deleted

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
DBV said:
General surgery, IR, obgyn just to name a few
Click to expand...
you consider gen surgery as a lifestyle specialty?

coffeenut0 said:
Hey! I'm a US-IMG studying in Pakistan in my final year. I'll be applying soon and was wondering what specialties are doable for me. I have a lot of interests outside of medicine i want to pursue/make time for so the priority for me is lifestyle/vacation time/free time etc.

My step 1 score was 240. I have some case reports published in the US, will be taking CK/CS this year. I also want to do one elective rotation in the summer before i fill out ERAS stuff in sept, so i feel like i should have an idea of what specialty i want to apply to before i confirm which rotation i do.

If anyone can guide me as to what specialties both a) are attainable with my step 1 score and b) suit my priorities i would be greatly obliged!

im also between anesthesia and hospitalist if someone could shed some light on the major lifestyle differences between those~
Click to expand...

Family med and peds are probably a safe bet. maybe psych
 
coffeenut0 said:
Hey! I'm a US-IMG studying in Pakistan in my final year. I'll be applying soon and was wondering what specialties are doable for me. I have a lot of interests outside of medicine i want to pursue/make time for so the priority for me is lifestyle/vacation time/free time etc.

My step 1 score was 240. I have some case reports published in the US, will be taking CK/CS this year. I also want to do one elective rotation in the summer before i fill out ERAS stuff in sept, so i feel like i should have an idea of what specialty i want to apply to before i confirm which rotation i do.

If anyone can guide me as to what specialties both a) are attainable with my step 1 score and b) suit my priorities i would be greatly obliged!

im also between anesthesia and hospitalist if someone could shed some light on the major lifestyle differences between those~
Click to expand...

Family/Radiology/Anesthesiology/Pathology
 
My advice would be Family, Peds, Psych, or Rads
 
Last edited:
Dermpire said:
What? IR would be a near impossible match for any IMG. Top tier competitive and they work pretty hard.

My advice would be Family, Peds, Psych, or Rads
Click to expand...

I'm just going to assume that you broke your sarcasm detector at your superbowl party last night and issue you a work order to get it fixed.
 
You can try nuclear medicine residency if you want to have free time because you won't have a job.

(For real, avoid nuclear medicine residencies because everyone will pick a radiology-trained nuclear medicine physician over someone who just did a nucs residency.)
 
libertyyne said:
What is fascinating about this IMGs/USIMGS matching into Derm and NSG.
Click to expand...
Yes, but single digits in each.
The non-US IMG's are some of the most qualified people on earth.
 
libertyyne said:
You have much to learn. Hospitalists are everyone's bitch, ETC, surgery, critical care, ent, the list goes on.
Click to expand...

Not really haha. Hospitalists, even as generalists, are respected internists. They have people consult on their patients but at least they have patients. Most people outside medicine don't even consider an anesthesiologist a true physician. Plus, the future is much more grim for anesthesia. Furthermore, to answer OP's question, IM is way better because they can specialize if they do well. Choose anesthesia and you can never get out of being at the surgeon's whim. FWIW, I highly respect anesthesiologists and understand how important their job is. I'm just saying most of the world doesn't.
 
DBV said:
I'm just going to assume that you broke your sarcasm detector at your superbowl party last night and issue you a work order to get it fixed.
Click to expand...

Wow, that went completely over my head, my bad. I fixed my original post.
 
LebronManning said:
Not really haha. Hospitalists, even as generalists, are respected internists. They have people consult on their patients but at least they have patients. Most people outside medicine don't even consider an anesthesiologist a true physician. Plus, the future is much more grim for anesthesia. Furthermore, to answer OP's question, IM is way better because they can specialize if they do well. Choose anesthesia and you can never get out of being at the surgeon's whim. FWIW, I highly respect anesthesiologists and understand how important their job is. I'm just saying most of the world doesn't.
Click to expand...
latest

Spend some time in a hospital and get back to me. Internal medicine is the dumping ground for most specialists. ETCs will even sandbag patients and dump them at shift change with little to no workup. Most patients dont even meet criteria for admission.
 
libertyyne said:
Spend some time in a hospital and get back to me. Internal medicine is the dumping ground for most specialists. ETCs will even sandbag patients and dump them at shift change with little to no workup. Most patients dont even meet criteria for admission.
Click to expand...

Lol I have spent thousands of hours in a hospital in the ED, general floor, ICU, and OR. You don't have to be a physician (yet) to notice these things. By and far, the anesthesiologists took more crap than anyone. I scribed in other areas of hospital but only shadowed in the OR. Even with a shadower there (me) I repeatedly saw surgeons disrespect anesthesiologists. The circulating nurse literally seemed to be more powerful than the anesthesiologists. On the contrary, every one including the specialists, surgeons, and nurses respected the hospitalist. Also remember, any hospitalists can just leave and go do PCP work and be their own boss. Anesthesia can never escape their subservient role.
 
LebronManning said:
Lol I have spent thousands of hours in a hospital in the ED, general floor, ICU, and OR. You don't have to be a physician (yet) to notice these things. By and far, the anesthesiologists took more crap than anyone. I scribed in other areas of hospital but only shadowed in the OR. Even with a shadower there (me) I repeatedly saw surgeons disrespect anesthesiologists. The circulating nurse literally seemed to be more powerful than the anesthesiologists. On the contrary, every one including the specialists, surgeons, and nurses respected the hospitalist. Also remember, any hospitalists can just leave and go do PCP work and be their own boss. Anesthesia can never escape their subservient role.
Click to expand...
sure thing pal. Anasthesia is subservient and all the specialties looked up to Internal Med PCPs.lol. Cant wait to tell all my IM/PCP buddies that lebronmanning says everyone looks up to them and that they should stop having some of the worst satisfaction scores out of all physicans. And that they can boss around anasthesia.
 
LebronManning said:
Lol I have spent thousands of hours in a hospital in the ED, general floor, ICU, and OR. You don't have to be a physician (yet) to notice these things. By and far, the anesthesiologists took more crap than anyone. I scribed in other areas of hospital but only shadowed in the OR. Even with a shadower there (me) I repeatedly saw surgeons disrespect anesthesiologists. The circulating nurse literally seemed to be more powerful than the anesthesiologists. On the contrary, every one including the specialists, surgeons, and nurses respected the hospitalist. Also remember, any hospitalists can just leave and go do PCP work and be their own boss. Anesthesia can never escape their subservient role.
Click to expand...
I don't know enough about everything else you said because I'm only a med student, but I repeatedly saw a lot of surgeons disrespect anesthesiologists too. I also saw a lot of surgeons disrespect other surgeons and other staff. I just think a lot of surgeons have a certain level of "arseholiness" to them.
 
Not necessarily disagreeing with these specific reports of happiness and choosing the same specialty again, but just asking in general how reliable are these Medscape surveys? Isn't it like a 10% response rate of people surveyed (small sample size, effect size inflation, low statistical power, etc.)?
 
libertyyne said:
sure thing pal. Anasthesia is subservient and all the specialties looked up to Internal Med PCPs.lol. Cant wait to tell all my IM/PCP buddies that lebronmanning says everyone looks up to them and that they should stop having some of the worst satisfaction scores out of all physicans. And that they can boss around anasthesia.
Click to expand...

Lol wtf. I️ never said that IM bosses everyone around. I’d agree they are near the bottom of the food chain. But at least internists aren't another physician's assistant
 
The stuff about surgeons constantly disrespecting gas docs is something anyone who has worked in the OR knows... Everyone who works in the hospital also knows that IM is a dumping ground.
 
W19 said:
The stuff about surgeons constantly disrespecting gas docs is something anyone who has worked in the OR knows... Everyone who works in the hospital also knows that IM is a dumping ground.
Click to expand...
Oh yeah it is...but at the same time if you're part of a hospitalist group at least it isn't purely on your head. When you're off you're off (for the most part)
 
LebronManning said:
Not really haha. Hospitalists, even as generalists, are respected internists. They have people consult on their patients but at least they have patients. Most people outside medicine don't even consider an anesthesiologist a true physician. Plus, the future is much more grim for anesthesia. Furthermore, to answer OP's question, IM is way better because they can specialize if they do well. Choose anesthesia and you can never get out of being at the surgeon's whim. FWIW, I highly respect anesthesiologists and understand how important their job is. I'm just saying most of the world doesn't.
Click to expand...

Anesthesia can do pain or critical care fellowships if they want to get out of the OR.

Abusive behavior is much less tolerated today than before. It’ll be hard to find an abusive surgeon in 10 years.

Anesthesiologists are very skillful physicians. They are airway masters, can put in any line, epidurals for OB and elective surgery etc. they’re really not the “surgeons helper”. Also, they know more about physiology and pharmacology than most.

IM can be great if it’s what you enjoy. Hospitalists have a lot of time off, but they earn that time off when they’re on. And they do a lot of babysitting for other services. Which they might be ok with because it’s easy work, I don’t know.
 
Last edited:
spacegun said:
Not necessarily disagreeing with these specific reports of happiness and choosing the same specialty again, but just asking in general how reliable are these Medscape surveys? Isn't it like a 10% response rate of people surveyed (small sample size, effect size inflation, low statistical power, etc.)?
Click to expand...
I mean it's possible. If you know the way surveys are conducted a 10% response rate is pretty good. A more valid criticism might be that there are intrinsic differences in these populations that they self select for. And maybe internists are more miserable people to begin with. I personally have yet to meet many internists who were over the moon about being an internist .
 
libertyyne said:
I mean it's possible. If you know the way surveys are conducted a 10% response rate is pretty good. A more valid criticism might be that there are intrinsic differences in these populations that they self select for. And maybe internists are more miserable people to begin with. I personally have yet to meet many internists who were over the moon about being an internist .
Click to expand...

I think that has to do with how many internists are selected. I have heard many times from students and attendings alike that if you don’t know what you want to do then pick IM because it leaves the most doors open. The indecisiveness breeds discontent.

The few IM docs I know that love their jobs chose IM and didn’t just fall into it by default
 
LebronManning said:
Lol I have spent thousands of hours in a hospital in the ED, general floor, ICU, and OR. You don't have to be a physician (yet) to notice these things. By and far, the anesthesiologists took more crap than anyone. I scribed in other areas of hospital but only shadowed in the OR. Even with a shadower there (me) I repeatedly saw surgeons disrespect anesthesiologists. The circulating nurse literally seemed to be more powerful than the anesthesiologists. On the contrary, every one including the specialists, surgeons, and nurses respected the hospitalist. Also remember, any hospitalists can just leave and go do PCP work and be their own boss. Anesthesia can never escape their subservient role.
Click to expand...

Being an anesthesiologist is no different than any other human to human relationship. People will abuse and disrespect you if you allow it.
I've been an anesthesiologist for several decades now in plenty of different institutions, and I'm not a surgeon's bitch nor do I allow them to disrespect me. I can count on less than one hand the number of surgeons I've truly been unable to get along with in all those years.
 
libertyyne said:
I mean it's possible. If you know the way surveys are conducted a 10% response rate is pretty good. A more valid criticism might be that there are intrinsic differences in these populations that they self select for. And maybe internists are more miserable people to begin with. I personally have yet to meet many internists who were over the moon about being an internist .
Click to expand...
So probably no one cares and this is beating a dead horse lol, but I went to the Medscape Physician Compensation Report 2017 and saw the survey response rate (slide 40).

AM3p0wo.jpg


Personally I like both anesthesia and IM, though I agree I don't know if I could stay in general IM after all that's been said here. I mean I really like the idea of general IM, of being so well rounded and knowledgeable, but what do I know I'm only a med student lol. But I'd probably do IM to try to subspecialize (I really like pulm & ccm and card but I change my mind on a daily basis). If I can't subspecialize, then maybe I can try to do a second residency in anesthesia if they'll take me as I heard IM is a good foundation for anesthesia.
 
spacegun said:
So probably no one cares and this is beating a dead horse lol, but I went to the Medscape Physician Compensation Report 2017 and saw the survey response rate (slide 40).

AM3p0wo.jpg


Personally I like both anesthesia and IM, though I agree I don't know if I could stay in general IM after all that's been said here. I mean I really like the idea of general IM, of being so well rounded and knowledgeable, but what do I know I'm only a med student lol. But I'd probably do IM to try to subspecialize (I really like pulm & ccm and card but I change my mind on a daily basis). If I can't subspecialize, then maybe I can try to do a second residency in anesthesia if they'll take me as I heard IM is a good foundation for anesthesia.
Click to expand...
I dont think that says what you think it says.
1. We have no better data.
2. 14,000 US physicians were surveyed as part of that survey.
3. Survey response rates in general are abysmal.
4.Thay may be representative of relative sizes of different specialties.
 
Last edited:
libertyyne said:
I dont think that says what you think it says.
1. We have no better data.
2. 14,000 US physicians were surveyed as part of that survey.
3. Survey response rates in general are abysmal.
4.Thay may be representative of relative sizes of different specialties.
Click to expand...
I'm not sure what you think I think it says, because I didn't say anything specific about it. I basically just posted the graph without any significant commentary.

However, since you bring it up, sometimes a perfectly acceptable conclusion to reach is that all the data we have = inconclusive. Nothing wrong with that.

Anyway I think all this is pretty trivial so I'll stop responding to this. I don't want to make it seem like a bigger deal than it is.
 
spacegun said:
I'm not sure what you think I think it says, because I didn't say anything. All I did was post the graph.

However, since you bring it up, sometimes a perfectly acceptable conclusion to reach is that all the data we have = inconclusive. Nothing wrong with that.

Anyway all this is pretty trivial for me.
Click to expand...
Or you know we have year after year of data indicating that internists are the least happiest, would not recommend doing it again, etc with a fairly large sample size. But you can draw whatever conclusion you want to.and hell if you are looking forward to it more power to you . Caveat emptor.
 
libertyyne said:
Or you know we have year after year of data indicating that internists are the least happiest, would not recommend doing it again, etc with a fairly large sample size. But you can draw whatever conclusion you want to.and hell if you are looking forward to it more power to you . Caveat emptor.
Click to expand...
The majority of internists planned to ultimately become specialists. That tends to create some unhappiness in the field, as they often end up trapped as hospitalists or outpatient general internists
 
libertyyne said:
Or you know we have year after year of data indicating that internists are the least happiest, would not recommend doing it again, etc with a fairly large sample size. But you can draw whatever conclusion you want to.and hell if you are looking forward to it more power to you . Caveat emptor.
Click to expand...
Cool I'm not disagreeing with you. I mean I'm not saying internists aren't the least happy. Maybe they are. But honestly I just don't know. I've personally never seen the "year after year of data" and like I said I would think Medscape data is likely inconclusive due to small sample size etc. (as I mentioned above). But like you said, maybe that's all we can expect from surveys so that has to suffice in relative comparisons.

I can only speak from my experience. In my experience I've seen happy and unhappy internists, but I know I can't generalize from my experiences to the entire group of internists. Personally like I said above my plan isn't to stay in IM but to subspecialize if I can. If I can't, then like I said above, I like anesthesia too, so maybe I can consider doing a second residency. Or maybe I can learn to be content with IM. I don't know. I'm just a med student so I probably have no idea what I'm talking about and will completely change my mind later!
 
Mad Jack said:
The majority of internists planned to ultimately become specialists. That tends to create some unhappiness in the field, as they often end up trapped as hospitalists or outpatient general internists
Click to expand...
FM is an outpatient specialty, but many (or even most) FM docs seem to be happy though.
 
W19 said:
FM is an outpatient specialty, but many (or even most) FM docs seem to be happy though.
Click to expand...
Same with general pediatricians who are probably some of the happiest doctors I've seen despite apparently being paid so poorly and having to deal with a lot of the same problems as other PCPs.
 
spacegun said:
Same with general pediatricians who are probably some of the happiest doctors I've seen despite apparently being paid so poorly and having to deal with a lot of the same problems as other PCPs.
Click to expand...
Agree... Inpatient IM is brutal... Every patient complaint is met by 'address that with your internist' by other physicians.
 
libertyyne said:
I mean it's possible. If you know the way surveys are conducted a 10% response rate is pretty good. A more valid criticism might be that there are intrinsic differences in these populations that they self select for. And maybe internists are more miserable people to begin with. I personally have yet to meet many internists who were over the moon about being an internist .
Click to expand...

Sorry the part of me that used to be a survey researcher in a former life before medicine has to chime in on the survey validity aspect - a 10% response rate is horrible, and no not all surveys have abysmal response rates. National surveys that are relied upon for research (like federal surveys) have response rates above 75% (used to be in the 90s but has been dropping for decades, which is scary and something to consider given how much policy is driven by papers using those datasets). I believe nowadays the best journals (in medicine anyway) usually won't accept studies that used surveys and lower than ~60% response rate. Now having sample that captures 10% of total population (given how large the total IM population is) could be quite good, and it's far higher a percent then national surveys get when they get their samples (NHANES captures 10k people over a 2 year period and weights that to represent the whole US!), but those national survey are often conducted with very complex multi-stage probability sampling methods which is why they can generalize results - guessing medscape literally sends a mailer out and reports who returns it, meaning the 10% in the sample likely are not an accurate portrayal of the population (or at least there isn't evidence that they are). I do agree with your other concerns about these types of surveys (that you can't get as much explanatory evidence from a lot of them, like IM may self-select for more miserable people or it could be the work itself but we don't know); considering this plus the aforementioned design flaws of the sampling for the survey itself plus the fact that IM is amongst the largest specialty groups (i.e. likely a lot of interspecialty variability), results from surveys like this should be interpreted carefully and overarching conclusions limited.

Otherwise, yep doesn't change that IM is absolutely rife with dealing with disposition issues and is mentally tough like many jobs in medicine. But I guess, at least at the three hospitals I've rotated at, I've never seen internists get "dumped" on (I mean, they get issues dumped on them, but they don't get disrespected) by anybody else any more than doctors throw shade at basically anybody who isn't doing what they're doing. But hey, that's my n=1, can't spend so long talking about the validity of surveys and then pretend anybody's one experience is actually generalizable everywhere.
 
Last edited:
You must log in or register to reply here.

Similar threads

I
(deleted)
Replies
3
Views
804
LucidSplash
LucidSplash
C
deleted
Replies
6
Views
1K
CJhooper123
CJhooper123
T
  • Locked
Deleted
Replies
1
Views
496
Mr.Smile12
Mr.Smile12
T
  • Locked
MD (deleted)
Replies
1
Views
836
Dantes
D
2
  • Locked
deleted
Replies
14
Views
1K
voxveritatisetlucis
V
Top