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- Thread starter AnesvsPsych
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Since you gave us absolutely no information about yourself to help you make a decision, I vote anesthesia.
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deleted1139416
Anesthesia
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deleted1139416
Watching TikTok videos while patients are knocked out >>>>>>>>>>>>>>> having a patient cuss you out when you refuse to give them any more Ativan
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$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ Gas
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I dunno. It’s just question after question here. My money is on psych.
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I feel like gas makes more on average but in psych it's more of a choice. You can hang a shingle on your own basically anywhere, take no insurance, and make bank in psych still. Gas is 5-10 years from feeling saturation that will only get worse as the mid-level wave comes of age, and the slimy private equity guys circling around boomers' practices will only make that worse.
Psych makes less because a lot of people who choose to go into psych actively steer away from the big money activities because they are boring. That leaves opportunity open if money becomes a priority down the line.
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Sounds like you should apply radiology. Thank me later
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Alphabetical.
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Why not both? Open a ketamine clinic
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None of us can actually give you a serious answer with what you’ve given us to work with.
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Honestly at this point, just take one of those medical specialty personality tests and figure it out that way lol. You haven't really given people much to work with and asking people to make your decision for you, without knowing anything about you in hopes that they can provide a solid reason for choosing that field that resonates with you isn't a good plan in my opinion. If you want input from anonymous forum people, its better for us to have a slight insight as to who you are to help us provide you the proper guidance. If you don't want to, then ask people who know you or your trusted faculty advisors or take a personality test. Honestly, I could find something fun about a specialty and advertise it as great so much so that it convinces you to pursue that specialty, only for you to realize that you hate it once you're actually in it. Considering that this is something that you're going to be doing for the rest of your life, if you're not going to give people something to go off of, don't expect the absolute best advice or for people to take it as seriously as you. That's the best I got.
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You did not give any other information for us to help you. You might as well flip a coin tbh if that's the case. If you actually want real advice, give us what you love/hate about each specialty and what goals you have in your life relating to medicine.
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It’s not our fault you’ve waited so long. I can’t imagine expecting good advice on a message board when the responders don’t know anything about you. I vote anesthesia.
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Experience of nurse practitioners performing colonoscopy after endoscopic training in more than 1,000 patients
Background and study aims The demand for screening colonoscopy has continued to rise over the past two decades. As a result, the current workforce of gastroenterologists is unable to meet the needs for colorectal cancer (CRC) screening. Therefore, ...
www.ncbi.nlm.nih.gov
They coming for everyone.
Dual apply and then rank one? Might give you more time and wouldn't be that much more expensive with virtual interviews
Otherwise these are two completely different fields. Need more info if we're giving you advice
Otherwise these are two completely different fields. Need more info if we're giving you advice
jstwannagraduaaate!!!
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Anesthesia then go into pain, youre welcome. Enjoy the private practice lifestyle, quick patient interactions, and lucrative field
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deleted1139416
I’m assuming you did rotations in both? What did you NOT like about both anesthesia and psych?
If you want almost total immunity from midlevels, do forensic psych. Depending on where you are, there may be statutory bars on anybody other than doctorate psychologists and psychiatrists doing certain important evaluations (like sanity evaluations). Even where that is not the case, you’ll just completely destroy any midlevels you’re testifying against because almost every judge or jury is going to believe a doctor over a nurse practitioner.
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deleted1139416
Excellent! With the things that you said, I think that you need to “pick your poison” so to speak. Anesthesia definetly does have its moments of high stress - because someone can literally die from your mistake. But, also keep in mind that a good program will train you to handle that. Your residency program won’t just throw you into a high stakes case, and you WILL eventually learn to handle the tough situations.
Now for psych - depending on what niche in psych you want to practice in, you will definitely have to deal with drug seeking behavior on at least a semi-regular basis. You have to ask yourself exactly how you feel about this. Do you think that eventually you will get used to it as you advance in your training, or do you not like drug-seeking behavior, full stop? A big caveat to this is that you will also have to deal with drug seeking behavior in anesthesia if you sub-specialize in pain medicine.
And OR cases still start early regardless. So if you're not a morning person something to consider
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Weekends and holidays too
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Sounds like psych is best for you. Indecisive and you get offended easily. Anesthesia would not be a good look.
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my only piece of advice is take a look at the thing that is the worst part of that specialty for you and ask yourself, would you be happy doing that thing for the rest of your life? Do that with both psych and anesthesia. Whichever one you feel less likely to hate yourself with, do that specialty then.
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Anesthesia isn’t really lifestyle. It can have good money but you earn it. There’s a lot of call.
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You want money do Anesthesiology. I personally think lifestyle in Psychiatry is better than Anesthesia. I have friends in Anesthesia and they do more weekends and nights. Work more hrs. I do call from home like one night a week.
Also, the decision tree is pretty clear. Want to hear your patient talk or not? Does whining about problems bother? Want to deal with families? Having to handle psychotic patients and force them to take treatment? Like life and death pressure? Working with surgeons? Being in the OR?
Personally, both were on my list. But, due to being in OR, stress levels and I personally think not that great a lifestyle compared to psych I chose Psychiatry. Also, in Psych, it is fairly common to have multiple side jobs for supplemental income. Very easy to work from home doing psych.
If you don’t care much about lifestyle, you can make bank in psych, too. I’m in what is theoretically a very saturated market, but some of my coworkers are locums and also doing call for the hospital. They are making tons of money. They’re working a lot, but I’m talking about buying Ferraris, having multiple properties including somewhat large ones in an expensive city, etc. I also have not seen as many Rolexes in one place as when I have lunch with my coworkers.
Personally, I prefer to make decent money at my state job, work business hours Mon-Fri, enjoy all state holidays off, and work towards my pension. I make plenty of money and I just want to enjoy my time off.
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"be quiet"
There is really no free lunch. It depends on how much you want to make and what you want your lifestyle to be. My salary is somewhere between $270K and $290K, for reference. Like I said, I basically work business hours Mon-Fri. I leave at the same time every day even if there is an admission because the admissions generally arrive earlier. I get all state holidays off and I don’t work weekends. I have good benefits and a pension plan. You can make a lot more but that is going to wind up involving either some weekends/overnights or significantly longer regular work hours. If you’re in a more rural area or a less saturated urban market you can probably make more, but I would not expect to make more than like low to mid 300s in most places (i.e. not like rural Alaska or something) and maintain a typical 9-5 or equivalent schedule.
Also, there is an in-between from living in the hospital and buying Ferraris and never working weekends/nights/holidays and just having one job. You can go moonlight at a hospital covering the ED and/or an inpatient unit. Depending on the gig, you can trade some of your weekends for extra income.
It all depends on what you value. You just can’t generally expect to just put in your 40 hrs a week and make boatloads of cash. I think this is probably the case for many specialties.
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Psych. Anesthesia has weekend and overnight call. Many psychiatrists have several part time gigs and make bank.
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I know a guy who like you, Only really cared about money and lifestyle. He was between psychiatry and radiology. He ended up only applying to radiology then after not getting many interviews threw pathology in the mix. He is now a pathology resident and boy does this guy have free time. More than he would in radiology and maybe even psych.
I really think psychiatry is a calling. There’s definitely psychiatrist out there that own inpatient units and barely go see their patients or doctors that have cash only practices and only see anxiety and depression. But I think that if you were unwilling to work with people with substance
use or schizophrenia/bipolar it would be pretty difficult to be happy in residency. Also how much do you like people? Can you imagine doing a one hour psych interview every single day while on the consult service? Can you handle a patient who refuses to take meds but sees you just to chat? The patience and perceived open-mindedness of psychiatrists makes them pretty unique and I would not want to do it if I wasn’t that kind of person
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Obviously biased here halfway through psychiatry training but have loved it. Even residency has had good work/life balance. Others may disagree but I think I’d find anesthesia not intellectually stimulating enough. The perk on being your phone at work doesn’t really sound like a fulfilling career to me (granted I’m sure there are many that would use this time more productively). But it feels like you learn your specialty and then that’s kind of it. It’s also super chill and then not.
I love the complexity of psychiatry, the development and future (TMS, psychedelics, DBS?), and the ability to learn psychotherapy. It’s certainly challenging and limiting at times but a field that feels like it’s growing.
I love the complexity of psychiatry, the development and future (TMS, psychedelics, DBS?), and the ability to learn psychotherapy. It’s certainly challenging and limiting at times but a field that feels like it’s growing.
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I disagree that Anesthesia is not intellectually stimulating. Maybe to some, and I get that. You must be proficient in in physiology, pharmacology, resuscitation, transfusion, TEE, pain management, US guided nerve blocks, critical care, the extremes of age, as they take care of all comers, regardless of age, physical status, etc.. Absolutely correct that there are mundane aspects, routine simple cases, lengthy complex cases, OB, night call, etc.. However, there is plenty to stimulate one intellectually, and emotionally, when the **** hits the fan in the OR.
sillypsych
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If you don't LOVE psych, if you're not passionate about helping people with mental illnesses, including severe mental illnesses, don't do psych. You absolutely should not do psych if you're only interested in "money and lifestyle." The schedule for psych is generally good and you can certainly make a good living, but the work is DIFFICULT and requires a lot of emotional energy and a level of genuine interest I'm just not sensing from OP.
This is actually perfect advice for someone who likes both anesthesia and psych.
This...if pain doesn't work out you can always fall back on gas
Anesthesia --- because it'll be easier to meet a surgeon, ideally a neurosurgeon, whom you then marry and either retire or just work part time.
[I'm a retiring anesthesiologist] Since you're a fourth year student, I am unclear as to why this is a "last minute decision" as you'll need a general year after med school prior to specialty training. Both your senior med school year and internship will provide opportunities to work in both fields and (necessarily) interrogate anesthesiologists and psychiatrists about their special likes and dislikes about the specialties. Your question tells us nothing about you, so it really is impossible to provide a substantive answer. In the most general sense: I trained with a board-certified neurologist/psychiatrist who was doing three more years of anesthesia; he wound up in private neurology practice. I had an anesthesiologist colleague who left anesthesia after fifteen years, went back to residency as a psychiatry resident, and finished his career in medicine as a private practice shrink. I don't know anyone who "went the other way". My pain subspecialty friends are seeing enormous cutbacks in pain reimbursements from third parties (Medicare, insurers--now--in 2022). So much that it is no longer profitable to do epidural steroid injections and/or RF ablations in their offices. A Medicare adjustment downward in January 2023 ( in the middle of a marked inflationary period) will sink many dependent practices.....perhaps private psychiatry practices may be immune to a large degree depending, of course, on their payor mix. Third party payments, in general, are heading south FAST. Any specialty where you can control your market and destiny looks preferable to me for new med school graduates who plan to practice the next 40 years. For example: a dually-boarded internist (or family practitioner)/ psychiatrist would be in an ideal position to own a fee-for-service weight loss, couseling, life-style-change clinic. Incorporating the many services such practices entail (that people are willing to pay for!!) would provide for cash flow free of government and third party payor manipulations.
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these are very different personalities for specialties.
psychiatry is more of a long term committment with a patient if you do outpatient work. anesthesia is generally more inpatient work where the patient is most likely to not remember who you are. when you go home at the end of the day, i would presume in psychiatry there will be continued need to document and potentially have issues to deal with. At the last there maybe patient issues to worry about. With anesthesia, once you're out the building you're done.
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there's very little taught about the finances that comes with any specialty until it is way too late.
This is highly dependent on your practice setting and how it is set up.
There are outpatient practices where the expectation is that you will respond to patient concerns/requests outside of your typical hours at the office. This is particularly true in private practice, especially if you’re not part of a big group where there is a coverage system. Many employed outpatient jobs, however, will have some sort of “call” system where there will be one psychiatrist responsible for responding to all these issues for the clinic on a given day.
Inpatient work is different, because there is generally a call system. Depending on the job, you may or may not have to take call as part of the job. My job, for instance, does not require that I do call, but I could sign up to be part of the call pool for extra money. Generally, if there is somebody on call, you can go home and not worry about anything until the next day.
Maybe others are different, but I do not document after I leave the hospital.
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One day? Some states already allow clinical psychologists to write scrips.
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I would add that this is not the only practice model though. I wouldn't make it a deciding factor. There is plenty of room for work-life balance in psychiatry, and there are plenty of jobs where you don't have to be available outside of office hours if that is what is important to you. One of my relatives practices at a clinic that goes to voicemail after business hours with an advisory to "note for your next appointment if the issue is not urgent and hang up and dial 911 if it is". So when he goes home in the afternoon, he is just as "off" as an anesthesiologist.
Inpatient is different of course and someone will need to be on call.
