What specialty is the best kept secret in medicine?

painmd87 said:

Those in sleep medicine fellowships might disagree with you. So would the general membership of the American Board of Sleep Medicine. Unless I'm misunderstanding your unusual comment?

Click to expand...

You find factual comments unusual? Why?

It doesn't matter who disagrees with me but Sleep Medicine is not an official ABMS specialty. That's a fact. You can't disagree with a fact.

See here: http://www.certificationmatters.org/abms-member-boards.aspx

Additionally, you don't even have to be an MD to become a ABSM diplomate.

So let's try again: Sleep medicine is not a medical specialty. It might be an area of practice or a field of interest but it is not a recognized medical specialty. Sleep medicine is no more of a specialty than Naturopathic Medicine or Anti-Aging medicine. Anyone can start a Board, give exams, and start collecting fees in exchange for a certificate.

Finally, if you don't believe me ask the ACGME or HHS. The Boards they recognize are the ABMS members.

carml said:

Except the daily staring at purple and blue and pink slides part ...man, that would get to me.

Click to expand...

Until you got the check....have you ever seen one work, it takes them like 10 seconds per slide...there's really nothing else like it as far as money vs effort goes in medicine, and nobody seems to know about it. Best kept secret for sure.

jdh71 said:

I mean we can sit around all day long and talk about the various sundry specialties and how they make way more than they are worth - diagnostic rads,

Click to expand...

Maybe 10-15 years ago bud but radiologists only make the money they do now because of volume..we get paid a pittance on a per study basis. To make the kind of money naive med students dream of youre talking reading 30 thousand or more studies per year. Radiology doesnt belong on the ROAD any more, those days are long over.

HondoCrouch said:

Maybe 10-15 years ago bud but radiologists only make the money they do now because of volume..we get paid a pittance on a per study basis. To make the kind of money naive med students dream of youre talking reading 30 thousand or more studies per year. Radiology doesnt belong on the ROAD any more, those days are long over.

Click to expand...

Is diagnostic making more than your average FP, pediatrician, or internist? Yes or no? Because, bud, they're still getting paid too much for what they do by my estimation. Though, I can't hate for getting while the getting is good.

jdh71 said:

Is diagnostic making more than your average FP, pediatrician, or internist? Yes or no? Because, bud, they're still getting paid too much for what they do by my estimation. Though, I can't hate for getting while the getting is good.

Click to expand...

That's a pretty hard thing to quantify, the value of their job that is. It will vary depending on who you ask.

jdh71 said:

Is diagnostic making more than your average FP, pediatrician, or internist? Yes or no? Because, bud, they're still getting paid too much for what they do by my estimation. Though, I can't hate for getting while the getting is good.

Click to expand...

Diag. rad is essentially image analysis. Computers can do this now and are rapidly getting better. And it can and is being outsourced as well.

The writing is on the wall. Get out while you can and don't get into it.

Radonkulous said:

That's a pretty hard thing to quantify, the value of their job that is. It will vary depending on who you ask.

Click to expand...

Um. Duh?

It is totally subjective, which is why I made sure I qualified my remarks as my own opinion/estimation. You did notice that? And if you did, then why even make the obvious and useless comment?

jdh71 said:

Is diagnostic making more than your average FP, pediatrician, or internist? Yes or no? Because, bud, they're still getting paid too much for what they do by my estimation. Though, I can't hate for getting while the getting is good.

Click to expand...

So your estimation of the relative value of any profession is how much money it makes compared to an FP, pediatrician or internist...I'm sorry I just dont follow your logic...they are different professions they have nothing to do with each other.

Id love to hear your theory on why all of the varying medical professions should be deemed valued or undervalued based on what an FP makes despite the fact they are essentially all different professions with widely varying post-graduate training.

HondoCrouch said:

So your estimation of the relative value of any profession is how much money it makes compared to an FP, pediatrician or internist...

Click to expand...

No. My estimate of relative value has nothing to do with ho much an FP, pediatrician, or internist make.

I'm sorry I just dont follow your logic...

Click to expand...

Well, I've not made an argument, therefore not put forth any particular logic. Your confusion is easily explained if you pay better attention to what is being said.

they are different professions they have nothing to do with each other.

Click to expand...

noh wai?! serius? i had noh klue

Id love to hear your theory on why all of the varying medical professions should be deemed valued or undervalued based on what an FP makes despite the fact they are essentially all different professions with widely varying post-graduate training.

Click to expand...

Uh. What is this I don't even . . .

I like path but assume I could never do it since my eyes are bad... Apparently I am "too myopic" for refractive surgery. Bleh. Q: can you do path if you're entirely reliant on high-power visual correction?

HondoCrouch said:

Until you got the check....have you ever seen one work, it takes them like 10 seconds per slide...there's really nothing else like it as far as money vs effort goes in medicine, and nobody seems to know about it. Best kept secret for sure.

Click to expand...

jdh71 said:

Uh. What is this I don't even . . .

Click to expand...

oh come on you are just avoiding the questions. You clearly stated that you believe rads makes too much money for what they do and you compared what they make to how much an internist, peds, or FP doc makes... What makes you think rads gets paid too much for what they do? Is it because they aren't in the hospital 24/7 taking care of the sickest patients? What makes a field "valuable" in your opinion?

You also make it sound like rads as a field is easy to learn and is not necessary to the extent that it is. OK fine. When you order any film do not send it to a radiologist. Just read and interpret it yourself. If you get a study don't look at the report ever again.

I just love docs who act like they know how to read films better than a radiologist. I see it all the time. Makes me laugh actually.

officedepot said:

oh come on you are just avoiding the questions.

Click to expand...

I'm not avoiding any questions. I merely lack the energy to completely engage in what amounted to incorrect accusations about what I was saying. If you don't have the common courtesy to stop and try and figure out what is being said before going off half-cocked, then I don't see why my valuable time should be wasted in any serious attempt in discussion.

You clearly stated that you believe rads makes too much money for what they do and you compared what they make to how much an internist, peds, or FP doc makes...

Click to expand...

It is my personal estimation that diagnostic rads makes too much for what they do. All, I asked was do they make more? It was a yes or question. The point of which is they are still doing very well for what they do.

What makes you think rads gets paid too much for what they do? Is it because they aren't in the hospital 24/7 taking care of the sickest patients? What makes a field "valuable" in your opinion?

Click to expand...

Ah. See, I can work with this. This is actually a discussion. You asked a relevant question. You're trying to clarify my position. I don't think diagnostic radiologists contribute as much to patient care as the people in the trenches. I get a chest radiograph, not so you can read it, but so I can see what it looks like. Which is not to say that there isn't a place for more specialized studies. However, based on my estimation of what is practically contributed to actual patient care, I think the average salary (as per the surveys of salaries I've seen) of a radiologist is too much, especially when the dictations tend to be as vague as possible. It's nothing personal. Nor am I on some sort of crusade to make sure you get paid less. If you're getting paid a grip for what you do, good on ya. I don't begrudge a man what he can get another to pay him for an honest day's work.

You also make it sound like rads as a field is easy to learn

Click to expand...

I don't think I ever said that. How did I make it "sound" that way? What was it that I said that made it "sound" that way?

and is not necessary to the extent that it is. OK fine. When you order any film do not send it to a radiologist. Just read and interpret it yourself. If you get a study don't look at the report ever again.

Click to expand...

Well, it's not just that completely simple in today's medical-legal environment. For better or worse the rest of us still need you signing off on your reads, though for many (but not all) things I do it is completely unnecessary. I do appreciate the exert opinion when I think I need it.

I just love docs who act like they know how to read films better than a radiologist. I see it all the time. Makes me laugh actually.

Click to expand...

Then I wonder why I have a whole stack of bad chest xray and chest CT reads in a collection . . . I don't know if "read better" is the best way to think about it. For many, many conditions read "just as well" could easily be appropriately used.

jdh71 said:

I'm not avoiding any questions. I merely lack the energy to completely engage in what amounted to incorrect accusations about what I was saying. If you don't have the common courtesy to stop and try and figure out what is being said before going off half-cocked, then I don't see why my valuable time should be wasted in any serious attempt in discussion.

Click to expand...

you talked about wasting your time yet you took the time to reply to something you thought would waste it? ok

It is my personal estimation that diagnostic rads makes too much for what they do. All, I asked was do they make more? It was a yes or question. The point of which is they are still doing very well for what they do.

Click to expand...

whatever. I think it was evident what you were trying to imply.

Well, it's not just that completely simple in today's medical-legal environment. For better or worse the rest of us still need you signing off on your reads, though for many (but not all) things I do it is completely unnecessary. I do appreciate the exert opinion when I think I need it.

Then I wonder why I have a whole stack of bad chest xray and chest CT reads in a collection . . . I don't know if "read better" is the best way to think about it. For many, many conditions read "just as well" could easily be appropriately used.

Click to expand...

you're pulm cc right? regardless, and I mean no offense, I regard a non-rad skill at reading a film as good as a NP or PA with equal experience in a niche field where you will be only looking for certain things. Thoracic surgery is a good example. They only look at CXR or chest CTs and that's pretty much it (maybe MIR occasionally). They know the basic imaging findings for their array of conditions that they see (effusions, pneumothorax, etc). Because you are with the patient you will be looking for something specific, say, a pneumothorax. However you are simply not trained to see other findings that you are not specifically looking for. Thus you may think you can read a film just as well but it doesn't take a genius radiologist to point out a pneumothorax, heck a nurse can do it (and I've seen them do it). But non-rads docs are more keen to miss things you aren't interested in.

I think from what you said you comprehend this point but don't give it much credit. You probably see so many films your forget the ones where the radiologist was more help and you don't give it the due respect it deserves. Lots of doctors are like this though. Ortho is another big field that comes to mind.

So in essence you're good at your small niche of reads. But it seems you neglect that rads are responsible for pretty much every single niche there is on any particular film and are essentially obligated to give a differential on any particular finding when possible. That is what separates rads from non-rads.

I'm not going to debate payments. You have a different view that I will not be able to change so that is not worth my time.

TheProwler said:

Yes, and surgeons will be replaced by highly advanced robotics.

Click to expand...

Probably. And hopefully. But it will be much much further into the future than the image analyzers. Surgery is much more complex than image analysis. And are the robots also going to the pre-op and post-op care? (I hope so)

And the first robots will be run by humans surgeons (e.g. DaVinci, Gamma Knife, etc.)

Anyone doing only Diag. Rad now can and will be either outsourced to a guy at a screen in India or some software and silicon. It's over Johnny.

per the original discussion...

I really think PM&R would be the best choice if this was a boards-style one best answer question. PM&R definitely isn't for everyone, and there are varying opinions on its "cush-ness"..lifestyle, compensation, etc...but...I'd imagine that quite a few M1s and M2s would wonder why the hell a dude from the university physics department was giving a lecture were someone to initially introduce themselves as a Physiatrist. Hence, because it offers comparable compensation, lifestyle, etc. to many other specialties that are much more well-known...I guess it could be considered a "secret" (IMHO).

jdh71 said:

I get a chest radiograph, not so you can read it, but so I can see what it looks like. Which is not to say that there isn't a place for more specialized studies. However, based on my estimation of what is practically contributed to actual patient care, I think the average salary (as per the surveys of salaries I've seen) of a radiologist is too much, especially when the dictations tend to be as vague as possible. It's nothing personal. Nor am I on some sort of crusade to make sure you get paid less. If you're getting paid a grip for what you do, good on ya. I don't begrudge a man what he can get another to pay him for an honest day's work.


Well, it's not just that completely simple in today's medical-legal environment. For better or worse the rest of us still need you signing off on your reads, though for many (but not all) things I do it is completely unnecessary. I do appreciate the exert opinion when I think I need it.

Click to expand...

We get, on average, $2-3 bucks reading your chest x-ray, we arent getting rich on your worthless chest x-rays.

I gather from your general tone that youre one of the typical bitter pulmonary fellows.

Here's a clue for you: The reason you think you can read chest x-rays and CTs so well is because 90% of the imaging you order is unecessary and you base your "read" on your clinical impression. Trust me nobody in radiology would shed a tear if you guys stopped having us read all your chest xrays and CTs that we all know are only ordered because you bought a xray machine and a CT scanner.

The only reason radiologists make good money is because technology allows us to read high volume. We get peanuts for our work.

Typical example: I read a mammogram on a 40 year old woman, work up a vauge finding and in the end diagnose an early breast cancer. If miss anything the woman can sue me for millions of dollars. My kings ransom for this work: $20. If thats not a value for the patient I dont know what is.

officedepot said:

you talked about wasting your time yet you took the time to reply to something you thought would waste it? ok

Click to expand...

Well, you often have to reply, a little, or people might actually think they made a real point. But we're quibbling about style.

whatever. I think it was evident what you were trying to imply.

Click to expand...

This is one of those things that frustrates me to no end. Someone asks you to explain your position, and then they say, "Nuh-uh, I don't care that you just told me what you meant, I'm going to tell you that you didn't mean that, you meant something else!"

you're pulm cc right? regardless, and I mean no offense, I regard a non-rad skill at reading a film as good as a NP or PA with equal experience in a niche field where you will be only looking for certain things. Thoracic surgery is a good example. They only look at CXR or chest CTs and that's pretty much it (maybe MIR occasionally). They know the basic imaging findings for their array of conditions that they see (effusions, pneumothorax, etc). Because you are with the patient you will be looking for something specific, say, a pneumothorax. However you are simply not trained to see other findings that you are not specifically looking for. Thus you may think you can read a film just as well but it doesn't take a genius radiologist to point out a pneumothorax, heck a nurse can do it (and I've seen them do it). But non-rads docs are more keen to miss things you aren't interested in.

I think from what you said you comprehend this point but don't give it much credit. You probably see so many films your forget the ones where the radiologist was more help and you don't give it the due respect it deserves. Lots of doctors are like this though. Ortho is another big field that comes to mind.

So in essence you're good at your small niche of reads. But it seems you neglect that rads are responsible for pretty much every single niche there is on any particular film and are essentially obligated to give a differential on any particular finding when possible. That is what separates rads from non-rads.

Click to expand...

I didn't make the claim that I was as good at everything that a radiologist has to be good at. I do realize I live in my niche and I've got lots of clinical context, but I've seen more cases where we saw things that the radiologist didn't than the other way around when it comes to CXR and CCT. My anecdotes and YMMV.

I do appreciate radiologist expertise in areas where I am much less comfortable with reads, or literally have no clue what I'm looking at. Again, in my anecdotal experience, when something looks odd on the CXR or CCT, I'll go down and look at it with the radiologists, and the interaction always underlines what we already thought and doesn't usually yield something we hadn't thought of or missed. And as non-specific as so much CXR and CCT is anyway we end up bronching or getting the surgeons involved for bx, and then after all of that work the pathologists still make the diagnosis (hopefully).

HondoCrouch said:

We get, on average, $2-3 bucks reading your chest x-ray, we arent getting rich on your worthless chest x-rays.

I gather from your general tone that youre one of the typical bitter pulmonary fellows.

Here's a clue for you: The reason you think you can read chest x-rays and CTs so well is because 90% of the imaging you order is unecessary and you base your "read" on your clinical impression. Trust me nobody in radiology would shed a tear if you guys stopped having us read all your chest xrays and CTs that we all know are only ordered because you bought a xray machine and a CT scanner.

The only reason radiologists make good money is because technology allows us to read high volume. We get peanuts for our work.

Typical example: I read a mammogram on a 40 year old woman, work up a vauge finding and in the end diagnose an early breast cancer. If miss anything the woman can sue me for millions of dollars. My kings ransom for this work: $20. If thats not a value for the patient I dont know what is.

Click to expand...

Bitter about what? You're the one who sounds bitter man.

How would you, as a non-clinician, make the assessment of when a film or CT is necessary?

TheProwler said:

I think that's a reasonable sum for your knowledge and review, and I wish patients could actually see how much we get paid for many things like this. Instead, we have Obama spouting off about how surgeons get paid $40,000 to amputate your leg.

What I would like to know is why an echo costs $3000 or an epidural costs $1500 or more. Which is exactly how much my insurance paid for those things. Paying a neurosurgeon $10-20K for peeling a tumor off my brain/spinal cord seems like a pretty good bargain though (I have no idea what they actually get reimbursed for those things though).

Click to expand...

Agree 1000%

jdh71 said:

Bitter about what? You're the one who sounds bitter man.

How would you, as a non-clinician, make the assessment of when a film or CT is necessary?

Click to expand...

I dont know why pulm fellows are always so bitter, I guess cause they didnt cards or GI? hell if I know, it's just my experience. The overarching theme is that they feel they are so good at reading chest x-rays and CTs because they just base their "read" off their clinical impression. And as you knowingly or unknowingly admitted in your above post, most chest imaging is nonspecific and will end up going to bronch anyways, so if you just make your "read" your clinical impression you will be right most of the time so pulm fellows tend to get the idea they are chest imaging experts.

As to the non-clinician comment, I dont know what corner of the wolrd you live in but where Im from radiologists are clinicians. I talk to 40-60 patients everyday.

HondoCrouch said:

I dont know why pulm fellows are always so bitter, I guess cause they didnt cards or GI? hell if I know, it's just my experience. The overarching theme is that they feel they are so good at reading chest x-rays and CTs because they just base their "read" off their clinical impression. And as you knowingly or unknowingly admitted in your above post, most chest imaging is nonspecific and will end up going to bronch anyways, so if you just make your "read" your clinical impression you will be right most of the time so pulm fellows tend to get the idea they are chest imaging experts.

Click to expand...

I still don't understand what I have to be "bitter" about. I never wanted to go into cards or GI. Why would I? Are you trying to project your nonsense onto me here or what? I think you should keep your ego defense mechanism to yourself, but that's just me.

I'm not being "bitter" when I think we read CXR and CCT just as well. It's an opinion and it's based on my experience. YMMV.

As to the non-clinician comment, I dont know what corner of the wolrd you live in but where Im from radiologists are clinicians. I talk to 40-60 patients everyday.

Click to expand...

So does the secretary and the tech. They clinicians too?

Look, all I said was I think certain specialties make too much in my opinion, but basically had no problem that they did so. Like, professional athletes. It's silly we pay them so much, but we do.

I have certain opinions. No real reason to get offended. And I've gone and kid of hijacked another thread, so I'm done with the pissing contest regarding radiology.

With regards to the OP, I'm of the opinion that PM&R is the secret specialty that you don't really hear much about in medical school. It's not a bad way to make a living. It's not my cup of tea, but I have a few friends who went that direction and residency is nice, and opportunities after residency are even nicer, at least currently, even in MOST markets. There will be weekend "call" where you'll round and probably cross-cover patients for your group from home, but you don't admit on the weekend. Anyone gets sick, they go back to a proper hospital. Pay is better than PC.

jdh71 said:

I still don't understand what I have to be "bitter" about. I never wanted to go into cards or GI. Why would I? Are you trying to project your nonsense onto me here or what? I think you should keep your ego defense mechanism to yourself, but that's just me.

I'm not being "bitter" when I think we read CXR and CCT just as well. It's an opinion and it's based on my experience. YMMV.




So does the secretary and the tech. They clinicians too?

Click to expand...

Only a bitter person would keep a stack of so-called "bad" chest xray and CT reads as you admittedly do. I dont keep a stack of stupid requests from clinicians to show how awesome I am.

Only a bitter person would make snide remarks about secretaries and techs seeing patients. As a breast imager i see patients in clinic every day, evaluate symptoms, perform physical exams and diagnose disease, sounds like a clinician to me. Interventionalists do the same as well. So do neurorads involved in spine and pain procedures. I guess those radiologists arent clinicians either.

Im sorry youre so bitter and obviously envious of other professions and it clearly blinds you to the reality of other fields if you think your chest x-rays are the highlight of our days and the key to our vast wealth.

I think he's jumping ship to do some sleep.

Its been said but my hat goes to allergy, it's a four year post med school mid to high 200k salary range and no call. Most of the allergists in my area work three days a week and I assume are making +100k. I dont know how competitive the fellowship is but internal med is all but a sure thing if you are interesting in going that route. Oh, and most the pt's they see they only see once and they get income from them for approx 3-4 years via the shots, pretty nice if that's your cup of tea.

If I told you on a public forum it clearly would not longer be a secret.

You two need to chill out. No one on here wants to hear you two bicker about who can read a chest CT better or who is the uber clinician. If the pulm fellow wants the responsibility and legal ramifications of reading all of his own chest CT's then so bet it. If the radiology guy wants to see patients and call himself a clinician then he can do that as well. At the end of the day you two both have the right to call yourself doctor, and are well trained at what you are supposed to be doing for a living.

fahimaz7 said:

You two need to chill out. No one on here wants to hear you two bicker about who can read a chest CT better or who is the uber clinician. If the pulm fellow wants the responsibility and legal ramifications of reading all of his own chest CT's then so bet it. If the radiology guy wants to see patients and call himself a clinician then he can do that as well. At the end of the day you two both have the right to call yourself doctor, and are well trained at what you are supposed to be doing for a living.

Click to expand...

voice of reason.

fahimaz7 said:

You two need to chill out. No one on here wants to hear you two bicker about who can read a chest CT better or who is the uber clinician. If the pulm fellow wants the responsibility and legal ramifications of reading all of his own chest CT's then so bet it. If the radiology guy wants to see patients and call himself a clinician then he can do that as well. At the end of the day you two both have the right to call yourself doctor, and are well trained at what you are supposed to be doing for a living.

Click to expand...

Meh. FWIW, I actually enjoyed reading the discussion.

I'm casting my vote for PM&R as being the best kept secret amongst all medical specialties for the following reasons:

1) well-compensated when broken down by hours worked
2) Hardly any call, great working hours that allows for time with family/friends
3) inpatient and outpatient privileges
4) good mix of clinic and procedures
5) great for those interested in "neuromuscular orthopedic medicine"
6) work in a team of healthcare professionals (from orthopods to occupational therapists)
7) interesting academic material (spinal cord rejuvenation, myopathies, neural plasticity a/w limb loss)

KinasePro said:

Meh. FWIW, I actually enjoyed reading the discussion.

Click to expand...

Yea, it was fun the first time. Arguing crap like this is like arguing about which religion is true. Just give up. The pulm fellow thinks that he is a radiologist. Even pulm attendings don't think they are a radiologist. It takes 10,000 hours to be proficient at doing something, which is a lot more than a pulm fellow has.

painmd87 said:

Those in sleep medicine fellowships might disagree with you. So would the general membership of the American Board of Sleep Medicine. ."

Click to expand...

thanks for your support. The American Academy of Sleep Medicine is the organization for sleep physicians. The American Board of Sleep Medicine ran the old sleep boards that have now been replaced. The American Board of Sleep Medicine now has a certification aimed at psychologists who do behav sleep med.

painmd87 said:

It depends how neurotic of a doc you are. I've worked in two labs; one doc did score AND interpret, and had a hand in every day-to-day minute detail of the lab. In the other lab, the doc is a rarely-contacted resource who only interprets. But I do see what you're saying, and it is more correct to say, "remote read/interpret" rather than "remote score."

Click to expand...

You are right, there are a few sleep docs who score studies, I'd estimate about 1%. I know one pulmonologist on the Gulf Coast of MS who owns a 2 bed sleep lab and does this.

fahimaz7 said:

You two need to chill out. No one on here wants to hear you two bicker about who can read a chest CT better or who is the uber clinician. If the pulm fellow wants the responsibility and legal ramifications of reading all of his own chest CT's then so bet it. If the radiology guy wants to see patients and call himself a clinician then he can do that as well. At the end of the day you two both have the right to call yourself doctor, and are well trained at what you are supposed to be doing for a living.

Click to expand...

The discussion was over, at least I had bowed out, a FULL 6 posts before you decided to chime in with your useless post. I'm really interested to hear in how you found your post actually helpful.

Klokke said:

You find factual comments unusual? Why?

It doesn't matter who disagrees with me but Sleep Medicine is not an official ABMS specialty. That's a fact. You can't disagree with a fact.

.

Click to expand...

http://www.abim.org/exam/certification/sleep-medicine.aspx

It's not a fact and you are wrong

http://www.abim.org/pdf/cert-related/Sleep-Medicine-Certification-FAQ.pdf

fahimaz7 said:

Yea, it was fun the first time. Arguing crap like this is like arguing about which religion is true. Just give up. The pulm fellow thinks that he is a radiologist. Even pulm attendings don't think they are a radiologist. It takes 10,000 hours to be proficient at doing something, which is a lot more than a pulm fellow has.

Click to expand...

This is some of the garbage that drives me nuts about this forum. Is it possible for students to pay attention what is said and what is not said? I don't think I am, nor did I ever say I am a radiologist. Are you really too stupid to understand what was said or simply that intellectually dishonest and lazy? Because that seems to be the only explanation here - one or the other.

For most of my work, I don't need a radiologist telling me what I already know I see. We will both agree on what we see. I appreciate expert opinion and work closely with my chest radiologists. In much the same way I appreciate expert cardiology opinion, and work closely with my cardiology consultants, but for most of cardiology critical care they are largely unnecessary to what I do.

michaelrack said:

http://www.abim.org/exam/certification/sleep-medicine.aspx

It's not a fact and you are wrong

http://www.abim.org/pdf/cert-related/Sleep-Medicine-Certification-FAQ.pdf

Click to expand...

pwned

I think sleep isn't so much a secret. I've had the chance to work some with one of the "big names" in sleep, and turns it into a really interesting topic for me (but we all know certain attending that can make anything seem awesome). But what I thought was kind of cool was going through a few sleep cases with one of my attendings who also does sleep on one of our weekends together. It has me giving some serious consideration to putting in the extra year. I need to find an elective with the sleep guys next year.

TheProwler said:

Lighten up, Francis.

Click to expand...

Word.

I've been trying to even more . . .

It has gotten better over the years. At least I think it has.

kaleerkalut said:

What is PM&R?

Click to expand...

If you are truly interested in PM&R, check out this link

Feel free to PM me as well. It's an awesome field!

PM&R and Rad Onc.

End thread.

fahimaz7 said:

Yea, it was fun the first time. Arguing crap like this is like arguing about which religion is true. Just give up. The pulm fellow thinks that he is a radiologist. Even pulm attendings don't think they are a radiologist. It takes 10,000 hours to be proficient at doing something, which is a lot more than a pulm fellow has.

Click to expand...

I on average worked 50 hours per week during residency training. If I was on call that weekend, that amount would probably go up to the 60-70 hours (sometimes into the 80 range). So doing some simple math: 50 hours/week x 4 weeks/month = 200 hours/ month x 12 months/year = 2400 hours/year x 4 years of residency training (in my case) = 9600 hours + 1 year of fellowship = 12000 hours. I think I am being conservative; I probably have more hours of training.

Of course, I feel proficient in my specialty as a whole, it probably takes a lot less time to master something in particular.

DrBowtie said:

PM&R and Rad Onc.

End thread.

Click to expand...

I agree. I would add sleep to it also, but it is a fellowship.

Rad Onc is a secret to M1-M2 student, and most students don't realize what an awesome job it is until it is too late. It is very competitive, but if you knew about it early on, you can get your research on and get yourself into shape to get a residency spot.