Least stressful specialty?

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Originally Posted by SLUser11

Mad Libs case-in-point.

With the difference being that i am not a Psych resident, but have much respect for the emergencies and stressful situations they have. I'm in anesthesiology... the boring, non-stressful, "lifestyle" choice ;-)

Originally Posted by cchoukal

He said boredom can "eat you out." Awesome.

Who is this Boredom?

Peds clinic should be the most stress-free medical environment of them all. Well baby checks, Immunizations, URIs, Otitis media, and Sports Physicals. Throw in a rash or two, along with a case of ADHD, and you've got 98% of thier day covered. Communicate clearly with parents, keep dirty diapers out of your garbage can, and have pre-printed antibiotic Rx pads in your drawer, and your day should be a walk in the park.

Originally Posted by dobonedoc

Peds clinic should be the most stress-free medical environment of them all.

Too bad you have to see at least fifty patients a day to keep the doors open. So much for leisurely conversations with parents. Not to mention the incessant after-hours phone calls. Add to it the fact that infants can, and sometimes do, get real sick, real fast.

Every specialty has its own kind of stress.

Originally Posted by Blue Dog

Too bad you have to see at least fifty patients a day to keep the doors open. So much for leisurely conversations with parents. Not to mention the incessant after-hours phone calls. Add to it the fact that infants can, and sometimes do, get real sick, real fast.

Every specialty has its own kind of stress.

Path seems low stress. Or at least I don't know the stressful parts of it.

This is a load of crap. As a PGY-3 anesthesia resident, I can assure you there is stress associated with the field. Not 24/7, but I can count on multiple occasions when sh*t hits the fan in a split second.

Preventive medicine can be stressful depending on the job. if you work for a gov agency and your supervisor or other member of Board are not agreeing with you or no funding for your programs. Also if there's a public emergency it can get stressful for a public health PM doc. "People's lives are at stake doc, what should we do?"
Having no residency is stressful too. " oh gosh what do I do with my student loans?" believe me, this is the place you don't want to be in.
I agree with dr. blue dog and other posters- it depends on the person- on their skills, interests, weaknesses, strengths, etc.

Originally Posted by DrSnips

Path seems low stress. Or at least I don't know the stressful parts of it.

Surgeon is doing a whipple and sees a nodule on the liver. sends a frozen section. is it metastatic carcinoma (= death sentence = close the patient up and give condolences to his wife and kids) or is it a incidental bile duct hamartoma? answer!! right now!! with the surgeon sitting at the microscope right next to you.

or in my subspecialty (forensic) - dead baby with a few bruises on the head, minimal underlying brain injury. blunt force injury homicide or undetermined cause and manner? if you call it homicide and you're wrong, parents may go to jail, lose any other kids at home, and will be labeled baby-killers the rest of their life. miss the homicide and maybe you get another dead baby from the same couple in 3 years.

i'm making a point here obviously, but i happen to agree that path is probably lower stress than many fields. but we do have our stress-inducing moments.

Dermatology. I believe this is why dermatologists have the highest career satisfaction of any group of docs, when various organizations have done such surveys. It's a combination of the money being good and the stress being low. Of course, they do do procedures and that comes with a certain amount of stress, but my impression is if they are not sure about something, they can just biopsy it. Also, they are some of the few doctors who can still go into private practice.

People mentioned psych, ophtho and anesthesia. Psych can be stressful because patients get assaultive, homicidal or suicidal. Ophtho - you can blind the patient if you screw up...so I would say NOT low stress...at least on some occasions. Anesthesia...you can quickly kill the patient if you screw up...airway emergencies, drug rxns, etc. plus potentially getting yelled at by surgeons...and maybe a CRNA will take your job or you'll be forced to "supervise" one...so I would say NOT low stress, though anesthesia jobs vary in their level of stressfulness (I'd say CT anesthesia >> stress of working at an outpatient surgery center than staffs mostly minor surgery cases).

Psych is pretty low stress 99.9% of the time. Depends on your work environment.

The type of stress is also key. Intermittent, high level threat (as encountered in anesthesia), tends to be worse than constant lower level stress (ophtho or derm).

that's right, and then the call that really determines how the patient will be treated comes from a pathologist. and we pathologists all hear in residency how dermpath specimens are the most likely to lead to a lawsuit. and that's why most pathologists sign out derm specimens (especially melanocytic ones) incredibly conservatively. there are probably hundreds of thousands of needless re-excissions of moles that are called "mildly atypical" by the pathologist because they are covering their arse. so i reassert my contention that path is not low-stress much of the time.

Originally Posted by dragonfly99

Dermatology. I believe this is why dermatologists have the highest career satisfaction of any group of docs, when various organizations have done such surveys. It's a combination of the money being good and the stress being low. Of course, they do do procedures and that comes with a certain amount of stress, but my impression is if they are not sure about something, they can just biopsy it. Also, they are some of the few doctors who can still go into private practice.

People mentioned psych, ophtho and anesthesia. Psych can be stressful because patients get assaultive, homicidal or suicidal. Ophtho - you can blind the patient if you screw up...so I would say NOT low stress...at least on some occasions. Anesthesia...you can quickly kill the patient if you screw up...airway emergencies, drug rxns, etc. plus potentially getting yelled at by surgeons...and maybe a CRNA will take your job or you'll be forced to "supervise" one...so I would say NOT low stress, though anesthesia jobs vary in their level of stressfulness (I'd say CT anesthesia >> stress of working at an outpatient surgery center than staffs mostly minor surgery cases).

Originally Posted by Leukocyte

Most stressfull clinicals

1)OB/GYN (more stressfull if you are a male)
2)General Surgery
3)Pediatrics (Getting a "good" H&P can be challenging. Parents are breathing done your neck. Abuse confrontations and calling Child services).
4)IM

Least Stressful:

1)Psychiatry
2)Family Medicine
3)Anesthesiology
4)Radiology

Wow. I'll give you 1 and 2....but come on, PEDS and IM??

The only thing better than the necrobump is acting like it never happened.

Originally Posted by cowme

Wow. I'll give you 1 and 2....but come on, PEDS and IM??

Sure, I buy it...especially, believe it or not, for peds (coming from a peds sub). What do you perceive as not particularly stressful about those fields?

Originally Posted by colbgw02

The only thing better than the necrobump is acting like it never happened.

Amen to that. Anyone that thinks anesthesiology is a low stress field needs to lay off the crack pipe. Anesthesiology can be extremely stressful.

Originally Posted by Philo Beddo

Other than neuroleptic-malignant syndrome, which a psychiatrist is not going to admit to the hospital by themselves anyway, there is no psych "emergency" that can't be solved with haldol or ativan.

Philo

hippocritis.com <---medical satire for residents and medical students

Spoken like someone whose only psych exposure was during MS3 year.

You can't give haldol and ativan to someone in emotional distress locked in a bathroom stall with a loaded gun (true story)

You can't give haldol and ativan to someone while you're wrestling with them, trying to take their homemade noose from around their neck (Although they would have passed out before anything really happened)

What happens when the haldol and ativan doesn't work? It doesn't do the job for everyone

Regarding NMS, in my experience internal medicine is notoriously horrible at properly identifying NMS as well as treating it.

Other emergent issues include significant medication interactions, dystonia, NMS, SS, delirium that medicine insists is not delirium, anticholinergic delirium that medicine missed, etc.

Neurology is relatevely chill although not like derm or pmr or radonce.....strokes are obviously emergent but there is a lot of outpatient and most residencies have in home call for pgy3 if not both pgy2/3.

Originally Posted by DrSnips

Path seems low stress. Or at least I don't know the stressful parts of it.

Wait- you brought this SIX YEAR OLD thread back to rag on Pathology? And you called it low stress?

Bahhhhhhahahahahaha! Strong work dude.

Originally Posted by Leukocyte

Most stressfull clinicals

1)OB/GYN (more stressfull if you are a male)
2)General Surgery
3)Pediatrics (Getting a "good" H&P can be challenging. Parents are breathing done your neck. Abuse confrontations and calling Child services).
4)IM

Least Stressful:

1)Psychiatry
2)Family Medicine
3)Anesthesiology
4)Radiology

Ha...you have no clue. While a lot of time is not stressful, there is always the lawsuit in the back of your head since everything is stored in PACS and can be critiqued by anyone else at any time. Also, on call with the surgery team around you basically asking "OR or no?" is not at all fun.

Originally Posted by penguinophile

Also, on call with the surgery team around you basically asking "OR or no?" is not at all fun.

True. But to be fair, every single consult we get in surgery asks us the question, "OR or no?".

Originally Posted by Buzz Me

True. But to be fair, every single consult we get in surgery asks us the question, "OR or no?".

Yeah but you don't have a picture to lock you in. Rads is interesting in that it has no room for creativity or independent thought. There's a picture in front of you. Within that picture, an answer lies. Can you see it? Yes or no.

The people I know who went into rads aren't good with poems or metaphor. Also not the most enjoyable folk to kill a couple hours at a bar with. They're like human computers. Such is the nature of the work I guess. Better them than me.

I enjoy psychiatry, but there are stressful moments. Psychotic people aren't usually that difficult. Once in a while there's someone who's dangerous. I usually worry more about the nurses/med students than myself, but I'm a big guy and have worked in the field for a while so it doesn't spook me too badly.

What hasn't been mentioned is dealing with (1) patients with Borderline PD (2) parents in child psych and (3) insurance companies that like to not pay for mental health.

One bad interaction with a patient with Borderline Personality Disorder can mess with one's emotional equilibrium for a week.

Still though, I find psych continually interesting and that keeps me happy. Other fields (IM, Rads, FM, Peds) would bore me and I think that would be stressful for me after a while. It's a matter of personal preference.

Originally Posted by diagonal

Yeah but you don't have a picture to lock you in. Rads is interesting in that it has no room for creativity or independent thought. There's a picture in front of you. Within that picture, an answer lies. Can you see it? Yes or no.

I'm not sure you're giving radiologists quite enough credit. No test is 100% accurate and it's tough to pick out certain details on any given modality (e.g. CT for intraluminal GI pathology, or MRI for the pancreas). Quite a bit of independent thought - including analyzing the clinical picture and comparing the current study to previous ones - is required.

Originally Posted by BobA

I enjoy psychiatry, but there are stressful moments. Psychotic people aren't usually that difficult. Once in a while there's someone who's dangerous. I usually worry more about the nurses/med students than myself, but I'm a big guy and have worked in the field for a while so it doesn't spook me too badly.

What hasn't been mentioned is dealing with (1) patients with Borderline PD (2) parents in child psych and (3) insurance companies that like to not pay for mental health.

One bad interaction with a patient with Borderline Personality Disorder can mess with one's emotional equilibrium for a week.

Still though, I find psych continually interesting and that keeps me happy. Other fields (IM, Rads, FM, Peds) would bore me and I think that would be stressful for me after a while. It's a matter of personal preference.

I never had a chance to work with a borderline personality disorder patient but I'd be interested to meet one now that you brought it up.

Originally Posted by Buzz Me

I'm not sure you're giving radiologists quite enough credit. No test is 100% accurate and it's tough to pick out certain details on any given modality (e.g. CT for intraluminal GI pathology, or MRI for the pancreas). Quite a bit of independent thought - including analyzing the clinical picture and comparing the current study to previous ones - is required.

I agree. I think radiology is interesting and challenging but just not for me.

Originally Posted by penguinophile

Ha...you have no clue. While a lot of time is not stressful, there is always the lawsuit in the back of your head since everything is stored in PACS and can be critiqued by anyone else at any time. Also, on call with the surgery team around you basically asking "OR or no?" is not at all fun.

Same issue in pathology. Slides and paraffin blocks are generally stored forever (although if not stored well they do degrade over time). Very easy to pull a slide in hindsight and say a pathologist missed early dysplasia when you know they have metastatic carcinoma 8 years after the biopsy.

Originally Posted by mlw03

Same issue in pathology. Slides and paraffin blocks are generally stored forever (although if not stored well they do degrade over time). Very easy to pull a slide in hindsight and say a pathologist missed early dysplasia when you know they have metastatic carcinoma 8 years after the biopsy.

Just so I understand, the arguments for pathology and radiology being higher-stress than other specialties are that 1) the record of their work is stored forever and 2) they worry about lawsuits?

It takes a very neurotic person to worry that much about lawsuits. Rads is about average for malpractice claims, so I'm not sure why all the concerns. The stressful part of radiology I think is how busy it has become on call.

It is pretty much nonstop from the second you walk in the door. The list of pending studies grows no matter how fast you fight it, you have to decide between which of 10 STAT studies to read first, while getting paged every minute in the middle of a study.

Originally Posted by diagonal

Yeah but you don't have a picture to lock you in. Rads is interesting in that it has no room for creativity or independent thought. There's a picture in front of you. Within that picture, an answer lies. Can you see it? Yes or no.

The people I know who went into rads aren't good with poems or metaphor. Also not the most enjoyable folk to kill a couple hours at a bar with. They're like human computers. Such is the nature of the work I guess. Better them than me.

I think its quite the opposite actually. Sure there is a learning curve for search patterns and then pathology pattern recognition, but often seeing the abnormality isn't the tough part many times. Its providing a differential diagnoses that is clinically relevant and requires independent thought and creativity.

[QUOTE=wannabeOBGYN;12596557]I never had a chance to work with a borderline personality disorder patient but I'd be interested to meet one now that you brought it up.

I think the movie Girl Interrupted does a decent job of showing Borderline pathology. It's a good movie and worth watching just for entertainment. Note though that it's not an accurate depiction of modern psychiatry (but it may have represented psychiatry at the time it was set)

Originally Posted by Tic

Just so I understand, the arguments for pathology and radiology being higher-stress than other specialties are that 1) the record of their work is stored forever and 2) they worry about lawsuits?

That's part of the stress, yes. I just came out of path residency, and not a day went by that I didn't see an attending make decisions based on fear of a lawsuit, such as a very clearcut diagnosis on H&E getting $500 worth of immunostains to confirm it because that's the standard now and if you don't do it and the case goes to trial, pathologist would have a hard time defending not having done it. Saw it EVERY. SINGLE. DAY.

Originally Posted by mlw03

That's part of the stress, yes. I just came out of path residency, and not a day went by that I didn't see an attending make decisions based on fear of a lawsuit, such as a very clearcut diagnosis on H&E getting $500 worth of immunostains to confirm it because that's the standard now and if you don't do it and the case goes to trial, pathologist would have a hard time defending not having done it. Saw it EVERY. SINGLE. DAY.

Defensive medicine is practiced daily in every specialty. Yes, the record is there for a long time in rads and path, but there is a statute of limitations on tort claims and it's usually only 2-4 years depending on the state.

Originally Posted by Dumb

Defensive medicine is practiced daily in every specialty. Yes, the record is there for a long time in rads and path, but there is a statute of limitations on tort claims and it's usually only 2-4 years depending on the state.

For some things though, the statute of limitations doesn't begin until the patient finds out about the error. If you don't get diagnosed with cancer until several years later, the clock might start ticking then. Also, with children, there can be a significant extension to the duration.

Here's a website that breaks it down by state - http://www.edgarsnyder.com/statute-l...ons/index.html

Originally Posted by Horticulture

What would you say is the least stressful specialty?

Epidemiology.
Dermatology.

Originally Posted by Horticulture

What would you say is the least stressful specialty?

Oh, I would have to say neurosurgery or trauma surgery, with FP or Derm being the MOST stressful

In general, podiatry is not very stressful. I could mad lib a few exceptions of course, but in general not too bad.

Originally Posted by genius19971995

Oh, I would have to say neurosurgery or trauma surgery, with FP or Derm being the MOST stressful

FP = family practice or forensic pathology?

I don't think primary care is super low stress...fp is family practice I'm sure...
remember they have to deal with a crapload of stuff in a short patient visit and get reamed with all the insurance company preapproval crap, patients asking for FMLA paperwork and disability paperwork and forms to get their power scooter for free, etc. Not that a lot of people die or crump in primary care clinic, but it's not what I would call "easy".
Nobody has mentioned urology as a low stress specialty...I guess things could get tense in the OR sometimes, but I feel like it's probably on the low stress end for surgical specialties...
I would put derm, endocrine, allergy/immunology and derm on the low stress end of the spectrum.

i'll agree with derm being low-stress. seems like equation in derm is simple: patient present with complaint. give steroid or anti-fungal. if it doesn't get better, biopsy it and put the onus on the dermatopathologist to make a real diagnosis. that's obviously a bit tongue-in-cheek, and of course there are a few derm emergencies, ie SJS. but all-in-all, not too bad it seems, and great pay.

Originally Posted by dragonfly99

Nobody has mentioned urology as a low stress specialty...I guess things could get tense in the OR sometimes, but I feel like it's probably on the low stress end for surgical specialties...

ever seen the dorsal vein complex bleed in a prostatectomy? Oh my God....not sure I've ever seen that much blood well up that fast.

Originally Posted by Skip Intro

I'd have to say, on the whole, anesthesiology offers the best stress/reimbursement ratio (but, I'm a little biased). You focus on one patient (i.e., problem) at a time. There are moments of terror, but there are hours of boredom too. Probably the biggest stress is the difficult surgeon who wanted to start the GB 20 minutes ago and you've got a 450lb patient trying to do an awake intubation on the table (and I was involved in such a case during med school). That's stress. Otherwise, low key. And, at least right now, it pays pretty damn well. Or, maybe you'll have to check with me again in 4 years.

Just my $0.02.

-Skip

I'm an ologists and I'll tell you right now that anesthesia is not stress free. On the contrary it is one of the more stressful specialties. With every case you are responsible for someone's life. Pt are sick, things happen quickly, surgeons can be difficult to deal with, complications can be devastating. You may be in charge of four rooms at the same time and not only do you have to worry about the pt but also the Crna if you don't have a good one. Just a brief view into anesthesia. Do not go into anesthesia thinking its stress free or a lifestyle specialty or that you may make a lot of money (money may decrease in the future). As an ologists your mistakes can quickly kill or harm someone for life. The amount of responsibility is awsome. But thats what makes us bad a@@. Enjoy.

Psych for sure. There's so little accountability in inpatient psych. It's like let's try every medication and dose we can think of (there aren't that many) and see what sticks. The patient is crazy and can't even sue you.

You just have to get over the smell of urine and the loud crazy people (until you knock them out with anti-psychotics and trazodone). The most stressed person on the psych ward: the social worker.

Anesthesiology is definitely stressful. Any field with instant reckoning is bound to be stressful.

Originally Posted by naus

Psych for sure. There's so little accountability in inpatient psych. It's like let's try every medication and dose we can think of (there aren't that many) and see what sticks. The patient is crazy and can't even sue you.

You just have to get over the smell of urine and the loud crazy people (until you knock them out with anti-psychotics and trazodone). The most stressed person on the psych ward: the social worker.

Anesthesiology is definitely stressful. Any field with instant reckoning is bound to be stressful.

My dad's a psychiatrist and even though he does consults at a hospital, he mainly sees patients in the office (outpatient). He says that one of the worst parts of psych is the drug addicts. They come to the office and they demand drugs. They threaten the doc and the secretaries. They make annoying phone calls. They act crazy. It's not pretty and very energy draining.

i agree...theres alot of %%%% on here to be honest

Originally Posted by naus

Anesthesiology is definitely stressful. Any field with instant reckoning is bound to be stressful.

i have no idea why people believe that being an "OLOGIST" is not stressful. My coronaries and adrenals are tested constantly.

Instant reckoning is NOT GOOD..
I would be ok with all of it if everyone else believed i work hard, but everyone thinks the anesthesiologist does nothing

In my experience, the least stressed looking residents seems to be psych, path, and pm&r. This may be a reflection of who the residency attracts as much as the residency itself.

Originally Posted by Horticulture

What would you say is the least stressful specialty?

Also very program dependent. I consider my specialty "lower stress" but thanks to my program expanding without increasing the number of residents it sure seems to be more stressful. I recall interviewing at locations that may have been less desirable but also definitely less stressful.

Originally Posted by notdeadyet

In my experience, the least stressed looking residents seems to be psych, path, and pm&r. This may be a reflection of who the residency attracts as much as the residency itself.

Well, I'm a pathologist, and path can be low-stress at times, quite high-stress at others, for reasons I've discussed above.