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Would you choose the same specialty today? -medical student seeking some advice

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  • Would you choose the same specialty today? -medical student seeking some advice

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  • #2




    I’m having a hard time deciding on career options, and was hoping to ask the opinions of physicians here.  I’m between Radiology and another field in medicine I like that is more clinical.  I overall don’t enjoy seeing patients as much as I thought I would, but much of that frustration centers around electronic charts, documentation, long note writing just for insurance requirements, etc. I realize that my perceptions as a student are somewhat skewed since I could hire a scribe or MAs to do some of that work and use dictation software as a private practice attending.

     

    I find Radiology really exciting, but I realize that 6 years and lots of studying involved won’t always be quite as exciting as seeing it for the first time as a student. I also love that it’s efficient and purely focused on medicine, plus I enjoy some of the image-guided procedures. I’ve heard very few radiologists say they’d want to pick anything else in medicine. The only possible downsides I’ve heard are the really fast pace in private practice and being on call.   The machine learning / deep neural networks developments concern me somewhat, since I’m planning for a career that will hopefully last a few decades in the future.  Obviously AI isn’t replacing radiology in the near term, but who knows how much software will develop in 20-30 years?

     

    Any thoughts from more experienced docs out there? Would you choose the same field?   If it matters, my other option also has a good income, with arguably a better lifestyle than radiology (no call, no evenings, no weekends). I feel thankful at least to get to choose between 2 good options, and I don’t think either one would necessarily be a bad choice. Thanks in advance!
    Click to expand...


    So what's the other option?  From your description, I think we can make a good guess, but it would probably help if you said what it was.  You would likely get more useful info that way.

    And why are you so reluctant to say what it is?

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    • #3
      I’m a radiologist in a busy private practice. If you enjoy both specialties equally I would choose the one with the better lifestyle...no call, evenings or weekends. If you enjoy radiology more go for it but realize especially in pp it’s not the lifestyle speciality that many medical students think it is(sort of like EM I suspect). Don’t get me wrong I’m not near as busy as the interventional cardiologist I know or my buddy that’s a trauma surgeon at a level 1 trauma center but it’s busy. Radiology in general has become shift work so I work a ton of evenings, weekends and holidays and the shifts are busy with little downtime. I rarely get lunch or dinner and if I’m not reading cases I’m protocolling studies, returning phone calls, reviewing cases for procedure etc.  I would still choose it again but I think when med students sit with me they are surprised that it’s not more “chill” as one student told me?. Yeah there’s no EMR or clinic to worry about but we have our annoyances too.

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      • #4
        Yes and no

         

        yes- it’s been an amazing career and provided me job stability and income security and the ability to provide for my parents, in laws, my own family, and have financial independence before 50.  These were things that were really important to me as a young person

        no-because now i would like more job flexibility and the career, while highly paid, does not offer easy part time work.

        but yes overall. I would do it again given the same circumstances.  No i wouldn’t encourage my children who will not need as much financially as i did to follow in my footsteps, or at least i would encourage them to consider a true academic career if their passion was in my life’s work.

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        • #5
          Whats the other specialty?

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          • #6
            The longer I do medicine the more I think the lifestyle thing is pretty over-rated outside of a few things.

            EM and Anesth are often cited, both are ok not great. EM sucks a lot more with a young kid. Those 4p-MN are no fun when baby wakes up at 6a sharp.

            Rads sounds like hard work and relatively high stress, weird medicolegal worries as well e.g. did you miss that little speck on the adrenal?

            Ophtho clinic sounds busy as ************************, sounds like the money comes mostly from volume.

            Psych seems ok, again a volume game and sounds like money isn't in psychoanalysis and digging deep but in med management.

             

            I still think the following are candidates for true lifestyle but don't have tons of inside info

            • Derm

            • Rad onc

            • Allergy

            • PMR

            • Pathology

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            • #7
              I would do Rads again (probably not IR), but knowing what I know now, if I were going into it today, there are two choices:

              Derm and Ortho. Are you surgical or not?

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              • #8
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                • #9
                  He's not done with training yet (close, but not yet) so I wasn't going to respond, but FWIW it's worth, my husband read just the title over my shoulder and said, "absolutely, yes." Radiology

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                  • #10




                    Thanks for the replies so far.  My other thought is pain management.  I love the fluoro-guided spinal procedures, but not so much racing through a busy clinic schedule each day of 20+ patients to keep up the volume. Again, this is mainly because of documentation/insurance denials/EMR issues (and somewhat the opioid crisis) that I see clinical physicians, especially pain management docs, dealing with on a daily basis.  I know some radiologists do MSK / pain management procedures as well.
                    Click to expand...


                    I would choose radiology over pain management but that’s just me. I have a friend who does pain management and 80% of what he does is clinic and 20% is the actual procedures you say you like. Not sure if that breakdown is true for most pain specialists but if so you’d better really like clinic.

                     

                    And yes...our IR doc do lots of pain management procedures.

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                    • #11
                      https://en.wikipedia.org/wiki/Tapestry_(Star_Trek:_The_Next_Generation) 

                      Yes - Realized in fourth year that I really enjoyed connecting and talking with my patients so moved from surgery to medicine.  Wanted to drive brown probes at first, but changed to General Internal Medicine during residency as it fit better with my preference for continuity of care arcs.

                      Finding the right field is one thing.  Another large factor is finding the right management/payor/patient mix that matches your goals.   In most cases, the if you match the first two, you'll be fine with everything else.

                       

                       

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                      • #12
                        Would I choose same specialty? 100% yes. Rad Onc is amazing. There's IM, Rads, Surg all rolled into one.

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                        • #13
                          8 yrs radiology private practice. It's very busy . There's little downtime and basically you need to fully concentrate 8-10-12 hrs continuously , so it's definitely not for everyone. However, I honestly cannot imagine doing anything else. I am grateful for my colleagues... I certainly wouldn't enjoy clinical medicine . Since I matched in radiology, I have thought about doing another specialty exactly zero times. Not sure how/if this helps .

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                          • #14




                            The longer I do medicine the more I think the lifestyle thing is pretty over-rated outside of a few things.

                            EM and Anesth are often cited, both are ok not great. EM sucks a lot more with a young kid. Those 4p-MN are no fun when baby wakes up at 6a sharp.

                            Rads sounds like hard work and relatively high stress, weird medicolegal worries as well e.g. did you miss that little speck on the adrenal?

                            Ophtho clinic sounds busy as ************************, sounds like the money comes mostly from volume.

                            Psych seems ok, again a volume game and sounds like money isn’t in psychoanalysis and digging deep but in med management.

                             

                            I still think the following are candidates for true lifestyle but don’t have tons of inside info

                            • Derm

                            • Rad onc

                            • Allergy

                            • PMR

                            • Pathology


                            Click to expand...


                            I get why derm is on your list, but it also makes its money in volume.  If you are going to knock out ophtho for volume, derm probably is not that different.

                            Rad Onc is terrific in lifestyle but job markets are all over the place.  You may dramatically limit where you can live, depending on market when you graduate.

                            occupational med can be good.  Wound can be good.  Lots of niche specialties that you never heard of if lifestyle is your focus. I don’t think there are too many where you merge high income with lifestyle though.  And different people certainly have different needs of loving how they spend their time rather than appreciating what it provides.

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                            • #15
                              I would still pick EM. I still consider it a lifestyle specialty strictly because of the time off that I have although your working hours can be sub-optimal. Maybe it's because I've gotten used to working evenings, nights, weekends, holidays, etc. It's fantastic to have random week days off. I can get all my errands done with hardly any traffic. I can easily schedule appointments and not have to worry about missing work. If I want to take a week long vacation every month, I can. It pays pretty well and I live a comfortable life. Whenever we get together with friends, nobody asks anybody else about crazy or awesome work stories. It's a challenging environment and encourages me to constantly learn to keep my knowledge base broad. It's one of the easiest, if not the easiest, specialties to do part-time. If I'm not working then I'm not working. Nobody is going to call me to come in.

                               

                              With that being said, it's a tough job and it isn't for anyone. You deal with all aspects of society. There's a very real chance that on any given shift, a patient is going to try to assault a staff member (it still blows my mind that we put up with this but that's a whole different thread). You deal with some of the most manipulative people out there. You deal with people that have been to every specialist imaginable without answers but want an answer right now...at 3am on Christmas morning. In order to be happy, the best thing you can do is to see the worst parts of a specialty. I know the worst parts of EM and I can deal with them.

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