 percent of this year's jobs. The biggest market by far is Ohio, with 23 percent of the region's opportunities. A large portion of Ohio's job opportunities (64%) will be with democratic groups and the markets in the “C cities,” Cleveland, Columbus, and Cincinnati, spread around fairly evenly. More direct hospital employers will be recruiting here as well. Indiana follows with 14 percent of the market, offering mostly medium-sized city locations (practically none in Indianapolis) with 42 percent in democratic groups and 33 percent in national contract groups, which equals the percentage of jobs open to physicians boarded in primary care.
Illinois and Missouri each represent 13 percent of the job market with a few openings in Chicago for the first time in years but very little activity in Kansas City. Most of the jobs in these states are with democratic groups, and a large percentage (33%) of the Missouri spots are in rural areas and open to primary care physicians.
Iowa appears to be a bit of a hot spot, though, with 77 percent of the jobs in rural areas and open to primary care doctors. Wisconsin, Kentucky, Michigan, and Minnesota will have average levels of opportunity with a high incidence of rural jobs (more than 50% in each state). Milwaukee, Louisville, Lexington, Detroit, and the twin cities will have very low levels of activity this year. That brings us to Kansas and Nebraska, both of which offer low levels of opportunity, with those few jobs that do arise coming mostly from direct hospital employers and rural areas.
Providing 16 percent of the nation's jobs this year, the five-state western region's market is actually located in two states representing more than 96 percent of the area's opportunities: Texas with 58 percent and California with 38 percent Although Las Vegas will offer a few scattered opportunities, as will Oklahoma, Hawaii barely makes it onto the charts. Texas leads the nation in job opportunities again this year, with nine percent of all the jobs in the country. Look for strong activity in the Dallas/Ft. Worth area, increased opportunity in San Antonio, and a job or two in Houston.
The bulk of the jobs (55%) are with national contract groups, but 36 percent of the state's opportunities will be with democratic groups. An interesting point is the number of directorships available in the state, so it's a good place for candidates interested in administrative posts to search. Rural areas represent 33 percent of the opportunities, and 36 percent will consider physicians with emergency medicine experience and primary care board certification.
California's a real hot spot, with more than 50 percent of the jobs being offered by democratic groups, though the few openings in San Francisco and San Diego will be with national contract groups. Los Angeles will have a stronger presence in the marketplace this year, and primary care physicians should give this state a pass because less than three percent of the jobs available will be open to physicians not board certified or trained in emergency medicine. Physicians looking in California should check out Valley Emergency Physicians, TeamHealth West, EmCare, California Emergency Physicians, and a regional group out of Marina del Ray called JJR.
The Middle Atlantic
This six-state region will provide 14 percent of job opportunities in the U.S., and they are fairly well dispersed among four of those states. Unfortunately, Delaware and the District of Columbia barely show up on the radar again this year. Pennsylvania is tops in the region again with 34 percent of the jobs, including a healthy showing in Philadelphia and Pittsburgh. Hospital employers rank highest at 43 percent, followed by democratic groups at 31 percent and national contract groups at 25 percent.
Less than 12 percent of the PA jobs will be rural or will consider primary care physicians. With 27 percent of the region's jobs, Virginia will allow 30 percent to go to primary care physicians though only 17 percent of the jobs are in rural areas. The D.C. area has very little activity, but both the gorgeous Blue Ridge Mountain and Richmond tidewater areas will be active. While half the jobs will be available through national contract groups, the rest are equally divided among democratic groups and hospital employers.
Maryland and New Jersey will each offer strong opportunities in this year's market, including a particularly strong showing in the Baltimore area. Suburban areas of New Jersey — around either New York City or Philadelphia — will not, however, be good search sites. Primary care physicians will be welcome in about 28 percent of New Jersey's jobs, but will find no such sentiment in Maryland where 66 percent of the jobs are with democratic groups.
Next month, I'll look at the weaker markets in the U.S., and explore the changes and current levels in emergency physician salaries and income packages.
Please visit me at the Emergency Medicine News booth during the Scientific Assembly of the American College of Emergency Physicians in New Orleans Oct. 15–18. I'll be providing career advice and counseling for all who seek it. Come by and sit for a spell!