Medical Student Specialty Selection Dilemma

[investmentminded]

I am a 26 year old 3rd year med student with no debt having some trouble choosing a specialty. I truly enjoy pediatrics and would fully intend on doing a fellowship such as picu/nicu, cardiology or GI. I also have some interest in anesthesia, however, it does not give me the gratification that pediatrics does. As an example, 2019 MGMA numbers show picu with a median salary around 330k and anesthesia around 450k. Is there a significant financial and quality of life difference in those salaries? My mentors have told me that medicine eventually becomes just a job and choosing based on what is more "rewarding" can lead to financial regret later in life when you start a family. In addition, my partner is not a "high earner" and we would be a single income family.

In short, I "really" enjoy peds and "kind of enjoy" anesthesia, but do not hate either. Peds subspecialty would not only pay less but would take 2 extra years of training compared to general anesthesia. If it just becomes a job in the end, is it really the rational choice to choose peds even though it might make me marginally happier in the short run.

[artemis]

If you really enjoy Peds, that is the specialty you should choose. Your best financial asset is a long career, and that is more likely if you are doing something you actually enjoy (rather than merely tolerate).

[Lordosis]

How much debt do you expect to have? I might be swayed into a higher paying field if otherwise you will be crippled financially. But if you have low to moderate amount of debt then pick what you like more. Being happy at work is huge.

Also median salaries are helpful but do not tell the full story. Different areas of the country compensate differently. Some fields/jobs make it easier to work more for more money.

[investmentminded]

How much debt do you expect to have? I might be swayed into a higher paying field if otherwise you will be crippled financially. But if you have low to moderate amount of debt then pick what you like more. Being happy at work is huge.

Also median salaries are helpful but do not tell the full story. Different areas of the country compensate differently. Some fields/jobs make it easier to work more for more money.

I mentioned in my post that I have zero debt, this is something that allows me some flexibility. However, i do have certain hobbies that can be very expensive.

[artemis]

If you have no medical school debt and can't manage to raise a family on $330k, you have a problem. Most American families (even in HCOL areas) make it on far, far less.

Pick happiness, and choose Peds. Your older self will be happy that you did!

[CordMcNally]

What are your ultimate goals? I know you’re still early but being ‘stuck’ in medicine is very common among practicing physicians. Find the highest paying specialty that you enjoy (or at least can live with the downsides of that specialty), live within your means, and opportunities will present themselves with your financial astuteness.

[F0017S0]

OP, PhD Clinical Researcher here: if you like working with children, do pediatrics. Example: had a long day and a kid ran down the hall and challenged me to a race. Ran the race with the kid because it made the day just a little nicer for everybody. Especially with no debt, you shouldn’t feel forced into a career that you “tolerate”.

[CordMcNally]

OP, PhD Clinical Researcher here: if you like working with children, do pediatrics. Example: had a long day and a kid ran down the hall and challenged me to a race. Ran the race with the kid because it made the day just a little nicer for everybody. Especially with no debt, you shouldn’t feel forced into a career that you “tolerate”.

I have drunks challenge me to all kinds of things so those interactions aren’t just in Peds.

[F0017S0]

I have drunks challenge me to all kinds of things so those interactions aren’t just in Peds.

Fair enough. I guess we all get to have our fun with our patients.

[artemis]

OP, PhD Clinical Researcher here: if you like working with children, do pediatrics. Example: had a long day and a kid ran down the hall and challenged me to a race. Ran the race with the kid because it made the day just a little nicer for everybody. Especially with no debt, you shouldn’t feel forced into a career that you “tolerate”.

Exactly. With no medical school debt, the only golden handcuffs the OP might end up wearing are the ones he puts on himself. If he lives like a middle-class person, he can always quit medicine entirely and do something else should he come to hate it. As long as he avoids adopting the "doctor lifestyle," the world is his oyster. So he might as well pick the field in medicine he really enjoys, have a long and happy career, and retire at least moderately wealthy.

[bovie]

No debt, you say? And you really enjoy pediatrics? Seems you have your answer.

[Lordosis]

I mentioned in my post that I have zero debt, this is something that allows me some flexibility. However, i do have certain hobbies that can be very expensive.

Well if that is the case definitely do whatever you want. Even Gen peds making 250K can live great without debt dragging you down.

Whatever your hobbies are just save 20% and spend the rest. Have fun!

[Hank]

No debt, you say? And you really enjoy pediatrics? Seems you have your answer.

Kids are great! Now some of the parents on the other hand…

[jfoxcpacfp]

I have drunks challenge me to all kinds of things so those interactions aren’t just in Peds.

Oh, my, you don’t know how much good that post did me😂!

I say pick the specialty that will give you the greatest chance at JOY while having an affordable lifestyle. I know some docs who are just frustrated schoolteachers (or even academics at heart) and I actually feel sorry for them. Maybe that is who is “mentoring” you. Life is not a game of golf and you don’t get mulligans; make the choices that will help you spend your finite number of days filled with purpose. Plenty of clients in our practice who simply love what they do simply because of the joy of practicing. You’ll look back and remember this thread one day. I hope it is with a heart filled with gratitude that you made the right choice.

[Anne]

It’s only October of your 3rd year…i wouldn’t stress too much yet.

what do you love about peds? Working with kids themselves? A specific subset of pathology? The general atmosphere of children’s hospitals? The attitude of healthcare workers who work in pediatrics compared with those who work in adult medicine?

what do you kind of sort of like about anesthesiology?

what specialties have you not encountered yet that you might like?

consider future lifestyle and potential practice settings as well as income…e.g. how difficult is it to find a position where you can avoid nights/call/weekends/holidays/whatever your kryptonite is. How easy is it to find a position in whatever your desired setting is (urban/rural/whatever). How easy is it to find a part-time position when you realize you have plenty of money but still want to practice at a more leisurely schedule. How likely are you to want to be your own boss vs employed, work solo or in a group.

I don’t know if it’s possible to know your priorities 15-30 years in the future. I know the view that my 26 year old self had of what my 40 year old self would want did not turn out to be very accurate.

basically my advice is to consider lifestyle factors as strongly as you do income and don’t get mentally locked into something too early, keep an open mind. And if you find something you really love doing, do it. You might not still love it at age 50 the way you once did, but really loving what you do for at least part of your career is worth quite a bit.