Derm vs rads?

[jambro]

Very few fields in medicine even get close to derm when it comes to money/lifestyle.

True that spine surgeons can make 1mil+ but their lifestyle sucks.
True that Rheumatologists can work 8-4 outpatient but their job market and the money are not that good.
True that radiologists can make more than derm but the lifestyle is OK at best.

telerad lifestyle seems better than derm. seeing a ton of patients per day seems crappy... plus you have to deal with having employees, overhead, patient satisfaction, etc

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[guytakingboards]

telerad lifestyle seems better than derm. seeing a ton of patients per day seems crappy... plus you have to deal with having employees, overhead, patient satisfaction, etc

telerad evening/overnight positions are far more common than telerad day positions, although the later is starting to become more common.

That being said, the usual trade-offs for telerad are shift timing (as above) or lower pay. Telerad gigs aren't particularly easy or secure either. You're usually grinding through studies and if ever a group needs to downsize, the telerad is the first to go.

 

[90sportsfan]

Dermatologist here.

Both great fields. Good income per time.

Many friends are radiologists and many do really well. I think their work is more intense than mine though. At this point in my career (15 years out) I can “turn my mind off” for some parts of the day. You learn to interact with different kinds of patients automatically and of course there are always a few interesting things every day— but for most skin exams, biopsies, bread/butter stuff I can go on autopilot and make all the right decisions.

I’ve heard you always have to concentrate in radiology. Not to say I can go to sleep - but I really I don’t need a super high level of focus to get through a day, which occasionally be boring but really is a blessing (ie I’m not stressed at 4pm after seeing 40 patients at the end of my day).

Yes. I think with Rads, you always need to be on your game. Even simple things like not getting a good night’s sleep or lack of sleep/insomnia due to stress could really throw you off the next day when looking at such fine details. A serious miss for a variety of reasons (lack of concentration due to stress, not enough sleep, bad day, etc) when grinding through images could come back to bite you down the road. I can definitely see Derm (and other routine clinical specialties) more conducive to “autopiloting” compared to Rads.

I think another big elephant in the room, which is somewhat related but I haven’t seen mentioned, is that Derm is one of the lowest risk specialties for malpractice, where as Rads is on the higher end. Again, I think the volume combined with the level of detail (greater opportunities for mistakes) is why Radiology is higher risk for malpractice.

 

[finalpsychyear]

Maybe these are all anomalies but i have 2 Derms in the family and 3 derm friends. They are all in PP some better at it then others but the range is 1-2m in this group after overhead. One does mohs who is on the higher end. They have multiple mid levels but are 4-5 day work weeks with waiting lists for months but most aren't willing to work more than that or longer hours due to reaching the lifestyle phase of their career.

 

[forchinet121]

Maybe these are all anomalies but i have 2 Derms in the family and 3 derm friends. They are all in PP some better at it then others but the range is 1-2m in this group after overhead. One does mohs who is on the higher end. They have multiple mid levels but are 4-5 day work weeks with waiting lists for months but most aren't willing to work more than that or longer hours due to reaching the lifestyle phase of their career.

They work 4 days a week and make 1.5M per year? Damn

 

[finalpsychyear]

They work 4 days a week and make 1.5M per year? Damn

They work 4 days a week and make 1.5M per year? Damn

no they make the least but they are longer days. everyone else is working 5 days full throttle to make the higher numbers. plus admin things on the wknds from home. They are busy people who maximize outpatient in outpatient practice doing a lot of cash business with cosmetics. Again they are Gen Xers aside from one who is the older doc generation. I doubt millennials or gen z would want a 40 ish hour of just clinical work but thats another topic.

Also, lets not forget rads was making multiple mills in the golden era when payments for imaging was another level and thats just the physician fee let alone those that owned the imaging facilities. Both great fields even now maybe the best 2 in medicine.

 

[doctalaughs]

no they make the least but they are longer days. everyone else is working 5 days full throttle to make the higher numbers. plus admin things on the wknds from home. They are busy people who maximize outpatient in outpatient practice doing a lot of cash business with cosmetics. Again they are Gen Xers aside from one who is the older doc generation. I doubt millennials or gen z would want a 40 ish hour of just clinical work but thats another topic.

Also, lets not forget rads was making multiple mills in the golden era when payments for imaging was another level and thats just the physician fee let alone those that owned the imaging facilities. Both great fields even now maybe the best 2 in medicine.

You may have some family members who are dermatologists but I literally know hundreds and it’s not typical to make 1.5 M working 40 clinical hours, even in mohs.

The upper end of mohs with the right referral base/ location can clear that - but they are hustling. General/medical non-niche dermatologists generally do not make that as a rule (sure some in high end cosmetics or owners making a ton off their associates and midlevels and skimming off the top do).

In the end making 500-800 with a reasonable lifestyle bankers hours and no nights, holidays, call or weekends is great- no need to exaggerate or cite edge-cases. I’m sure there are some radiologists who also make 1.5 m today but not the majority.

 

[SeisK]

You may have some family members who are dermatologists but I literally know hundreds and it’s not typical to make 1.5 M working 40 clinical hours, even in mohs.

The upper end of mohs with the right referral base/ location can clear that - but they are hustling. General/medical non-niche dermatologists generally do not make that as a rule (sure some in high end cosmetics or owners making a ton off their associates and midlevels and skimming off the top do).

In the end making 500-800 with a reasonable lifestyle bankers hours and no nights, holidays, call or weekends is great- no need to exaggerate or cite edge-cases. I’m sure there are some radiologists who also make 1.5 m today but not the majority.

Grass is greener effect. Lots of people not in radiology say we make up to 800-900 pretty reasonably which is not the case. They’ll say the same about derm and cite the same figures, again not the case. People will talk about how IM makes 400-450k, again not the case.

Statistics don’t lie. Median numbers are true median, and they are reasonably easy to get an estimate for. The variance may be higher for some specialties for others, but those are always outliers. I don’t know why I keep seeing reddit or SDN posts where people discard medians (high n’s) for a few n=1 edge-cases. People’s minds are weird.

 

[finalpsychyear]

Grass is greener effect. Lots of people not in radiology say we make up to 800-900 pretty reasonably which is not the case. They’ll say the same about derm and cite the same figures, again not the case. People will talk about how IM makes 400-450k, again not the case.

Statistics don’t lie. Median numbers are true median, and they are reasonably easy to get an estimate for. The variance may be higher for some specialties for others, but those are always outliers. I don’t know why I keep seeing reddit or SDN posts where people discard medians (high n’s) for a few n=1 edge-cases. People’s minds are weird.

I don't know how accurate MGMA total compensation data is but as of 2021 its median is 510 and 450 for diag rads and derm. Should be no surprise as they are both less than the 2019 data of 532 and 455. Let's not get into inflation it is depressing for all of medicine the numbers always go down and inflation is going up.

 

[Cognovi]

I don’t know why I keep seeing reddit or SDN posts where people discard medians (high n’s) for a few n=1 edge-cases. People’s minds are weird.

The average person thinks they are above average and believes they could be the outlier if they wanted to.

 

[doctalaughs]

I don't know how accurate MGMA total compensation data is but as of 2021 its median is 510 and 450 for diag rads and derm. Should be no surprise as they are both less than the 2019 data of 532 and 455. Let's not get into inflation it is depressing for all of medicine the numbers always go down and inflation is going up.

Yeah those numbers for derm are probably somewhat low for a 5 day 40 hour person and skewed by the number of part timers (ie many women working 25-30 hrs/wk, and 4-day often is considered full time). That sort of data is hard to capture in these surveys (ie money per hour).

That being said it’s probably 20% off, not 100% as some imply.

 

[Splenda88]

Grass is greener effect. Lots of people not in radiology say we make up to 800-900 pretty reasonably which is not the case. They’ll say the same about derm and cite the same figures, again not the case. People will talk about how IM makes 400-450k, again not the case.

Statistics don’t lie. Median numbers are true median, and they are reasonably easy to get an estimate for. The variance may be higher for some specialties for others, but those are always outliers. I don’t know why I keep seeing reddit or SDN posts where people discard medians (high n’s) for a few n=1 edge-cases. People’s minds are weird.

Not difficult to make 400k in IM.

Second year out of residency and will make a little over 400k (~406k) this year as a hospitalist working 7am-6pm, 7 days on/off. I will work ~18 shifts on average every month for this year.

 

[SeisK]

Not difficult to make 400k in IM.

Second year out of residency and will make a little over 400k (~406k) this year as a hospitalist working 7am-6pm, 7 days on/off. I will work ~18 shifts on average every month for this year.

…

I guess you didn’t get my point.

 

[SeisK]

Probably not.

My point was salary of 400k is probably around the 70-75th percentile for IM, not 95th percentile.

My MGMA data has internal medicine, generalist range (25th, 50th, 75th) %iles as (205, 249, 312)

The same data for hospitalist (internal medicine) is (251, 289, 337).

Now this data is a few years old admittedly, but my suspicion is hospitalists didn’t get a net average 20% bump over a few years while everyone’s reimbursements have been falling.

Since I don’t think you did get my point I’ll just repeat it: the data is eminently available. You need aggregates, not anecdotes.

 

[Skindoc83]

I am mohs and obviously never did a radiology residency. But I suspect derm is slightly easier than radiology simply because in Radiology the films are permanent. Someone can go back in 5 days, 5 months, or 5 years and re-read the films and hold you liable for what was missed. With that said, derm is high volume, repetitive, and you deal with crazy patients on the regular. We also have to have staff, and if you’re in private practice, managing staff is often the worst part of the job. I am personally jealous of radiologists that can work from home or get practically months of vacation. In general derm, it’s not uncommon to see 40 patients a day, 4-5 days a week, with 3 weeks of vacation. This isn’t bad in the short run but after 5, 10, 15 years it becomes pretty exhausting

 

[GadRads]

I am mohs and obviously never did a radiology residency. But I suspect derm is slightly easier than radiology simply because in Radiology the films are permanent. Someone can go back in 5 days, 5 months, or 5 years and re-read the films and hold you liable for what was missed. With that said, derm is high volume, repetitive, and you deal with crazy patients on the regular. We also have to have staff, and if you’re in private practice, managing staff is often the worst part of the job. I am personally jealous of radiologists that can work from home or get practically months of vacation. In general derm, it’s not uncommon to see 40 patients a day, 4-5 days a week, with 3 weeks of vacation. This isn’t bad in the short run but after 5, 10, 15 years it becomes pretty exhausting

Radiology can get exhausting quickly. Today I read 45-50 CTs (mostly chest and abdomen), a handful of US, 5 MRs, and nearly 50-55 X-rays in <9 hrs and had a slight headache after my shift. For some reason, a good number of the CTs were more complex than usual. Some docs read more than this, and I honestly have no idea how they safely do it. If I had to do this kind of work with only 3-4 weeks of vacation, I would definitely quit radiology. Radiologists have a lot of vacation for a good reason, otherwise you would see a massive exodus due to burn out.

 

[StartsInGut]

Radiology can get exhausting quickly. Today I read 45-50 CTs (mostly chest and abdomen), a handful of US, 5 MRs, and nearly 50-55 X-rays in <9 hrs and had a slight headache after my shift. For some reason, a good number of the CTs were more complex than usual. Some docs read more than this, and I honestly have no idea how they safely do it. If I had to do this kind of work with only 3-4 weeks of vacation, I would definitely quit radiology. Radiologists have a lot of vacation for a good reason, otherwise you would see a massive exodus due to burn out.

this sounds crazy. That's 100-115 studies in 9 hrs. Did you have any phone calls or other interruptions or was it a straight 9 hr grind?

 

[guytakingboards]

Radiology can get exhausting quickly. Today I read 45-50 CTs (mostly chest and abdomen), a handful of US, 5 MRs, and nearly 50-55 X-rays in <9 hrs and had a slight headache after my shift. For some reason, a good number of the CTs were more complex than usual. Some docs read more than this, and I honestly have no idea how they safely do it. If I had to do this kind of work with only 3-4 weeks of vacation, I would definitely quit radiology. Radiologists have a lot of vacation for a good reason, otherwise you would see a massive exodus due to burn out.

Dang. that's quite a busy day. over 100 RVUs if those CT's were mostly with contrast.

 

[finalpsychyear]

Radiology can get exhausting quickly. Today I read 45-50 CTs (mostly chest and abdomen), a handful of US, 5 MRs, and nearly 50-55 X-rays in <9 hrs and had a slight headache after my shift. For some reason, a good number of the CTs were more complex than usual. Some docs read more than this, and I honestly have no idea how they safely do it. If I had to do this kind of work with only 3-4 weeks of vacation, I would definitely quit radiology. Radiologists have a lot of vacation for a good reason, otherwise you would see a massive exodus due to burn out.

I wonder if radiology has been able to maintain pay because of the almost double amount of volume expected now vs 10-15 years ago. In reality, the pay was more 10 years ago for half the volume from what i have been told.

 

[SeisK]

I wonder if radiology has been able to maintain pay because of the almost double amount of volume expected now vs 10-15 years ago. In reality, the pay was more 10 years ago for half the volume from what i have been told.

When medicare cuts reimbursements, what they’re cutting is quality. We’re not going to just lie down and take it.

When you cut, we speed. We’ll create hedgier, more useless reports to defend against the litigation risk.

I wonder how long it’ll be before practice standards change so that we no longer look for incidentals.

 

[qxrt]

I work in a group that covers both a large quaternary level care transplant and trauma academic center and smaller community hospitals.

My days at the smaller community hospitals are very busy, and I read similar volumes to GadRads, and I read and do everything - CT/MR/US/XR/nucs in all specialties in addition to covering all IR procedures. My days at the large academic center are much more relaxed - even though the IR cases I do and read there are far more complicated, everything is subspecialized, and interruptions are minimized (neuro questions go to neurorads, body questions go to the body section, etc.). As a neuroradiologist, for example, you're never in a situation where you're stressed having to try to read an MRI body case, and focusing on your own specialty makes life easier, even if the cases are more complex. Plus I have trainees who can also make my life easier as well.

As someone in a unique position of practicing both academic and community-level radiology, academics lifestyle is easier than community radiology, not gonna lie. The community rads I work with could probably survive at the academic center, but I doubt that most if any of the academic rads I work with could survive at the community hospital. I am one of the few in my group who works in both environments.

 

[efle]

I thought I was derm vs rads too.

Then I did a derm rotation and immediately knew I was rads. I'd burn out much faster in a general derm clinic. It may be less mentally taxing, but meeting and examining dozens of strangers in 10 minute appointments is exhausting in a different way. Rads is one of the most introverted, derm is one of the most extroverted.

Should also mention that radiology nocturnists ("nighthawks") have probably the best deal in medicine, typically 1 week on:2 weeks off for 500k+ and can be remote/work-from-home. You're reading nonstop on your shift, but you're also making $500+/hr with 8 months of vacation time. Probably doesn't pair well with starting a family, but if you're a single guy that likes being up late, can't beat those numbers

 

[finalpsychyear]

I thought I was derm vs rads too.

Then I did a derm rotation and immediately knew I was rads. I'd burn out much faster in a general derm clinic. It may be less mentally taxing, but meeting and examining dozens of strangers in 10 minute appointments is exhausting in a different way. Rads is one of the most introverted, derm is one of the most extroverted.

Should also mention that radiology nocturnists ("nighthawks") have probably the best deal in medicine, typically 1 week on:2 weeks off for 500k+ and can be remote/work-from-home. You're reading nonstop on your shift, but you're also making $500+/hr with 8 months of vacation time. Probably doesn't pair well with starting a family, but if you're a single guy that likes being up late, can't beat those numbers

Its a great deal if you can live in a timezone like hawaii and negate the ill effects of night shift work by covering EST nights. Otherwise your losing health ultimately in such set ups.

 

[GadRads]

Dang. that's quite a busy day. over 100 RVUs if those CT's were mostly with contrast.

To be exact, it was 46 CTs (mostly chest and abdomen, and most with contrast), 5 MRs (3 brains, 1 knee, 1 spine), 4 US, and 51 plain films. This came up to 82 wRVU which should translate to over 100 RVUs. We have 9 hr work days, but I had a 40 minute meeting and took 15 minutes for lunch, so I did that work in <9 hrs. I usually don't read this much, else I would die or quit. Average day tends to be 55-60 wRVU (about 70-80 RVUs). I rarely read MR.

On busy shifts, the fastest guy in my group can read 70+ CTs and 60+ plain films. I honestly don't know how he does it safely. He rarely misses important things when I read follow ups for which he has read the priors. Dude is gifted.

 

[GadRads]

this sounds crazy. That's 100-115 studies in 9 hrs. Did you have any phone calls or other interruptions or was it a straight 9 hr grind?

I had a 40 minute meeting and took 15 minutes for lunch. Interruptions were 30 mins tops. You get more interruptions and phone calls if your list is backed up and/or your reports don't provide enough clarity.

This pace is not sustainable on a daily basis. I think something like 35-50 cross-sectionals is more reasonable in a 9 hr work day for a radiologist.

 

[letmebe]

50 cross-sectionals per day on consecutive days, with complicated post-op stuff, makes me fantasize over skin rashes.

 

[GoPelicans]

I'm in my last year of residency. How complicated are these cases you guys are looking at approaching 50 CT's a day? I think I hit 40 once in a 10 hour night shift which was like half inpatient half ED and it felt incredibly unsafe going at that speed. Definitely brushed by several incidental things.

We have one new attending who started after 10 years in community private proactice and she complains all the time about the complexity of our patients so I don't know if most stuff is much more straightfoward once you leave a busy level 1 trauma academic center?

 

[Womb Raider]

I'm in my last year of residency. How complicated are these cases you guys are looking at approaching 50 CT's a day? I think I hit 40 once in a 10 hour night shift which was like half inpatient half ED and it felt incredibly unsafe going at that speed. Definitely brushed by several incidental things.

We have one new attending who started after 10 years in community private proactice and she complains all the time about the complexity of our patients so I don't know if most stuff is much more straightfoward once you leave a busy level 1 trauma academic center?

I don’t know how our program compares nationally, but our ER night shifts are 12 hours and we read on average 45-50 CTs/CTAs a night with about 90-100 plain films/US on top. Most I had was 240 total studies, 80 cross sectional. Every year our volume grows by ~10% so I’m not sure how newer classes will survive since residents are in charge of clearing the list. Roughly 2/3 trauma/ED and 1/3 inpatient. The inpatient complexity was pretty tough but trauma weren’t bad unless they were just a train wreck.

 

[bobjonesbob]

I don’t know how our program compares nationally, but our ER night shifts are 12 hours and we read on average 45-50 CTs/CTAs a night with about 90-100 plain films/US on top. Most I had was 240 total studies, 80 cross sectional. Every year our volume grows by ~10% so I’m not sure how newer classes will survive since residents are in charge of clearing the list. Roughly 2/3 trauma/ED and 1/3 inpatient. The inpatient complexity was pretty tough but trauma weren’t bad unless they were just a train wreck.

That seems like really high volume for one resident. Are all of the cross sectional studies prelims? Any MRI over night?

 

[Womb Raider]

That seems like really high volume for one resident. Are all of the cross sectional studies prelims? Any MRI over night?

Yeah those nights sucked. Zero breaks, reading non stop. Exhausting. Good grooming for PP I guess. No MRI with the exception of emergencies for cauda equina or the occasional hip for fracture.

 

[finalpsychyear]

I don’t know how our program compares nationally, but our ER night shifts are 12 hours and we read on average 45-50 CTs/CTAs a night with about 90-100 plain films/US on top. Most I had was 240 total studies, 80 cross sectional. Every year our volume grows by ~10% so I’m not sure how newer classes will survive since residents are in charge of clearing the list. Roughly 2/3 trauma/ED and 1/3 inpatient. The inpatient complexity was pretty tough but trauma weren’t bad unless they were just a train wreck.

This will only continue in the field. Mid levels are only increasing these numbers and their numbers will grow exponentially. Will need to be a breaking point. Cannot keep increasing films by 10 percent and cutting payments by the same. 10 years ago rads were reading half the films today for similar inflation adjusted pay.

P.S. The good news is that there will likely always be a shortage in the fields especially with no mid level encroachment on the horizon. Probably as good of job security out there until AI or whatever in the future. Bad news is future rads are going to be busier than ever as the demand is crazy for the supply.

 

[GadRads]

Bad news is future rads are going to be busier than ever as the demand is crazy for the supply.

Then you will see radiologists leave in droves if busy means reading 75+ wRVUs nearly everyday with all the liability that comes with it. It is not just sustainable. And with cuts, you have to work harder to read 75 wRVUs each passing year.

 

[finalpsychyear]

Then you will see radiologists leave in droves if busy means reading 75+ wRVUs nearly everyday with all the liability that comes with it. It is not just sustainable. And with cuts, you have to work harder to read 75 wRVUs each passing year.

not sure what the solution is then. all we know imaging is growing at a rate that is not sustainable for any sane radiologist. Will they have to start training midlevels at the current rate of growth since the supply is not there 10 years from now..

 

[GadRads]

not sure what the solution is then. all we know imaging is growing at a rate that is not sustainable for any sane radiologist. Will they have to start training midlevels at the current rate of growth since the supply is not there 10 years from now..

I think the goal will be to control utilization. Too many scans for no good reason. Obviously litigation drives clinical behavior these days.

 

[radrad5]

I don’t know how our program compares nationally, but our ER night shifts are 12 hours and we read on average 45-50 CTs/CTAs a night with about 90-100 plain films/US on top. Most I had was 240 total studies, 80 cross sectional. Every year our volume grows by ~10% so I’m not sure how newer classes will survive since residents are in charge of clearing the list. Roughly 2/3 trauma/ED and 1/3 inpatient. The inpatient complexity was pretty tough but trauma weren’t bad unless they were just a train wreck.

full dicatations? that is absurd volume. i can;t imagine the quality of reports are good either

 

[Womb Raider]

full dicatations? that is absurd volume. i can;t imagine the quality of reports are good either.

Yeah full dictations. Corners are definitely cut with speeds that high.

 

[efle]

Do you have attendings on at night to final sign? That is ridiculous volume for a trainee, seems like a matter of time until there are big misses

 

[Womb Raider]

Do you have attendings on at night to final sign? That is ridiculous volume for a trainee, seems like a matter of time until there are big misses

Yes, attending is overreading us the entire night but is usually 1-2 hours behind us depending on how busy it is and type of study. If we miss something "big", we call provider after attending corrects it.

 

[finalpsychyear]

I think the goal will be to control utilization. Too many scans for no good reason. Obviously litigation drives clinical behavior these days.

Yeah, the issue is until litigation changes no one is going to risk it. Scans will stay high and increasing. UR has been in place for a while. Not sure it's made a difference other than requiring PA and such.

 

[qwerty89]

I work for a "private practice" which is really a group that has a contract with a large multi-state outpatient only practice (you've heard of it). Read 60ish wRVU of neuro MR/CT (probably 85:15 MR to CT split). So 40 degen MR spines/day. Rarely read US/XR. M-F 8-5. 1 hour lunch. Leave whenever all the contrast studies are done (5 at the latest). Pay is 350-400k. Ends up being 12-13 weeks off a year. Chill.

For all the residents reading this you have to know that not all wRVUs are created the same. Reading 60-75 wRVU/day is much harder when you have a fat stack of plain films at 0.18-0.3 wRVU each rather than MR spine or brain (1.48 wRVU wo contrast and 2.29 wRVU with contrast).

 

[finalpsychyear]

I work for a "private practice" which is really a group that has a contract with a large multi-state outpatient only practice (you've heard of it). Read 60ish wRVU of neuro MR/CT (probably 85:15 MR to CT split). So 40 degen MR spines/day. Rarely read US/XR. M-F 8-5. 1 hour lunch. Leave whenever all the contrast studies are done (5 at the latest). Pay is 350-400k. Ends up being 12-13 weeks off a year. Chill.

For all the residents reading this you have to know that not all wRVUs are created the same. Reading 60-75 wRVU/day is much harder when you have a fat stack of plain films at 0.18-0.3 wRVU each rather than MR spine or brain (1.48 wRVU wo contrast and 2.29 wRVU with contrast).

2021 MGMA 25th percentile is 400 roughly with a median of 500. Sounds like your set up is worth it not having to work wknds, nights and still with 12-13 wks pto rather than working more for a lifestyle hit.

 

[Tiger100]

D

I don't know how accurate MGMA total compensation data is but as of 2021 its median is 510 and 450 for diag rads and derm. Should be no surprise as they are both less than the 2019 data of 532 and 455. Let's not get into inflation it is depressing for all of medicine the numbers always go down and inflation is going up.

Most radiologists work longer hours/week than dermatologists.
Typical radiology in private practice:
5 days a week which includes one evening or one early morning shift.
Q4-Q6 weekend call.
8-10 weeks of vacation.

Typical Derm:
4 days a week. No evenings.
No weekends.
2-3 weeks of vacation.

8-10 weeks of vacation become old very soon. It looks sexy at first but becomes "too much vacation" after 3-4 years. After a few years, you prefer to give up most of your vacation but get a day off during week or get a weekend off. Weekends and evenings are very annoying once you hit 40 or once you have kids at home.

My ideal working schedule is:
4 days a week.
No weekends.
No evenings.
Nothing that starts before 8 am.
4-5 weeks of vacation but whenever you want.

Derm is closer to my ideal compared to rads.

 

[Womb Raider]

D


Most radiologists work longer hours/week than dermatologists.
Typical radiology in private practice:
5 days a week which includes one evening or one early morning shift.
Q4-Q6 weekend call.
8-10 weeks of vacation.

Typical Derm:
4 days a week. No evenings.
No weekends.
2-3 weeks of vacation.

8-10 weeks of vacation become old very soon. It looks sexy at first but becomes "too much vacation" after 3-4 years. After a few years, you prefer to give up most of your vacation but get a day off during week or get a weekend off. Weekends and evenings are very annoying once you hit 40 or once you have kids at home.

My ideal working schedule is:
4 days a week.
No weekends.
No evenings.
Nothing that starts before 8 am.
4-5 weeks of vacation but whenever you want.

Derm is closer to my ideal compared to rads.

Do most PP force you to take vacation in blocks? If you had 8-15 weeks of vacation it would be very easy to just shave off 1 or 2 days a week, every week.

 

[Tiger100]

Do most PP force you to take vacation in blocks? If you had 8-15 weeks of vacation it would be very easy to just shave off 1 or 2 days a week, every week.

Yes. In most practices you have to take vacations in a week block.

To make things worse, I am telling you that in most practices you have to decide on your vacation schedule many months in advance. For example, in October they decide on vacation schedule of January through June.

Also to make things even worse, you probably can choose only half of those vacation weeks. Then you have to pick the leftovers. In most practices, only certain number of radiologists can be off at any time.

And to make things worse, if there are only 3 IRs or 3 mammographers in a practice, probably only one of them can take the week off.


In my opinion, having 4 weeks of vacation with the option to choose them whenever you want and with the option of taking single days off is ten times better than 8-9 weeks of vacation in a way that is designed in traditional radiology practice practice.

 

[SeisK]

Yes. In most practices you have to take vacations in a week block.

To make things worse, I am telling you that in most practices you have to decide on your vacation schedule many months in advance. For example, in October they decide on vacation schedule of January through June.

Also to make things even worse, you probably can choose only half of those vacation weeks. Then you have to pick the leftovers. In most practices, only certain number of radiologists can be off at any time.

And to make things worse, if there are only 3 IRs or 3 mammographers in a practice, probably only one of them can take the week off.


In my opinion, having 4 weeks of vacation with the option to choose them whenever you want and with the option of taking single days off is ten times better than 8-9 weeks of vacation in a way that is designed in traditional radiology practice practice.

Grass is greener. I know burnt out derms who wish they weren’t beholden to their practice and had as much vacation as we do. They also have to schedule well in advance, they can’t just cancel spuriously and no show on their scheduled patients.

Dude if you want to do derm so bad, just get some academic affiliations for research projects and apply. It seems you’re unhappy in radiology from your posts:

 

[finalpsychyear]

Yes. In most practices you have to take vacations in a week block.

To make things worse, I am telling you that in most practices you have to decide on your vacation schedule many months in advance. For example, in October they decide on vacation schedule of January through June.

Also to make things even worse, you probably can choose only half of those vacation weeks. Then you have to pick the leftovers. In most practices, only certain number of radiologists can be off at any time.

And to make things worse, if there are only 3 IRs or 3 mammographers in a practice, probably only one of them can take the week off.


In my opinion, having 4 weeks of vacation with the option to choose them whenever you want and with the option of taking single days off is ten times better than 8-9 weeks of vacation in a way that is designed in traditional radiology practice practice.

Having the week of thanksgiving and xmas off as a given always is worth something along with making most of those 3 days federal holiday wknds 4 days by using single day vacations. most people don't realize that luxury just think pure numbers is always better.

 

[Tiger100]

Grass is greener. I know burnt out derms who wish they weren’t beholden to their practice and had as much vacation as we do. They also have to schedule well in advance, they can’t just cancel spuriously and no show on their scheduled patients.

Dude if you want to do derm so bad, just get some academic affiliations for research projects and apply. It seems you’re unhappy in radiology from your posts:

It is too late.

Have been in private practice for 24 years. Now working part time and will probably retire in the next 24 years

 

[Tiger100]

Having the week of thanksgiving and xmas off as a given always is worth something along with making most of those 3 days federal holiday wknds 4 days by using single day vacations. most people don't realize that luxury just think pure numbers is always better.

Exactly.
In most radiology private practices, out of Thanksgiving, Christmas and New Year, you have to work at least one of them. This is not the case for many other fields.

During my career, I have missed a good number of family gathering and special occasions due to the vacation structure of radiology.

I am not saying radiology is good or bad. But when you hear about 10 weeks of vacation, take into account that the devil is in the details.

 

[colbgw02]

When comparing jobs, I find it more useful to conceptualize time off in terms of total shifts, rather than vacation time, etc.. Obviously, this works better the more alike the jobs are otherwise, and clearly some people would rather work 12 hours a day in a derm clinic than 6 hours in front of a PACS workstation. Still, I think it helps.

Let's just say that there's a private practice radiology job in which partners get 10 weeks of vacation and work every fifth weekend. Then there's a dermatology job with 4 weeks of vacation. On the face of it, the radiology job seems like it's the way better deal vis-a-vis time off, but let's dig a little deeper.

The dermatology job is much more likely to have a 4-day (Monday-Thursday) work week. Let's further stipulate that the derm job requires no nights, weekends, or holidays, whereas the radiology position requires everyone to rotate through holiday shifts, averaging 1.2 holidays worked per annum.

That works out to 232 shifts per year for the radiologist, while the dermatologist is working 186 shifts. If the dermatologist has a 5-day work week, then it's virtually identical (232 vs. 234).

 

[Steve_Zissou]

I’m curious, what would your top 5 best lifestyle/income mix specialties be?