Are there any "lifestyle" specialties left?

SDN Members don't see this ad. (About Ads)

Originally Posted by IJL

This is all well and good, but I am likely just smarter than you ---> less time studying and reading for me. Sorry, just the way it is.

lol what year are you? Wait until you get some real responsibility to even talk and you'll see just how little you know. We are not talking about studying for an exam or NBME shelf, we're talking about real studying, knowing your stuff so you don't hurt people or do unnecessary things for people.

Sorry, your intelligence won't just download information to your brain, you actually have to work for it. Hope you dont fall too hard when your superiors will point out at some point how little you know.

Originally Posted by KnuxNole

What's wrong with viewing medicine as simply a job? Because....it IS a job. You'll find that 90% of med students feel this way too. It's not like doctors out there walk around thinking they are answering a calling every waking second lol

I'm not saying you're wrong, but I'm curious if you were upfront about considering medicine simply a job when you were interviewing for medical school.

Originally Posted by phltz

I'm not saying you're wrong, but I'm curious if you were upfront about considering medicine simply a job when you were interviewing for medical school.

Well I didn't say it was my calling lol. But, of course I didn't just say it was just a day job, since...people interpret things differently and catering to "professionals" are a bit different.

Originally Posted by phltz

I'm not saying you're wrong, but I'm curious if you were upfront about considering medicine simply a job when you were interviewing for medical school.

I told the admissions committees what they wanted to hear. What else would I have told them? The truth? Lol

Originally Posted by KnuxNole

What's wrong with viewing medicine as simply a job? Because....it IS a job. You'll find that 90% of med students feel this way too. It's not like doctors out there walk around thinking they are answering a calling every waking second lol

It is perceived as "just a job", but many of those people have never had any other real world job for a stretch of time. It is a job that many of us invest far more time and effort into than other jobs. Sure, there are docs out there that clock punch. Overall, I think we have a skewed perspective on what a "job" entails. Very few of us are great at completely shutting out our work world from the rest of our life. It all blurs together. Many of us hold our identity pretty friggin close to our title. My friends that code all day may think about a problem and work a lot of hours, but I know they also don't get kept up worrying if what they did was the right decision or if their script is doing alright.

I don't think we are god's gift or beautiful snowflakes or any of that junk, but I do think the nature of our chosen path makes it more of a "career" or "profession" than a simple job.

Originally Posted by IJL

This is all well and good, but I am likely just smarter than you ---> less time studying and reading for me. Sorry, just the way it is.

Smarter? Maybe.

Douchier? Definitely.

Originally Posted by IJL

I told the admissions committees what they wanted to hear. What else would I have told them? The truth? Lol

People with your attitude succeed in the short-term off of talent and manipulation. Yet, eventually your insincerity will be revealed and your patients and/or colleagues will want to avoid you.

Originally Posted by JackShephard MD

People with your attitude succeed in the short-term off of talent and manipulation. Yet, eventually your insincerity will be revealed and your patients and/or colleagues will want to avoid you.

I'm pretty sure most of us told some half truths to get into medicine. Do I love the challenge, working with people, and helping people? Of course. Do I also like the prospect of being in the 1% of earners, insane job security, and prestige too? Of course as well, but I didn't state those during interview date.

Originally Posted by thomprya

I'm pretty sure most of us told some half truths to get into medicine. Do I love the challenge, working with people, and helping people? Of course. Do I also like the prospect of being in the 1% of earners, insane job security, and prestige too? Of course as well, but I didn't state those during interview date.

There's a difference between presenting your best self and lying. Choosing to display your strongest qualities is not being untruthful, lying about your motivations is.

Originally Posted by Slack3r

Lol, oh ya?

Hey slacker does it really matter if I hate my girlfriend? I mean it's not really necessary to actually like the person you're with right?

Edit: my bad dude I completely misread your post

People in here are ridiculous. I don't understand the pre-med/med student thought process where they convince themselves they need to be masochists to be good physicians. There is absolutely nothing wrong with wanting the highest pay possible at the lowest amount of work possible, as long as you do your absolute best to treat/take care of patients when you're there.

In my opinion, there is nothing more important than the work-life balance. If you make medicine everything in your life, you're bound to be miserable at some point. I'm sorry but my wife and children will take precedence over my work hours... and being in a specialty that allows me to adhere to this rule is very important to me. I also feel the responsibility to bring home as much income as possible for my family's future financial security. People in certain other fields work a lot less than the laziest physicians and make a whole lot more. Spare me the criticism about how I'm a terrible person for feeling this way

Originally Posted by JackShephard MD

There's a difference between presenting your best self and lying. Choosing to display your strongest qualities is not being untruthful, lying about your motivations is.

I don't think anyone is defending blatantly lying to an ADCOM. That is 100% wrong. Most people wouldn't even think about doing this, but a few definitely do. I think people try to present themselves in the most positive light even if all they did was stand there and watch other people do things (not too different than med school anyway... lol). You have to do this in your interviews to succeed. That's a fact.

Originally Posted by RadicalRadon

People in here are ridiculous. I don't understand the pre-med/med student thought process where they convince themselves they need to be masochists to be good physicians. There is absolutely nothing wrong with wanting the highest pay possible at the lowest amount of work possible, as long as you do your absolute best to treat/take care of patients when you're there.

In my opinion, there is nothing more important than the work-life balance. If you make medicine everything in your life, you're bound to be miserable at some point. I'm sorry but my wife and children will take precedence over my work hours... and being in a specialty that allows me to adhere to this rule is very important to me. I also feel the responsibility to bring home as much income as possible for my family's future financial security. People in certain other fields work a lot less than the laziest physicians and make a whole lot more. Spare me the criticism about how I'm a terrible person for feeling this way

I agree with all of this. At the same time, the OP lauded his laziness as a driver of choosing a field. Which doesn't seem right. Secondly, how many hours are you talking about? Many fields work ~60 hrs a week, even surgeons. You can be balanced working that much. I think you're polarizing the other stance saying they place work in front of family. No one mentioned that.

Originally Posted by JackShephard MD

I agree with all of this. At the same time, the OP lauded his laziness as a driver of choosing a field. Which doesn't seem right. Secondly, how many hours are you talking about? Many fields work ~60 hrs a week, even surgeons. You can be balanced working that much. I think you're polarizing the other stance saying they place work in front of family. No one mentioned that.

lol, it's not at all easy to be balanced in your life if you're working 60hrs/week... even as an attending. Say no weekends. That means a minimum of 12hr/day. That means 6am to 6pm or 7am to 7pm everyday. This is just time in the hospital and doesn't include potentially 25-45min of commuting time, which is not at all uncommon.

How much time does that leave you with your wife and kids? I'd rather not be walking in exhausted on the evenings and spending maybe 1-2 hours with my family. A 60hr work week isn't really all that balanced. 50 hours is manageable. Those 10 hours make a huge difference in quality of life and how well you know your kids while they grow up lol. See how you feel when you're an exhausted attending putting in 12 hours on every work day.

Now, imagine your wife is a doctor too with similar hours (also fairly common)... now, tell me who raises the kids?

Originally Posted by RadicalRadon

People in here are ridiculous. I don't understand the pre-med/med student thought process where they convince themselves they need to be masochists to be good physicians. There is absolutely nothing wrong with wanting the highest pay possible at the lowest amount of work possible, as long as you do your absolute best to treat/take care of patients when you're there.

In my opinion, there is nothing more important than the work-life balance. If you make medicine everything in your life, you're bound to be miserable at some point. I'm sorry but my wife and children will take precedence over my work hours... and being in a specialty that allows me to adhere to this rule is very important to me. I also feel the responsibility to bring home as much income as possible for my family's future financial security. People in certain other fields work a lot less than the laziest physicians and make a whole lot more. Spare me the criticism about how I'm a terrible person for feeling this way

The problem is this - Making "the most money possible" and "work as little as possible" OFTEN contradicts "doing the best for the patient". This is what you guys dont understand. Plowing through patients, or doing unnecessary procedures with net you more money, but wont be doing the best for the patient. Again, staying up to date, reading up on your patients, this all requires time and if you wanna be good, just like ANYTHING else in the world, you gotta put in your time.

Furthermore, its not all black and white. Can you pretty good lifestyle, make pretty good money and still be the best doctor possible for the patient? Yes, of course. But you cannot go be at the extremes and still do whats best for patients.

Originally Posted by RadicalRadon

lol, it's not at all easy to be balanced in your life if you're working 60hrs/week... even as an attending. Say no weekends. That means a minimum of 12hr/day. That means 6am to 6pm or 7am to 7pm everyday. This is just time in the hospital and doesn't include potentially 25-45min of commuting time, which is not at all uncommon.

How much time does that leave you with your wife and kids? I'd rather not be walking in exhausted on the evenings and spending maybe 1-2 hours with my family. A 60hr work week isn't really all that balanced. 50 hours is manageable. Those 10 hours make a huge difference in quality of life and how well you know your kids while they grow up lol. See how you feel when you're an exhausted attending putting in 12 hours on every work day.

Now, imagine your wife is a doctor too with similar hours (also fairly common)... now, tell me who raises the kids?

Its not really set up like that all evenly. 60 hours is manageable, but some days you will come home real late or be at the hospital overnight. Some days you'll be off by 2. Its sacrifice some days for rewards later on. You may need to come in and round on your patients on the weekend just in the morning and leave. Its not sliced up nicely as you put it.

Furthermore I'd like to make the argument although time is certainly important with spouse/children, QUALITY of time is even more important. There are people who work 40 hours a week but don't necessarily spend quality time with their kids because they got other things going on in their life, like chores and dropping off kids to x, y, z events etc..

I'd also like to add that - you'd be more exhausted after working 8 hours of something you don't enjoy vs. 12 hours of something you do. Its a real experience students often get in 3rd year medical school (7 hours of FP is torture and more exhausting on my mind but 12 hours of ICU is a lot more fun and less exhausting)

Originally Posted by RadicalRadon

lol, it's not at all easy to be balanced in your life if you're working 60hrs/week... even as an attending. Say no weekends. That means a minimum of 12hr/day. That means 6am to 6pm or 7am to 7pm everyday. This is just time in the hospital and doesn't include potentially 25-45min of commuting time, which is not at all uncommon.

How much time does that leave you with your wife and kids? I'd rather not be walking in exhausted on the evenings and spending maybe 1-2 hours with my family. A 60hr work week isn't really all that balanced. 50 hours is manageable. Those 10 hours make a huge difference in quality of life and how well you know your kids while they grow up lol. See how you feel when you're an exhausted attending putting in 12 hours on every work day.

Now, imagine your wife is a doctor too with similar hours (also fairly common)... now, tell me who raises the kids?

Lol. If 60 hours isn't manageable, how in the world did surgeons work 100-120 hrs a week before the work restrictions. That's an extra full time job or more over 60 hours, I think if you work hard you can fit a family in.

Welcome to the real world. Lots of people work 60 hrs a week. Many poor people have a full time and part time job just to pay bills.

In my book, 50 hrs a week is a pretty easy work week, 60 hrs is average, and 80 hrs is hard.

Originally Posted by todds

The problem is this - Making "the most money possible" and "work as little as possible" OFTEN contradicts "doing the best for the patient". This is what you guys dont understand. Plowing through patients, or doing unnecessary procedures with net you more money, but wont be doing the best for the patient. Again, staying up to date, reading up on your patients, this all requires time and if you wanna be good, just like ANYTHING else in the world, you gotta put in your time.

Furthermore, its not all black and white. Can you pretty good lifestyle, make pretty good money and still be the best doctor possible for the patient? Yes, of course. But you cannot go be at the extremes and still do whats best for patients.

Good point. I don't think of a good doctor or worker as someone who is self-proclaimed "lazy" and "wants to do as little work possible for the most money."

I know we all want to be efficient and effective, but sometimes you will have to do lots of work for little pay because it's the best thing for the patient. Is that really the guy you want to work with? A person who will only do the easy and profitable cases/projects. Sign him up for partner.

Some specialties aren't going to want to admit that they're a lifestyle specialty, because most people want to think that they work long and hard for their money.

Originally Posted by RadicalRadon

lol, it's not at all easy to be balanced in your life if you're working 60hrs/week... even as an attending. Say no weekends. That means a minimum of 12hr/day. That means 6am to 6pm or 7am to 7pm everyday. This is just time in the hospital and doesn't include potentially 25-45min of commuting time, which is not at all uncommon.

How much time does that leave you with your wife and kids? I'd rather not be walking in exhausted on the evenings and spending maybe 1-2 hours with my family. A 60hr work week isn't really all that balanced. 50 hours is manageable. Those 10 hours make a huge difference in quality of life and how well you know your kids while they grow up lol. See how you feel when you're an exhausted attending putting in 12 hours on every work day.

Now, imagine your wife is a doctor too with similar hours (also fairly common)... now, tell me who raises the kids?

1. Every weekend off? That's pretty nice.
2. Don't commute 45 minutes/day if you want free time.
3. It's not 12 hours all day every day. If you're in a specialty that takes call, one of those days might be an 18 hour day, and then on Friday, you wrap it up around noon because you just scheduled a few outpatient cases in the morning and no clinic.

someone mentioned hospitalist but it was never really addressed. talk about that some.

Originally Posted by TheProwler

1. Every weekend off? That's pretty nice.
2. Don't commute 45 minutes/day if you want free time.
3. It's not 12 hours all day every day. If you're in a specialty that takes call, one of those days might be an 18 hour day, and then on Friday, you wrap it up around noon because you just scheduled a few outpatient cases in the morning and no clinic.

I started a similar discussion on work vs. lifestyle on a thread called "How does one survive a neurosurgey residency?". There are many individuals out there, potentially each and every one of us, who would be willing to donate just about all their time to performing hour-high specialties. This entails basically putting your specialty first and your home life second. I believe that the hours of a resident are more strict than the of an attending, but even so, many new attendings continue the same hours b/c they love the work.

A lifestyle specialty is one which gives you freedom. Some of the biggest factors of how much freedom you will have is whether you will be on-call and whether you have shift-work vs. procedure-work. Shift work can include specialties such as rads, internal medicine, derm, opthamalogy, EM, and possibly anesthesia. Procedure work includes most surgical specialties (neuro, ortho, general, cardiothoracic, uro), interventional cards, and some rads/ana mixed in. On-call can is mostly for surgeries or specialties related to surgeries such as rads/ana. Any shift-work type of job will afford you a "better" lifestyle (define by hours of free time).

As a final disclosure, all aforementioned job discussion pertains to hospital work, not private practice where hours and regulations may differ.

Originally Posted by JackShephard MD

Lol. If 60 hours isn't manageable, how in the world did surgeons work 100-120 hrs a week before the work restrictions. That's an extra full time job or more over 60 hours, I think if you work hard you can fit a family in.

Welcome to the real world. Lots of people work 60 hrs a week. Many poor people have a full time and part time job just to pay bills.

In my book, 50 hrs a week is a pretty easy work week, 60 hrs is average, and 80 hrs is hard.

Well, obviously, that's *your* book/opinion and I'm glad there are people who feel that way about working.

I don't plan on working that much each week, especially if I don't receive proportionally increased pay for my extra work (i.e. make partner and earn a proportion of the practice's income).

I plan to schedule work around my life, not the other way around. Honestly, I'm glad a lot of people feel more like you than me because otherwise we'd need a lot more providers. If medicine doesn't accommodate what I demand as necessary or if pay continues to worsen, I'll transition out of patient care or medicine entirely. Fortunately, there are specialties that accommodate my requirements but they are proportionally more competitive (rads, rad onc, derm, ophtho).

Regarding surgeons: well, that was in an era where surgeons were predominately male and their wives were expected to take care of all the other aspects of male surgeons' lives (i.e. cooking, cleaning, raising kids...). That's not feasible these days unless you want a divorce.

Originally Posted by TheProwler

1. Every weekend off? That's pretty nice.
2. Don't commute 45 minutes/day if you want free time.
3. It's not 12 hours all day every day. If you're in a specialty that takes call, one of those days might be an 18 hour day, and then on Friday, you wrap it up around noon because you just scheduled a few outpatient cases in the morning and no clinic.

1. just an assumption to simplify comparisons. I'd desire weekends off but obviously I'm okay with working weekends occasionally (like every fourth week).
2. Sometimes that's unavoidable. Most people living in suburbs or even expensive cities live at least 20 minutes away (often more).
3. Call sucks. That is even worse than 12hrs/day, evenly distributed.

Originally Posted by RadicalRadon

I plan to schedule work around my life, not the other way around. Honestly, I'm glad a lot of people feel more like you than me because otherwise we'd need a lot more providers. If medicine doesn't accommodate what I demand as necessary or if pay continues to worsen, I'll transition out of patient care or medicine entirely. Fortunately, there are specialties that accommodate my requirements but they are proportionally more competitive (rads, rad onc, derm, ophtho).

Regarding surgeons: well, that was in an era where surgeons were predominately male and their wives was expected to take care of all the other aspects of male surgeons' lives (i.e. cooking, cleaning, raising kids...). That's not feasible these days unless you want a divorce.

Right there with you, RadicalRadon. However, I am finding that I am not attracted to the less intensive specialties, such as optho or derm, as much as the higher-demanding specialties, like ortho and neurosurg. I realize that high-demand specialties come with a lot of baggage (reduced free time, strain on family, strain on own personal health via to sleep/exercise) but I think overall I would be happier with my life knowing I spent the majority of my time doing something I really enjoy vs something I "settled" for. I do NOT mean to say anyone who matches into derm/optho/rads is settling, because of course there are MANY people who see it as their #1 choice regardless of its lifestyle. I think in an ideal system we would be able to do the high-demand job we want but with more hours of free time or more days in between work.

For example, here's an ideal week:

Day 1: Perform a 13 hours neurological procedure.
Day 2: Off. Have sex with wife.
Day 3: Perform a 6 hour neurological prodecure. 8 hours of follow-up outpatient stuff.
Day 4: 12 pm - 5 pm follow ups. Come home to have sex with wife. Try anal

Originally Posted by CassieBagley

Right there with you, RadicalRadon. However, I am finding that I am not attracted to the less intensive specialties, such as optho or derm, as much as the higher-demanding specialties, like ortho and neurosurg. I realize that high-demand specialties come with a lot of baggage (reduced free time, strain on family, strain on own personal health via to sleep/exercise) but I think overall I would be happier with my life knowing I spent the majority of my time doing something I really enjoy vs something I "settled" for. I do NOT mean to say anyone who matches into derm/optho/rads is settling, because of course there are MANY people who see it as their #1 choice regardless of its lifestyle. I think in an ideal system we would be able to do the high-demand job we want but with more hours of free time or more days in between work.

For example, here's an ideal day:

Day 1: Perform a 13 hours neurological procedure.
Day 2: Off. Have sex with wife.
Day 3: Perform a 6 hour neurological prodecure. 8 hours of follow-up outpatient stuff.
Day 4: 12 pm - 5 pm follow ups. Come home to have sex with wife. Try anal

Win lol.

Haha, yeah. First and foremost, you must enjoy what you do. Fortunately, for me, I like one of those "lifestyle" fields more than any others. Honestly though, a big part of why I hate gen med is all the horrendous clerical work. I seriously cannot and will not do all of that. Something like radiology makes much more sense to people who like challenging work but swear off all the frustrating aspects of medicine (clerical work, billing/reimbursement, patient non-compliance, horrendous hours, inefficient work, clashing egos... etc).

Originally Posted by MossPoh

..., but I know they also don't get kept up worrying if what they did was the right decision or if their script is doing alright...

this. It's simply not the same animal as pumping gas or stocking shelves at Walmart. Those are just jobs. Medicine requires a much higher standard and level of commitment and personal investment which inhabits your brain 24-7. Yes, you will lose sleep over things. You will make calls to your buddies on call asking them to double check that you remembered to do X, Y and Z. You will show up early to double check on Mr W, because you had another thought about his condition while on the can last night. You will stay late more days than not because you are in the middle of things you simply cant walk out on. You are the caretaker of people's well being, not someone waiting for the quitting bell. I guess until you live residency, its hard to appreciate. But there's a huge difference between this commitment and a mere job.

Originally Posted by Law2Doc

this. It's simply not the same animal as pumping gas or stocking shelves at Walmart. Those are just jobs. Medicine requires a much higher standard and level of commitment and personal investment which inhabits your brain 24-7. Yes, you will lose sleep over things. You will make calls to your buddies on call asking them to double check that you remembered to do X, Y and Z. You will show up early to double check on Mr W, because you had another thought about his condition while on the can last night. You will stay late more days than not because you are in the middle of things you simply cant walk out on. You are the caretaker of people's well being, not someone waiting for the quitting bell. I guess until you live residency, its hard to appreciate. But there's a huge difference between this commitment and a mere job.

You're describing inpatient medicine. Not everyone wants to do inpatient medicine.

Originally Posted by RadicalRadon

...Something like radiology makes much more sense to people who like challenging work but swear off all the frustrating aspects of medicine (clerical work, billing/reimbursement, patient non-compliance, horrendous hours, inefficient work, clashing egos... etc).

id be shocked if fields like radiology don't have components of all of these, maybe worse than IM. For instance, There's tons of clerical work protocoling studies appropriately, all radiology studies get billed/reimbursed somehow, patients don't comply with drinking contrast, premedication for allergies, eating food before certain studies, etc. and that's just the diagnostic stuff -- IR pretty much faces the same issues as an surgical subspecialty, including admitting and discharging some of it's own patients. Good luck with that.

Originally Posted by RadicalRadon

You're describing inpatient medicine. Not everyone wants to do inpatient medicine.

Hate to break it to you, but what I'm describing is found in almost every medical field.

Originally Posted by Law2Doc

id be shocked if fields like radiology don't have components of all of these, maybe worse than IM. For instance, There's tons of clerical work protocoling studies appropriately, all radiology studies get billed/reimbursed somehow, patients don't comply with drinking contrast, premedication for allergies, eating food before certain studies, etc. and that's just the diagnostic stuff -- IR pretty much faces the same issues as an surgical subspecialty, including admitting and discharging some of it's own patients. Good luck with that.

Yeah, hate to break it to you, but those issues aren't nearly as big a deal as they are on gen med. There is absolutely no comparison.

--protocoling studies is determined by radiologists based on indication and implemented by techs; what clerical work are you talking about beyond a phone call?
--billing/reimbursement --> you've got me here; don't know the dynamics of that but I bet it's less subjective than "performed >3 items on ROS"
--premedication/food --> pretty simple. either they followed protocol and can get the study; or they didn't and have to wait.

IR: in a university setting, basically a resident gets a consent, they go on the board and they get the procedure, and then they are subsequently managed by the ordering team

Originally Posted by RadicalRadon

1. just an assumption to simplify comparisons. I'd desire weekends off but obviously I'm okay with working weekends occasionally (like every fourth week).
2. Sometimes that's unavoidable. Most people living in suburbs or even expensive cities live at least 20 minutes away (often more).
3. Call sucks. That is even worse than 12hrs/day, evenly distributed.

1. One weekend of working both days is going to significantly lower your average daily hours.
2. You win some, you lose some. Don't insist on a big house/yard and then whine about how much it costs or how far away it is.
3. I'd much rather take call than have 12 hours/day, evenly distributed.

Originally Posted by RadicalRadon

You're describing inpatient medicine. Not everyone wants to do inpatient medicine.

He's describing most specialties, IMO. It varies as to the extent.

Originally Posted by TheProwler

1. One weekend of working both days is going to significantly lower your average daily hours.
2. You win some, you lose some. Don't insist on a big house/yard and then whine about how much it costs or how far away it is.
3. I'd much rather take call than have 12 hours/day, evenly distributed.


He's describing most specialties, IMO. It varies as to the extent.

*shrugs* I guess you win? I think people will still do whatever they feel like. Folks like the OP or me shouldn't be judged negatively for valuing different things in their lives than some ridiculous standard of self-sacrifice, assuming they provide excellent care for their patients within limited work hours. It is possible. Many physicians in many specialties are able to do so.

Originally Posted by RadicalRadon

Yeah, hate to break it to you, but those issues aren't nearly as big a deal as they are on gen med. There is absolutely no comparison.

--protocoling studies is determined by radiologists based on indication and implemented by techs; what clerical work are you talking about beyond a phone call?
--billing/reimbursement --> you've got me here; don't know the dynamics of that but I bet it's less subjective than "performed >3 items on ROS"
--premedication/food --> pretty simple. either they followed protocol and can get the study; or they didn't and have to wait.

IR: in a university setting, basically a resident gets a consent, they go on the board and they get the procedure, and then they are subsequently managed by the ordering team

Post back when you get further down the road. You will be enlightened.

Originally Posted by TheProwler

1. One weekend of working both days is going to significantly lower your average daily hours.
2. You win some, you lose some. Don't insist on a big house/yard and then whine about how much it costs or how far away it is.
3. I'd much rather take call than have 12 hours/day, evenly distributed.


He's describing most specialties, IMO. It varies as to the extent.

Completely agree. I dont know any resident who rather would do 12 hours daily. The work hour limitations are PAINFUL because of this. 12 hours a day x 6 days is disgusting. 24-28 hour call q4-q6 working the same hours allows plenty of afternoons off to enjoy the sun, go to the bank, do normal human things.

Originally Posted by Law2Doc

Post back when you get further down the road. You will be enlightened.

lol, you always talk so condescendingly to people who are a few years your junior... as if you know so much more than us. I remember reading your posts regarding prestige of school/match lists. It's a recurring theme, and it's funny how right you think you are about everything.

After rotating through many specialties for several weeks, I'm pretty sure I know enough about the different specialities to make a decision about what I want to do for the rest of my life and what the culture/lifestyle is like in each. I don't need you to tell me I'll be more enlightened further on down the line, dad.

Originally Posted by todds

Completely agree. I dont know any resident who rather would do 12 hours daily. The work hour limitations are PAINFUL because of this. 12 hours a day x 6 days is disgusting. 24-28 hour call q4-q6 working the same hours allows plenty of afternoons off to enjoy the sun, go to the bank, do normal human things.

The problem is, with work restrictions, you don't really get that choice anymore -- at least at my institution, you don't. I agree with both of you though. Working 12-14h*6days is hell on earth. I don't want to do that to myself ever again, let alone as a career.

Originally Posted by Law2Doc

id be shocked if fields like radiology don't have components of all of these, maybe worse than IM. For instance, There's tons of clerical work protocoling studies appropriately, all radiology studies get billed/reimbursed somehow, patients don't comply with drinking contrast, premedication for allergies, eating food before certain studies, etc. and that's just the diagnostic stuff -- IR pretty much faces the same issues as an surgical subspecialty, including admitting and discharging some of it's own patients. Good luck with that.

Zero chance that radiology has any paperwork component that even sniffs that of internal medicine. All of the issues you cite exist, certainly, but they comprise a tiny component of a radiologist's day. The IR comparison is most relevant, but even that is highly dependent on the particular department/practice, considering the wide variety in nature of IR practices at present.

Originally Posted by Law2Doc

Post back when you get further down the road. You will be enlightened.

Regarding the post to which this quote responds, I generally find RadicalRadon's thoughts to be accurate. I would like to hear your experiences that lead you to believe otherwise.

Originally Posted by bodonid

someone mentioned hospitalist but it was never really addressed. talk about that some.

Most will do seven days on and then seven days off. Seems like cake, but apparently those seven on days are tough enough to cause significant burn-out.

Originally Posted by colbgw02

Regarding the post to which this quote responds, I generally find RadicalRadon's thoughts to be accurate. I would like to hear your experiences that lead you to believe otherwise.

Well, for instance, at the institution I'm at, every radiology cross sectional study has to be protocoled by a radiologist. That's thousands of studies a day, each involving figuring which study is appropriate, how it should be performed, sometimes talking to the clinician and tech, and all this has to be documented. It's not a small amount of "paperwork" and sure doesn't seem to be an insignificant part of any radiologist here's day. My experience with IM is they really have nothing like this. And can you seriously say there are eg no battling egos in radiology? I gave examples above of patient noncompliance -- radiology is a procedural field and so folks need to comply with things before and after the procedure, which can certainly cause headaches. And how does radiology not have billing or reimbursement issues? They are the highest paid specialty (per medscape) magically?

Anyway I think the prior poster lost me at the notion of a magic field with no scut or battling egos. this doesn't anywhere exist in medicine. There are simply dogs with different fleas. Thats why I think the prior poster is going to have a very different take in a few years.

Originally Posted by Law2Doc

Well, for instance, at the institution I'm at, every radiology cross sectional study has to be protocoled by a radiologist. That's thousands of studies a day, each involving figuring which study is appropriate, how it should be performed, sometimes talking to the clinician and tech, and all this has to be documented. It's not a small amount of "paperwork" and sure doesn't seem to be an insignificant part of any radiologist here's day. My experience with IM is they really have nothing like this. And can you seriously say there are eg no battling egos in radiology? I gave examples above of patient noncompliance -- radiology is a procedural field and so folks need to comply with things before and after the procedure, which can certainly cause headaches. And how does radiology not have billing or reimbursement issues? They are the highest paid specialty (per medscape) magically?

Anyway I think the prior poster lost me at the notion of a magic field with no scut or battling egos. this doesn't anywhere exist in medicine. There are simply dogs with different fleas. Thats why I think the prior poster is going to have a very different take in a few years.

I didn't read his comments as speaking in absolutes, nor was I.

Clearly there are ego issues. I think the point remains that it's less of an issue than in many, if not most, other fields. Like several specialties, radiology tends to attract laid-back personalities. I don't think that's particularly earth shattering news.

You're way off on your thoughts on protocoling; it's a small part of a radiologist's day. To give you an idea, I recently protocoled about 250 studies - it took me 10 minutes. Even when confusing or difficult orders show up, that number maybe gets pushed to 30 minutes. Maybe.

Yes, there are non-compliance issues, but again - as compared to other fields - it's an afterthought. The patient ate breakfast before a RUQ? Fine, reschedule it. The patient refuses contrast? Fine, do it without. The patient didn't stop their coumadin before a biopsy? Fine, reschedule it. Most of these problems have solutions that are so simple that I don't even know about it until after. The conversation normally goes like this: "What happened to the nine o'clock UGI?" "The patient ate breakfast, so he's coming back next week." "Oh, okay (heads back to reading room)."

And let's not conflate IR with DR. Depending on your institution's IR practice model, then they will have all of the issues of what is essentially a minimally-invasive surgery clinic. That model isn't, at present, reflective of IR elsewhere, and those issues certainly don't apply to DR.

Regarding reimbursements, I read RadicalRadon's comments differently. I think he was simply pointing out that coding is not a day-to-day issue for radiologists. It's not. Reimbursement is a big issue in radiology nowadays, certainly, but it's not like radiologists spend their days filling out insurance forms or choosing ICD-9 codes.

Everyone can cite specific examples that don't jive with my experiences. Nonetheless, I've been doing this for long enough and in enough different places that I'm confident that the above is generally reflective of the field. And I'm very confident that these issues are less of a concern than in most other fields, to include IM, as you suggested.

Well, good luck to OP.

Most people that I know only work Mon-Fri for 40 hours a week...I guess I dunno what people work 60hrs/week that they think is the norm. I see tons of people in their 20s who seem to go on vacations every month and have weekdays off constantly

Originally Posted by KnuxNole

Most people that I know only work Mon-Fri for 40 hours a week...I guess I dunno what people work 60hrs/week that they think is the norm. I see tons of people in their 20s who seem to go on vacations every month and have weekdays off constantly

no no, man, you got it all wrong...

60 hours is normal.

55 hours is 'livin the life' to the point that you should feel guilty.

Father Medicine would have it no other way:


40 hours?! What are you - a degenerate?

haha, I know for physicians, 40 hrs/wk isn't the norm, but I meant for the average 20something person.

Originally Posted by KnuxNole

haha, I know for physicians, 40 hrs/wk isn't the norm, but I meant for the average 20something person.

The average 20 something person is not a professional. Average professionals in the US work 60ish. If you don't want profession hours you can always just get a regular 9-5 job. But it's going to be fruitless to try to force medicine to bend to your schedule.

Oh no, I don't mind working more than 40 hrs/week. I knew well before applying that it might be the case, which I was content with. But, I was commenting on how I noticed that the norm was 40, whereas a lot of people were mentioning most people work 60 or more. But that is a great point, that it is meant for "professionals". That makes a lot of sense in that case.

Originally Posted by IJL

Are you not familiar with the myth amongst medical students that all "business people" and lawyers make $300k whilst working 30 hours a week with two rounds of golf thrown in there?

Not to mention that it is a breeze to get into I-banking.

Medical students and doctors get angry when the public has a warped perception of medicine (million dollar a year salary, rounds of golf between patients.) But then they turn around and do the same thing with business and law.

Originally Posted by RadicalRadon

*shrugs* I guess you win? I think people will still do whatever they feel like. Folks like the OP or me shouldn't be judged negatively for valuing different things in their lives than some ridiculous standard of self-sacrifice, assuming they provide excellent care for their patients within limited work hours. It is possible. Many physicians in many specialties are able to do so.

I'm not trying to win or make you cry uncle. I'm not trying to change your mind. I just want med students reading this thread to see the whole picture, including different people's perspectives.

Originally Posted by CassieBagley

Right there with you, RadicalRadon. However, I am finding that I am not attracted to the less intensive specialties, such as optho or derm, as much as the higher-demanding specialties, like ortho and neurosurg. I realize that high-demand specialties come with a lot of baggage (reduced free time, strain on family, strain on own personal health via to sleep/exercise) but I think overall I would be happier with my life knowing I spent the majority of my time doing something I really enjoy vs something I "settled" for. I do NOT mean to say anyone who matches into derm/optho/rads is settling, because of course there are MANY people who see it as their #1 choice regardless of its lifestyle. I think in an ideal system we would be able to do the high-demand job we want but with more hours of free time or more days in between work.

For example, here's an ideal week:

Day 1: Perform a 13 hours neurological procedure.
Day 2: Off. Have sex with wife.
Day 3: Perform a 6 hour neurological prodecure. 8 hours of follow-up outpatient stuff.
Day 4: 12 pm - 5 pm follow ups. Come home to have sex with wife. Try anal