Would competitive specialties be competitive if everyone made the same?

[AR]

Plastics was lucrative, but I hated it toward the end. To this day, i have zero respect for cosmetic surgeons- be they actual plastic surgeons or the wanna-be crowd of Otos, Derms, and Ophthalmologists with the plastics -suffix. I might have been in the upper echelons of plastics earners, but I now regard it as a waste of a good mind and hands.

Facial Plastic Surgeons (oto) and Oculoplastic surgeons (ophtho) being "wanna-be" is quite the hot take.

[Hank]

There might be some things that are hard to get into that don’t pay that well, but I don’t know of hardly anything that’s easy to get into that pays a great amount.

[TheDangerZone]

Plastics was lucrative, but I hated it toward the end. To this day, i have zero respect for cosmetic surgeons- be they actual plastic surgeons or the wanna-be crowd of Otos, Derms, and Ophthalmologists with the plastics -suffix. I might have been in the upper echelons of plastics earners, but I now
regard it as a waste of a good mind and hands.

So, do you regret going into plastics? And to be clear, you’re saying you don’t respect the ones who just focus on cosmetics, right?

[Bdoc]

Plastics was lucrative, but I hated it toward the end. To this day, i have zero respect for cosmetic surgeons- be they actual plastic surgeons or the wanna-be crowd of Otos, Derms, and Ophthalmologists with the plastics -suffix. I might have been in the upper echelons of plastics earners, but I now
regard it as a waste of a good mind and hands.

This is also what bothers me. Are our "smartest minds" just giving botox all the time?

[Zaphod]

This is also what bothers me. Are our "smartest minds" just giving botox all the time?

Our smartest minds are rigging the market, seriously.

People performing cosmetic surgery are simply supplying services to a massive demand, and without that, you'd have a ton of underemployed surgeons, there literally isnt enough of the other work to employ 65% of the plastics out there. Recon is a super tiny amount of whats out there, and dwindling.

Self loathing plastics types like that are part of the problem, ceding ground to dentists and others that arent even remotely trained.

We provide a service, that is chosen, and our patients are super happy, satisifed and I dont give a ************************ what others think about it.

I will if you want to support my lifestyle and pay me in a way i see fit, otherwise, no. Just lame and counter productive to anything at all.

[CM]

[*] if you want standing in your community as a doctor - neurosurgeons and obstetricians get it, EM and pathology do not.

That's an interesting opinion.

[burritos]

This is also what bothers me. Are our "smartest minds" just giving botox all the time?

Well, honestly our smartest people should be teaching kids. But because of money, prestige, hierarchy, and parental pressure(for me at least), we are just doing academic custodial gymnastics using fancy snake oil/knives/gizmos to clean up crappy eating habits and sedentary lifestyles 95% of the time.

[xraygoggles]

This is also what bothers me. Are our "smartest minds" just giving botox all the time?

No - the smartest minds go into math, physics, and (most saliently) finance, as Zaphod mentioned above.

Hate to break it to you, but there are other fields out there that require a much higher amount of critical thinking & synthesizing acumen than the predominately algorithmically-based field which is medicine in general...

[Auric goldfinger]

So, do you regret going into plastics? And to be clear, you’re saying you don’t respect the ones who just focus on cosmetics, right?

I trained in general surgery, then 3 years of plastics, with fellowships in burn, craniofacial, hand, and micro vascular. So, you could say I was overqualified to do breast augmentations and face lifts. Reconstructive surgeons are to be respected. Unfortunately, cosmetics is the “dark side,” where it takes the technical acumen of a chimpanzee to do the procedures. After 4000+ augmentations it was a bit of an epiphany.

[medicoFIRE]

Correction. I think you mean the smartest minds should go into math and physics. And sometimes they go into finance but that’s a stretch to say the smartest minds go into finance over medicine as a blanket statement. I can’t prove this but I know it to be true- those in finance will have a lower IQ than physicians as a group. Even if you sample the top 5% most intelligent outliers, I also believe that it would show higher IQ in medicine vs. finance within this 5% group. Math and physics I can’t really dispute. The smartest minds should go into those fields. Whether that is the reality is debatable. But certainly if you sample the top 5% in those fields, it would undoubtedly show higher intelligence than medicine. Finance no way. Finance requires a rung seeking personality type. Finance nerds are maybe making good money but they arent making billions unless they are the top 0.0001% who created a company and happen to be brilliant.

[CM]

When we started our physical exam classes as second year students, the instructor asked us all what field we intended to choose. Having never given the subject much thought before that moment (yes, really), I immediately answered, "Cardiology." I'm not sure why, but cardiology was always much more interesting to me than other fields.

Nevertheless, I applied for an anesthesiology residency and landed my dream location (at that point in my life) for residency; LA. I chose anesthesiology because I expected a much better lifestyle in that field than cardiology. I never thought about money until my senior year (1985-1986) when someone told me that I'd be earning $120,000 in anesthesiology after a mere four more years of training. I thought that was a fortune, and had no idea what I might do with all of that money.

As an intern I was so interested in my CCU experience, that I decided I just couldn't go forward in anesthesia, so I called some folks at my alma mater and they took me on as a second year IM resident after internship. I rued that decision for many years.

However, after years of suffering, I now work only about 60 hours per week with no call. I might have an even better lifestyle in anesthesia, but for me, this is preferable. I enjoy the subject matter enough that I like reading on the weekends. I usually do CME questions online as I eat lunch at my desk during the week. I enjoy getting better at this job, but doubt I'd have the same enthusiasm for anesthesia.

[xraygoggles]

Correction. I think you mean the smartest minds should go into math and physics. And sometimes they go into finance but that’s a stretch to say the smartest minds go into finance over medicine as a blanket statement. I can’t prove this but I know it to be true- those in finance will have a lower IQ than physicians as a group. Even if you sample the top 5% most intelligent outliers, I also believe that it would show higher IQ in medicine vs. finance within this 5% group. Math and physics I can’t really dispute. The smartest minds should go into those fields. Whether that is the reality is debatable. But certainly if you sample the top 5% in those fields, it would undoubtedly show higher intelligence than medicine. Finance no way. Finance requires a rung seeking personality type. Finance nerds are maybe making good money but they arent making billions unless they are the top 0.0001% who created a company and happen to be brilliant.

Actually, if you look at any hedge fund, quant fund, prop trading desk, big bank, etc - the vast majority of people responsible for the "plumbing" of their setup (computer programs, algorithms, data science, etc) are whiz kid PhDs from various fields of high-level math and physics from Ivy Leagues.

It's not a good thing that the brightest minds who ideally should be going into other careers go straight into high finance because of the 7-8 figure payouts they can potentially make even after a year or two. It doesn't make the world a better place, but it's the truth.

[Hank]

Well, honestly our smartest people should be teaching kids. But because of money, prestige, hierarchy, and parental pressure(for me at least), we are just doing academic custodial gymnastics using fancy snake oil/knives/gizmos to clean up crappy eating habits and sedentary lifestyles 95% of the time.

Two or three generations ago we did have our smartest people teaching kids. Or at least the smartest people from one gender.

Frankly, I prefer today where women can be lawyers, surgeons, senators and so forth. Limiting career opportunities to teacher, nurse, and secretary resulted in very smart women working in those fields, at artificially low wages compared to the jobs those women would have filled a couple generations later.

[Brains428]

No - the smartest minds go into math, physics, and (most saliently) finance, as Zaphod mentioned above.

Hate to break it to you, but there are other fields out there that require a much higher amount of critical thinking & synthesizing acumen than the predominately algorithmically-based field which is medicine in general...

There is a decent amount of medicine that is merely toiling- doing something for the sake of doing something. Some actions driven by patients, some by physicians, some by malpractice.

It's how APPs can get similar outcomes to alot of problems with less knowledge. The human body can tolerate a lot (but not everything). (To add: I don't think APPs have the same level of knowledge or critical thinking skills, and the ones that are good have been working closely with a physician who has appropriately trained them to be an extension of the physician).

Anyways- in regards to the jobs that require middle of the night waking that med students haven't really thought about-- that sexy IR job all the smart students are gunning for.

Money does factor into some specialties chosen, but we can only know how good or bad something is looking backward. And much of what might have satisfied us in a specialty might get ruined by the practice setup one ends up in.

FM, PMNR, Psych all at least have some avenue for independent practice still. Hard to do in some fields (like rads).

[Shant]

How many bright people are expending their lives figuring out how to get people to click on ads? What a waste.