2 months into residency I've decided I absolutely hate inpatient medicine, especially the hours. I also hate the hierarchy that comes with hospital medicine. There are times when I regret going into this field at all and wish I had a 9-5 job with weekends off like normal people (instead of looking forward to this mythical golden weekend). I've decided I'm going to get through the 3 years then go into a specialty where I work normal hours and don't have to deal with douchey people. What sub specialties should I be looking into? So far I've come up with rheumatology, private practice....what else?
career options with 9-5 lifestyle
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Probably endo, you can always do occupational medicine, or switch fields completely and do something like PMR, even in psych you can have a PP and not work weekends after a few years when you are out of residency and established.
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Private practice isn't a specialty so much as it is a type of practice arrangement (vs academic or HMO).
If you want to subspecialize and avoid call, Rheum, A/I and Endo are all good options. They will likely have some sort of call but it will be nothing like what you're used to.
Of all my colleagues who have absolutely no call (no nights or weekends at all...ever) and no inpatient responsibility, the vast majority work as academic or HMO PCPs.
But to be honest, the end of your first month of internship may not be the best time to be making major career decisions. If you don't like what you do, 10 hours a month will feel like hell. If you love what you do, the hours are less of a problem.
If you want to subspecialize and avoid call, Rheum, A/I and Endo are all good options. They will likely have some sort of call but it will be nothing like what you're used to.
Of all my colleagues who have absolutely no call (no nights or weekends at all...ever) and no inpatient responsibility, the vast majority work as academic or HMO PCPs.
But to be honest, the end of your first month of internship may not be the best time to be making major career decisions. If you don't like what you do, 10 hours a month will feel like hell. If you love what you do, the hours are less of a problem.
yeah...you absolulte hate it while you're an intern? see if you still hate it next year when you are a senior and call more of the shots. if you STILL hate it, then dude, go into GI (if you can that is; it's competitive). it's pretty cush; you do take some call but if you are in a big enough practice you only have to do call a weekend a month and a day a week or something like that, and you make tons of money working not even 8 hours a day on the other days doing scopes.
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Allergy is VERY cush and people are not as sick so you can have less grouchy patients
Also check out consulting companies - McKinsey - http://www.mckinsey.com/careers/your_background/advanced_professional_degrees/medical_degree_faq
Also check drug companies that run trials
or wait till you are a SAR and then decide.
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Allergy/immunology is the derm of IM/peds. It's very competitive. But it would give you more pleasant hours, less ill patients (if you do PP allergy, that is, not academic immunodeficiency cases - which will indeed be more sick), and high compensation.
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You're an intern who hates being in the hospital? Shocking. Suck it up and deal for a year, life gets better. The worst part of being a resident is having absolutely no ability to say NO to any request made of you. But that's reality, and you will be content if you accept it.
In 1 1/2 years when you're assembling fellowship applications you want your attendings to write about how affable you are, how nothing gets by you, and about your grace under pressure. As an intern you're making first impressions everywhere you rotate. Every one of them is an opportunity. Don't waste any with a bad attitude.
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Hey, some people aren't inpatient people, others are. Yay to you for figuring it out quickly. Primary care, allergy, rheum, endo, as others have mentioned are all great choices for the calm clinic lifestyle. However, almost any subspecialty ends up doing a fair amount of clinic, something that gets overlooked. If you're not into long hours in the hospital, avoiding GI/cards is probably a good idea. Renal and heme-onc also spend a fair amount of time inpatient as well. However, if you are interested in these fields, you can create your own lifestyle after your fellowship. I'd say the thing to do right now is to spend some time in clinic and see if you do feel comfortable and happy there. Good luck 
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sleep
Was that a command or a specialty.... 🙂
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I know of several heme/onc docs that basically work 9-5 with minimal call. Yes, you'll have to set foot in the hospital again and round after that point but really I don't think that's so bad.
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In the (hem/onc) group I'm joining, on the days you're at work (FT there is 4 days/wk) you're expected to round on your own patients at your site (we have 5 different offices at 5 different hospitals), and those of your partners who aren't there. At my office, they generally have 1 to 3 inpatients at any one time. Night call (M-Th) is split among the whole group (10 people) so you cover 2 nights a month. Weekends are similarly split however a semi-retired guy covers almost 30 of those weekends so we do 2-3 weekends /yr.
Honestly, I consider that very minimal call and manageable call.
OTOH, a friend of mine works in a 3 person group. They rarely have inpatients but do take Q3 call. I wouldn't roll with that.
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Yeah, I agree. Your arrangement sounds terrific.
I'm not sure I'd be willing to put up with q3 call as an attending either.
I'm not sure I'd be willing to put up with q3 call as an attending either.
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Allergy/immunology is the derm of IM/peds in lifestyle only. Derm is actually kind of interesting, with difficult diagnoses and requires a fair amount of medical knowledge. A/I, outside of academic research, is about as interesting as paint drying on a wall.
