IM vs Psych vs Anesthesia?

[BLTsandwich]

I just finished my MS3 and I'm really confused.
MS3 was tough and super jaded at this point. I don't find anything particularly interesting...

Besides the advice of get out of medicine and follow your passion, can anyone help guide me make a decent decision.
Things I value are as follow: lifestyle > joy in work > compensation > procedure

Currently it's psych > IM > anesthesia.
Psych pros: good lifestyle (36-40 hour work week, no calls, weekends off, decent pay (≥300k), very flexible work (outpatient, weekend inpatient coverage, ECT/TMS clinic, Telehealth). You have good control over your schedule. For inpatient, can leave when done work in the early afternoon.
Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

IM pros: lifestyle. I really enjoy 7on7off until my future kids want to start hanging out on weekends; then I'll go into PCP). I can travel with a good amount. I talked to my gf friend (hospitalist 6 yrs out of training) and he LOVES his job. He has a 4on/5off type of gig, comes home on average around 5pm (730a-5pm) sometimes 6 or sometimes 4 on weekends. Idk why people claim that hospitalist work 80hrs/week. I've never seen anyone come in by 7 and leave at 7 for an entire week. Compensation on the rise (≥250-300k). IM residency sucks, but only 3 years. It feels nice to be the doctor that everyone envision what a doctor is in the hospital.
IM cons: I don't really have interest in managing electrolyte, CHF/COPD/asthma exacerbation, or UTI. I also feel like they are sometimes note robots, just typing away from like noon to 4pm.

Anesthesia pros: lifestyle decent-ish. I heard on paper it's 7a-3p but you never really know what time you'll get out (5pm or as late as 7pm). Will have to wake up 530/6am for the rest of my life. I also heard the average work week is 55-60 hrs (ofc huge range since crazy variability in anesthesia). Also wouldn't want to do mommy track out of training bc I think it's dangerous for pts. A pilot coming out of pilot school should continue to gain experience rather than flying the least amount as possible. Your skills grow dull and dangerous for pts. I enjoy procedures (lines, intubations, etc). No difficult pt interaction. Can work on stock portfolio or read on real estate during downtime (ofc pt first).
Anesthesia cons: lifestyle (stated above). There are a handful of anesthesiologist out there that is adamant on this field not being lifestyle-friendly. I'll get tired of calls/weekends for the rest of my life. Stress. I heard you need to be able to make quick decision which I don't feel comfortable with. But at the same time, if nurses can work majority of the case, how stressful can it be? Surgeons & CRNA's can be annoying.

I come here for advice bc I don't have a lot of friends/family in medicine.

To be honest, I want to have time & money to be able to go into real estate and retire medicine in the 50's. I'm also into photography so I want to travel a lot. My parents were dirt poor growing up (we almost became homeless many times) and we never went on any vacations.

I'm almost 30. I gave up my entire 20's and will give up half of 30. I'm just really tired guys...
My personality is - medicine is just a job. I don't want to live to work but work to live. Just being very honest with myself and everyone here.

Thanks .

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[UTsksk]

Which of the 3 can you tolerate the most for the next 20 years? I had the same issue between psych, neuro, IM (pulm/crit). Ended up in psych and now child psych due to the lifestyle. My intellectual interests were more neuro related but the bread and butter neuro bored me. I wrote down the basic stuff you would see in each field and decided I would rather deal with psych. My kids also really changed my mindset with family time and being there.

 

[Prometheus2772]

Psych is a good choice. Very in demand. anesthesia is good, just plan on doing a fellowship. There are lifestyle options. Our peds anesthesia make like $400k and work 7-3 and one peds call weekend a month.

 

[sluggs]

If your personality is "medicine is just a job" you should go in to something outside of medicine. Medicine is still a profession and a calling.

 

[Zeldaspikes]

If your personality is "medicine is just a job" you should go in to something outside of medicine. Medicine is still a profession and a calling.

Lol… okay it’s definitely a profession. Calling? That is for each individual to decide, not you.

 

[Dral]

You could consider one of the IM subs. Allergy might work for you. I would suggest Rheum, but it sounds like some of the B&B rheum patients might try your patience.

Also don't forget about preventive med and occ med. I don't know how the job market is right now for those though.

What is Preventive Medicine?

The goal of Preventive Medicine is to protect, promote, and maintain health and well-being and to prevent disease, disability, and death. Learn more here.

www.acpm.org

 

[BLTsandwich]

Which of the 3 can you tolerate the most for the next 20 years? I had the same issue between psych, neuro, IM (pulm/crit). Ended up in psych and now child psych due to the lifestyle. My intellectual interests were more neuro related but the bread and butter neuro bored me. I wrote down the basic stuff you would see in each field and decided I would rather deal with psych. My kids also really changed my mindset with family time and being there.

I have such limited experience in all of field. COVID really shortened a lot of my 3rd year rotation. IM (4 weeks), psych (4 weeks), anesthesia (1 week)...
It sucks how I have to make 4th year schedule now and already know what I want to do. Idk why I hate how I had to spend useless weeks in OBGYN, geriatrics, and other when some of us have no interest.

IM - My first rotation so I was so clueless. Like I didn't even know what a progress note was. By the time I felt like I was getting the hang of it, it was over. Plus it was impossible to do like 2000 UWORLD Q in 4 weeks, so I just studied whenever I had the chance in the hospital instead of reading up or following up on pts.

Psych - only inpatient experience. I felt like an intern here bc they let me do so much. I knew all of my pts and dose in my head. I hated seeing people there involuntarily and them begging us to leave, that was pretty sad. I did child psych (2 weeks) and was not the biggest fan. Only so much we can do before going home for parents to screw everything up. I really wish I got outpatient experience since outpt is the majority of psych outside of residency. I wanna see what it feels like talking with people for an hour back-to-back. In theory, it sounds very exhausting, but idk what it feels like in reality.

Anesthesia- the job sounds fun. I got to intubate a few times and succeeded every one without much difficulties. I was also able to put IV's in. Some people, however, cautioned me that it's a stressful job. That you're the goalkeeper, the last man in line, to save a person during a crash. Or that minor-moderate complication occur in a daily basis. Not sure if I have the tenacity to perform under pressure and make quick decisions.

 

[BLTsandwich]

Psych is a good choice. Very in demand. anesthesia is good, just plan on doing a fellowship. There are lifestyle options. Our peds anesthesia make like $400k and work 7-3 and one peds call weekend a month.

Is this outpatient or inpatient? Do they really leave at 3pm or average around 5pm?

 

[BLTsandwich]

If your personality is "medicine is just a job" you should go in to something outside of medicine. Medicine is still a profession and a calling.

There are a lot of 23-24 year olds in my school who are so blindly passionate going into gen Surgery, ortho, etc.
I envy their youth sometimes, but I highly value my family time and life at home. Medicine, like any other job, is just a job. It brings you an income after doing hard work. I don't want to live to work but work to live.

 

[Dral]

"Idk why I hate how I had to spend useless weeks in OBGYN, geriatrics, and other when some of us have no interest."

Remember that you're not just there to figure out if that's what you want to do or not. Physicians don't work in a bubble. We interact with other specialties and the more we understand about what each other does, the better for us and patients.

Does your school offer any type of time off? It sounds like you want to just get to it, but it also seems like you could use some time to think about what you want to do moving forward.

 

[BLTsandwich]

"Idk why I hate how I had to spend useless weeks in OBGYN, geriatrics, and other when some of us have no interest."

Remember that you're not just there to figure out if that's what you want to do or not. Physicians don't work in a bubble. We interact with other specialties and the more we understand about what each other does, the better for us and patients.

Does your school offer any type of time off? It sounds like you want to just get to it, but it also seems like you could use some time to think about what you want to do moving forward.

Yea I do understand the idea behind rotating through core specialties. I was just venting haha
Well I finished my 3rd year and studying for step 2 at the moment.
Then straight into 4th year

 

[Dral]

I think if psych is standing out to you, maybe that is something to explore. It sounds like it could fit in your big picture plans.

There are a decent number of subspecialties to look into. You may be able to avoid some of the general psych patients that you mentioned may not appeal to you.

I think you can do a lot of tele medicine too which may be attractive to a psychiatrist. I personally do not like telemed one bit, but I'm a dermatologist...telederm isn't great based on the visual/tactile portion of what we do.

 

[Ashers]

Don't choose a career for the shift. You may not get what you're promised. I'm an anesthesiologist. While most ORs I've been in started at 0730, I work places where they start at 0600. I've also worked places where they started at 0600 a 50min drive from my house, and then I have to drive to another location 30min from the first place to do more cases. Or I'd have one case in the morning, 5 hour break and 1 case in the afterrnoon. I wouldn't get paid for the 5 hour break. This was in a surgery center practice.

I had one job tell me most days were 7-3, but almost none were. Some days I worked 12-15 hours some days I worked 15 mins. (Now that I'm doing locum tenens, it's the closest to 7-3 I've ever worked in my adult life, and it's amazing.)

I've taken call -- 3 days in a row, Fri-Sun where I spent most of that time in hospital. Sometimes I never got called back in after I left Friday.

That being said, there is nothing in God's great earth that would make me choose to do psych or IM. I love what I do despite sometimes crazy schedules. I have fun in the OR, but if you're looking at schedules only, you won't be happy. You will run into difficult patients you can't intubate easily. Patients with problems you can't diagnose easily. Choose what you want to do based on what fits you. I don't do well talking to patients for extended periods of time, especially with psych problems (borderline patients do not like me -- they haven't since I was on psych as a student), and clinic and rounding kill my soul.

 

[Psych_hopeful]

If your personality is "medicine is just a job" you should go in to something outside of medicine. Medicine is still a profession and a calling.

Please get off your high horse. If medicine paid nothing or next to nothing, would you still do the work?

I just finished my MS3 and I'm really confused.
MS3 was tough and super jaded at this point. I don't find anything particularly interesting...

Besides the advice of get out of medicine and follow your passion, can anyone help guide me make a decent decision.
Things I value are as follow: lifestyle > joy in work > compensation > procedure

Currently it's psych > IM > anesthesia.
Psych pros: good lifestyle (36-40 hour work week, no calls, weekends off, decent pay (≥300k), very flexible work (outpatient, weekend inpatient coverage, ECT/TMS clinic, Telehealth). You have good control over your schedule. For inpatient, can leave when done work in the early afternoon.
Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

IM pros: lifestyle. I really enjoy 7on7off until my future kids want to start hanging out on weekends; then I'll go into PCP). I can travel with a good amount. I talked to my gf friend (hospitalist 6 yrs out of training) and he LOVES his job. He has a 4on/5off type of gig, comes home on average around 5pm (730a-5pm) sometimes 6 or sometimes 4 on weekends. Idk why people claim that hospitalist work 80hrs/week. I've never seen anyone come in by 7 and leave at 7 for an entire week. Compensation on the rise (≥250-300k). IM residency sucks, but only 3 years. It feels nice to be the doctor that everyone envision what a doctor is in the hospital.
IM cons: I don't really have interest in managing electrolyte, CHF/COPD/asthma exacerbation, or UTI. I also feel like they are sometimes note robots, just typing away from like noon to 4pm.

Anesthesia pros: lifestyle decent-ish. I heard on paper it's 7a-3p but you never really know what time you'll get out (5pm or as late as 7pm). Will have to wake up 530/6am for the rest of my life. I also heard the average work week is 55-60 hrs (ofc huge range since crazy variability in anesthesia). Also wouldn't want to do mommy track out of training bc I think it's dangerous for pts. A pilot coming out of pilot school should continue to gain experience rather than flying the least amount as possible. Your skills grow dull and dangerous for pts. I enjoy procedures (lines, intubations, etc). No difficult pt interaction. Can work on stock portfolio or read on real estate during downtime (ofc pt first).
Anesthesia cons: lifestyle (stated above). There are a handful of anesthesiologist out there that is adamant on this field not being lifestyle-friendly. I'll get tired of calls/weekends for the rest of my life. Stress. I heard you need to be able to make quick decision which I don't feel comfortable with. But at the same time, if nurses can work majority of the case, how stressful can it be? Surgeons & CRNA's can be annoying.

I come here for advice bc I don't have a lot of friends/family in medicine.

To be honest, I want to have time & money to be able to go into real estate and retire medicine in the 50's. I'm also into photography so I want to travel a lot. My parents were dirt poor growing up (we almost became homeless many times) and we never went on any vacations.

I'm almost 30. I gave up my entire 20's and will give up half of 30. I'm just really tired guys...
My personality is - medicine is just a job. I don't want to live to work but work to live. Just being very honest with myself and everyone here.

Thanks .

I'm coming from an IM perspective (did consider Psych, but I was too lazy/unmotivated to change my SDN username). I'll say this. 7 on days can be really grueling and admin will be on you about metrics and whatever. 7 off is good however.

I'll just say also that there isn't anything having your patient's breathe again or saving them from a heart attack. Outpatientwise, when you see your patient losing 80 lbs through dieting/exercise or catching a cancer that can be intervened upon, you can't beat that either. If this doesn't give you satisfaction, it's gonna be hard to do IM big time.

In my opinion, I think it sounds as though you want to do anesthesia. You do not desire as much patient interaction, but love procedures. I think therefore you ought to do something that you like because even with the erratic hours, you will enjoy the work. Eventually, I've heard several anesthesiologists find a way to make it a lifestyle sort of specialty. In the meantime, you can invest in VTSAX, S&P500 indexs or REITs. Or else do real estate.

 

[deleted456421]

I wish I could wholeheartedly endorse psychiatry, but the field is facing many of the same pressures that other fields are experiencing.

The job is great right now with relatively high salaries and good work/life balance, but I'm not sure how long that's going to last. I have worked in multiple institutions where MDs were literally replaced by midlevels. I see nothing but legions of NPs on the horizon wherever I turn. Even though I'm a contractor at my current job, I've been asked to supervise and train these individuals without extra pay or administrative time. I'm literally one of three psychiatrists left; they now employ 7-8 NPs without direct supervision when it was approximately 1:1 just a few years ago. I've inquired about 5-10 inpatient positions and was told I need to supervise midlevels or cover administrative tasks to warrant a potential $250k salary.

Private practice psychiatry is still a good option. However, some states (Oregon) and insurance companies have started to offer parity for NPs and psychiatrists. I suspect that this will become the norm just the same as independent NP practice is becoming the norm. There is absolutely no way I would have chosen the MD psychiatry route if I had known my compensation would be the same as someone with 1/8 of the knowledge base. Sure, cash practice sounds lucrative given quotes of $300-400/hr on this forum, but check out the psychiatry threads. Several posters have completely abandoned their private practice endeavors without ever getting close to full-time (interestingly, they don't seem to check back in after posting incessantly about the initiation phase). Everyone else has only heard secondhand of such rates.

The real question to ask is this: Do you want to de-prescribe crappy psychiatric NPs' horrible regimens, deal with crappy "hospitalist" NPs who offer broad spectrum abx for every indication while also ordering pan-CTs, or manage CRNAs that likely have no respect for your superior training?

IM and anesthesia at least have unique fellowships that can truly improve specialization and income whereas psych fellowships lose you money. Sure, child and forensics can help income, but the opportunity costs simply aren't worth the effort. Not that this needs to be about the money, I can just tell you that higher income with the B.S. >>>> lower income with the B.S.

Numerous outpatient and inpatient psych positions require call (overnight and/or weekend), many inpatient units don't want you leaving after rounding anymore, and numerous places have restrictive covenants (one job even banned external moonlighting and had legal recourse to take the income you made).The crap other fields experience is creeping into psychiatry at a concerning pace.

I apologize for my cynicism. These trends are disgustingly clear once you step foot in a hospital they seem unlikely to change soon.

 

[lucid_leprechaun]

I just finished my MS3 and I'm really confused.
MS3 was tough and super jaded at this point. I don't find anything particularly interesting...

Besides the advice of get out of medicine and follow your passion, can anyone help guide me make a decent decision.
Things I value are as follow: lifestyle > joy in work > compensation > procedure

Currently it's psych > IM > anesthesia.
Psych pros: good lifestyle (36-40 hour work week, no calls, weekends off, decent pay (≥300k), very flexible work (outpatient, weekend inpatient coverage, ECT/TMS clinic, Telehealth). You have good control over your schedule. For inpatient, can leave when done work in the early afternoon.
Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

IM pros: lifestyle. I really enjoy 7on7off until my future kids want to start hanging out on weekends; then I'll go into PCP). I can travel with a good amount. I talked to my gf friend (hospitalist 6 yrs out of training) and he LOVES his job. He has a 4on/5off type of gig, comes home on average around 5pm (730a-5pm) sometimes 6 or sometimes 4 on weekends. Idk why people claim that hospitalist work 80hrs/week. I've never seen anyone come in by 7 and leave at 7 for an entire week. Compensation on the rise (≥250-300k). IM residency sucks, but only 3 years. It feels nice to be the doctor that everyone envision what a doctor is in the hospital.
IM cons: I don't really have interest in managing electrolyte, CHF/COPD/asthma exacerbation, or UTI. I also feel like they are sometimes note robots, just typing away from like noon to 4pm.

Anesthesia pros: lifestyle decent-ish. I heard on paper it's 7a-3p but you never really know what time you'll get out (5pm or as late as 7pm). Will have to wake up 530/6am for the rest of my life. I also heard the average work week is 55-60 hrs (ofc huge range since crazy variability in anesthesia). Also wouldn't want to do mommy track out of training bc I think it's dangerous for pts. A pilot coming out of pilot school should continue to gain experience rather than flying the least amount as possible. Your skills grow dull and dangerous for pts. I enjoy procedures (lines, intubations, etc). No difficult pt interaction. Can work on stock portfolio or read on real estate during downtime (ofc pt first).
Anesthesia cons: lifestyle (stated above). There are a handful of anesthesiologist out there that is adamant on this field not being lifestyle-friendly. I'll get tired of calls/weekends for the rest of my life. Stress. I heard you need to be able to make quick decision which I don't feel comfortable with. But at the same time, if nurses can work majority of the case, how stressful can it be? Surgeons & CRNA's can be annoying.

I come here for advice bc I don't have a lot of friends/family in medicine.

To be honest, I want to have time & money to be able to go into real estate and retire medicine in the 50's. I'm also into photography so I want to travel a lot. My parents were dirt poor growing up (we almost became homeless many times) and we never went on any vacations.

I'm almost 30. I gave up my entire 20's and will give up half of 30. I'm just really tired guys...
My personality is - medicine is just a job. I don't want to live to work but work to live. Just being very honest with myself and everyone here.

Thanks .

So the market isn’t certain at the moment but have you considered EM? Shift work, work when scheduled, can work when you want depending on group. Procedures but also generalist and for many patients the primary diagnostician. It has a lot to offer if you want to be hospital based. Otherwise an IM sub is likely the way to go. Anesthesia is nice if you like Sudoku and day trading intermixed with procedures.

 

[Drrrrrr. Celty]

If you don't enjoy dealing with the most common diseases in internal medicine and if the notion of dealing with electrolytes hurts your soul then don't do IM. The most common thing you'll literally be dealing with is COPD, CHF, and Hyponatremia.

Subspecialty medicine a lot of the time doesn't really get you more lifestyle in my opinion either. GI, Cardio, Pulm/CC are making a lot of money but they're pounding away in the hospital like mad men. 25 consults and follow ups even if the notes are written by NPs and residents still means you're making high quality attestations that cover your ass from law suits.

Endo, AI, Rheum and outpatient Pulm and Hem/Onc are probably the most lifestyle of the bunch. Though most IM programs don't actually give you much exposure to the former 3 because they're outpatient that you need to know about them coming in or else you'll brush them off your 3rd year as being too late. In my residency there are a few ppl who only had rotations in those fields 3rd year and then decided that it's too late to change course.

One can further argue that if you want lifestyle and you wanted to do outpatient medicine that doing an FM program might actually be the better way. You can leave residency prepared to manage a panel and operate a clinic much more efficiently than most IM trained individuals.

 

[ResidentAnonymous001]

I was actually deciding between these 3 as well, and I went with psychiatry without any regrets.

 

[allantois]

Red flags all over for psychiatry. Sounds like you have no interest in the field other than lifestyle

 

[vm26]

Which of the 3 can you tolerate the most for the next 20 years? I had the same issue between psych, neuro, IM (pulm/crit). Ended up in psych and now child psych due to the lifestyle. My intellectual interests were more neuro related but the bread and butter neuro bored me. I wrote down the basic stuff you would see in each field and decided I would rather deal with psych. My kids also really changed my mindset with family time and being there.

"Tolerate" seems pretty accurate. In many cases this will be for 25-30+ years.

At the end of the day, choosing a career is a leap of faith-so many things beyond our control that ultimately influence the quality of our jobs/day-to-day grind, pretty much a roller-coaster. In a certain job market and geographic location, career choice C could be much more desirable that choice A. Impossible to predict though going into fields that are less prone to mid-level/Private equity infiltration is probably a good idea.

 

[Nudexta]

I just finished my MS3 and I'm really confused.
MS3 was tough and super jaded at this point. I don't find anything particularly interesting...

Besides the advice of get out of medicine and follow your passion, can anyone help guide me make a decent decision.
Things I value are as follow: lifestyle > joy in work > compensation > procedure

Currently it's psych > IM > anesthesia.
Psych pros: good lifestyle (36-40 hour work week, no calls, weekends off, decent pay (≥300k), very flexible work (outpatient, weekend inpatient coverage, ECT/TMS clinic, Telehealth). You have good control over your schedule. For inpatient, can leave when done work in the early afternoon.
Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

IM pros: lifestyle. I really enjoy 7on7off until my future kids want to start hanging out on weekends; then I'll go into PCP). I can travel with a good amount. I talked to my gf friend (hospitalist 6 yrs out of training) and he LOVES his job. He has a 4on/5off type of gig, comes home on average around 5pm (730a-5pm) sometimes 6 or sometimes 4 on weekends. Idk why people claim that hospitalist work 80hrs/week. I've never seen anyone come in by 7 and leave at 7 for an entire week. Compensation on the rise (≥250-300k). IM residency sucks, but only 3 years. It feels nice to be the doctor that everyone envision what a doctor is in the hospital.
IM cons: I don't really have interest in managing electrolyte, CHF/COPD/asthma exacerbation, or UTI. I also feel like they are sometimes note robots, just typing away from like noon to 4pm.

Anesthesia pros: lifestyle decent-ish. I heard on paper it's 7a-3p but you never really know what time you'll get out (5pm or as late as 7pm). Will have to wake up 530/6am for the rest of my life. I also heard the average work week is 55-60 hrs (ofc huge range since crazy variability in anesthesia). Also wouldn't want to do mommy track out of training bc I think it's dangerous for pts. A pilot coming out of pilot school should continue to gain experience rather than flying the least amount as possible. Your skills grow dull and dangerous for pts. I enjoy procedures (lines, intubations, etc). No difficult pt interaction. Can work on stock portfolio or read on real estate during downtime (ofc pt first).
Anesthesia cons: lifestyle (stated above). There are a handful of anesthesiologist out there that is adamant on this field not being lifestyle-friendly. I'll get tired of calls/weekends for the rest of my life. Stress. I heard you need to be able to make quick decision which I don't feel comfortable with. But at the same time, if nurses can work majority of the case, how stressful can it be? Surgeons & CRNA's can be annoying.

I come here for advice bc I don't have a lot of friends/family in medicine.

To be honest, I want to have time & money to be able to go into real estate and retire medicine in the 50's. I'm also into photography so I want to travel a lot. My parents were dirt poor growing up (we almost became homeless many times) and we never went on any vacations.

I'm almost 30. I gave up my entire 20's and will give up half of 30. I'm just really tired guys...
My personality is - medicine is just a job. I don't want to live to work but work to live. Just being very honest with myself and everyone here.

Thanks .

Psych

 

[Psych_hopeful]

Psych

His post: Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

Can he/she really be effective and happy as a Psychiatrist if this is an issue for him?

 

[Nudexta]

His post: Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

Can he/she really be effective and happy as a Psychiatrist if this is an issue for him?

Yes he can be happy, especially with training. His fears are normal
and many people in the field overcome it.

 

[seniormd]

I just finished my MS3 and I'm really confused.
MS3 was tough and super jaded at this point. I don't find anything particularly interesting...

Besides the advice of get out of medicine and follow your passion, can anyone help guide me make a decent decision.
Things I value are as follow: lifestyle > joy in work > compensation > procedure

Currently it's psych > IM > anesthesia.
Psych pros: good lifestyle (36-40 hour work week, no calls, weekends off, decent pay (≥300k), very flexible work (outpatient, weekend inpatient coverage, ECT/TMS clinic, Telehealth). You have good control over your schedule. For inpatient, can leave when done work in the early afternoon.
Psych cons: talking with borderline, people with tangential speech, low functioning schizo pts, or with depressed people all day. I have finite amount of patience and sometimes redirecting people rambling can get tiredsome. Stigmatized and friends may think I'm psychoanalyzing them all the time.

IM pros: lifestyle. I really enjoy 7on7off until my future kids want to start hanging out on weekends; then I'll go into PCP). I can travel with a good amount. I talked to my gf friend (hospitalist 6 yrs out of training) and he LOVES his job. He has a 4on/5off type of gig, comes home on average around 5pm (730a-5pm) sometimes 6 or sometimes 4 on weekends. Idk why people claim that hospitalist work 80hrs/week. I've never seen anyone come in by 7 and leave at 7 for an entire week. Compensation on the rise (≥250-300k). IM residency sucks, but only 3 years. It feels nice to be the doctor that everyone envision what a doctor is in the hospital.
IM cons: I don't really have interest in managing electrolyte, CHF/COPD/asthma exacerbation, or UTI. I also feel like they are sometimes note robots, just typing away from like noon to 4pm.

Anesthesia pros: lifestyle decent-ish. I heard on paper it's 7a-3p but you never really know what time you'll get out (5pm or as late as 7pm). Will have to wake up 530/6am for the rest of my life. I also heard the average work week is 55-60 hrs (ofc huge range since crazy variability in anesthesia). Also wouldn't want to do mommy track out of training bc I think it's dangerous for pts. A pilot coming out of pilot school should continue to gain experience rather than flying the least amount as possible. Your skills grow dull and dangerous for pts. I enjoy procedures (lines, intubations, etc). No difficult pt interaction. Can work on stock portfolio or read on real estate during downtime (ofc pt first).
Anesthesia cons: lifestyle (stated above). There are a handful of anesthesiologist out there that is adamant on this field not being lifestyle-friendly. I'll get tired of calls/weekends for the rest of my life. Stress. I heard you need to be able to make quick decision which I don't feel comfortable with. But at the same time, if nurses can work majority of the case, how stressful can it be? Surgeons & CRNA's can be annoying.

I come here for advice bc I don't have a lot of friends/family in medicine.

To be honest, I want to have time & money to be able to go into real estate and retire medicine in the 50's. I'm also into photography so I want to travel a lot. My parents were dirt poor growing up (we almost became homeless many times) and we never went on any vacations.

I'm almost 30. I gave up my entire 20's and will give up half of 30. I'm just really tired guys...
My personality is - medicine is just a job. I don't want to live to work but work to live. Just being very honest with myself and everyone here.

Thanks .

Anesthesia lifestyle stinks. As bad as OB, or worse. Inflexible schedule. Unpredictable hours so you never know when you’ll have time. Per hour, money is meh.

 

[deleted1100659]

Red flags all over for psychiatry. Sounds like you have no interest in the field other than lifestyle

this

If you don't like what you do then no matter what the hours are you wont have a great lifestyle. You still work at least 40 hours a week generally, which is a substantial amount of time to not like something. When I was a 4th year med student I had concerns about becoming a psychiatrist but i still had an interest in the field. Definitely do not make a decision based mainly on lifestyle.

I mean it is totally reasonable to want good money and a good lifestyle but you have to be real with yourself and figure out if its something you can have a passion for long term.

 

[comp1]

Psych is amazing and I don't see how we can go from the shortage we have now to some sort of surplus that drives down salaries. Most NPs do not go into psych and even fewer are willing to do inpatient psych. Yes, if you're in a salaried job, you aren't going to be leaving after rounding on inpatients. Patients do keep coming in after all and they keep having needs. If you're willing to put up with the hassles of 1099 contracting work, you probably will be able to, but that's a tradeoff. You shouldn't be accepting any sort of non-compete clause ever. It doesn't matter what specialty you go into. Have that struck right off any contract immediately. The vast majority of employers are going to be so hard up that they will happily remove it. Even better, move to a state where that kind of thing is illegal and unenforceable, as they all should be. It's reasonable to worry about the stress of talking to manic, psychotic or severely personality disordered patients after your clerkships. However....as an attending physician, you aren't going to be spending nearly as much time with these sort of patients as you did as a medical student. There is extremely little to be gained from listening to 10 minutes of disorganized speech or or even 10 minutes of complaints/threats. Once you get comfortable with diagnoses, often by the end of residency, you're going to be spending no more than 5 minutes each daily with inpatients who cannot carry on linear, appropriate conversations. As far as people thinking you are psychoanalyzing them, I've not really seen it. People will want to hear about your job and they sometimes make jokes, but it's definitely never serious. I don't know if lifestyle is enough to make a job workable for someone (since I love every day), but I can tell you that I sure don't see many people switching FROM psychiatry.