Cards vs Hem/Onc: which one wins in the salary/lifestyle head to head?

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TexasMed22

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There hasn't been a thread on this for a while, was wondering what everyone's thoughts are.

(obviously one shouldn't decide between these two fields solely based on salary/lifestyle)

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cards has the higher ceiling probably but you end up working for it more; i'll make close to 600k this year from rvu goal/group bonus/quality metrics.

most days are packed; reading echoes, stresses, ekgs, holters, nukes, clinic, rounding.

heme/onc probably more chill but also 1 cms change away from being 400k to 200k if chemo billing changes.

that said, cancer and cards both keep hospitals afloat, so likely salary would be subsidized from downstream revenue if there were major reimbursement changes (eg no cards = no cv surgery = no hospital; onc is likely similar with surgery, infusions, radiology, halo effect, etc). cards has had **** cut a bunch in the past 10 years and everyone in the community still makes >500k.
 
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Heme/Onc and it's not even close IMO, the acuity of cardiac disease just does not lend itself to "ok sounds good we'll see them in the morning"

I went back to the hospital after hours a single digit number of times (I think 5-8) in my 3 year fellowship.

*Applicable to medicine in 2023
**OP I still recommend Derm since you asked in the Derm forums
 
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The only thing that would even be remotely comparable “lifestyle” wise would be General Cardiology only in a very large group (so basically general cardiology call 2-3x month with hospitalist support)

Otherwise it’s not even close.
 
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Right now: Oncology. Assuming you're a medical student now, things may look very different in 7-8 years when you are done.
 
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It can be 2023 or 2043.. it will be the same for the next 40 years of your career. So choose wisely whether you truly want to care for actively dying patients at 2 am every fourth night for the remainder of your life.
 
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cards has the higher ceiling probably but you end up working for it more; i'll make close to 600k this year from rvu goal/group bonus/quality metrics.

most days are packed; reading echoes, stresses, ekgs, holters, nukes, clinic, rounding.

heme/onc probably more chill but also 1 cms change away from being 400k to 200k if chemo billing changes.

that said, cancer and cards both keep hospitals afloat, so likely salary would be subsidized from downstream revenue if there were major reimbursement changes (eg no cards = no cv surgery = no hospital; onc is likely similar with surgery, infusions, radiology, halo effect, etc). cards has had **** cut a bunch in the past 10 years and everyone in the community still makes >500k.
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Cards ceiling is higher but you’ll work hard to get there. Hem-Onc lifestyle is (to me at any rate) better than Cards.

But the reality is that if you love being in the cath lab and making an immediate impact on someone’s life, and you hate long discussions about goals of care and chemo side effects, then the lifestyle/money discussion is kind of meaningless.

The OP seems to be fishing for an “easy” well compensating specialty, to which the answer is Derm if you can get it and Psych if you’re not Derm material. Otherwise choose the specialty you like most/hate least.
 
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Cards ceiling is higher but you’ll work hard to get there. Hem-Onc lifestyle is (to me at any rate) better than Cards.

But the reality is that if you love being in the catch lab and making an immediate impact on someone’s life, and you hate long discussions about goals of care and chemo side effects, then the lifestyle/money discussion is kind of meaningless.

The OP seems to be fishing for an “easy” well compensating specialty, to which the answer is Derm if you can get it and Psych if you’re not Derm material. Otherwise choose the specialty you like most/hate least.

This is the right answer. Focus on the personalities (if you have the "right" packet for ERAS) and see which group of people seem more like you. Cardiology is a mixture of surgery/procedures, radiology, and medicine (mostly critical care) and heavily physiology based. Oncology is a slow burn and victory is a moving target with truly horrific morbidity even from current therapies. Two VERY different type of people thrive in these different specialities. Similarly most cardiologists and hematologists/oncologists probably would be miserable in derm clinic. Money will become secondary if you're truly misreable, especially given payment models can, and will, change.
 
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Very different speciality made for different people.

$: card>onc in general, higher ceiling in card for sure but you work for your $.

Lifestyle: onc >> card

The best combo of $ and lifestyle in medicine currently: anesthesia and rad.
 
Very different speciality made for different people.

$: card>onc in general, higher ceiling in card for sure but you work for your $.

Lifestyle: onc >> card

The best combo of $ and lifestyle in medicine currently: anesthesia and rad.
Dunno about either of those. Rad goes hard when on but they have lots of time off.

Gas works hard and will come in just about time when on call for several hours. Worse if they pursed CV anesthesia.

Bottom line, love the work first. Money is important but if the only deciding point you'll be miserable no matter what field you choose.
 
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