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How to pick a medical specialty - finances vs interest vs lifestyle

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  • jz
    replied
    Are you an introvert or extrovert?    If excess face-to-face time with masses of emotional  humanity drain your energy,  then seeing 30-50 patients daily in derm or ER or primary care will suck your soul dry.  If you need  the face-to-face time to charge up your energy,  then avoid rads, anesthesia, and pathology.

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  • shishka32
    replied




    Except it’s picking a specialty discussion. But thanks for clarification.
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    You're welcome. And finances is literally in the title of this thread.

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  • Complete_newbie
    replied
    Except it's picking a specialty discussion. But thanks for clarification.

    Leave a comment:


  • shishka32
    replied
    Thanks again everyone for the really great advice. I certainly have a lot to think about in the coming months.

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  • shishka32
    replied




    So this is now SDN ? Ok.
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    No, this is the White Coat Investor forums. Where med students to physicians to others discuss financial matters.

    Leave a comment:


  • Craigy
    replied
    Ortho question is an easy decision matrix--> Are you a meathead?  Then Ortho. 

    Just remember the ROAD to success:  Rads, Ophtho, Anesthesia and Derm, can't go wrong.   

    If nothing feels like it's your calling, at least pick one that pays well.  Then, at the very least, you'll have the financial wherewithal to pay off your student loans and go back to residency to change careers if you find out you hate your first choice.

    Leave a comment:


  • MochaDoc
    replied










    I was in a similar place, lots of interests but nothing grabbing me hard. For me I also was older with a family in tow… There is a book called  “choosing a medical specialty” which I found and made myself read all the way through even though I had some ideas.  Made me consider anesthesia (hadn’t even thought about it before) and it turned out to be my best match in terms of temperament and skills…check the book out and read it all the way through.
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    Would you mind including a link to the specific text you’re referencing? There are quite a few, at widely different price points, on Amazon and the internet.
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    https://www.amazon.com/Ultimate-Guide-Choosing-Medical-Specialty/dp/007141052X

     
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    I figured it was the $11 to $34 option. Thanks for the reply.

    A 3rd edition is available for anyone who's interested: https://www.amazon.com/Ultimate-Guide-Choosing-Medical-Specialty/dp/0071790276/ref=dp_ob_title_bk

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  • Kamban
    replied
    I feel that your work environment impacts your lifestyle as much if not more than the specialty you choose. One might love cardiology but if you end up being in a S***y PP group or end up being a hospital employee in a terrible hospital your job satisfaction, lifestyle and pay might be worse than as a rheumatologist or nephrologist in a good group making decent money.

    But if one happens to have an open mind and tries to enjoy the job and make it work for him / her, it can lead to a long term good outcome. At least that is what happened to me.

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  • AO
    replied







    I was in a similar place, lots of interests but nothing grabbing me hard. For me I also was older with a family in tow… There is a book called  “choosing a medical specialty” which I found and made myself read all the way through even though I had some ideas.  Made me consider anesthesia (hadn’t even thought about it before) and it turned out to be my best match in terms of temperament and skills…check the book out and read it all the way through.
    Click to expand…


    Would you mind including a link to the specific text you’re referencing? There are quite a few, at widely different price points, on Amazon and the internet.
    Click to expand...


    https://www.amazon.com/Ultimate-Guide-Choosing-Medical-Specialty/dp/007141052X

     

    Leave a comment:


  • Complete_newbie
    replied
    So this is now SDN ? Ok.

    Leave a comment:


  • HLM
    replied
    I just want to weigh in as one of the impoverished pediatricians.

    There are any number of things I find frustrating about my job and medicine in general (see my comment in the other thread about job satisfaction) but my pay actually isn't one of them.

    I'm a peds hospitalist who lives in a HCOL area with a stay at home husband and 2 kids and I find my pediatrician pay has worked out just fine. I was a bit spendy until recently and just started getting more serious about savings but none of that had anything to do with my salary. I'm sure I just would have spent more if I had made more!

    I make a little under $300K a year. I work all nights which gives me a little pay boost compared to my other colleagues but even my day time colleagues make around $250K.

    I know that in the grand scheme of doctor pay, we are at the bottom. But $250K with the lifestyle of a hospitalist is not bad at all. We work about 12 shifts a month and when we leave the hospital, we leave work behind which I love. No call! As hospitalists, we also have the flexibility to work more or less. Some people in my group work 0.75 FTE and work 8 days a month and others moonlight at community hospitals or urgent care clinics to boost pay because we have so much extra time available around our shifts.  The down side is weekends and holidays (and nights for those of my colleagues who hate those but that's not a problem for me). But nights and weekends and holidays are tough for most physicians to avoid.

    There's a lot of different things to do in peds hospital medicine too. You could be at an academic center with residents and fellows. You could be at a community hospital going to deliveries and seeing newborns. Or you could even do sedation in certain programs. Lots of flexibility.

    The only warning I would give about peds hospital medicine is that now that it is on it's way to being a board certified subspecialty, at some point in the near future you will need to do the a 2 year fellowship which is a time and money suck with no extra pay off. Fortunately for the old timers, none of us who got in years ago have to worry about that and will be grandfathered in if we take the exam once it exists. But definitely something to consider for young docs going forward.

     

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  • abds
    replied
    Interest > income > lifestyle

    If you don't have the interest, you'll either burn out or you will hate your life no matter how much you make or how much free time you have. You mention multiple times that you don't like call and you don't like long hours. I suggest thinking about it long and hard before you consider a surgical specialty. At the very least your training (between 5 and 10 years depending on specialty/subspecialty) will have a lot of both. Your life as an attending may as well but can also have very little call and good hours if you choose the right job and set your practice up that way.

    Which brings me to my next point: in my opinion, in the right job, income and lifestyle can both be tailored to whatever you want (especially in a private practice surgical specialty), and are somewhat inversely proportional. I know surgeons who are happy with their 300-400k income and work 3.5 days a week, and I know some that work 7am-8pm every day and bring in 2M. Some in each of those two extremes take no call and some choose to take a lot of call. In the right practice you can work really hard and make a lot of money when you're young and care more about income, and work less and make less when you're at a point where lifestyle matters more.

    From what I've seen, EM has a great balance of decent hours, a lot of time off, no call, and good pay. Anesthesia can have good hours, good pay, and variable call. Derm may have great pay and great hours but I would rather work construction than do dermatology. And to make everything more complicated, with the healthcare environment we live in none of the above is guaranteed. There are a lot of variables but make sure it's something you like and you can hopefully figure the rest out as you move along within whatever specialty you choose.

    Leave a comment:


  • AO
    replied
    I was thinking of Peds and then read the book I mentioned above, and realized Anesthesia was my tribe. Peds Anes is always an option and shorter training than Peds-based specialties (4 yrs +1 for Peds Anes vs 3 yrs +3 for Peds specialties). I chose Anes recognizing I could always do Peds Anes if I wanted to keep with kids. And re: the CRNA problem, less of an issue if you have specialty (i.e. Peds Anes) training in the field. I just wish I knew how much other peoples' saliva grosses me out before I chose this path as I deal with it every day. ICK. I didn't end up doing a peds Anes fellowship, btw, bc I wanted to join a certain practice that didn't need any more pedi people.

    Leave a comment:


  • shishka32
    replied
    Thank you all again. To the above two posters, I actually have a couple of days in ENT and PICU set up over the next couple of weeks with faculty. Maybe they will pull me in or push me away and keep whittling my list down.

    Leave a comment:


  • pulmdoc
    replied
    Lots of great advice already given. My personal opinion is that interest>lifestyle>income potential. If you pick derm despite rashes making you want to vomit, going to clinic every day is going to be punching the clock, and life is too short for that. Income potential can and will change. Lifestyle is negotiable, I know FP's working 70 hour weeks and general surgeons taking call 1x/month.

    You said you ruled out IM, keep in mind if you want to do GI, cards, pulm, etc you need to do IM first before a fellowship.

    Based on what you have shared as your interests, I would strongly consider peds ENT if you are a strong enough student to get into ENT. Work with kids, good mix of office and surgery, good pay, many more elective surgeries with significantly less potential for "8 hours in the OR on a Saturday night" call then other surgical specialties.

    Leave a comment:

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