Mayo Regional Hospital is a 25 bed CAH in Dover-Foxcroft, Maine, just 35 miles north of Bangor. We see approximately 11,000 patients annually in our level III ED, without large seasonal variation. We staff the department full-time with a single qualified EM provider, either a physician or PA-C. Our day shift is from 0700 through 1900, the night shift is from 1800 through 0700. Full-time providers work three shifts weekly. Although much of what we see in the ED could be managed in an office setting, the providers need to have the critical recognition skills for those who are acutely ill and require hospitalization, as well as be able to implement independently those life-saving skills (intubation, ACLS, thrombolysis) that can be essential to resuscitation. We are only 40 miles from Eastern Maine Medical Center, a tertiary care facility in Bangor. We transfer cases to them that we can’t safely handle here (i.e. multiple trauma, complicated orthopedics, severe sepsis, and STEMi patients after thrombolysis) and are able to do that either by ground or air transport. The ED has telemedicine capacity with them for all of their trauma surgeons, pediatric ICU physicians, and Neurology for telestroke consultation. Benefits include group health and dental, 403(b) retirement program with employer match, educational loan payback eligibility, and a generous paid time off program.