D.O.s in specialties.

[cliquesh]

Not sure what COMLEX scores have to do with anything I wrote.

When I started school, I didn't even consider pursuing radiology because SDN said, " you have to be a rockstar to match radiology as a DO." From my classmates' experiences, I don't think that's the case anymore. Of the people in my class that matched radiology only one scored above a 240. The rest had mid 220s to low 230s or comlex scores around 550s. I guess when people can match Acgme radiology at a community hospital with slightly above average comlex scores it can't be all that bad.

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[Dr. Zombie]

When I started school, I didn't even consider pursuing radiology because SDN said, " you had to be a rockstar to match radiology as a DO." From my classmates' experiences, I don't think that's the case anymore. Of the 8 or so that matched radiology only one scored above a 240. The rest had mid 220s to low 230s or comlex scores around 550s. I guess when people can match Acgme radiology at a community hospital with slightly above average comlex scores it can't be all that bad.

If everyone listened to SDN we would all be jaded Family Practice residents at bottom-of-the-barrel community health centers.

 

[csx]

When I started school, I didn't even consider pursuing radiology because SDN said, " you have to be a rockstar to match radiology as a DO." From my classmates' experiences, I don't think that's the case anymore. Of the people in my class that matched radiology only one scored above a 240. The rest had mid 220s to low 230s or comlex scores around 550s. I guess when people can match Acgme radiology at a community hospital with slightly above average comlex scores it can't be all that bad.

Any field that you think is gonna be the next big thing 10 years from now? Conversely, any field that will fall from stardom?

 

[cabinbuilder]

Radiology reimbursments are declining and the job market is becoming saturated with new radiologists. It's not uncommon for new radiologist to do a fellowship or 2 before finding a job. The salary is still good, however. A similar situation can be seen in pathology and, to a lesser extent, in anesthesia and cardiology.

Yes, because with the advent of technology radiology is outsourced incredibly. You don't have to work in the town where the films are being read. When I was in Southeast Alaska my films were read in Central Oregon. Overnight films are read in Australia. Many and most places I work don't have a radiologist within 100 miles or more. They are at big centers that service a huge area.

 

[cliquesh]

Any field that you think is gonna be the next big thing 10 years from now? Conversely, any field that will fall from stardom?

There is a lot of uncertainty right now due to the ACA and potential future changes in reimbursement models, so I think it's pretty hard to predict anything. Plastic surgery and derm are probably safe because they are cash businesses. Primary care will be in a better position in the future than it is today. I have no clue about the rest.

 

[happypremed1]

There is a lot of uncertainty right now due to the ACA and potential future changes in reimbursement models, so I think it's pretty hard to predict anything. Plastic surgery and derm are probably safe because they are cash businesses. Primary care will be in a better position in the future than it is today. I have no clue about the rest.

How about OMM in wealthy communities with cash only business?

You are in anesthesiology right? Where do you think it's heading?

 

[cliquesh]

How about OMM in wealthy communities with cash only business?

You are in anesthesiology right? Where do you think it's heading?

You can make a good living with OMM only. However, you actually have to be good at OMM and not everyone is capable of being good at OMM. Moreover, not every omm clinic, like any private business, is going to be successful. It's kind of a gamble.

Anesthesia's overall reimbursements will be going down next year and will likely continue to decline. The job market is already pretty saturated, at least in major cities, and there is an unprecedented influx of mid levels. But, whatever, I think it's fun and there isn't anything else in medicine I'd rather do.

 

[happypremed1]

so when the market is saturated and it's difficult to find a job, doing a fellowship to further specialize is the way to go in the future?

 

[cliquesh]

so when the market is saturated and it's difficult to find a job, doing a fellowship to further specialize is the way to go in the future?

Yep. Also being flexiable where you live/work helps a lot, too. Unlike radiology and pathology, which basically require a fellowship to get a job, doing a fellowship in anesthesia is still somewhat uncommon.

 

[ChineseKid]

Interesting to see you're in anesthesia.
Something I'm thinking of pursuing. Gonna follow your posts more closely now

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[happypremed1]

Radiology reimbursments are declining and the job market is becoming saturated with new radiologists. It's not uncommon for new radiologist to do a fellowship or 2 before finding a job. The salary is still good, however. A similar situation can be seen in pathology and, to a lesser extent, in anesthesia and cardiology.

Geez, it seems like a lot of medical fields are becoming less and less competitive except for surgery, dermatology, optho, urology and ENT. It's also kinda sad to see that the reduced compensation is shifting the level of competition.

 

[cliquesh]

Geez, it seems like a lot of medical fields are becoming less and less competitive except for surgery, dermatology, optho, urology and ENT. It's also kinda sad to see that the reduced compensation is shifting the level of competition.

I suppose, but anesthesiologists aren't hurting. Some of the cardiac and peds anesthesia fellows at my insitution are getting jobs in the 500k range. You'll always make plenty of money (300k) as an anesthesiologist.

General surgery pays like poo for the hours you put in.

 

[Dr. Zombie]

I suppose, but anesthesiologists aren't hurting. Some of the cardiac and peds anesthesia fellows at my insitution are getting jobs in the 500k range. You'll always make plenty of money (300k) as an anesthesiologist.

General surgery pays like poo for the hours you put in.

What is it about Anesthesia that is so high-paying?

Is it very intellectually demanding? (you need to be an Einstein).

Is it a high-risk for mistakes in terms of killing patients via wrong drugs?

Is the lawsuits extremely common like OBGYN?

What are the pros/cons of Anesthesia that makes it so lucrative?

 

[Postictal Raiden]

The way that medicare reimbursement works is that procedures are paid significantly more than diagnostics. This in turn has driven the salaries of specialties such as Gas/GI/IR up the roof while causing specialties like neurology/Rheumatology/etc. to pay "poorly".

Anesthesia is very procedural. In fact, I would think of it as more procedural than general surgery since anesthesiologists spend more time in the OR than most surgeons. This is the reason why anesthesiologists get paid well.

 

[cliquesh]

What is it about Anesthesia that is so high-paying?

Is it very intellectually demanding? (you need to be an Einstein).

Is it a high-risk for mistakes in terms of killing patients via wrong drugs?

Is the lawsuits extremely common like OBGYN?

What are the pros/cons of Anesthesia that makes it so lucrative?

Too my understanding, in the past anesthesia use to have just as bad, if not worse, complications than surgery, which lead to a high reimbursement for anesthesia. Now we have better technology and drugs, and less complications, but the reimbursment for anesthesia still remains high. Nearly all procedures, many of which are performed by anesthiologists themselves, require anesthesia, which means lots of billing for high reimbursing codes.

I wouldn't say anesthesia is a highly cerebral speciality; it's kind of in the middle of the road. It is, however, a skillful speciality and when a patient starts to decline rapidly and no one knows what to do they page anesthesia to come save the day, hah.

Anesthesia is kind of in the middle, or lower end, in terms of lawsuites.

Anesthesia isn't for everyone. Some people find it stressful or dreadfully boring, like I find family medicine to be boring. I wouldn't pick a speciality based on current incomes; things may change drastically in the future. Just pick something that makes you happy.

 

[baboxxyun]

Too my understanding, in the past anesthesia use to have just as bad, if not worse, complications than surgery, which lead to a high reimbursement for anesthesia. Now we have better technology and drugs, and less complications, but the reimbursment for anesthesia still remains high. Nearly all procedures, many of which are performed by anesthiologists themselves, require anesthesia, which means lots of billing for high reimbursing codes.

I wouldn't say anesthesia is a highly cerebral speciality; it's kind of in the middle of the road. It is, however, a skillful speciality and when a patient starts to decline rapidly and no one knows what to do they page anesthesia to come save the day.

Anesthesia is kind of in the middle, or lower end, in terms of lawsuites.

Anesthesia isn't for everyone. Some people find it stressful or dreadfully boring, like I find family medicine to be boring. I wouldn't pick a speciality based on current incomes; things may change drastically in the future. Just pick something that makes you happy.

I don't mean to hijack the thread or anything, but what made you pick anesthesia over other specialties?
I've read numerous posts about experiences with surgery, but havent seen many posts about anesthesia.

 

[cliquesh]

I don't mean to hijack the thread or anything, but what made you pick anesthesia over other specialties?
I've read numerous posts about experiences with surgery, but havent seen many posts about anesthesia.

It was the only speciality in med school that I thought was fun and I literally hated nearly every other speciality, so it made my choice pretty easy. Additionally, the hours are good and the paper work is minimal, hah.

 

[Dr. Zombie]

It was the only speciality in med school that I thought was fun and I literally hated nearly every other speciality, so it made my choice pretty easy. Additionally, the hours are good and the paper work is minimal, hah.

Did u graduate from a DO school? If so, how is the MD vs DO shenanigans in the real non-SDN, non-premed world as an Anesth?

 

[cliquesh]

Did u graduate from a DO school? If so, how is the MD vs DO shenanigans in the real non-SDN, non-premed world as an Anesth?

Yep, I'm a DO.

Anesthesia is one of the most DO friendly specialties. Most residencies, even top places, take DOs for anesthesia. With that said, DOs and USMDs are not on the same playing field. My MD buddy with a mid-230 usmle, for instance, did better securing impressive interviews than I did despite my 250something score.

It's not that bad being a DO, though. If you take the usmle and do about average, you'll have plenty of options. Being a DO is bad if you want to do one of the surgical subspecialties ( except aoa ortho), derm or rad/onc. Everything else is do able.

When you are an attending no one will really care if you're a DO or MD.

 

[Dr. Zombie]

Yep, I'm a DO.

Anesthesia is one of the most DO friendly specialties. Most residencies, even top places, take DOs for anesthesia. With that said, DOs and USMDs are not on the same playing field. My MD buddy with a mid-230 usmle, for instance, did better securing impressive interviews than I did despite my 250something score.

It's not that bad being a DO, though. If you take the usmle and do about average, you'll have plenty of options. Being a DO is bad if you want to do one of the surgical subspecialties ( except aoa ortho), derm or rad/onc. Everything else is do able.

When you are an attending no one will really care if you're a DO or MD.

Foremost, I want to congratulate you on your 250 no matter how irrelevant it is at this stage of your career. It shows such a tremendous dedication and a good example for the rest of us.

Do you mind if I PM you. I would love some tips. I plan to take the USMLE in case I decide to pursue an MD residency.

Yeah I'm really looking into PMR as a possible option. I'm not into surgery thankfully lol. Nonetheless, I know residencies can be an issue but I'm mentally prepared for that.

My main concern is being a DO attending and onward. Thank you for clearing it up. You should totally open up a "Ask Cliquesh anything Anesthesia" Thread. People will love you lol.

 

[cliquesh]

My main concern is being a DO attending and onward.

I wouldn't worry about that part too much. The major problem being a DO, in my opinion, is matching into your speciality of choice. PM&R is probably the most DO friendly speciality and I would almost say it hardly matters if you're a DO or not, almost...

Take the usmle, do well, and match at mayo or MGH for pm&r. It's totally possible.

Yea, you can PM about anything.

 

[BestDoctorEver]

I wouldn't worry about that part too much. The major problem being a DO, in my opinion, is matching into your speciality of choice. PM&R is probably the most DO friendly speciality and I would almost say it hardly matters if you're a DO or not, almost...

Take the usmle, do well, and match at mayo or MGH for pm&r. It's totally possible.

Yea, you can PM about anything.

Are you on your last year of residency? Do you already have a job line up for you? 250+? What is the percentile?

 

[cliquesh]

Are you on your last year of residency? Do you already have a job line up for you? 250+? What is the percentile?

Hah, no, I'm a 1st year.

They don't give you a percentile, so I don't know for sure. Some random Internet usmle percentile calculators say its somewhere between the 90th and 95th percentile. A 235 is around the 70th percentile.

 

[ChineseKid]

I wouldn't worry about that part too much. The major problem being a DO, in my opinion, is matching into your speciality of choice. PM&R is probably the most DO friendly speciality and I would almost say it hardly matters if you're a DO or not, almost...

Take the usmle, do well, and match at mayo or MGH for pm&r. It's totally possible.

Yea, you can PM about anything.

Aww. Share the useful tips with us!

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[cabinbuilder]

My main concern is being a DO attending and onward. Thank you for clearing it up.

I totally don't get this statement or concern.

 

[BestDoctorEver]

I totally don't get this statement or concern.

It's an urban myth in SDN, but in reality almost no one in a healthcare setting knows who is MD or DO. Every physician is addressed by: Dr. Fontanetta.

 

[Dr. Zombie]

It's an urban myth in SDN, but in reality almost no one in a healthcare setting knows who is MD or DO. Every physician is addressed by: Dr. Fontanetta.

What?! I don't wanna change my last name....nooooooooooooooo!!!!

 

[BestDoctorEver]

What?! I don't wanna change my last name....nooooooooooooooo!!!!

Lol.... I meant Dr. 'X'. I just chose a random last name.

 

[Dr. Zombie]

Lol.... I meant Dr. 'X'. I just chose a random last name.

Dr. Eamy

(See what I did there?)

 

[BestDoctorEver]

Dr. Eamy

(See what I did there?)

No....

 

[HopefulSpartan]

No....

Dreamy, like Dr. McDreamy from Greys

 

[ChineseKid]

I'll be McSteamy

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[hallowmann]

Residency competitiveness goes up and down in cycles. Path was not competitive at all and filled only by FMGs, then it became competitive, and now its getting saturated and less competitive. The same is true for almost every specialty. Its all peaks and troughs. Pick based on what you like, how you want to spend the rest of your life, etc. Worst case scenario (if the market is iffy) you get a job a bit farther away from your dream location or do a fellowship to make yourself more competitive.

Heck, I know a guy who worked in IM for 5 years, decided he didn't want to live his whole life that way, and then went back for PM&R (although switching will likely get harder in the future).

...Anesthesia isn't for everyone. Some people find it stressful or dreadfully boring, like I find family medicine to be boring. I wouldn't pick a speciality based on current incomes; things may change drastically in the future. Just pick something that makes you happy.

Best advice.

 

[csx]

Radiology reimbursments are declining and the job market is becoming saturated with new radiologists. It's not uncommon for new radiologist to do a fellowship or 2 before finding a job. The salary is still good, however. A similar situation can be seen in pathology and, to a lesser extent, in anesthesia and cardiology.

If, as a DO, since it is inherently extremely difficult to get a fellowship? what do you do as a DO radiologist because you can't land a fellowship and you can't land a job....?

 

[cabinbuilder]

If, as a DO, since it is inherently extremely difficult to get a fellowship? what do you do as a DO radiologist because you can't land a fellowship and you can't land a job....?

Move to Australia and work for Nighthawk

 

[cliquesh]

If, as a DO, since it is inherently extremely difficult to get a fellowship? what do you do as a DO radiologist because you can't land a fellowship and you can't land a job....?

Competitive, high paying fellowships are difficult for DOs, but not all fellowships are competitive. In internal medicine, cardiology, GI, and hem/onc are competitive. On the other hand, rheumatology, nephrology, infectious disease and pulm crit are not competitive. In radiology, neuroradiology and interventional radiology are competitive, but abdominal, MSK, and women's imaging are not as competitive.

I'd estimate 30 to 50% of Acgme DOs match into neuroradiology or IR.

It will be 10 years from now before you're looking for a job. A lot will be different in 10 years. I wouldn't worry about it too much.

 

[Mr Kenobi]

I'll be McSteamy

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If you're headed to MUCOM, you'll have to be somebody else, because the position of McSteamy is already filled by yours truly. Sorry.

 

[ChineseKid]

If you're headed to MUCOM, you'll have to be somebody else, because the position of McSteamy is already filled by yours truly. Sorry.

Damn
I'll be McDonald, eating chicken nuggets then

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[Mr Kenobi]

Damn
I'll be McDonald, eating chicken nuggets then

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Better share those nuggets.

 

[ChineseKid]

Better share those nuggets.

Only if you promise to bring the ladies, using your McSteamy-ness.

 

[Mr Kenobi]

Only if you promise to bring the ladies, using your McSteamy-ness.

Wherever I go, ladies will be.

 

[csx]

Wherever I go, ladies will be.

^Nah, he just uses force (Pun intended?!)

 

[box29]

Competitive, high paying fellowships are difficult for DOs, but not all fellowships are competitive. In internal medicine, cardiology, GI, and hem/onc are competitive. On the other hand, rheumatology, nephrology, infectious disease and pulm crit are not competitive. In radiology, neuroradiology and interventional radiology are competitive, but abdominal, MSK, and women's imaging are not as competitive.

I'd estimate 30 to 50% of Acgme DOs match into neuroradiology or IR.

It will be 10 years from now before you're looking for a job. A lot will be different in 10 years. I wouldn't worry about it too much.

Just for clarification, in radiology, IR and women's imaging have been the most competitive fellowships for a few years now followed by MSK. Peds has not been too competitive except at the big name places. Neurorads has not been competitive for a while. Chest/Thoracic, abdomen, and body fellowships are the least competitive.

As stated before, things are cyclical and what has been competitive will eventually become less competitive and vice versa.

 

[cliquesh]

Just for clarification, in radiology, IR and women's imaging have been the most competitive fellowships for a few years now followed by MSK. Peds has not been too competitive except at the big name places. Neurorads has not been competitive for a while. Chest/Thoracic, abdomen, and body fellowships are the least competitive.

As stated before, things are cyclical and what has been competitive will eventually be
come less competitive and vice versa.

Thanks for clarifying.

It's kind of funny when I was looking into radiology 5 years ago, IR and neuro radiology were the popular fellowships and everything else was a distant second. Things change quickly. I wonder if my experiences will be obsolete in the near future.

 

[csx]

Just for clarification, in radiology, IR and women's imaging have been the most competitive fellowships for a few years now followed by MSK. Peds has not been too competitive except at the big name places. Neurorads has not been competitive for a while. Chest/Thoracic, abdomen, and body fellowships are the least competitive.

As stated before, things are cyclical and what has been competitive will eventually become less competitive and vice versa.

Are we talking AOA fellowships or ACGME?

 

[cliquesh]

Are we talking AOA fellowships or ACGME?

There are no AOA radiology fellowships.

If you did an AOA radiology residency you would be potentially excluded from any Acgme accredited fellowship, which would include Neuroradiology, peds, nuclear, and vascular.

Non-Acgme accredited fellowships, which include abdominal, women's, Ultrasound, MSK, and heart&lung, would still be an option. Some of them may become acgme accredited at one point, though.

 

[cliquesh]

What about endocrinology?

Endocrinology is considered to be not competitive. With that said, in 2011, 11 DOs matched endocrin and 9 didn't, which are actually worse odds than a DO applying for cardiology or hem/onc. I think, however, it probably has to do with the applicant pool; not the competitiveness of the speciality.

 

[MedSchoolMama]

Anesthesia isn't for everyone. Some people find it stressful or dreadfully boring, like I find family medicine to be boring. I wouldn't pick a speciality based on current incomes; things may change drastically in the future. Just pick something that makes you happy.

YES! Brilliant!
Listen, none of us are going to starve to death. Do what you like to do regardless of whether it is one of the more or less compensated specialties. That is what is best for both you and your patients.

 

[cabinbuilder]

Some of the guys in my med school class - the authors of COMBANK. Very smart and look at where they did residency, even the unpenitratable California!!! Hopefully this will ease some fears??? Maybe???? Cardiology, Radiology, Anesthesia, and ER. One who does research, has received awards and trained at the CDC.

Todd Zynda, DO
Chief Editor / Cardiology Fellow, PGY-6 / Division of Cardiology, Department of Medicine / University of California, Irvine / Orange, California

Dr. Zynda currently serves as the Chief Cardiology Fellow at the University of California, Irvine Medical Center and is board-certified in Internal Medicine. He also completed his residency at UC-Irvine and is a 2006 graduate of the Lake Erie College of Osteopathic Medicine (LECOM). Todd has received multiple awards for his academic excellence and greatly enjoys teaching both medical students and residents. He graduated in the top 5% of his class and has scored in the 95th percentile or greater on all three levels of COMLEX and Steps 1 and 2 CK of the USMLE. His research focus has included the advancement of novel modalities of coronary angiography. Todd is a native of Michigan and is a huge fan of the Michigan State Spartans.

Joshua Courtney, DO
Academic Director / Chief Editor / Staff Anesthesiologist / Charlotte, NC

Dr. Courtney is an Anesthesiologist licensed in Charlotte, North Carolina. Dr. Courtney serves as an advocate for Osteopathic medical students nationwide. He spends much of his time outside of the hospital studying evidence-based learning principles and works with medical schools and Osteopathic organizations alike to promote Osteopathic practice and enhance board preparation and testing skills. Joshua believes that every Osteopathic medical student can achieve his or her goals in medicine with commitment and dedicated preparation. He completed his residency in Anesthesiology in 2011 at the Western Pennsylvania-Allegheny Health System and is a 2006 graduate of the Lake Erie College of Osteopathic Medicine (LECOM), where he received multiple honors for his research in vector-borne diseases. Prior to medical school, Joshua received his undergraduate degree at Washington and Jefferson College where he graduated with honors in Cellular and Molecular Biology and English. He subsequently went on to complete an Emerging Infectious Diseases (EID) laboratory fellowship at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. Joshua is a decorated scientific writer with publications in several journals, including the Journal of Clinical Microbiology and Emerging Infectious Diseases.

Jacob Brown, DO
Senior Author / Attending Physician / Department of Radiology / University of Pittsburgh Medical Center (UPMC) / Pittsburgh, PA

Dr. Brown is a staff Radiologist at the University of Pittsburgh Medical Center in Pittsburgh, PA. He received his Doctor of Osteopathic Medicine at the Lake Erie College of Osteopathic Medicine (LECOM) in 2006. Prior to medical school, Dr. Brown received his undergraduate degree in General Biology at Washington and Jefferson College. He is a true outdoorsman and loves to hunt and fish in his free time.

Robert Graessle, DO
Senior Author / Attending Physician / Department of Emergency Medicine / Riverside Methodist Hospital

Dr. Graessle is a board-certified Emergency Medicine physician at Riverside Methodist Hospital in Columbus, OH. He completed his residency at Michigan State University Kalamazoo Center for Medical Studies (MSU/KCMS) in 2010. Dr. Graessle is a 2006 graduate of the Lake Erie College of Ostoepathic Medicine (LECOM). Prior to medical school, he completed his undergraduate work at Malone College and received a Masters degree in Exercise Physiology at the University of South Carolina. He was a nationally ranked track and field star at the collegiate level. Dr. Graessle’s professional interests include toxicology and addiction medicine.

 

[costales]

Listen, none of us are going to starve to death. Do what you like to do regardless of whether it is one of the more or less compensated specialties. That is what is best for both you and your patients.

Let's just say I don't know of any DO who drives a used Hyundai and lives in a crappy neighborhood.