Can’t decide between Rads or EM

[MedLyfee]

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Hey fellas,

so I’ve finished rotating through EM and Rads and honestly I enjoy both. I know, they’re completely different fields but I can see myself being happy doing either of the two.

I was leaning towards Rads more than EM for the last month up until I recently began thinking about job opportunities. EM is killing it, they can pretty much land a job almost anywhere they want. However when it comes to Rads, this concerns me. I have no doubt that if I choose Radiology i’ll also do a fellowship, but I feel like even with a fellowship I will be limited to what cities I can practice in versus EM (mind you my goal isn’t anything super saturated like Cali or NYC, it’s moreso FL/Texas.)

I just saw in the RadOnc forum how a new grad is miserable living in an underpopulated area because he can’t find a job elsewhere. This is my nightmare, because no matter how much I love my job, if i’m in a place where I don’t want to live I won’t be happy. I don’t fear AI, I don’t fear outsourcing, I fear being forced to practice in a place I have no interest living in. And albeit the job market is improving, but the fact that at one point it took a hit makes the specialty volatile.

I’d appreciate some input.

 

[Gadofosveset]

If your #1 goal is guaranteeing where you live rather than what you're doing with your life, then, most things being equal, EM offers more flexibility than radiology in 2018.

 

[TCOM12]

Both are essentially shift work, now. EM is shorter training so potential to earn attending salary faster. Higher income potential in radiology at the moment (partnership pay that is). The two markets you’re looking at (TX and FL) are brutal and becoming highly corporate in radiology.

I liked EM, but I couldn’t deal with malingerers or hospital policies making me become a bad physician (turn around times need to be lower which leads to pan ordering studies quickly). Also, I haven’t met a clinician that thinks the ED does a good job properly working up a patient. This opinion is from working at about 8 hospitals... private academic, VA. They have a hard job and we don’t appreciate the good ones as much.

At the end of the day, do what you think would make you happy. My advice to all med students—- look at the worst part of the every day job and see if you can tolerate that. At the end of the day, the cases you think are cool just become work (saving a gsw through the chest with a chest tube in EM, insert odd tumor that you make a good call on in radiology) because you’ve seen them a bunch of times.

I would pick radiology over all other things, but I genuinely love this job. Having said that, it’s not for everyone. Good luck.

 

[Aurum]

Hey fellas,

so I’ve finished rotating through EM and Rads and honestly I enjoy both. I know, they’re completely different fields but I can see myself being happy doing either of the two.

I was leaning towards Rads more than EM for the last month up until I recently began thinking about job opportunities. EM is killing it, they can pretty much land a job almost anywhere they want. However when it comes to Rads, this concerns me. I have no doubt that if I choose Radiology i’ll also do a fellowship, but I feel like even with a fellowship I will be limited to what cities I can practice in versus EM (mind you my goal isn’t anything super saturated like Cali or NYC, it’s moreso FL/Texas.)

I just saw in the RadOnc forum how a new grad is miserable living in an underpopulated area because he can’t find a job elsewhere. This is my nightmare, because no matter how much I love my job, if i’m in a place where I don’t want to live I won’t be happy. I don’t fear AI, I don’t fear outsourcing, I fear being forced to practice in a place I have no interest living in. And albeit the job market is improving, but the fact that at one point it took a hit makes the specialty volatile.

I’d appreciate some input.

Nobody knows what the rads job market will be like when you're done training, but I doubt it will be as restrictive as the radonc job market. Even at it's nadir I don't think it was as bad as radonc. There's also telerads which allows total geographic flexibility.

 

[rocksalt]

Can't say what the job market will be in the future. But right now it's pretty strong in Rads. One of my junior residents is skipping fellowship and taking a job in the exact place he want to live (Long Island)

 

[MedLyfee]

Both are essentially shift work, now. EM is shorter training so potential to earn attending salary faster. Higher income potential in radiology at the moment (partnership pay that is). The two markets you’re looking at (TX and FL) are brutal and becoming highly corporate in radiology.

I liked EM, but I couldn’t deal with malingerers or hospital policies making me become a bad physician (turn around times need to be lower which leads to pan ordering studies quickly). Also, I haven’t met a clinician that thinks the ED does a good job properly working up a patient. This opinion is from working at about 8 hospitals... private academic, VA. They have a hard job and we don’t appreciate the good ones as much.

At the end of the day, do what you think would make you happy. My advice to all med students—- look at the worst part of the every day job and see if you can tolerate that. At the end of the day, the cases you think are cool just become work (saving a gsw through the chest with a chest tube in EM, insert odd tumor that you make a good call on in radiology) because you’ve seen them a bunch of times.

I would pick radiology over all other things, but I genuinely love this job. Having said that, it’s not for everyone. Good luck.

To be fair corporate consolidation doesn’t deter me from Rads as much as not having a job haha. EM is far worse now with CMGs as it seems and they’re doing fine.

Nobody knows what the rads job market will be like when you're done training, but I doubt it will be as restrictive as the radonc job market. Even at it's nadir I don't think it was as bad as radonc. There's also telerads which allows total geographic flexibility.

Do you think Telerads will always be available though, even if the field becomes saturated with Radiology physicians?

 

[19pieces19]

Both are essentially shift work, now. EM is shorter training so potential to earn attending salary faster. Higher income potential in radiology at the moment (partnership pay that is). The two markets you’re looking at (TX and FL) are brutal and becoming highly corporate in radiology.

I liked EM, but I couldn’t deal with malingerers or hospital policies making me become a bad physician (turn around times need to be lower which leads to pan ordering studies quickly). Also, I haven’t met a clinician that thinks the ED does a good job properly working up a patient. This opinion is from working at about 8 hospitals... private academic, VA. They have a hard job and we don’t appreciate the good ones as much.

At the end of the day, do what you think would make you happy. My advice to all med students—- look at the worst part of the every day job and see if you can tolerate that. At the end of the day, the cases you think are cool just become work (saving a gsw through the chest with a chest tube in EM, insert odd tumor that you make a good call on in radiology) because you’ve seen them a bunch of times.

I would pick radiology over all other things, but I genuinely love this job. Having said that, it’s not for everyone. Good luck.

Did you ever consider dermatology?

 

[TCOM12]

Derm was never an interest to me. Skin conditions are really the only thing that gross me out.

In regards to telerad... it’s considered to be a career killer as of now. The exceptions are getting the Hawaii jobs which you are employed by a hospital and you actually get benefits and a matched retirement. The big companies pay low/RVU and then you have to figure out your own insurance.

Who knows where radiology will be in 10 years. Telerad may gain some more respect and the bigger companies may offer equity partnerships.

 

[Cognovi]

If your #1 goal is guaranteeing where you live rather than what you're doing with your life, then, most things being equal, EM offers more flexibility than radiology in 2018.

Truth here. Personally, I would prioritize what I was doing with my life rather than where I was living. Moreover, the job markets in every specialty fluctuate over time. Conditions will differ when you graduate residency.

 

[meister]

What do you like about each particular field? They are very different.

 

[MedLyfee]

What do you like about each particular field? They are very different.

I enjoy being in the ED, working up a patient, and then sending them on their way. With the occasional procedures thrown in, it’s a fun time. For Rads, I enjoy the cerebral nature of the work. Love the relationship it has with technology (i’ve built my own own PC), and also enjoy the occasional procedures.

To be fair I can see myself being happy doing many things though, inside and outside of medicine.

 

[deleted859535]

I'm a board certified EM attending who was thinking about radiology also when I was a med student.

If I could do it over again, I'm not sure if I'd still pick EM. There's a lot of bull**** in this specialty -- but there's a lot of bull**** in every specialty. You just have to pick, as alluded to above, what kind of bull**** you're willing to stomach in exchange for the pros of the job.

EM: flexible scheduling, high hourly pay relative to many specialties, get to do and see some neat things, but it's a tough job. A quasi-lifestyle specialty at best, if that. But one with an excellent job market with versatility that's hard to beat for the time being, and with a three (sometimes four) year residency.

Would you rather plow through studies on a workstation with other rads duties mixed in, or would you rather be the attending for a dozen+ patients at once in the ED?

 

[meister]

In my opinion, if you enjoy being in the ED, working up patients and dispo'ing them you should probably do ED. It's hard for me to reconcile someone enjoying being in the ED with enjoying being in the reading room for 8+ hours, as they are about as far apart as you can get. In my younger days when I was in medical school I also enjoyed EM in addition to radiology but I later realized what I was doing as a med student and intern in the ED (managing a handful of lower acuity patients) was way different from what the senior residents and attendings were doing (managing everyone and oh by the way someone is dying over here and PS someone is delivering a baby in the elevator). EM physicians manage dozens of patients and make hundreds or more decisions a shift directly caring for patients. Radiologists do none of that. As a radiologist many people won't realize you are a physician, and even among those that do there is a large percentage that won't consider you a "real" doctor anyway. Chips on shoulders abound in medicine, for whatever reason. Most radiologists don't care, but just something else to consider if it's important to you that people think of you as a "real doctor."

On the other hand, if you enjoy puzzles, enjoy anatomy, don't mind working on your own and enjoy procedures, radiology is rewarding. Your job is almost like an air-traffic controller, making calls that you hope will set patients down the right trajectory for their management (similar to ED in a certain sense). Often you will make the right call, sometimes you won't. It can be thankless, but many jobs in medicine are thankless. Nobody else will be able to interpret any modality of practically any part of the body and have a decent chance of competently sifting among the useless data to find the clinically useful info. It's a great job.

 

[txguy]

Radiology is also one of the few (if not only) specialties that allow you to work from home and take call from home via a home workstation. That level of flexibility is a really nice perk. Radiology also requires one of the least amount of paperwork/admin/scut work out there--you practice a larger percentage of actual medicine than most primary care specialties. The procedures and interactions with patients are short and meaningful and just like EM, you leave the hospital without patients to worry about or be responsible for.

 

[Dro133]

Radiology is also one of the few (if not only) specialties that allow you to work from home and take call from home via a home workstation. That level of flexibility is a really nice perk. Radiology also requires one of the least amount of paperwork/admin/scut work out there--you practice a larger percentage of actual medicine than most primary care specialties. The procedures and interactions with patients are short and meaningful and just like EM, you leave the hospital without patients to worry about or be responsible for.

How often do you get to work from home as a radiologist?

 

[rocksalt]

How often do you get to work from home as a radiologist?

It just depends if you want, and look for that kind of position. I've seen plenty of telerad and internal nighthawk positions posted over the last year.

 

[txguy]

How often do you get to work from home as a radiologist?

As stated above, there is a wide variety of options. Nighthawk positions will provide basically 100% work from home and you can typically choose where you live, unless its an internal nighthawk position at a specific practice. Also, you can choose to supplement your income with a nighthawk position as a "side gig" as they call it now.

At my practice, I take my call from home, use my home workstation to dictate/ponder/research non-emergent studies (which would otherwise force me to stay at work longer or go in earlier), and I also moonlight from my home workstation.

 

[DOFOSHO]

Hey fellas,

so I’ve finished rotating through EM and Rads and honestly I enjoy both. I know, they’re completely different fields but I can see myself being happy doing either of the two.

I was leaning towards Rads more than EM for the last month up until I recently began thinking about job opportunities. EM is killing it, they can pretty much land a job almost anywhere they want. However when it comes to Rads, this concerns me. I have no doubt that if I choose Radiology i’ll also do a fellowship, but I feel like even with a fellowship I will be limited to what cities I can practice in versus EM (mind you my goal isn’t anything super saturated like Cali or NYC, it’s moreso FL/Texas.)

I just saw in the RadOnc forum how a new grad is miserable living in an underpopulated area because he can’t find a job elsewhere. This is my nightmare, because no matter how much I love my job, if i’m in a place where I don’t want to live I won’t be happy. I don’t fear AI, I don’t fear outsourcing, I fear being forced to practice in a place I have no interest living in. And albeit the job market is improving, but the fact that at one point it took a hit makes the specialty volatile.

I’d appreciate some input.

Do you like sitting on a budget hospital chair listening to people scream or do you like sitting in a comfy chair listening to peace and quiet?

 

[wegh]

Derm was never an interest to me. Skin conditions are really the only thing that gross me out.

In regards to telerad... it’s considered to be a career killer as of now. The exceptions are getting the Hawaii jobs which you are employed by a hospital and you actually get benefits and a matched retirement. The big companies pay low/RVU and then you have to figure out your own insurance.

Who knows where radiology will be in 10 years. Telerad may gain some more respect and the bigger companies may offer equity partnerships.

You and I sound similar. I really enjoy EM, especially having worked in the field for a few years, but I think radiology is the better career choice. I can see EM getting old with time and that's when all the "cool" stuff becomes crappy