current trends in residency selection

[secretasianman]

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does anyone know what specialties in medicine are currently popular now, and which were popular say 10 years ago?

 

[YouDontKnowJack]

the ones that are popular now are the ones that have the highest salaries, or the highest salary/work ratio.

 

[Chris127]

Derm, ENT, Optho I imagine have the best salaries/work ratios

Ortho surgery is popular I guess because, well, its surgery, and s ub specialty of surgery in which you can earn major $$$$$$. I'm talking $500k and up/year.

 

[YouDontKnowJack]

so don't believe people when they say they're not in medicine for the money ......

 

[Daiphon]

old attending of mine gave me this little tidbit...

"cush lifestyles will erode (EROAD) medicine"

ENT
Rads
Ophtho/Ortho
Anesthesia
Derm

i just thought it was funny... d=) then again, some are starting to add my specialty (EM) to the list, so mayhap it's not so funny.

-t

 

[Chris127]

I dont know if I would consider anesthesiology cush....

 

[YouDontKnowJack]

I dont know if I would consider anesthesiology cush....

haven't you heard what anes docs do in the OR? they just check readings and then go back to reading the newspaper. I'm sure you could make it more exciting than reading a newspaper though.

 

[secretasianman]

ortho doesn't sound very cush from what i've read... $$$$$$ maybe, but cush?

 

[Chris127]

ortho doesn't sound very cush from what i've read... $$$$$$ maybe, but cush?

I know, I didnt say Ortho was cush, but he*** if you want to be a millionaire, Ortho or some sub specialty of Ortho is for you.

 

[TheEponine]

I would say IM and even peds

 

[WhoisJohnGalt]

old attending of mine gave me this little tidbit...

"cush lifestyles will erode (EROAD) medicine"

ENT
Rads
Ophtho/Ortho
Anesthesia
Derm

i just thought it was funny... d=) then again, some are starting to add my specialty (EM) to the list, so mayhap it's not so funny.

-t

What's cush about EM???

--naive first year who doesn't understand what could possibly be "cush" in the Emergency Room...

 

[jpro]

What's cush about EM???

--naive first year who doesn't understand what could possibly be "cush" in the Emergency Room...

Three 12hr shifts a week with absolutely no call. Plenty of money too.

 

[ms. a]

Three 12hr shifts a week with absolutely no call. Plenty of money too.

I don't know, ER really isn't that cush, aside from the no call aspect. The 3 12-hour shift thing - it's not like you work 6a -6p for 3 days the have 4 days off. A lot of times you're working overnight, which wipes out the next day and night - family doesn't like that too well. Working weekends is very common. The patient population is generally very frustrating - lots of drug seekers, people abusing the health care system, many difficult patients. Each shift ends with a huge load of stress - again, makes it hard to relax with a family immediately after a shift. Add to that the fact that most ER docs burn out after 10 years, shortly after they finally start making a decent amount of money. Bottom line, you really have to love emergency medicine, because otherwise you're going to go nuts. Oh, and my husband is a former ER doc.

 

[secretasianman]

I don't know, ER really isn't that cush, aside from the no call aspect. The 3 12-hour shift thing - it's not like you work 6a -6p for 3 days the have 4 days off. A lot of times you're working overnight, which wipes out the next day and night - family doesn't like that too well. Working weekends is very common. The patient population is generally very frustrating - lots of drug seekers, people abusing the health care system, many difficult patients. Each shift ends with a huge load of stress - again, makes it hard to relax with a family immediately after a shift. Add to that the fact that most ER docs burn out after 10 years, shortly after they finally start making a decent amount of money. Bottom line, you really have to love emergency medicine, because otherwise you're going to go nuts. Oh, and my husband is a former ER doc.

what does he do now?

 

[quideam]

Well, first off, the training of ER docs - as well as who works in the ERs - has really changed over the last 10 - 20 years. The burnout rate used to be much, much higher because many of the docs who worked in the ER simply weren't trained for it. Many docs were "grandfathered in" IM/FM docs, while now almost all of the physicians working in ERs (particularly the busy, city ones) are EM-board certified. Also, I don't know about this 'finally start making decent money' thing - straight out of residency, it's fairly easy to get a job making around 160-180 K. And if you're willing to live in less 'desirable' locations (very rural, etc), you can make 200K+ STARTING OUT. EM salaries don't go up that much from there, but I certainly would consider these 'decent', and you get them straight out of residency. (Check out the EM forum for more info... do a search on salaries).

As for being a good 'lifestyle' choice, I think it's pretty much the best you're going to get if you want to work in a hospital. If you want to do private practice - particularly as a generalist - you can almost definetely wrangle much better hours (though not $$). But if you want to work in, say, a busy academic hospital, EM really does have the best lifestyle, being beat out only by psych and derm.

Q

 

[Daiphon]

What's cush about EM???

--naive first year who doesn't understand what could possibly be "cush" in the Emergency Room...

em is NOT cush... i'm just saying that many people tend to think it is (mostly b/c of lifestyle issues)...

by no means was i saying EM was cush... jeez, i'd get fired from my residency if that was actually believed.

-t

 

[bulletproof]

Anesthesia has begun to enjoy a resurgence in terms of interest. It is consistently one of the most frequented forums on these boards. People had been scared off by the whole CRNA thing....but are now beginning to realise it does not pose a huge threat. This year I believe had a record number of applicants. Money is great with opportunities to specialise in pain, trauma etc. The anesthesia forum has quite a few individuals inquiring about transferring from surgery, IM and even EM. Many students seem to perceive the field as boring, wheras those who have actually done a rotation or who work in the field seem to tell a different story. For my money, that is where its at....autonomy, no rounding, excellent pharm and physio base, procedural oriented, in at 6 out by 3-5 most days according to those in the field. Of course there is not much thanks by the patient, or maybe even recognition of exactly what it is you do, but I can live with that. 60-70 hrs a week, interesting workload, $200,000 + and time for the family and interests. Sign me up.

 

[Chris127]

People had been scared off by the whole CRNA thing.

What is that?

 

[ms. a]

what does he do now?

He's an astronaut (but he left EM before that).

 

[shorrin]

I'm currently on an anesthesia roataion and we probably spent three mornings talking about the erosion of attending's pay d/t medicare policies and CRNA's. This info comes from my attd's, if it's wrong don't yell at me.

CRNA's are certified nurse anesthetists. They are nurses that are allowed to perform the functions of anethesiologists without all the medical school training. They are taught by other CRNA's.

When they first started out CRNA's (depending on state's law) had to be monitored by an attd anesthesiologist. Then legisaltion was changed, as nurses are good organizers, and only an MD had to oversee their actions and sign off, usually a surgeon as happened to be most handy. Now further legislative changes in some states, as I understand it, no longer require MD oversight.

Additionally, CRNA's are not required to disclose thier status to the patient. Not to be MD's are better but.... I've seen a share of PGY2 mishaps.... but I'd sure rather someone with that 5 years of medical training behind them be behind me if I was going under.

Anesthesia, is NOT cush from what I've seen. It's highly dangerous and you need to know what you are doing every minute. paper? that's funny and not true with a good anesthesiologist, even the older ones I've spent time with.

As for reimbursement, as an attd at a teaching hosp overseeing resident's, it's a little known fact that the more surgeries they oversee that overlap the lower the reimbursement gets. eg. 1 surg = 100%, 2 surg 50% each, 3 surg, 33% each.

no specialty in medicine is cush, not if you do it right. 😛

 

[shorrin]

He's an astronaut (but he left EM before that).

i would love to be an astronaut... cool

 

[erin682]

i would love to be an astronaut... cool

heh, thats exactly what I was thinking. I would actually even go for it after residency if it weren't for my bad eyesite. D@mn my eyes!

 

[bulletproof]

I'm currently on an anesthesia roataion and we probably spent three mornings talking about the erosion of attending's pay d/t medicare policies and CRNA's. This info comes from my attd's, if it's wrong don't yell at me.

CRNA's are certified nurse anesthetists. They are nurses that are allowed to perform the functions of anethesiologists without all the medical school training. They are taught by other CRNA's.

When they first started out CRNA's (depending on state's law) had to be monitored by an attd anesthesiologist. Then legisaltion was changed, as nurses are good organizers, and only an MD had to oversee their actions and sign off, usually a surgeon as happened to be most handy. Now further legislative changes in some states, as I understand it, no longer require MD oversight.

Additionally, CRNA's are not required to disclose thier status to the patient. Not to be MD's are better but.... I've seen a share of PGY2 mishaps.... but I'd sure rather someone with that 5 years of medical training behind them be behind me if I was going under.

Anesthesia, is NOT cush from what I've seen. It's highly dangerous and you need to know what you are doing every minute. paper? that's funny and not true with a good anesthesiologist, even the older ones I've spent time with.

As for reimbursement, as an attd at a teaching hosp overseeing resident's, it's a little known fact that the more surgeries they oversee that overlap the lower the reimbursement gets. eg. 1 surg = 100%, 2 surg 50% each, 3 surg, 33% each.

no specialty in medicine is cush, not if you do it right. 😛

Anesthesia is not Cush. I was not trying to suggest otherwise. I was simply trying to establish why many are attracted to it as opposed to say surgery or Im ( longer hours, malignant programs, rounding on patients etc.) It is a highly skilled profession and those who do it right make it look easy ( ie. anticipate the problems before they occur ). As to the whole CRNA vs "MDA" ( medical doctor anesthesiologist...many hate this title as they suggest that only physicians are anesthesiologists and everyone else is an anesthetist), please do a search on it in the anesthesia forum, as the arguments are complex and tedious, and are best left to those with more experience than I. Suffice it to say that having followed the arguments for over the past two years I do not feel threatened by CRNAs. There are a number of mid-level practitioners working in medicine ( surg. techs, NPs, AAs, etc.), and yet there surgeons, FPs etc. are still highly sought after. I believe MD oversight is still required, although perhaps you have evidence to the contrary. In any event in many institutions the MDAs run the surgical ICUs, and CRNAs do not have the option of specialising in pain etc. Again, for those interested, I would advise you to go to the anesthesia forum. It is not a best fit for all but for those who have an aversion to treating diabetes, HTN, and hypercholesterolemia all day long...its a God-send.

 

[edouble]

Med students in general are sleep on PM&R thus a huge shortage. But people are waking up. Its becoming quite popular. It's cush even in residency: 40-50 maybe 60 if malignant hrs/wk.