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Emergency Medicine News:
doi: 10.1097/01.EEM.0000360606.96171.0a
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The 2009–2010 Job Market: It's All about Location

Katz, Barbara

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Ms. Katz is the president of the Katz Company, an emergency medicine consulting firm dedicated to providing expert physician recruitment services and training emergency medicine residents in effective job searching.

With so little change in the market from last season, I probably could have rerun last year's location report. With a second candidate-driven, job dominated market, there are a plethora of jobs but not much detail about them. A significant percentage of leftovers exist, most of which are in less-desirable lifestyle areas and rural regions. At least 26 percent of this year's opportunities are open to primary care physicians. In some areas, that number increases to 50 percent or higher. Be diligent about asking for details, including the history of the job.

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The Midwest

The 13 states of the Midwest top the nation in job opportunities this year, with 27 percent of the county's jobs. Leading the way is Ohio, with 19 percent of the region's openings, including opportunities in Cleveland, Cincinnati, and particularly Columbus. Employers are primarily regional physician-run groups with some smaller democratic groups in the mix and about 10 percent national contract groups (NCGs).

Illinois will be chock full of jobs this year, with a lot of action in and around Chicago. A quarter of the jobs will be with smaller democratic groups, and there is strong regional group presence, too. Missouri and Indiana will each have about 15 percent of the region's jobs, but will accept primary care boards in 45 percent and 36 percent, respectively. Don't expect to find opportunity in Indianapolis, but St. Louis will be popular, and a few slots will open around Kansas City. Iowa has more than 55 percent of its jobs in rural areas accepting primary care boards, but there is also high-level opportunity for emergency medicine trained doctors in Des Moines and Cedar Rapids.

Detroit is off the radar this year, but the rest of Michigan will see some action. The same goes for Kentucky, with Louisville inactive but the rest of the state wide open. Expect 55 percent NCG positions and 40 percent open to primary care boards. Kansas and Minnesota will provide about eight percent of the jobs, with scarce but good opportunity in Wichita and Minneapolis. Wisconsin is a hot spot this year with great group opportunities in and around Madison and Milwaukee, plus some longstanding groups in the northern and western parts of the state. Wisconsin also gets the “peer purity” award for zero opportunity open to nonemergency trained physicians anywhere in the state (that I could find). Nebraska and the Dakotas will see very little opportunity, with nothing in Omaha but a spot or two in Fargo and Sioux Falls.

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The Southeast

The Southeast squeezes in a close second with 25 percent of the nation's job openings, with 35 percent open to primary care boards. As usual, Florida leads the way, with a great deal of that due to unprecedented opportunity around Tampa/St. Petersburg and the Miami-Ft. Lauderdale corridor. Even pediatric emergency physicians can find good spots in these regions. As usual, 50 percent of the state's jobs are with NCGs, but 25 percent are with democratic private groups offering partnership. Look for some good slots in the Keys and St. Augustine.

Tennessee is the land of “who needs EM boards?” More than 70 percent of the openings won't require them. Nashville is a hot bed of opportunity, followed by Knoxville and even Memphis. Many positions will be in more rural areas of the state. North Carolina is hopping this year with positions around Charlotte, some on the coast, and even a few within a short drive to Asheville. Raleigh/Durham and Chapel Hill are still quiet, despite one group advertising to the contrary. The western Smoky Mountains will have some activity this year, and Georgia will have a spot or two in Atlanta and a few along the coast. Look for 50 percent with NCGs and only a few small groups.

In Mississippi, 65 percent accept primary care boards, and NCG penetration is 45 percent. The highest paying job I found so far is in a prison. For more on that, tune in next month for the compensation report. Alabama and South Carolina will each provide about 10 percent of the region's jobs with a few nice spots near Birmingham, in the southern panhandle area, and even one in Hilton Head, but as usual, nothing in Charleston. New Orleans is making a comeback with several openings through large and regional groups. The state has 50 percent NCG spots and about 45 percent primary care acceptance with positions all over the state. Arkansas and West Virginia will have sporadic openings with very high NCG employer numbers and more than 50 percent primary care board openings.

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The West/Southwest

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Like last year, Texas has the most job openings, but California is in the mix with 17 percent of the country's job openings. A very high 40 percent are open to primary care physicians, and 42 percent will be with NCGs in both states. Houston, San Antonio, Austin, and especially Dallas/Ft. Worth will offer strong opportunities. In contrast, jobs in the major California cities will be very thin, with most inland and in the valleys. If you're a wine lover, however, there are some opportunities mid-state and north in the Napa and Sonoma valleys.

Phoenix is hot this year, and the rest of Arizona has some opportunity north and south. Banner Health is the major employer, but many of the facilities contract with various groups. Look for a few nice spots in Oklahoma City and Tulsa and a few more rural sites. New Mexico's opportunity is primarily rural, with maybe one group hiring in Albuquerque. Nevada is all about Las Vegas, and the major employer there this year is EmCare. There is an academic spot in Denver, a few small groups in the west, and the usual openings in the east. I found a job or two in rural Utah and even in Hawaii, but don't expect those to be around for long.

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The Northeast

Fourteen percent of U.S. jobs are in this region, with New York in the lead offering 45 percent of the area's opportunities, including respectable showings in New York City and Long Island. Also expect to see some spots in Rochester and around the northern and western parts of the state. Only about 10 percent of the region's positions will accept primary care and fewer than that are with NCGs. Hospital employees are the primary status here.

Massachusetts and Maine will provide 15 percent each of the area's opportunities with some good jobs around Boston and a few along the Maine coast, including Bangor. Check Cape Cod and the beautiful Berkshires for positions, too. The other New England states will have activity as well, with more openings in Vermont than New Hampshire. Connecticut has strong opportunity scattered throughout the state, but Rhode Island is very quiet with an NCG job or two in Providence and a few other rural ones.

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The Middle Atlantic

Pennsylvania leads these six states with unprecedented amounts of opportunity in Philadelphia, the city of emergency physician love. Even Pittsburgh will see some activity, as will the rest of the state with fewer than 25 percent NCGs and very few small democratic groups. The Tidewater area of Virginia will be steaming from Richmond down to Virginia Beach, and the western part of the state is open, too.

A few jobs actually will turn up in Washington, D.C., this year. Surrounding Maryland is quiet, but look for positions in Baltimore and the western part of the state. The physician-owned group EMA is the major employer in New Jersey with 25 percent of the state's jobs, two in the New York metro area. Delaware continues to be sparse with only one or two opportunities.

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The Pacific Northwest

Fewer than four percent of the nation's jobs are in this area, with few or none in Seattle, Portland, and Boise. Look for some interesting coastal and inland spots from Northwest Emergency Physicians of Team Health. There will be a couple of slots in Tacoma area and on the Olympic peninsula.

You'll find higher than usual activity in Wyoming, primarily in central and eastern parts of the state. Montana will have jobs in Missoula, Bozeman, Helena, and, of course, the annual search in Butte goes on. Oregon has sporadic opportunity throughout the state, but major lifestyle areas are closed. Veterans Affairs in Anchorage has an ED opening or two.

The most interesting emergency physician job I've found this year is located in Idaho, which advertised itself this way: “Work from home as long as you live 10 minutes away. No experience required!” Words fail me!

© 2009 Lippincott Williams & Wilkins, Inc.

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