endocrine info

Hey Scrub- Generally speaking, Endocrine is a wide open fellowship. Most fellowships are 2 years, with a few being 3 years. FMGs fill most of the Endocrine fellowship positions. Most of what an Endocrine doc does is mgmt of diabetes, lipid disorders, hypertension, and thyroid. After fellowship, many Endocrine docs are purely office-based. As an aside, some of the smartest docs I have known have been in Endocrine.

Does anyone have any good links, especially with regards to fellowships? I am interested in both IM and peds.

The Physician Compensation and Production Survey of 2000 by MGMA shows a mean salary of $174,557. General Internal Medicine was $156,322.

Not very procedural-based. You can do thyroid biopsies and DEXA bone scans if you are certified.

Probably not many emergencies that you have to get out of bed for -- DKA, hyperosmolar syndrome and thyroid crisis can be handled by the ICU. Best of all, you are in a sub-specialty and you don't have to do primary care!!

The "baby boomers" are approaching the diabetes age, and insulin-resistance from obesity is out of control... if that is an indication of the market for endocrinologists.

I'm biased cause I'm going into endocrine. Sorry!

Are there any notably great places to do your fellowship? If so, how competitive do they tend to be? Just wondering if it's analogous to IM in that the majority of people can get in, but the top programs are as competitive as other specialties.

Besides lack of procedures (which so far would be fine with me!) are there any other reasons why it's not up to cards or GI in terms of popularity? I imagine the patients would be varied enough since endocrine disorders affect many different body systems, you can help improve quality of life, and emergencies + risk of malpractice lawsuits must be fairly limited. I'm guessing the biggest frustration would be patient compliance, but it still doesn't seem too bad. Any thoughts would be appreciated.

Lara,

My insight towards the subspecialty mirrors yours. The subspecialty is naturally competitive in the best programs. I agree with you that it is analogous to IM. I am unsure of the top endocrinology programs in the country because I based my applications on location (which was difficult cause I wanted to be in California only).

Fellowships, in general, are competitive because there are few positions. One of the programs I interviewed at had almost 100 applications and they interviewed 11 candidates for one position. I have been told during my interview season that there are now more IM graduates who are interested in sub-specializing than before, so the competition for fellowships has increased.

Endocrinology is not as popular as cards or GI probably because it does not pay as well. I am sure you know that any specialty that involves procedures pays better. When I started my residency, I realized that every specialty pays according to how hard you work and the hours you put in. I would never be envious of a cardiologist who makes $500K a year when I make my little $150K a year because I know he/she works much longer hours than me and has to wake up more times in the night (and not because of nocturia either!) than me.

I am not an endocrinologist (yet). One of the reasons I chose endocrinology was because I felt I would have less lawsuits. Being the chicken that I am, living in this litigious society, I figured that less procedures = less mistakes = less lawsuits. Also, I thought about how endocrine lab tests come back in absolute numbers that can help me decide on my next course of action. The decision to treat is easier to make compared to, say, a fuzzy lesion on an echocardiogram.

Patient compliance will be a problem no matter what specialty, but it becomes more prominent in specialties that have long-term patient-doctor relationships such as endocrinology. It used to annoy me when I started out as an intern, but now I just take it all in stride.

I think I have said more than I wanted to. It's great that you are already looking at subspecialties, because early preparation is so important. When I was in high school, I thought I was going to be a cardiothoracic surgeon. If you want more details on why I chose endocrinology, please send me a message.

A mentor of mine, a pediatric endocrinologist put it best,

"You don't get paid to think"

This is unfortunate. I have always been intersted in peds endocrine, but I have talked to a few endos personally who say not to do it because managed care destroyed it with decreased reimb and need to see more patients, which is hard to do in endocrine and still be a very effective doc.

Can you please give me hard salary figures if you don't mind. I have to decide on a peds fellowship before long (I am starting rez in June). Unfortunatley, it will factor into my decision as it is a 3 year fellowship and I will not do it if they don't make a healthy sum more than primary care. I will do another specialty where I get compensatec for my extra 3 yearts of scut monkeying.

Thanks