Neurology or Cardiology?

[Venom]

Neurology and cardiology are the two areas I am interested in. I am really passionate about cardiology but the grueling IM residency and the lack of a personal life as cardiologist scares me. I am female and I would like to balance a family life with work. I know that only 15% of cardiologists are female---. Is it possible to cut down hours/call? Neurology sounds really interesting esp. stroke but I've heard horror stories of getting frustrated with the lack of treament. I think neurologists have reasonable hours with interesting work and patients.

Which one would you choose?

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[fettucine]

Neurology residency is pretty hard as well, however it gets light as you progress through the years. The second point: it is 1 year longer than IM, but has a lot of fellowship options, and more or less evens out with IM+cards. Academic (or private) neurologists have a lighter workload. Cardiology doesn't have to be that bad either, don't have to do interventional. IM residencies have gotten much easier in the past decade, and are grueling at only certain places.

Cardiology fellowship is hard (regardless of the place), Neurology fellowships are easier unless you do critical care or stroke.

Choice is yours in the end, Neurology and cardiology are different academically in certain aspects, hours (in my opinion is not one of them: because that you can set when you are an attending or a private physician), and in regards to monetary compensation: you could make about the same money reading EEG or EKG.

-fa8

 

[Stormreaver]

Actually: they are miles apart with regards to compensation. Typically, cardiologists are the one of the best-compensated specialties while neurology compensation is merely average.

 

[andreg]

I couldn't have said it better:
The choice is either:
4-years slavery, then $200,000/year, rest of your life,
OR,
6-years slavery, then $500,000++/year, rest of your life,
Trust me,
$$$$ is everything, once you get older, and with family.
Hence,
if you are in the top 10%, go for Cardio.
Bon chance ))

 

[v-tach]

Neurology and cardiology are the two areas I am interested in. I am really passionate about cardiology but the grueling IM residency and the lack of a personal life as cardiologist scares me. I am female and I would like to balance a family life with work. I know that only 15% of cardiologists are female---. Is it possible to cut down hours/call? Neurology sounds really interesting esp. stroke but I've heard horror stories of getting frustrated with the lack of treament. I think neurologists have reasonable hours with interesting work and patients.

Which one would you choose?

You sound somewhat like me. I find both areas very interesting, and am leaning heavily toward cardiology at this point (but then again, I am not even in med school yet--next year if all goes well!). A major reason for this is one you mentioned, the fact that treatment options for cardiac problems tend to be a LOT better and actually help in most cases (although some areas still leave a lot to be desired; antiarrhythmics come to mind...). I am female as well, but have no plans at this point for marriage/kids--but you never know. At this point I feel it is a blessing for me to be single and therefore able to do what I want, but that's me. I'm not saying that's true for everyone. Your concerns about the hours are certainly shared by many people; personally I am the type of person who doesn't know what to do with downtime and can't just sit around and relax easily, so cardiology would probably be a suitable specialty for my personality... Anyway, enough of my rambling, just thought I'd share my thoughts on the matter. Good luck to you!

 

[Venom]

Thanks for all the advice!

I'm thinking cardiology can be more manageable for me as a female who wants to have a family by cutting down clinic days, doing research, and doing Non-invasive cards. Does that sound reasonable?


Does anyone know what it takes to get a cardiology fellowship--esp if you're not AOA? I am an MS III right now, is there anything I could do at this point? Maybe, a 4th year cardiology research elective?

 

[Smoke This]

Thanks for all the advice!

I'm thinking cardiology can be more manageable for me as a female who wants to have a family by cutting down clinic days, doing research, and doing Non-invasive cards. Does that sound reasonable?


Does anyone know what it takes to get a cardiology fellowship--esp if you're not AOA? I am an MS III right now, is there anything I could do at this point? Maybe, a 4th year cardiology research elective?

Just focus on getting into a good academic IM residency, especially one with a track record for placing people in cardiology fellowships. IM isn't terribly competitive so that should be doable even without AOA. Do well. Make connections. Maybe do some research. Apply for fellowship.

 

[v-tach]

I know that only 15% of cardiologists are female---. Is it possible to cut down hours/call?

It would be interesting to find out why the male/female ratio is so skewed--is it due to perceptions of not being able to balance work with family (probably the most likely reason, or at least a major factor), has there historically been discrimination (as has been the case in surgery) that discourages women from entering this field, etc? Or is there a chance that the skewed ratio itself is a turnoff to some women? (Personally I probably would barely notice, as I currently attend a university where the ratio is almost that bad--sometimes I feel bad for the guys!)

 

[csullivan]

Not sure who told you cardiologist (even non-invasive) was a nice life style but no cardiologist I have spoken with says that. The hours are longer than a Neurologist. If you want research you are talking academic which are paid less and work even more in most cases because you are required to keep money flowing in through clinic as well as being tapped for institutional requirements. The average salary for a cardiologist is not 500,000++. The average for the US is around 300,000. You can subtract about 40-60k for academic cardiologist.

Not wanting to discourage you, but from your post and some of the others you guys really need to speak to some (not 1 or 2) cardiologist and see what is really going on. What has been posted here are exceptions not the general rule.

If you are interested in academics for the research aspect then you really need to speak with some of your professors in cardiology and see how much they work. It is unlikely you will find an academic cardiologist who works less than 55 hours a week and most (if they have active research) are working a lot more.

Good luck but I would advise you to do some more research on your career choice and not rely on the board posters since there are some vast errors in some replys here.

 

[14022]

i have been told by a program director for cardiology at an average midwest program about the best way to get a fellowship spot...go to the best residency program you can, as long as youre not a jackass...ie, if youre going to be the absolute worst resident at mass general, it may be better to be average at a really good program...this of course is impossible to determine in advance so my advice would be go to as good of a program as possible and work your ass off

talking to people who successfully got into a fellowship they said if youre not a stellar applicant you absolutely MUST do one of these two things...

1) good cardiology research with publication

or

2) a chief residency year after your 3rd year of residency

 

[studmuffin2005]

I am a cards fellow and I could tell ou that a cards lifestyle is definitely harder than most specialties!! In private practice, you could be having call every 2-3 nights and these are greuling calls (ie u are up all night). In academics, night calls are less and most of the time u don't come in (fellows are there), but your pay is substantially lower (~50% lower), but u also work hard as well.

Cards is awesome, but the lifestyle is really hard, especially in private practice (even if u are noninvasive).

 

[Hudson]

I am a cards fellow and I could tell ou that a cards lifestyle is definitely harder than most specialties!! In private practice, you could be having call every 2-3 nights and these are greuling calls (ie u are up all night). In academics, night calls are less and most of the time u don't come in (fellows are there), but your pay is substantially lower (~50% lower), but u also work hard as well.

Cards is awesome, but the lifestyle is really hard, especially in private practice (even if u are noninvasive).

Studmuffin,

I am curious to know how manageable(or unmanageable) life is as a cards fellow? Do you have anytime to spend with family/friends?(any weekends off?) How does it compare with other hard working specialties(ortho/gensurg?)

Also, I have spoken with quite a few PP cardiologists (~5), none of whom were terribly upset by how much they worked. All these guys were from different LARGE practices. Talking to them and looking at current job offers online most cal seems to be q5-7 with separate weekday/weekend call. Maybe it is not the norm, but it seems to be a trend to establish large groups to lighten the call load. I'd be interested in hearing your experiences with this as a fellow, who will soon be looking for a job.

 

[studmuffin2005]

cards fellowship is not that bad (depends where u train). Some programs are in-house call, some home call. Weekends are mosltly off unless u are on a ccu/consult month. LIfe is definitely pleasant as a fellow, but that changes depending on the size of the group. again, most places that are smaller (ie <5-6 cardiologists), wil have busier workloads.

 

[Hudson]

cards fellowship is not that bad (depends where u train). Some programs are in-house call, some home call. Weekends are mosltly off unless u are on a ccu/consult month. LIfe is definitely pleasant as a fellow, but that changes depending on the size of the group. again, most places that are smaller (ie <5-6 cardiologists), wil have busier workloads.

Studmuffin,

PM me if you have more questions. But I know that in my home town of about 300k people there is one large Cards group of about 15 guys. They do very well financially, scheduled office visits are M-Thur. Friday is usually off for the established guys and the younger guys choose to work to build their practice. Their call is q7. Partnership tract is a few years. It seems like guys in more metropolitan areas work their as**s off b/c there is a lot more competition, and the insurance or "payor population" tends to reimburse less. Lower reimbursement combined with a higher cost of living drives docs to work more to make more money. If you can find a large group in a mid-sized city that doesn't have stiff competition for its patients then your lifestyle will be very manageable. This same line of thinking applies to Ortho/GI/Urology/Neurology.

Good to hear that you can have a a semblance of a life outside of medicine as a fellow.

 

[bachi]

this is an old thread, but applies to me very well, and i would love some feedback, ideas. i am ms4 female and love cardiology but thinking neurology bc its the only other i sort of like, with better lifestyle but getting tired of saying "there's no treatment.."

help me decide!

 

[dragonfly99]

My friend's dad is in private practice cards, and he has a pretty good lifestyle (Q7 or Q8 call). Cardiology is more work than neuro, though.

I am female starting cardiology fellowship...I think about 18% of cards fellows are women. Some are put off by the hours and length of training, but also there are/were some attendings who will try to discourage women from trying to apply to cardiology, and some interviewer faculty along the fellowship trail as well who seem to have bias, and will hammer you trying to find out if you are tough enough to do cardiology, and to see whether you are married and/or engaged. However, most people are open-minded if you show that you are willing to work hard.

Internal medicine residencies and cards fellowships both vary quite a bit in the hours required and the difficulty of the residency or fellowship. When I went around doing cards fellowship interviews, I was surprised to find out how few call months, and how many electives, IM residents @other programs reported they had. I think @whatever cards fellowship you do, you will work hard on your critical care and cath lab months, but other than that the schedule appears to be far, far easier than my IM residency. Also, in clinic you only have to deal with the cardiac-related problems, instead of trying to fix everything that is wrong with your elderly+diabetic+poor social situation IM residency clinic patients.

Interventional cards, particularly in private practice, can be a brutal lifestyle. Noninvasive cardology is somewhat better.

I don't think you should be afraid to do cardiology if you want it...don't let people intimidate you. Just show that you are better than the next guy, and that your work harder, and you will get in somewhere. It's probably honestly better not to have kids until you are done, but I know of one female cards fellow who has a kid, and several female cards attendings who have kids.

 

[dragonfly99]

My friend's dad is in private practice cards, and he has a pretty good lifestyle (Q7 or Q8 call). Cardiology is more work than neuro, though.

I am female starting cardiology fellowship...I think about 18% of cards fellows are women. Some are put off by the hours and length of training, but also there are/were some attendings who will try to discourage women from trying to apply to cardiology, and some interviewer faculty along the fellowship trail as well who seem to have bias, and will hammer you trying to find out if you are tough enough to do cardiology, and to see whether you are married and/or engaged. However, most people are open-minded if you show that you are willing to work hard.

Internal medicine residencies and cards fellowships both vary quite a bit in the hours required and the difficulty of the residency or fellowship. When I went around doing cards fellowship interviews, I was surprised to find out how few call months, and how many electives, IM residents @other programs reported they had. I think @whatever cards fellowship you do, you will work hard on your critical care and cath lab months, but other than that the schedule appears to be far, far easier than my IM residency. Also, in clinic you only have to deal with the cardiac-related problems, instead of trying to fix everything that is wrong with your elderly+diabetic+poor social situation IM residency clinic patients.

Interventional cards, particularly in private practice, can be a brutal lifestyle. Noninvasive cardology is somewhat better.

I don't think you should be afraid to do cardiology if you want it...don't let people intimidate you. Just show that you are better than the next guy, and that your work harder, and you will get in somewhere. It's probably honestly better not to have kids until you are done, but I know of one female cards fellow who has a kid, and several female cards attendings who have kids.

 

[dragonfly99]

Go for cards, and do not let being female stop you. A few attendings will try to discourage you, feeling that it's an unsuitable career for a woman, but to me it's great. It will be more work than neurology. The money is better (not my motivation for doing this) but $500,000 is unrealistic for most people...you could get that doing private practice interventional if you worked all the time, probably. Noninvasive cards has better hours than interventional.

Neuro residency is pretty tough the first 2 years, but then gets a lot better. I don't like neuro b/c I feel there are not a lot of good treatments for things.

IM internship can be brutal, and PGY2 and 3 are going to be either somewhat easier or quite easy, depending on where you do residency. Along the cards fellowship interview trail, I was shocked at how little call, and how many elective months, some residents from other programs reported they had. Personally, I had trouble even arranging my schedule so I could go to the required fellowship interviews, as our program wanted us there working, not gone, and there wasn't really a mechanism for what to do when people had to be out of town for multiple interviews within a couple month period.

 

[dragonfly99]

Go for cards. It is great and you can actually help the patients.
Fellows are about 18% female on average. I do think that some faculty try to discourage women, but many more are supportive. Don't let the naysayers discourage you if this is what you want to do. Interventional cards makes the most money, but has the worst hours.

 

[bachi]

thanks dragonfly99!
were you wavering at all on what you wanted to do during med school? did you feel like you had to be more competitive bc you are female (eg with research/chief yr etc). do you have a stat on how many % of card applicants get it? is it really going to be career long call schedule even for general cardiology?

Thanks!

 

[dragonfly99]

Sure, you are definitely going to take call as an attending cardiologist. If you want to not have much call, need to do endocrine or rheum or outpatient general IM or something like that. Academic call lis better b/c you have house staff to do some of the work for you...

I think as a female applicant you don't necessarily have to be better than male applicants, for the vast majority of programs. However, you do need to be as good...contrary to what some male applicants seemed to think, you need the same stats, etc. to get to the interview stage and nobody is going to really cut you any slack for being female. Most programs are just looking for good fellows, who they think will work hard. The attendings (and perhaps a few programs) who don't really like females mostly will probably be retired by the time you would be interviewing for cards anyway, b/c it's a lot of the older guys. Also, in terms of the people who really don't want women, you aren't going to change their opinion by doing more research, or being an even better resident, etc. Your time would be better spent just trying to be the best resident you can be, and being sure to apply broadly to fellowship so you can dump (or just rank low) any programs where you get a bad vibe during the interview.

 

[jabreal00]

If you like both and are more interested in the lifestyle, Neuro is the way to go. Cards fellowship can be brutal. Some programs are as intense as a critical care fellowship. On the other hand I have a buddy at a major program in CA who says it's a joke. He has so much time that he does a **** load of moonlighting. For the most part cards fellowship and private practice is more demanding on the time especially if one wants to make the average cardiology salary. The caveat is that you could always just do noninvasive and just clinic work as a cardiologist but there's not much differentiation between that and an internist. Why go through the hassle of doing a fellowship in cardiology if you relegate yourself to just OP care? ---------------- Listening to: Laurent Garnier - Sweet Mellow D via FoxyTunes

 

[PennDippody]

I couldn't have said it better:
The choice is either:
4-years slavery, then $200,000/year, rest of your life,
OR,
6-years slavery, then $500,000++/year, rest of your life,
Trust me,
$$$$ is everything, once you get older, and with family.
Hence,
if you are in the top 10%, go for Cardio.
Bon chance ))[/QUOTE

 

[glorfindel]

Trust me,
$$$$ is everything, once you get older, and with family.

I'm not a neurologist or a cardiologist, but I can confidently reject this statement.

If $$$$ is "everything" when you're "older" and "with family" (wtf does that mean?), then you f***ed up somewhere.

Financial security is important, but if you're a neurologist or a cardiologist and you aren't financially secure when you're "older" and "with family" then you managed your money poorly. You overspent. That's got nothing to do with your specialty choice.

 

[infarct]

I couldn't have said it better:
The choice is either:
4-years slavery, then $200,000/year, rest of your life,
OR,
6-years slavery, then $500,000++/year, rest of your life,
Trust me,
$$$$ is everything, once you get older, and with family.
Hence,
if you are in the top 10%, go for Cardio.
Bon chance ))[/QUOTE

this is garbage. i'm going into cards...but wow. no words. lol

btw...you might want to look into what actual salaries are. By the time you get into the real world the difference b/w neuro and cards isnt going to be that great.

 

[bluenebula83]

I don't know if that's necessarily true. Go with your gut (definitely not GI)! Haha, jk jk

 

[P Diddy]

I couldn't have said it better:
The choice is either:
4-years slavery, then $200,000/year, rest of your life,
OR,
6-years slavery, then $500,000++/year, rest of your life,
Trust me,
$$$$ is everything, once you get older, and with family.
Hence,
if you are in the top 10%, go for Cardio.
Bon chance ))[/QUOTE

This is not necessarily true; neuro-critical care docs make a pretty penny. You can make money in any specialty, but it's a rough go if you don't love what you're doing, especially in the labor intensive field of medicine.

p diddy

 

[nstemi]

this is a simple choice. do you prefer to help cure terrible disease or tell people they have a terrible disease with no cure?