The downsides are the hours of work. You work a mandatory 50 hours per week. Soon after being hired you will work at least 60 hours per week. If you really want to be promoted and succeed then you will have to come on your days off. If you care about family time then this is a bad job for you. You will spend at least 1 year and a half before being promoted to a higher position with weekends off. If there are hurricanes then you will have to stay and live at the hospital. Any natural disaster and you will not be allowed to leave. This can cost you your job. The hospitals are in the business of keeping patients and making money. They will not transport patients because it can mean losing money. You will be scrubbing out toilets and cleaning floors etc during natural disasters. It is hard to picture this when you own a business degree. As an Operations Manager it is a very challenging career both physically and mentally. They expect you to complete your paper work but you are only allowed in the office for 20% of your day. The rest of the day you have to be out and about inspecting every inch of the hospital. That is the reason you need to come to work on your days off. On your days off you are completing the office work that is needed on a daily basis.