Anesthesiology or Dermatolgy?

[flatulence]

Gas is sweet, great income, great lifestyle, still practicing very stressful life and death medicine. Dermatology is great income, even better lifestyle, and not really dealing with life or death (aside from skin cancer). If your main goal was to have good income, a good lifestyle, with your job taking a backburner,and really just what you do to pay for the things you REALLY enjoy which would you pick if you knew you could match in either one...honestly? Flame ******ent gear on!

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[lvspro]

If your main goal was to have good income, a good lifestyle, with your job taking a backburner,and really just what you do to pay for the things you REALLY enjoy which would you pick if you knew you could match in either one...honestly?

Derm

 

[militarymd]

 

[militarymd]

then pick DERMATOLOGY.....then PLEASE pick dermatology.

 

[militarymd]

AND, I'll write GREAT letters or recommendation to the DERMATOLOGY program of your choice.

 

[powermd]

Smack.

 

[cdql]

If your main goal was to have good income, a good lifestyle, with your job taking a backburner,and really just what you do to pay for the things you REALLY enjoy which would you pick if you knew you could match in either one...honestly?

a) Burger King Fry Fryer
b) McDonalds Burger Browner
c) Taco Bell Shell Shaper
d) KFC Chicken Cooker
e) Wendy's Window Wiper
f) All of the above

I'm assuming, Mr./Ms. Flatulence, that you are a pre-med student. (May God smite the admissions committee of your medical school if you have advanced beyond the pre-med level)

Helpful advice I give to all pre-med students: If you enter medicine with the ultimate goal of income, lifestyle, and cool toys, you will end up doing (F). Have fun!

 

[jetproppilot]

Gas is sweet, great income, great lifestyle, still practicing very stressful life and death medicine. Dermatology is great income, even better lifestyle, and not really dealing with life or death (aside from skin cancer). If your main goal was to have good income, a good lifestyle, with your job taking a backburner,and really just what you do to pay for the things you REALLY enjoy which would you pick if you knew you could match in either one...honestly? Flame ******ent gear on!

I like my job. Really.

But nights are the nemesis of this business.

Dermatology has no nights.

Heres my rhetorical answer:

Try and look beyond all the artificial, meaningless, competition/hype/this-specialty-is-better-than-that-specialty/ bull s h i t that goes along with the specialty-selection-period in medical school.

This is a CRITICAL decision for med students. And yet many times one's decision is not heartfelt....what I mean by that is you have to be honest with yourself. So here's a list of non-politically correct questions you should be asking yourself when you're trying to pick a specialty (being politically correct isnt a forte/desire of mine anyway...I'll tell you how I see it...sometimes to my demise):

1) Did you do a rotation that REALLY IMPACTED you? That really grabbed your attention? Got you so excited that you were waking up before the alarm clock with anticipation? Can you honestly say to yourself that no matter what happens to the specialty (reimbursement changes for example) and no matter what the hours are, you still HAVE to be a heart surgeon/pediatrician/neurosurgeon/geriatric physician etc etc??
Congratulations. You are one of the lucky ones. Go with this specialty because this is your life calling.
The percentage of med students fulfilling this mindset I'd say is less than 20%. This 20% can stop reading this post NOW. For the rest of you, read on.

2) OK, so you're in the 80% that are on the fence with 3 or 4 specialties. Maybe you're lucky and you've got it down to 1 or 2 specialties. Please take my advice since I think you'll thank me later....like in year 2016:

Think LONG TERM here. Try and look beyond all the alleged prestige, guts, glamour, and adrenaline rush you feel from your narrowed-down specialties.

Don't let your buddies opinions of your selected specialty impact you.

Please believe me that you, and your life will be totally different once you finish your training and you are 5-10 years into your private practice life.. Your priorities will most likely change.

Why is this SO important? Because remember that decision you made late in your third year of med school....I wanna be a (you fill in the blank here)? This decision affects you FOREVER. Yeah, that sounds dramatic, but, well, it IS dramatic.

Pick the wrong specialty for the wrong reasons and ten years from now you probably wont be happy with your life.

3) Be honest with yourself. You fell in love with heart surgery but the hours are intimidating to you. Dont go into heart surgery. You really loved internal medicine but you hate clinic. Dont go into internal medicine. You really love family medicine but the most important thing to you is money. Don't go into family medicine.

Thinking ahead, no matter what your buddies say, to what you perceive will make you happy 10 years from now concerning the right mix of medicine/lifestyle/money, should be the number one concern of yours. Not what is making you happy RIGHT NOW during your academic rotations.

4) Seek opinions of doctors outside academia when selecting a specialty. Call them. Talk with the dudes in private practice, since most likely this is where you will end up. Many times a specialty is viewed differently by docs outside academia.

There it is in a nutshell. Look ahead.

Good luck.

 

[sevoflurane]

 

[flatulence]

Excellent reply as always Jet! Wishin' I was premed as I may have chosen to pursue DDS/DMD instead looking back, but i am finising 3rd year, starting 4th year in one month and have to make a decision. Through the hoopla of the past 3 years I have realized a job is a job is a job. No matter what it is (for most of us) after doing something for >10 years things get to be routine and today is just another day. That being said, if you knew you would be happy practicing either specialty, and again had an excellent chance of matching in either, how would you make your decision.

Sincerely,
*****

 

[sevoflurane]

I like my job. Really.

But nights are the nemesis of this business.

Dermatology has no nights.

Heres my rhetorical answer:

Try and look beyond all the artificial, meaningless, competition/hype/this-specialty-is-better-than-that-specialty/ bull s h i t that goes along with the specialty-selection-period in medical school.

This is a CRITICAL decision for med students. And yet many times one's decision is not heartfelt....what I mean by that is you have to be honest with yourself. So here's a list of non-politically correct questions you should be asking yourself when you're trying to pick a specialty (being politically correct isnt a forte/desire of mine anyway...I'll tell you how I see it...sometimes to my demise):

1) Did you do a rotation that REALLY IMPACTED you? That really grabbed your attention? Got you so excited that you were waking up before the alarm clock with anticipation? Can you honestly say to yourself that no matter what happens to the specialty (reimbursement changes for example) and no matter what the hours are, you still HAVE to be a heart surgeon/pediatrician/neurosurgeon/geriatric physician etc etc??
Congratulations. You are one of the lucky ones. Go with this specialty because this is your life calling.
The percentage of med students fulfilling this mindset I'd say is less than 20%. This 20% can stop reading this post NOW. For the rest of you, read on.

2) OK, so you're in the 80% that are on the fence with 3 or 4 specialties. Maybe you're lucky and you've got it down to 1 or 2 specialties. Please take my advice since I think you'll thank me later....like in year 2016:

Think LONG TERM here. Try and look beyond all the alleged prestige, guts, glamour, and adrenaline rush you feel from your narrowed-down specialties.

Don't let your buddies opinions of your selected specialty impact you.

Please believe me that you, and your life will be totally different once you finish your training and you are 5-10 years into your private practice life.. Your priorities will most likely change.

Why is this SO important? Because remember that decision you made late in your third year of med school....I wanna be a (you fill in the blank here)? This decision affects you FOREVER. Yeah, that sounds dramatic, but, well, it IS dramatic.

Pick the wrong specialty for the wrong reasons and ten years from now you probably wont be happy with your life.

3) Be honest with yourself. You fell in love with heart surgery but the hours are intimidating to you. Dont go into heart surgery. You really loved internal medicine but you hate clinic. Dont go into internal medicine. You really love family medicine but the most important thing to you is money. Don't go into family medicine.

Thinking ahead, no matter what your buddies say, to what you perceive will make you happy 10 years from now concerning the right mix of medicine/lifestyle/money, should be the number one concern of yours. Not what is making you happy RIGHT NOW during your academic rotations.

4) Seek opinions of doctors outside academia when selecting a specialty. Call them. Talk with the dudes in private practice, since most likely this is where you will end up. Many times a specialty is viewed differently by docs outside academia.

There it is in a nutshell. Look ahead.

Good luck.

I agree with Jets words of wisdom.

Personally, I like the OR. I like the fact that I'm guaranteed procedures on a daily basis. I don't like office based practice. I don't like writing long a$$ notes. I like to see vitals and other data on screens and change my management based on what I see from a moment to moment basis. I love pharm and drugs/effects of drugs. I like to develop the clinical skills of reaching in and pulling someone out of disaster as they circle the deepest depths of a black vortex.

Stressful...? yes. Not always so... but definitely at times. Doubt I'll ever get bored. Anesthesia folk are some of the happiest/funniest/coolest/smartest dudes I've seen in every hospital I've ever been at- this I think says a lot. I'm biased and these are my views. At some point money plateaus and what you are actually doing can bring you enormous satisfaction. Jet hit it on the button: This decision affects you forever.

 

[jetproppilot]

Excellent reply as always Jet! Wishin' I was premed as I may have chosen to pursue DDS/DMD instead looking back, but i am finising 3rd year, starting 4th year in one month and have to make a decision. Through the hoopla of the past 3 years I have realized a job is a job is a job. No matter what it is (for most of us) after doing something for >10 years things get to be routine and today is just another day. That being said, if you knew you would be happy practicing either specialty, and again had an excellent chance of matching in either, how would you make your decision.

Sincerely,
*****

If you knew you'd be happy practicing either specialty, I'd pick the one that paid the most and gave me the most time off.

 

[wrx]

I like my job. Really.

But nights are the nemesis of this business.

Dermatology has no nights.

Heres my rhetorical answer:

Try and look beyond all the artificial, meaningless, competition/hype/this-specialty-is-better-than-that-specialty/ bull s h i t that goes along with the specialty-selection-period in medical school.

This is a CRITICAL decision for med students. And yet many times one's decision is not heartfelt....what I mean by that is you have to be honest with yourself. So here's a list of non-politically correct questions you should be asking yourself when you're trying to pick a specialty (being politically correct isnt a forte/desire of mine anyway...I'll tell you how I see it...sometimes to my demise):

1) Did you do a rotation that REALLY IMPACTED you? That really grabbed your attention? Got you so excited that you were waking up before the alarm clock with anticipation? Can you honestly say to yourself that no matter what happens to the specialty (reimbursement changes for example) and no matter what the hours are, you still HAVE to be a heart surgeon/pediatrician/neurosurgeon/geriatric physician etc etc??
Congratulations. You are one of the lucky ones. Go with this specialty because this is your life calling.
The percentage of med students fulfilling this mindset I'd say is less than 20%. This 20% can stop reading this post NOW. For the rest of you, read on.

2) OK, so you're in the 80% that are on the fence with 3 or 4 specialties. Maybe you're lucky and you've got it down to 1 or 2 specialties. Please take my advice since I think you'll thank me later....like in year 2016:

Think LONG TERM here. Try and look beyond all the alleged prestige, guts, glamour, and adrenaline rush you feel from your narrowed-down specialties.

Don't let your buddies opinions of your selected specialty impact you.

Please believe me that you, and your life will be totally different once you finish your training and you are 5-10 years into your private practice life.. Your priorities will most likely change.

Why is this SO important? Because remember that decision you made late in your third year of med school....I wanna be a (you fill in the blank here)? This decision affects you FOREVER. Yeah, that sounds dramatic, but, well, it IS dramatic.

Pick the wrong specialty for the wrong reasons and ten years from now you probably wont be happy with your life.

3) Be honest with yourself. You fell in love with heart surgery but the hours are intimidating to you. Dont go into heart surgery. You really loved internal medicine but you hate clinic. Dont go into internal medicine. You really love family medicine but the most important thing to you is money. Don't go into family medicine.

Thinking ahead, no matter what your buddies say, to what you perceive will make you happy 10 years from now concerning the right mix of medicine/lifestyle/money, should be the number one concern of yours. Not what is making you happy RIGHT NOW during your academic rotations.

4) Seek opinions of doctors outside academia when selecting a specialty. Call them. Talk with the dudes in private practice, since most likely this is where you will end up. Many times a specialty is viewed differently by docs outside academia.

There it is in a nutshell. Look ahead.

Good luck.

dude, great advice. can i have your autograph?

A couple of guys i know are going into anesthesiology because of the $$. they don't give a crap about the field, figuring they can GROW to like it & be proficient at it, given the $$ they'll make. Sad but true. Who says they won't end up being be good docs?

 

[cdql]

They can be good docs but they won't be great docs.

Would you do extra prep work in a subject you didn't find interesting? Would you attempt to learn as much as possible about a subject that bores you?

 

[militarymd]

dude, great advice. can i have your autograph?

A couple of guys i know are going into anesthesiology because of the $$. they don't give a crap about the field, figuring they can GROW to like it & be proficient at it, given the $$ they'll make. Sad but true. Who says they won't end up being be good docs?

MDs like that are the ones selling out our profession.....per some of the other threads that we've had.

I've always encouraged folks like that to go ahead and become a dermatologist.

We DON'T need anymore half committed MDs anymore.

Reimbursements WILL drop. They ARE dropping already....We'll have a specialty filled with a bunch of people who really don't like their specialty and bitter because of lower income........and at that point ....enter non-MD providers to step right in...and say....well you know what will be said....and you know what.......those guys won't care.

 

[jennyboo]

If you'd really enjoy either job to the same degree, then I agree with jet -- pick the one that pays you enough but that gives you fewer hours and fewer nights.

In reality, though, few people like two jobs exactly the same. The odds are 99 to 1 that you'll like one okay, and hate the other, and that's how you'll choose. And spend the next 20 years thinking the grass is greener on the other side.

 

[stephend7799]

dude, great advice. can i have your autograph?

A couple of guys i know are going into anesthesiology because of the $$. they don't give a crap about the field, figuring they can GROW to like it & be proficient at it, given the $$ they'll make. Sad but true. Who says they won't end up being be good docs?

those guys will be remarkable unhappy. you have to like it.. There are way too many drawbacks of the field to not like it when you go into it

 

[burntcrispy]

That being said, if you knew you would be happy practicing either specialty, and again had an excellent chance of matching in either, how would you make your decision.

Sincerely,
*****

I'm a 4th year and I had a good chance at matching in both as well. I never even considered derm because I thought it was too boring. Also, I hate clinic. You should do some anesthesia rotations to see if you really like it. We had some people in my class who were dead set on anesthesia until they did a rotation. Some people just can't take the "boredom" of sitting through long surgeries when the patient is rock solid stable. It seems that you've already realized that everything is just "a job" but you will have to do that job every day, day after day after day. Point is, try to find something that you won't absolutely end up hating. For me, no money in the world is worth a job that you hate. I've been down that road and belive me it's no fun.

I went with anesthesia because it was a good fit FOR ME. I like airway management, pharm, phys, etc so it was a natural choice. For a while I thought about surgery but by the end of the rotation I was already getting bored with it. But after around 250+ intubations I never get tired of them. Hell, I've probably started around 7,000-10,000 IV's (literally) and I still like doing that. You wont get this much experience on your rotations but it will give you a feel of what the job is about.

If you're just looking for a lifestyle job you may want to consider RADS. Great hours and those guys really rake it in. There are some medicine specialties such as allergy that make great money with minimal call, nights, etc.

Like someone else posted above, you can't predict who will be making the most money down the line because things change. Derm seems to be pretty safe though. The derm guys I've met in private practice see insurance or cash paying patients only, no freebies. They also do alot of cosmetic BS (botox, etc) which really pads the income.

Good luck with your choice.

 

[Sugar72]

Gas is sweet, great income, great lifestyle, still practicing very stressful life and death medicine. Dermatology is great income, even better lifestyle, and not really dealing with life or death (aside from skin cancer). If your main goal was to have good income, a good lifestyle, with your job taking a backburner,and really just what you do to pay for the things you REALLY enjoy which would you pick if you knew you could match in either one...honestly? Flame ******ent gear on!

I vote for Derm. Enjoy.

 

[InductionAgent]

I would applaud the OP for recognizing that he doesn't want to spend 75% of his waking hours involved in clinical practice. Everyone has a different burnout threshold and needs for time away from work. Some docs who work light schedules probably need to do so for their own sanity and are more effective as result.

Still, aneshesia and derm are vastly different specialties, and I would base my career choice on the nature of the work that best suits one's aptitudes and interest, and let the rest work itself out.

 

[DrRobert]

MDs Reimbursements WILL drop. They ARE dropping already....We'll have a specialty filled with a bunch of people who really don't like their specialty and bitter because of lower income.

They will only drop if we let them.

 

[cdql]

Probably not true. They will drop because the insurance companies refuse to pay us any more.

That being said, I would agree that derm is one of the specialties that will be hit less because many of the procedures that they bill for are not covered by insurance anyway. (e.g. botox, chemical peels, laser rejuvenation, etc...)

 

[emtji]

Probably not true. They will drop because the insurance companies refuse to pay us any more.

That being said, I would agree that derm is one of the specialties that will be hit less because many of the procedures that they bill for are not covered by insurance anyway. (e.g. botox, chemical peels, laser rejuvenation, etc...)

i have to admit that i don't know a ton about derm reimbursement.

BUT, reimbursements for what you do will likely drop in the future no matter what. society just isn't going to pay for treating all the baby boomers so you'll be working harder to make the same bucks.

as for derm, there's always the elective stuff, but the dropping reimbursements affect them too. and fact is, derm's territory is probably the least safe of any specialty. family practice docs inject botox. unlicensed medical spas do peels. i'd have to imagine the bread and butter ($$$) are the procedures, which *are* affected by medicare and private insurance.

 

[Induc(junc)tion]

I think Derm is not a bad gig, but I cant help but get the feeling that many of them are like salesmen. I mean walk into an officc of their ones day, and you will know what I mean.

 

[FlacoFlo]

I think both fields are great but I agree with Jet. You have to find what you really enjoy doing because inevitably, regardless of which field you pursue, after you're out in practice for a few years the 'honeymoon period' will come to an end. And you'll ask yourself (1) am I truly happy doing what I am doing? and (2) am I happy with the return on my investment (i.e. yrs of education)?? If you can see yourself treating rich kids acne for the next 20 years then have at it. Personally, I see the field of anesthesiology much more rewarding. Now, you have to take call unlike in derm but the level of skill and critical thinking is much greater in anesthesia. No bones about it, they both make a great living. I think the schedules can be pretty close to the same if you want it that way.

Another great aspect about our field of anes. is the pervasive type of personality of us. Generally, most of us are laid back and have many other interests outside of medicine (i.e. outdoors activities, business, family, volunteering). The original post talked about having other interests and obviously if you look at many of the members of this forum you'll find tons of interests that have nothing to do with medicine. I think that is one great aspect of the personalities of many anesthesiologists: we love medicine but we also have lives outside of it!!! You wont find that in some other fields!

 

[cdql]

and fact is, derm's territory is probably the least safe of any specialty. family practice docs inject botox. unlicensed medical spas do peels. i'd have to imagine the bread and butter ($$$) are the procedures, which *are* affected by medicare and private insurance.

That's true but I would guess that most people who are serious about botox or a chemical peel would rather pay just a bit more to get it done from someone who knows what they are doing.

(Of course, that's just my thinking. I guess if someone needs botox treatments all the time, they'll eventually go to a cheaper source. But if someone is sticking a needle in my face, I would hope they've had extensive training in it!)