Choosing where to practice is one of the most important career decisions for emergency and hospital medicine physicians. While every setting has its merits, large city and metro health systems offer advantages in expanding clinical knowledge, increasing income potential, and providing a collaborative work environment.

As you decide on your future professional path, have you considered how well a large health system would fit your objectives?

Developing Your Clinical Skills 

Emergency and Hospital Medicine clinicians in metro health systems encounter a broad spectrum of cases, from routine admissions to complex, multidisciplinary situations. Access to trauma centers, subspecialists, and advanced technologies allows doctors to practice at the top of their licensure and stay at the forefront of medical advancements.

Metro hospitals enable specialization, unlike smaller settings where physicians may need to cover a broader range of cases due to resource limitations. This means doctors can hone their expertise in high-acuity care and apply the latest treatments.

“Physicians and Advanced Practice Providers in large health systems gain exposure to advanced clinical practices,” says Kevin Yerovsek, Senior Director of Recruiting. “The complexity of cases and collaborative environment accelerate clinical growth.”

Hospitalists in a large health system benefit from consulting subspecialists, working with intensivists, and following research-driven treatment plans. These practices improve patient outcomes and enhance professional development.

Professional Collaboration and Career Growth

Large health systems foster a team-based approach, reducing individual clinician workload and promoting collaboration with nurses, support staff, and specialists.

This environment strengthens professional networks and opens doors to opportunities for medical leadership, mentoring, and research. Clinicians can also enhance their careers by engaging in public health initiatives, teaching, and advocacy efforts.

“Large health systems serve as anchors within their communities,” explains Kelli Younker, Manager of Clinician Recruiting. “Our physicians and APPs often take on leadership roles that shape healthcare policies and improve patient care.”

Work-Life Balance and Lifestyle Advantages

Younger clinicians increasingly prioritize work-life balance, and large health systems are adapting innovative scheduling models to meet these needs.

Unlike smaller settings, which can place greater demands on time and energy, metro-based hospitals offer clinicians a well-rounded lifestyle with flexible scheduling and telemedicine options, helping reduce burnout.

Additionally, metro hospitals offer competitive salaries and substantial benefits, making urban living more accessible. According to the Medscape Physician Compensation Report 2024 (login required), physicians in metro areas earn 10-15% more than their counterparts in smaller markets, even after factoring in the cost of living.

Kevin Yerovsek highlights these benefits: “While urban areas may have a reputation for higher costs, large metro health systems balance this through strong compensation and comprehensive benefits, allowing clinicians to enjoy a vibrant lifestyle without financial strain.”

Beyond salary, city life provides:

• Top-tier restaurants, entertainment, and cultural attractions.
• Career opportunities for spouses or partners.
• Convenient access to major airports and public transportation.

Professional Development and Leadership Prospects 

Whether in a suburban setting or bustling city center, metro locations offer EM and HM clinicians proximity to high-quality hospitals and career growth opportunities.

For instance, large health systems provide structured career paths in leadership, administration, and academics. Many are affiliated with medical schools, offering teaching prospects and access to research initiatives. Those interested in leadership roles can move into hospital administration, quality improvement, or department leadership.

In addition, clinicians in large health systems frequently have opportunities to apply Core’s first principles thinking by reimagining workflows and protocols. Participating directly in quality-improvement initiatives, they develop innovative methods to streamline patient care, optimize processes, and elevate clinical standards.

Impact on Patient Care 

Large health systems provide clinicians with the necessary resources to deliver exceptional care. These systems, including integrated hospitalist programs and cutting-edge technology, support medical professionals in making informed, efficient decisions.

Metro hospitals also enable immediate access to specialized therapies, reducing the need for patient transfers and improving clinical outcomes. Structured emergency department systems and hospitalist support teams streamline workflows, allowing doctors to focus on patient care rather than administrative burdens.

“Our clinicians often express how fulfilling it is to practice in environments equipped to deliver immediate, specialized patient care,” says Younker. “The streamlined processes and technology-driven support foster faster, more informed decision-making.”

Is a Large Metro Health System Right for You?

For many Eemergency and Hospital Medicine doctors, the advantages of a metro hospital or health system outweigh the alternatives. Key benefits include:

• Exposure to diverse, high-acuity cases.
• Strong professional collaboration and leadership pathways.
• Competitive compensation and comprehensive benefits.
• Better work-life balance with urban lifestyle perks.

However, choosing a practice environment is a personal decision. To determine if a metro hospital aligns with your career goals, consider the following:

• Do you want exposure to a broad spectrum of cases, from routine to complex?
• Are you interested in using the latest medical technology?
• Do you want to specialize in a particular area of Emergency or Hospital Medicine?
• Are you interested in teaching, research, or leadership roles?
• Do you prefer an urban environment with cultural and recreational opportunities?
• Do you want to engage in clinical research, publish peer-reviewed articles, or contribute to medical innovation?
• Do you want to build a broad professional network with peers, mentors, and leaders in your field?

“Clinicians should carefully evaluate how their goals align with opportunities in large health systems,” concludes Younker. “Shadowing, networking, or speaking with current metro-based physicians can provide valuable insights.”

Next Steps

• Speak with clinicians who have switched into metropolitan-based health systems.
• Look at employment in academic medical centers and major hospitals.
• Consider shadowing or completing residency rotations in big health systems to see the surroundings.

You own your career — where will you take it next? 

At Core, we recognize that clinicians value autonomy, work-life balance, and meaningful engagement. We used that knowledge to build a recruitment model that aligns physicians with positions that fit their personal and professional goals, fostering long-term satisfaction and retention.

Ready to explore whether a metropolitan opportunity is right for you? Schedule a 15-minute call with Kevin Yerovsek and take the first step toward finding the career path that fits you best.