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I really enjoyed my pathology class. Why did you decide to go with pathology and what do you enjoy about it now that you have had the chance to practice?
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I really enjoyed my pathology class. Why did you decide to go with pathology and what do you enjoy about it now that you have had the chance to practice?
yaah, I am interested in hearing your answers to these questions as well.
forgot to mention: and I thought that pathologists made a decent wage. Isn't the average salary somewhere near ~$175,000? That's pretty good if you ask me.
I just liked the way the field approaches disease and medicine in general. I learned about it 2nd year of med school, before that point I had no idea what pathologists did, I guess I had never thought about what happened between when a biopsy is taken and when the results come back. I liked how you actually saw the disease represented and that you served something as a consultant to other physicians, and practiced with patient interests in mind but without much actual interaction. I like people just fine, but I found that patient interaction left a lot to be desired (too much paperwork, too many algorithms, too much spinning your wheels). I guess it appeals more to my scientific side than medicine in general did. What is interesting is that if I was to do anything else in medicine, I would probably focus on geriatrics or end of life care. I hated the OR. I hated floor medicine (although I liked outpatient medicine). I hated procedures. I didn't like radiology.
Part of the problem is that med students don't get much pathology exposure anymore. Lab keeps getting marginalized at the expense of more patient interaction or group discussions. And what is present most med students treat as learning enough to do well on the test. So unless you take it upon yourself to learn about path as a specialty, you won't know much about it or whether it appeals to you.
I enjoy pathology know because I never quite know how my day is going to go and what I am going to learn. We see the entire spectrum of disease represented on slides or lab tests, and physicians depend on us to make sense of them. I also enjoy the people I work with and the environment. It is much less rigid and inflexible.
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I think the average salary (starting salary) is somewhere around $150-175, although I am not entirely sure. There is a large discrepancy between a starting academic salary (generally $100-130k) and a starting private salary (average probably $200k, ranging $150-300). Partners in private practice can make considerably more, although probably not quite to the level of radiology.
I always thought that Path & Rads were sister specialties. Path interpret tissue samples & Rads interpret imaging modalities. They both serve as consultants to other physicians, providing patient care indirectly, w/o the glorified 'patient contact'.
I loved my Path labs during M2, but Rads is where all the action is, it's practically the backbone of modern medicine.
It depends on your perspective. To me, a lot of radiology is vague and not diagnostic (What's the radiologist's favorite plant? The hedge! What's the radiologist's favorite food? The waffle!) 😉 . It suggests things more often than it proves them. It creates opportunities for further investigation more than definitively ending the investigation. Many studies are based on surveillance strategies and tracking small lesions and comparing them with the previous. I know that's a vast overgeneralization and not real life, but it's part of it, and that's the part of it that is dull to me. And the "exciting" parts of radiology just don't seem exciting to me - a CT on an acute abdomen, trying to find the abnormality? No thanks.
See, to me, path is where the action is. Radiology is less exciting. Plus, lots of radiologists do too many procedures for me. I do think it is easier for clinicians to have a basic understanding of radiology than it is for them to understand pathology - so sometimes it makes for a healthier communication between the specialties. Perhaps it's because radiology is easier to access these days - images are online or can be put up on a viewbox. Everybody's an expert (but not enough of an expert to go without a radiologist!). Pathology you need a scope plus the prepared slide. Technology is improving though so that increasingly we are able to look at slides in computer format - but the difference between a radiology file on a computer and a path slide file is orders of magnitude - a single path slide takes up multiple GB of memory.
But all this is why there are so many specialties and why everyone (hopefully) can find their own niche. What is good for some is not for others. Anyone who has not decided on their career choice needs to find a way to be as sure as they can about their decision before they make it - and NOT make their decision primarily on lifestyle issues.
The field with the best "bang for your buck" is the specialty you actually enjoy practicing. That way you never feel like you're actually doing "work" and you still make a good living.
If you hate any of the fields mentioned earlier - ophtho, derm, path etc, you'll hate your career and simply collect a paycheck. There's way too many threads on this forum about getting the most money by working the least.
If you hate any of the fields mentioned earlier - ophtho, derm, path etc, you'll hate your career and simply collect a paycheck. There's way too many threads on this forum about getting the most money by working the least.
EM is pretty sweet, while you will work harder when you have to go to work, but you have a 36hr work week, no on call. Most are actually paid hourly, so if you choose to work OT you get time and a half. Average salary without OT is 235k/yr (starting a little lower about 200k/yr) that is with malpractice already taken out. Only work about 15 days/month. Can move whenever you want, dont have to have your own office or patient base.
I know a managing partner in a rads practice in rural Kansas who was having trouble recruiting new residency graduates, so they got this one guy to come up there from Georgia and started paying him $550k/year plus paid off all his his student loans. Sounds pretty nice to me. They work 3 weeks on, one week off, and one of those three weeks they take 24-hour home call for the surrounding hospitals they cover. Cush.
But other than that, two words... Aerospace Medicine
just kidding i have no clue what they do
But other than that, two words... Aerospace Medicine
just kidding i have no clue what they do
I found this page about doctors' salaries in Canada for year 2008.http://www.discoveryfinance.com/medical-doctor-salary-can-surprise-you.html
It's for Canadian, so should it be higher here?
It's for Canadian, so should it be higher here?
Is it just me, or do some of those numbers look off? You're telling me that the avg. opthalmologist makes the same as the avg. OB/GYN??? There has to be some kind of catch with those stats.
How do some of those docs make less than $10K/year (unless I'm reading that wrong). I don't care what country you're in... that's pathetic.
Part-time? About to retire? Students in training? Docs starting working in last quarter of the year?
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Bump for more opinions please
Here are my two cents as a practicing attending, on how I am choosing my eventual job.
First I knew I didn't want to deal with kids, crazies, outpatient office crap, pregnant people, or surgery (absolutely hated being in the OR). That cut out peds, psych and neurology, obgyn, family med/derm, anything surgery, ophtho.
I also deliberately avoided any field requiring lengthy training. That again leaves out surgery specialties and radiology (they take 6-7 years to get a job).
I also didn't want a field with a terrible job market (pathology) or low pay (PMR) or decent pay but a declining/tough job market (rads, and anesthesia)
FYI: Why is training length so important?
Because of opportunity cost and compound interest. Your loans will only grow bigger while you survive on a PGY stipend for those extra years plus you are missing out on investment growth in the market - a double whammy.
So I was left with two big choices:
Emergency medicine (3-4 year residency).
-pay in desirable area is $170-200 per hour for a mix of days/nights
-typically see 2-3 patients an hour, vast majority you have never met before so it is NOT stress free like in an office setting when you see follow up patients you have established care with already
-have to deal with crazies, drug seekers
-might have to deal with ob/gyn things or kids
-have to deal with pressure from admin about moving the meat, press ganey
-have to deal with mental anguish/ liability of discharging people home you barely met (THIS IS HUGE)
-90% patients are primary care issues that you thought you would get away from by choosing EM...
-the few crashing sick patients you encounter will ruin your shift, critical care can be stressful
-in most places when you are working you rarely feel like you can take a break...you feel worked to the BONE
-difficult to recover from switching around nights/days
Or,
Nocturnist (3 year internal medicine residency).
-pay in desirable area is $150-175 /hour for doing ONLY nights in closed ICU hospital
-admit typically 5-6 patients in 12 hour shift (0.5 patients an hour, far fewer volume than the ER doc sees)
-crosscover 40-50 patients in hospital (so perhaps 1-2 rapid responses to deal with, not often you have critical care if you work in closed ICU setting)
-lots of downtime. often get to sleep, watch tv, play video games for few hours most nights.
-no liability with discharging patients. No discharge paperwork to do. Because you don't discharge...only admit!!
-often the ER has done a lot of the workup for your admit so you don't need to do as much
-no care coordination meetings or coordinating massive consults, deal wihh family meetings because that is for daytime hospitalist!
-con is being on nights
As you may gather, I chose to be a nocturnist (switching to it in a couple months as full time). EM pay at face value is higher per hour but the work, burnout, and bullcrap involved is NOT worth it.
I work as a day hospitalist (but I moonlight a lot of nights) primarily rght now and am switching jobs. My upcoming nocturnist contract requires 144 hours (12 shifts) per month (36hr a week avg) at $265000 base pay. I plan on taking extra shifts (8 per month) which would bring my pay to $460000 over a year for working 60 hr a week on avg.
Also keep in mind I am still a fresh grad from residency. And this new job is in Chicago not rural bumblef*ck nowhere.
Couldn't agree more with the general thought process here. I speak to many people who seem to think residency training length isn't a bit deal. I always beg to differ, and feel like I'm in the minority when doing so. Good for you.
Yes if your goal is financial freedom as fast as possible, it makes no sense to accumulate interest on 200k worth of loans and skip on years of 400k-500k income. Like if you do training for 3 years longer than you otherwise could have chosen... and you are working 70 hr/ week for those training years.... that's potentially 1.5 million bucks you missed out depending on market returns/inflation and after taxes
Absolutely spot on analysis as one would expect from an attending.
Question though, this nocturnist thing intrigues me. Up until now I had written off IM completely because of the barbaric levels of paperwork. So how bad is it?
Outpatient general internal medicine can involve a lot of paperwork unless your practice has excellent staff to take care of most of it (prior auths, disability forms etc). As a nocturnist there is no extra paperwork to do other than direct patient care related things (admission or event notes), and daytime hospitalists similarly. Though the daytime direct patient care stuff has more (but very essential) things to write like discharge summaries, daily progress notes, admission notes etc.
To add on a bit more advice:
I am not saying one should choose their specialty only based upon expected pay and length of training.
Obviously you should always pick something you like or at least can tolerate for years. BUT knowing the future job market is super important, and weighing it with the length of training needed to get a job is very critical to understand or you may get locked into misery.
See threads I just saw: FUTURE RESIDENT, DO NOT BECOME A RADIATION ONCOLOGIST!!!
anyone have info on seattle area market?
And, do not get easily fooled by the face value of specialty salaries. For example: 350k to do general surgery versus 240k family medicine. Sounds like surgery wins right? Wrong, family medicine wins (financially) --here are real numbers for my region:
Surgeon takes 5-7 years (with brutal >80 hr work weeks) training, graduates and works 60hr on avg a week. That comes out to 112/hr.
FM does 3 year training. Graduates and works 40hr a week. Comes out to 115/hr. If they hustled as much as the surgeon they could make the same or more, and having suffered less!
Do your due diligence!
I am not saying one should choose their specialty only based upon expected pay and length of training.
Obviously you should always pick something you like or at least can tolerate for years. BUT knowing the future job market is super important, and weighing it with the length of training needed to get a job is very critical to understand or you may get locked into misery.
See threads I just saw: FUTURE RESIDENT, DO NOT BECOME A RADIATION ONCOLOGIST!!!
anyone have info on seattle area market?
And, do not get easily fooled by the face value of specialty salaries. For example: 350k to do general surgery versus 240k family medicine. Sounds like surgery wins right? Wrong, family medicine wins (financially) --here are real numbers for my region:
Surgeon takes 5-7 years (with brutal >80 hr work weeks) training, graduates and works 60hr on avg a week. That comes out to 112/hr.
FM does 3 year training. Graduates and works 40hr a week. Comes out to 115/hr. If they hustled as much as the surgeon they could make the same or more, and having suffered less!
Do your due diligence!
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I don’t understand why no one has said the obvious: that psych wins by a wide margin.
I hate to say that this is a factor, but it’s not a very competitive residency and most US MDs can probably get in by just passing. Less work?
But peachy, you say, the average salary is on par with FM! True, I say... but the average working hours are much lower. The surveys often show the average psychiatrist working less than 40 hours a week, with some giving a number as low as 30. The implication being that you can vastly increase your earning with a small increase in hours.
It’s probably the easiest specialty to establish a private practice in. All you need is office space. No staff, no overhead, no equipment.
It’s easy to get a large client base in a big city.
If you don’t want your own practice, psychiatrists are in high demand virtually everywhere.
The downside is that you’re a psychiatrist.
I hate to say that this is a factor, but it’s not a very competitive residency and most US MDs can probably get in by just passing. Less work?
But peachy, you say, the average salary is on par with FM! True, I say... but the average working hours are much lower. The surveys often show the average psychiatrist working less than 40 hours a week, with some giving a number as low as 30. The implication being that you can vastly increase your earning with a small increase in hours.
It’s probably the easiest specialty to establish a private practice in. All you need is office space. No staff, no overhead, no equipment.
It’s easy to get a large client base in a big city.
If you don’t want your own practice, psychiatrists are in high demand virtually everywhere.
The downside is that you’re a psychiatrist.
With the evidence / efficacy and patient base of psychiatry and how it is practiced you would have to pay me 3X more compared to what psychiatrists currently make to even consider it.
As someone who’s seen so many people start at the absolute bottom, reclaim their lives, and go on to do amazing things (probably accomplished more than you have) because of modern psychiatric practice, I take personal offense to your sentiment.
You can be offended. I am just showing that it isnt for everyone. Just like Rad Onc isnt for everyone or surgery isnt for everyone.
Also thanks for adhoming me and my accomplishments, I am sure my mother is going to be depressed over that.
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To me, your choice of wording sounded suspiciously like that of the kind of person who I’ve met many times - the one who hates psychiatrists and writes it off as dealing useless drugs to the mentally inferior. In the moment, this is who I clocked you as. Please accept my apologies.
sure, the effect size for improvement in BP is pretty strong tho. But in all seriousness Inpatient pysch is not for everyone just like Dealing with death in rad onc everyday isnt for everyone.
Uhh...where else would you put those fingers when saying "shhh?" I hope you at least washed your hands first.
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The real money in psych is outpatient. I did a rotation with a guy whose overhead was under $1500/mo, the whole office was him and an assistant to help schedule appointments and keep track of payment. Charged $100 for 25 min or $200/50hr plus extra if they needed forms or something signed. Was taking home over $350k/yr working less than 35 hrs/wk, no weekends, no call. He could have pulled in over $500k annually if he wanted to easily, and his rates aren't even uncommon for cash only practices. I know a few other psychiatrists just in my city making well over $400k, and most of them aren't working crazy schedules.
Psych as a whole isn't for everyone, like you said. Different strokes for different folks, but I agree with Peach that psych (especially outpatient) seems to frequently get overlooked because people just look at the yearly earnings and see it's on the lower end of the spectrum instead of looking at the whole picture. You can do the same thing with EM as well, but you have to deal with odd shifts and high stress situations.
Wow, just looked at the MGMA data and was surpised that the mean Pysch was 300K vs 230 for IPS.
Could you point me to the source of this data?
Now this man was a real OG.
