We are all acutely aware of the pressures of working in Emergency Medicine. My opinions on ED overcrowding and risk taking by hospital management, fixated on KPI’s are on the public record, but 4 years down the track it seems nothing’s changed, if anything, things are getting worse. Here is another example of Emergency Physician’s under the pump, asking for help, and hospital management providing the usual conciliatory pat on the head, despite real dangers being expressed. What a shame we’ve let our specialty become a political football, we’ve let them impose the dreaded 4 hour rule on us, and we have our clinical risk levels determined by beaurecrats and pencil pushers. I won’t harp on about it, but for those planning to start a career in Emergency Medicine, or if you’ve already started and are about to sit the first part or fellowship exams, both of which require you to sacrifice a year or more of your life for the privilege of being left in charge of a hospital ED, have a good hard think about what you’re getting yourself into, and the potential cost to your personal and professional life, as it’s not for the faint hearted. And it’s not going to get better anytime soon. Anaesthetics, ICU or GP training sound attractive?