choosing a specialty

[Newyawk]

Didn't know where to put this one and I'm sure this topic has been covered numerous times, but I thought I'd make one that's more personal to me. Would really appreciate any advice
I was always the student who thought I would do anything fulfilling, etc regardless of how much work it required. After my rotations and realizing just how hard some doctors work, I am positive I no longer want to pursue anything that will hurt my lifestyle. I figured I can't be sure I'll choose a field that I will always be intrigued by, but I can guarantee I will always like my family, free time, etc. Don't get me wrong - I love medicine, I always have. I love patient's stories, I love physical exam, imaging, the whole shabang. I just really like doing things outside of the hospital.
That being said, I have the grades and step score to do just about anything. My research isn't great although not absent entirely. I do fine during interviews.
I want a field that will one day give me 250-300k+ (in NYC) and good work hours (<50/week). I also preferably would like a residency that doesn't destroy 5-10 years of the best years of my life (i.e. seeing my kids grow up, ability to play sports and take trips with my SO, etc.)

Can you guys touch on a few things:
-what is your opinion on the "ROAD" specialties or other "lifestyle" specialties. how much does a field have to interest me in order to pursue it if I'm weighing lifestyle just as significantly?
-some people say to just ignore the workload of residency in your decision. Whats your opinion?
-do you have any regrets choosing the field you chose? why?

Thank you!!

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[Crayola227]

Lol ROAD

Most specialties will give you close to $200K if you work hard. Most doctors with a reasonable schedule (EM works less hours) will work 50-60 hrs a week unless you are part time.

Listen, if you become a doctor you are looking at salary near $200K and 60 hr work weeks when you factor in administrative & continuing ed, etc.

I keep saying this, rather than focus on how close to $250K you are and whether you work 45 or 55 hrs a week, pick something you enjoy & you're good at. Compromising hours and money to enjoy what you do will always trump compromising them to be less and more respectively, in something you don't.

I hate this. Rather than telling us how much money and what hours you want, why not tell us what kind of practice you like?

You just started 3rd yr? What experiences do you have? Are you a cutter or a thinker? Do you like clinic or hospital? Old or young? Healthy or sick? Acute or ongoing? What sort of patient population? Academia, teaching, research?

These are the questions you should be asking yourself. 90% of doctors are going to agree this is what you should focus on first.

Go take the specialty quiz on SDN and AAMC. See what they suggest. Look into how those fit into everything we've discussed here, then look at hours compensation lifestyle.

Once you've done your homework to narrow it *that way*, then tell us ahout yourself and what you want, and what we see as fitting your expectations.

 

[Crayola227]

No one can recommend a good fit based on hours and money. That's not possible.

Anything from IM to gen surg could fit what you've described to some extent, but doing either is hardly the same thing, is it?

This is why specialty choice relies more on other factors to pick between them.

 

[Newyawk]

Thanks for the reply. I thought I was a doer until surgery then I realized that I am actually a thinker. I still think I can be a doer, particularly for shorter procedures, I just prefer to think.
To me, 200k and 300-400k are worlds apart. I will have a very expensive lifestyle (bc of my location and school tuition). I will retake the test but I dont know if I agree with your sentiment that I should just do what I like and then think about the rest later. Thats why I created this post in the first place.

 

[Newyawk]

No one can recommend a good fit based on hours and money. That's not possible.

Anything from IM to gen surg could fit what you've described to some extent, but doing either is hardly the same thing, is it?

This is why specialty choice relies more on other factors to pick between them.

I never asked for recommendations.... I asked what your opinions were on the matter. You have demonstrated time and again your view on the matter. I have met several other physicians who tell me to choose something that will earn a lot of money, particularly bc my step score is such that it would allow me to pursue any specialty.

 

[Crayola227]

Absolutely don't consider residency workload in specialty choice, unless you think it will break you and you won't finish. You don't want that under any circumstance. 90% of them are < 5 years. Worrying about how hard you will work during those years rather than looking at attendinghood is like mortgaging up to 40 years of your working life for 5. It's unbelievably shortsided.

So beyond can I make it yes/no I don't think it should be a major factor in your choice.

 

[Crayola227]

I never asked for recommendations.... I asked what your opinions were on the matter. You have demonstrated time and again your view on the matter. I have met several other physicians who tell me to choose something that will earn a lot of money, particularly bc my step score is such that it would allow me to pursue any specialty.

....and more than $200K isn't a lot of money?

Ok

 

[Newyawk]

....and more than $200K isn't a lot of money?

Ok

I appreciate your advice, but you're pretty stubborn sometimes. I just told you that I will have significant costs bc of my location and several other factors. Yes, 200k is a lot of money. But 400k is much, much more.

 

[Crayola227]

Thanks for the reply. I thought I was a doer until surgery then I realized that I am actually a thinker. I still think I can be a doer, particularly for shorter procedures, I just prefer to think.
To me, 200k and 300-400k are worlds apart. I will have a very expensive lifestyle (bc of my location and school tuition). I will retake the test but I dont know if I agree with your sentiment that I should just do what I like and then think about the rest later. Thats why I created this post in the first place.

No, I suggested you narrow based on practical considerations like is this something you can maintain performance in for up to 40 years.

Say you were torn between surgery and neurology (I had a friend who was). Like, really really torn.

Then sure, absolutely use hours and money as your tiebreaker.

Although in that example it's a bit unclear....

 

[Crayola227]

I appreciate your advice, but you're pretty stubborn sometimes. I just told you that I will have significant costs bc of my location and several other factors. Yes, 200k is a lot of money. But 400k is much, much more.

Just go look up what fields make more than $250K and work less than 50 hrs. Then I guess look at how long and grueling the residency is since you mentioned that.

I say it's a stupid question because you answer it yourself.

Once you have identified those fields it starts to become an apples to oranges conversation because of how different they are.

Come up with a list and then ask us what we think they are like.

 

[Newyawk]

No, I suggested you narrow based on practical considerations like is this something you can maintain performance in for up to 40 years.

Say you were torn between surgery and neurology (I had a friend who was). Like, really really torn.

Then sure, absolutely use hours and money as your tiebreaker.

Although in that example it's a bit unclear....

A large reason why I created this is precisely that I have no strong feelings towards any field. Sure, I like some more than others and still really dislike some others, but I don't know if any one field will keep me intrigued.

 

[Crayola227]

It's not rocket science, it's just such a hard choice it's easy to want to look without for answers. It's a hard choice because it is about a lot of factors, many of which you can't totally predict and really depend on you.

The reality is besides us sharing what it's like in practice, we can't tell you what to do.

If you want money, go into something procedure based. Anything from GI which has the IM path, to ENT, to urology with its own path.

You're a thinker, not a cutter? They make less. Look at the higher paid ones then.

 

[Crayola227]

A large reason why I created this is precisely that I have no strong feelings towards any field. Sure, I like some more than others and still really dislike some others, but I don't know if any one field will keep me intrigued.

I started by deciding what I hated. I hated surgery, but not working with my hands. I hated working with sick kids and their parents. I hated ob/gyn for a lot of reasons.

That did a lot to narrow things, for me.

It was still hard to know what would keep my interest.

I heard a saying once, "The hardest part about saying yes to one of a number of possibilities, isn't saying yes to that, but saying no to everything else."

So that was one thing I considered.

 

[GoSpursGo]

I want a field that will one day give me 250-300k+ (in NYC) and good work hours (<50/week). I also preferably would like a residency that doesn't destroy 5-10 years of the best years of my life (i.e. seeing my kids grow up, ability to play sports and take trips with my SO, etc.)

I don't think what you are looking for exists... No matter what specialty you go into, residency is hard, and while you'll presumably have some lighter months, when you're on the wards your time is going to be stretched very tight. So yes, I personally would ignore how rough residency is and stay focused on what life is going to be like as an attending.

Of all the specialties out there, derm might be the only one that can approach the kind of pay you're seeking while only working 9-5. Any surgical specialty is going to likely come with some amount of call where you're super busy, and also come with the grueling residency that you said you didn't want.

 

[evilbooyaa]

Here's what I read as your goals - <50 hours a week, 300k+ salary, ability to live in NYC. Let me know if there's anything else that needs to go on that list. I didn't read the rest of the thread outside your OP.

Most physicians make more than 200k (at least pre-tax, which is what I'm basing my numbers on). If you're going to do primary care you gotta shoot for DPC or you're going to likely work more hours than you want. Most specialties will get you above 200k. If you're really adamant about being above 300k and living in NYC, maybe rads?


Easier path may be process of elimination:
Obviously most surgical specialties are out if you don't want to suffer during residency. I'm not sure what the salary for ophtho in NYC is, but ophtho might be the exception in terms of painfulness of surgical residency.

Know that heavy procedure specialties are the most painful to train in generally, but give you the best earning potential. Wouldn't recommend rad onc if you're adamant about living in NYC. Ditto with other bad job market professions like Path. I have heard Rads market is rebounding recently, and could get you to 300k+ in NYC.

EM is a consideration, but it's < 50 hours a week that is much harder than other specialties < 50 hours a week.

Could consider going hospitalist. 7 on, 7 off means that you work 84 hours in 1 week (12 x 7) but get the whole next week off. That alone isn't going to push you above 300k, but if you tack on some extra shifts during your week off you might be able to get more.
GI is reasonable as well. There are emergencies but it's not every single of x diagnosis (like Cards having to come in for every single STEMI), and will easily get you above 300k.
Non-interventional cards is a consideration.

Would avoid most other IM sub-specialties: Rheum, Endo, Nephro aren't going to routinely let you break 300k.

Would stay away from Peds. FM is doable only if you get into a DPC practice, which isn't a guarantee.

I've heard psych for not people busting their ass is 225-250ish. Similar for neurology.

No idea what PM&R docs get paid but overall they have a chill life and schedule.

 

[Crayola227]

Really what people seem to want is reinforcement of their own preconceived notions.

Doctors told you money and lifestylem. You want money and lifestyle. Well then that should be easy.

But it isn't, is it?

So I suggest out of a list of what is tolerable to you as far as your numbers go, you look at qualitative factors.

That itself makes it hard.

Road? Nothing in road is as easy as it might seem, and they are all great fields for some of what you've discussed but not others, and they are each so distinct in practice that picking a road specialty for hours or money won't separate them into different categories.

Only you can decide if you want $400K as an ENT or cards.

 

[Crayola227]

Notice that 90% of my advice matched up with evilbooyas.

Like I said, the fixed points of what each specialty is like, the training, the hours, the salary, the job market, are knowns.

So let us know if you pick ENT or rads.

 

[Crayola227]

Sorry I'm so testy.

There's a way forth and you'll find it. Especially if you're starting 3rd yr and you just keep an open mind

The worst thing I think is pigeon holing yourself.

People who really loved peds or psych trying to shove themselves in the optho mould for the hours money or perceived prestige. I've seen it and it's just terribly terribly sad for those folks.

Regretting specialty choice is worse than a bad marriage.

 

[atomi]

You chose the wrong career if you want to live in NYC. You’ll take a massive financial hit no matter what specialty you choose. Not only will you be entering an extremely over saturated job market where you likely will be exploited and have shyt work conditions and low pay, you want to live in one of the highest cost of living areas in the country with terrible taxes.

 

[Newyawk]

You chose the wrong career if you want to live in NYC. You’ll take a massive financial hit no matter what specialty you choose. Not only will you be entering an extremely over saturated job market where you likely will be exploited and have shyt work conditions and low pay, you want to live in one of the highest cost of living areas in the country with terrible taxes.

Yea im aware, thanks.

 

[lulu09]

Rad onc residency is ridiculously easy and you make bank coming out, but they are quite restricted in terms of open spots.

Within IM, A&I and rheum have great lifestyles and easy fellowships, but it's still going to be a stretch to get up to half million.

Honestly, in NYC, you can push every outpatient based practice (derm, PCP, rheum, endo, cards, GI, oncology, rad onc...to name a few) to the heights of "concierge medicine" if you have the right CV, form the right connections, and know the right people. In those cases, you can have whatever schedule you like and make bank. In that case, focus on getting to the best NYC residency possible and start forming connections for your future private practice.

If you like staying in the hospital and want flexibility, you're better off finding a shift-based job like EM or hospitalist. Know though you'll never get out of night shifts doing EM, and neither of these specialities will pay up to half million in NYC (in the midwest and Texas very possible). For both you can pick up extra shifts and almost essentially double your salary to get there, but then you would be sacrificing lifestyle and time off.

As far as the surgical specialities go, the only easy ones (no long cases once practicing, primarily outpatient based) I can think of are plastics, ophtho, and ENT, however getting through the residencies is kind of rough. If you like physical diagnosis and clinical reasoning though, I strongly think you're better off doing a more medicine-focused field (and this doesn't include derm or rad onc, IMO).

 

[Goro]

A large reason why I created this is precisely that I have no strong feelings towards any field. Sure, I like some more than others and still really dislike some others, but I don't know if any one field will keep me intrigued.

Even if you're at the point of knowing more what you don't like, as opposed to what you DO like, that's OK.

Yawkee, one thing to consider: with us Baby Boomers getting old, I think that being a gerontologist will be a licence to print money, just like being a peds in the 50s and 60s was.

Do you like doing procedures and seeing patients? How about urology?

 

[Newyawk]

Even if you're at the point of knowing more what you don't like, as opposed to what you DO like, that's OK.

I just feel a lot of pressure, even with my step score and grades, to pick something now and get some research done...

 

[Goro]

I just feel a lot of pressure, even with my step score and grades, to pick something now and get some research done...

Research as in scientific research, or research in the field to see what it's like?

 

[Newyawk]

Research as in scientific research, or research in the field to see what it's like?

Research to prove interest and be productive as has become almost a requirement

 

[Newyawk]

Even if you're at the point of knowing more what you don't like, as opposed to what you DO like, that's OK.

Yawkee, one thing to consider: with us Baby Boomers getting old, I think that being a gerontologist will be a licence to print money, just like being a peds in the 50s and 60s was.

Do you like doing procedures and seeing patients? How about urology?

I was thinking urology but idk if i can survive all those years in residency

 

[Neuronix]

Rad onc residency is ridiculously easy and you make bank coming out, but they are quite restricted in terms of open spots.

This is outdated information.

Rad onc residency does vary based on institution. There are places that average 40 hours a week (easy) and places averaging over 60 hours a week.

The job market in rad onc is collapsing. You won't make bank coming out like people used to. Jobs in places like NYC barely exist anymore. You will need to be prepared to go anywhere to find a job and hopefully you will get a job in the desired state or metro area, but it may be hours away from a big city.

 

[smq123]

I was thinking urology but idk if i can survive all those years in residency

Are you a non-trad?

 

[Newyawk]

I would hesitate to say that rad onc residency is "ridiculously" easy. It less time intensive than, say, neurosurgery, sure. But it requires a lot of reading, especially since the subject matter is not something that most students get any significant exposure in. You'll still be working >50 hours, particularly as an attending.



I find it hard to envision a rad onc setting up a concierge type practice. The amount of money involved in keeping the rad onc machines up and running (average price for a new Linac is in the $2.5 million range) requires a steady supply of patients, which is not usually how most concierge practices work. I suppose you can keep whichever schedule you like, but only treating patients between the hours of, say, 10 to 3 is not feasible from either a financial or a clinical point of view. This is also if you envision yourself treating more than just run of the mill breast and prostate, although it sounds like the OP isn't particularly interested in the unusual/challenging clinical cases.

Actually i am. In fact thats what ive always loved about medicine. My first love was genetics. But i find that clinical practice isnt like what i envisioned. No field is always interesting and im sure that gets worse over time

 

[Newyawk]

Are you a non-trad?

That means i did something else before medicine right? No..

 

[smq123]

That means i did something else before medicine right? No..

Well, it also means that you're coming out of med school at a slightly older age than someone who went straight through.

The reason why I ask is because of the concern of "surviving" residency. At the end of the day, it's 3-6 years (unless you do neurosurgery). Most people survive just fine; many people have families, even in the most time and labor intensive of residencies. So I think your concern is a leeetle overblown. I can see it being a bigger concern if you're going to be in your mid-40s when you graduate residency, and still haven't started a family yet.

 

[Newyawk]

Well, it also means that you're coming out of med school at a slightly older age than someone who went straight through.

The reason why I ask is because of the concern of "surviving" residency. At the end of the day, it's 3-6 years (unless you do neurosurgery). Most people survive just fine; many people have families, even in the most time and labor intensive of residencies. So I think your concern is a leeetle overblown. I can see it being a bigger concern if you're going to be in your mid-40s when you graduate residency, and still haven't started a family yet.

ill be less than 35 at residency graduation even in the lengthiest field. its not the time as much as it is just the day in and day out grind. I despised my surgery hours and I know it only gets worse. I can't imagine doing that for 5-8 years

 

[DokterMom]

I was always the student who thought I would do anything fulfilling, etc regardless of how much work it required. After my rotations and realizing just how hard some doctors work, I am positive I no longer want to pursue anything that will hurt my lifestyle. I figured I can't be sure I'll choose a field that I will always be intrigued by, but I can guarantee I will always like my family, free time, etc. Don't get me wrong - I love medicine, I always have. I love patient's stories, I love physical exam, imaging, the whole shabang. I just really like doing things outside of the hospital.

Your odds of liking your work (if you choose based on doing what you actually like to do) are much better.

 

[Crayola227]

You chose the wrong career if you want to live in NYC. You’ll take a massive financial hit no matter what specialty you choose. Not only will you be entering an extremely over saturated job market where you likely will be exploited and have shyt work conditions and low pay, you want to live in one of the highest cost of living areas in the country with terrible taxes.

lol I guess with a name like OP's we shouldn't be surprised it's "Newyark" or bust.

 

[Crayola227]

ill be less than 35 at residency graduation even in the lengthiest field. its not the time as much as it is just the day in and day out grind. I despised my surgery hours and I know it only gets worse. I can't imagine doing that for 5-8 years

I don't know about it being like surgery hours, I do know that I hope you can imagine doing a fair number of weeks at 60-80 pr week and 4 days off a month averaged over the month.

I didn't apply to medical school until I had pulled a few years like that in college. I still knew I would be working harder in med school and residency, and I did.

 

[Newyawk]

I was born and raised here. everyone and everything I know is here. its not like I'm striving to be a park avenue doctor....
of course I know that ill work hard during residency. you're supposed to work hard. but surgery is just straight up inhumane. get there at 430-530. stand for 12+ hours. leave anywhere between 5 and 10 PM and come back the next day and do it again. then 24 hour calls on the weekends? you must be kidding me.

 

[GoSpursGo]

I was born and raised here. everyone and everything I know is here. its not like I'm striving to be a park avenue doctor....
.

I mean that's cool, but you're hardly the only NYC born and raised person who wants to stay. It sounds like you've got a crazy competitive application, but lots of people with competitive apps want to stay in/go to NYC. As a result of market forces, employers in NYC can work you harder and pay you less because they know if you don't like it they can find someone else willing to do the same job 95% as well for what they're willing to offer.

It's a classic truism: location you want; hours you want; money you want. Pick two. In the extremes you may need to pick one. It's unlikely you're going to hit a perfect sweet spot.

 

[evilbooyaa]

Idk why we're all bashing the NYC guy for wanting to stay in NYC.

Also, the thing about concierge rad onc really made me LOL. My god, I wish. "Here's this bill for 20-50k for the treatments we completed, please pay on your way out the door, thanks!"

 

[BigPikachu]

Don't worry about the money and job security. Whether it's a Family Physician or a Neurosurgeon, there will always be jobs for doctors (perhaps not necessarily in the suburb you want but nonetheless) and your income will be more than enough for you and your family to survive well. Real wealth comes from how you choose to invest and manage your finances wisely in assets, such as property, or in stocks, the foreign exchange markets, gold, et cetera.

Everyone has their own individual choices and reasons, you have to make your own that's right for you; do something you'll enjoy and can realistically see yourself doing for the rest of your working life. Also worth noting that your ambitions will change as you mature in both your professional and personal life.

I wanted to really become a Internist and/or Intensivist after graduating medical school. Then I got married. Then I had kids. Then I bought a house and started paying a mortgage. And the next thing I know I am a simple Family Physician in a rural town of 5,000 or so friendly farmers, which is mostly day-in-day-out standard primary care clinic work, but then I also get run my own base hospital which has more than enough emergency and critical care cases to keep me interested and in touch with my acute medical care skills. So, in the end for me, it worked out; I got the best of both worlds.

The best tip a former boss gave me: "Your work shouldn't be your life. Work simply pays for you to enjoy your life."

 

[Crayola227]

people forget that in a paradigm where you sleep 8, work 8, you have 8 hours off a day, and a good number of those are involved in ADLs like doing laundry and bathing your kids.

This rubric also makes you figure out that guess what, like most people you're going to spend X number of hours a week working, and it's really just going to be a matter of getting more bang for you buck or buck for your hour, and that time sucking less. I've spent 8 hours in a day sorting garbage and I've done it as a doctor.

Work is a not insignificant portion of your life. For people that like their work it's actually a refuge from their home life, even when their home life is good.

Why do I go on and on about loving your work? Because I love being at home watching TV with my cats more than anything. I always wanted a family and that was always the most important thing in my entire life. When I was engaged, spending time with my significant other was my heaven on this Earth. We both wanted nothing more than to stay in bed, but we both had careers that gave us a sense of mission.

That stacked things up pretty high. Basically, I needed a job that was so compelling that I would actually be willing to kiss my children/cats goodbye and leave them in someone else's hands while I ventured forth into the world. So work really had to matter a lot, to hold a candle up to that.

Anyone would rather be skiing in Switzerland or watching reality TV at home. But do you have a job takes you away from that, that you might actually look forward to going to in the morning?

If work is the next best thing to being home, man, you have it made.

 

[Crayola227]

Well there's also something to getting out of your major city LA or NYC. This is a foreign concept to people from there. I was from a super duper huge city, and I never wanted to leave until I had to, then I experienced other places. I learned that there's a lot of places in this country where you can be happy.

 

[Crayola227]

@BigPikachu brings up the last point I didn't write an essay about yet....

which is how a lot of young people obsess over money and free time... and even though it doesn't seem like it, odds are that you are going to end up married with kids. Or dogs. Even if you didn't even ****ing mean to. We're biological beings and we don't have nearly as much sway over that as we think, and somehow these things have a way of happening. I don't care if you're gay (hell, even asexual as an orientation, many people still want companionship and commitment even if sex isn't part of the equation) and don't believe in marriage. You're likely to settle down. Or were you really planning on dying alone?

At that point, yeah, money matters. For your house. In a nice area. Good schools. Decent commute. Weather? If you're lucky you can travel a few times a year for vacation - you won't really have time to miss the big city in the average Rocko's Modern Life with work and family, and when you do, you have enough time to visit it then instead.

I know so many people that moved out of the big city when they had kids so the kids could have actual grass to play on, a street to learn to ride their bike, and play fetch with the dog. I know someone from LA who as a girl developed a really bad eating disorder, and later in life said, "I would never raise kids in a city like LA." Put that one together.

With the amount of free time I had all through my schooling, it was pretty clear to me I just wanted a nice place to rest my head, decent weather, and [insert your favorite thing to do after a work day]. I'm a foodie so just stick me where the nice restaurants are, that's a reasonable thing to think you're going to want to do any given weeknight after work even after you've had kids. We all have to spend the time to have dinner, might as well be a good one.

I know people that like to snowboard every weekend during the season, and that's something you can keep doing when you have kids, too.

It isn't terribly sexy, but there you have it. I could be glib and say it's basically the reason that >90% of the population doesn't live in NYC or LA. This is why suburbia USA exists. Might as well embrace it.

 

[Crayola227]

Lastly, education, and work, might be the first of many reasons that you end up outside your comfort zone. You never know what's going to happen.

A natural disaster sent me from one place to the next. The next time I left state I fell in love, and that person's career moved us from one spot to the next. For a lot of people grad/professional school/residency/fellowship is how they end up the next place.

Or are you just writing off your future soul mate because she's in the military and has to move around the country, and you're not willing to move to Nashville? (a great city, btw)

Even if you fell in love with someone from NYC, that person might be from somewhere. With friends and family. Maybe you have to move with them after 15 years of marriage to care for their ailing parent for the last 5 years of their life? And you don't want to move the kids again after that.

LIKE JESUS ****ING CHRIST WHY DO YOU GUYS HAVE TO BE SO STUCK IN YOUR WAYS. Open your minds. Go to new places. Cultivate being flexible and adaptable in your life, it has so many benefits.

Life took me to places I would have otherwise never looked at on the map and said, hey, why don't I go there. What I did realize, is that saying "you can't go home again..." is bullshyte.

You can always go back home, one way or another. Go big first. You don't have to be born and die in the same place, but you can try later to if you want. No one will stop you from getting a divorce after the kids have grown up, and moving back to Jersey.

 

[Crayola227]

I had zero interest in a lot of things until I got older and actually did them.

 

[GoSpursGo]

Idk why we're all bashing the NYC guy for wanting to stay in NYC.

I'm not bashing him, I'm just saying there are very few jobs in NYC that pay what he wants for as few hours as he wants to work, so it may be wise to figure out now if he can be happy having only some of the things he wants. In general I think the advice he's gotten on specific specialties to aim for is good to maximize his chances of finding that job.

 

[TonsilPlucker]

Didn't know where to put this one and I'm sure this topic has been covered numerous times, but I thought I'd make one that's more personal to me. Would really appreciate any advice
I was always the student who thought I would do anything fulfilling, etc regardless of how much work it required. After my rotations and realizing just how hard some doctors work, I am positive I no longer want to pursue anything that will hurt my lifestyle. I figured I can't be sure I'll choose a field that I will always be intrigued by, but I can guarantee I will always like my family, free time, etc. Don't get me wrong - I love medicine, I always have. I love patient's stories, I love physical exam, imaging, the whole shabang. I just really like doing things outside of the hospital.
That being said, I have the grades and step score to do just about anything. My research isn't great although not absent entirely. I do fine during interviews.
I want a field that will one day give me 250-300k+ (in NYC) and good work hours (<50/week). I also preferably would like a residency that doesn't destroy 5-10 years of the best years of my life (i.e. seeing my kids grow up, ability to play sports and take trips with my SO, etc.)

Can you guys touch on a few things:
-what is your opinion on the "ROAD" specialties or other "lifestyle" specialties. how much does a field have to interest me in order to pursue it if I'm weighing lifestyle just as significantly?
-some people say to just ignore the workload of residency in your decision. Whats your opinion?
-do you have any regrets choosing the field you chose? why?

Thank you!!

Derm...the answer is Derm. Anesthesiology too...but good luck finding a job where you aren't in a call pool that requires overnight call. Yes...in house call.

Optho...similar to Derm but paid less and in a major city really hard to find jobs without a fellowship. Radiology? I have no clue.

If you're not willing to put in 60+ hours (and days where you are in the OR until 9pm to 1am weekly) for 5 years, please don't choose ENT. You are going to hate it. Attending life is better but then again...I take call for 1 week at a time. Most of the time it's just phone triage but at least once a week I get called in middle of the night for something. Sometimes I spend an entire weekend day operating and/or seeing ED consults. Are you ready to face a full day of clinic (25+ patients) after getting woken up and taking a tonsil bleed to the OR at 3 am? I can't speak for Urology but I'd imagine the same. However, pick the right job and you're only taking 2-4 call weeks a year. FWIW, I work in a super saturated, high density area (not by my choice, grrrr!). The other posters are right; my pay is probably 2/3, maybe 1/2 of what I could be making in a suburb and/or less dense city but I get by (I have kids too). City life is over-rated IMO. Someone please tell my SO.

The days of getting paid merely because you have a MD behind your name is over.

Don't have too much more to add. Just that one day the robots will take all our jobs so get it while the gettings good.

So to recap. Choose Derm. Start research. Get connected. Be ready to match anywhere. Maybe you'll broaden your horizons that way.

 

[Newyawk]

Derm...the answer is Derm. Anesthesiology too...but good luck finding a job where you aren't in a call pool that requires overnight call. Yes...in house call.

Optho...similar to Derm but paid less and in a major city really hard to find jobs without a fellowship. Radiology? I have no clue.

If you're not willing to put in 60+ hours (and days where you are in the OR until 9pm to 1am weekly) for 5 years, please don't choose ENT. You are going to hate it. Attending life is better but then again...I take call for 1 week at a time. Most of the time it's just phone triage but at least once a week I get called in middle of the night for something. Sometimes I spend an entire weekend day operating and/or seeing ED consults. Are you ready to face a full day of clinic (25+ patients) after getting woken up and taking a tonsil bleed to the OR at 3 am? I can't speak for Urology but I'd imagine the same. However, pick the right job and you're only taking 2-4 call weeks a year. FWIW, I work in a super saturated, high density area (not by my choice, grrrr!). The other posters are right; my pay is probably 2/3, maybe 1/2 of what I could be making in a suburb and/or less dense city but I get by (I have kids too). City life is over-rated IMO. Someone please tell my SO.

The days of getting paid merely because you have a MD behind your name is over.

Don't have too much more to add. Just that one day the robots will take all our jobs so get it while the gettings good.

So to recap. Choose Derm. Start research. Get connected. Be ready to match anywhere. Maybe you'll broaden your horizons that way.

Thanks for the response. Ophtho i could prob do.. im not sure i could even fake an interest in derm...

 

[TonsilPlucker]

Thanks for the response. Ophtho i could prob do.. im not sure i could even fake an interest in derm...

Not judging. I get it. We work so hard and sometimes the payoff is fustrating.

Again, your mileage may vary but where I trained Ophtho call was horrendous. If I was called in to see a not nec fasc at midnight, I'd give my greetings to the poor Ophtho resident dragging his rolly bag of goodies going from ER room to ER room fielding consults. Then again, we were a quaternary referral center, especially for open globe and such.

Good luck! I hope you find what you're looking for.

 

[Newyawk]

Not judging. I get it. We work so hard and sometimes the payoff is fustrating.

Again, your mileage may vary but where I trained Ophtho call was horrendous. If I was called in to see a not nec fasc at midnight, I'd give my greetings to the poor Ophtho resident dragging his rolly bag of goodies going from ER room to ER room fielding consults. Then again, we were a quaternary referral center, especially for open globe and such.

Good luck! I hope you find what you're looking for.

Im ophtho now btw!

 

[Goro]

Im ophtho now btw!