Does anyone else find it crazy how most specialties are stratified?

[KeikoTanaka]

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This is a survey from residents surrounding regret in career choice from 2018

Association of Clinical Specialty With Symptoms of Burnout and Regret Among US Resident Physicians

This survey study investigates risk factors for symptoms of burnout and career choice regret among US physicians during their second year of residency.

jamanetwork.com

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Anyone notice Family Medicine is the lowest Career Choice Regret Prevalence for non-surgical? Perhaps we're all missing something here....

 

[Matthew9Thirtyfive]

So you’re basically saying if people didn’t have to work they’d just be bored all day? Isn’t that one of the reasons people look forward to retirement?

People are different. I get bored when I’m on leave for more than a week or two, and I have plenty of hobbies I enjoy and a family I love being around.

Also you’re not thinking laterally enough about these things. It’ll be snowy at a high enough altitude, and if you’re near a beach, you can always surf or water ski.

Or you live in San Diego. I’ve gone skiing in Big Bear and then gone to the beach the same day.

 

[Chibucks15]

Everybody is salivating over EM because of the short residency, higher pay, and less hours. I’ve found many of those people haven’t actually had to work in their lives so don’t realize how much of a grind 12 or 24 hour shifts are when you’re 60. Sure it’s doable when you’re 35 but it’d get old pretty damn fast.

On the flip side though, the people that are made for it have a pretty sweet gig.

 

[slowthai]

Everybody is salivating over EM because of the short residency, higher pay, and less hours. I’ve found many of those people haven’t actually had to work in their lives so don’t realize how much of a grind 12 or 24 hour shifts are when you’re 60. Sure it’s doable when you’re 35 but it’d get old pretty damn fast.

On the flip side though, the people that are made for it have a pretty sweet gig.

I've always heard from EM attendings that the best way to do it is to FIRE your way out of EM. Work more shifts at first, get a surplus of capital, invest wisely (real estate or whatever), and escape at the ripe young age of 50.

 

[Chibucks15]

I've always heard from EM attendings that the best way to do it is to FIRE your way out of EM. Work more shifts at first, get a surplus of capital, invest wisely (real estate or whatever), and escape at the ripe young age of 50.

Even with that, working MORE 12- 24 ish hour shifts is still something I couldn’t do haha

 

[NotaCop]

Urology looks out of place. They are among the most cheerful docs I know.

I suspect one component of this is small sample size and bias in who is most likely to fill out a survey (those wanting to vent). Not saying this is explanatory but I see this a lot in uro in studies like this. Results conflict with reality and # of docs surveyed is usually lower in comparison vs other specialties

 

[otocurmudgeon]

There is a plethora of knowledge amongst medical students about which schools are better and the converse. There is also a lot of knowledge about which rotations to avoid. Finally there is a lot of knowledge amongst residents about which specialties and which specific programs to avoid. Finally, when it comes time to find a job, there are some positions that are perpetually unfilled and always seeking locums coverage, there are positions that have a high rate of turnover (once one has the opportunity to determine what the work environment is truly like), and there are groups and organizations where many physicians feel that they have lost control of their practice and quality of life. I would be very enlightening for everyone to have more of this type of honest and open discussion available; we are fortunate to have a forum to facilitate this sharing of information.

 

[CidHighwind]

There is a plethora of knowledge amongst medical students about which schools are better and the converse. There is also a lot of knowledge about which rotations to avoid. Finally there is a lot of knowledge amongst residents about which specialties and which specific programs to avoid. Finally, when it comes time to find a job, there are some positions that are perpetually unfilled and always seeking locums coverage, there are positions that have a high rate of turnover (once one has the opportunity to determine what the work environment is truly like), and there are groups and organizations where many physicians feel that they have lost control of their practice and quality of life. I would be very enlightening for everyone to have more of this type of honest and open discussion available; we are fortunate to have a forum to facilitate this sharing of information.

Problem is people don’t want to share too much. Once people know about a place/specialty, it becomes much harder for them. Look at how radiology had their salaries reduced when everyone found out how much they make, look at how EM has gotten more competitive over the past several years once people found out how much they make in those locum threads. Same with psych, etc.

 

[efle]

Problem is people don’t want to share too much. Once people know about a place/specialty, it becomes much harder for them. Look at how radiology had their salaries reduced when everyone found out how much they make, look at how EM has gotten more competitive over the past several years once people found out how much they make in those locum threads. Same with psych, etc.

Dude, just look at the ENT match rates from the last couple years.

2018 it was about 300 applicants, match rate of 96%.

Everybody noticed and said hey look at this easy-to-match surgical subspecialty, I'll apply to that!

2019 match had 400 applicants and a match rate of 77%.

Everybody is always chasing the easiest of the attractive options, but it's a moving target.

 

[ginsengreset]

Dude, just look at the ENT match rates from the last couple years.

2018 it was about 300 applicants, match rate of 96%.

Everybody noticed and said hey look at this easy-to-match surgical subspecialty, I'll apply to that!

2019 match had 400 applicants and a match rate of 77%.

Everybody is always chasing the easiest of the attractive options, but it's a moving target.

Wasn't this because ENT programs started requiring program-specific essays, noticed the drop in applications, and then stopped doing them in 2019?

There's also this article: Is the Program-Specific Paragraph Responsible for Declining Application Numbers? A Commentary. - PubMed - NCBI

 

[Matthew9Thirtyfive]

Dude, just look at the ENT match rates from the last couple years.

2018 it was about 300 applicants, match rate of 96%.

Everybody noticed and said hey look at this easy-to-match surgical subspecialty, I'll apply to that!

2019 match had 400 applicants and a match rate of 77%.

Everybody is always chasing the easiest of the attractive options, but it's a moving target.

There's only 1 spot in mil med for neurosurgery. I'm not sure if that's good because I'm sure some people choose not to apply thinking it's not worth it, but it also means you have to literally be the highest scoring applicant lol.

 

[slowthai]

Wasn't this because ENT programs started requiring program-specific essays, noticed the drop in applications, and then stopped doing them in 2019?

There's also this article: Is the Program-Specific Paragraph Responsible for Declining Application Numbers? A Commentary. - PubMed - NCBI

Some ENT people said that it wasn't that, but that it was because people just got too intimidated by the difficulty of the ENT match, that they scared themselves out of even trying.

 

[efle]

Wow, it's pretty crazy that asking for a paragraph per program was enough to scare off 1/4th of the entire applicant pool.

If it consistently had a ~77% match rate in the past, I'd be scared of applying, too

 

[efle]

There's only 1 spot in mil med for neurosurgery. I'm not sure if that's good because I'm sure some people choose not to apply thinking it's not worth it, but it also means you have to literally be the highest scoring applicant lol.

Surely you can still apply for multiple specialties? Like the IR match had a 50% match rate this year, but that doesn't mean half of them had to SOAP, just that half of them landed in backup specialties especially DR

 

[Matthew9Thirtyfive]

Surely you can still apply for multiple specialties? Like the IR match had a 50% match rate this year, but that doesn't mean half of them had to SOAP, just that half of them landed in backup specialties especially DR

Yeah, you have to list two (in the Navy anyway).

 

[otocurmudgeon]

Dude, just look at the ENT match rates from the last couple years.

2018 it was about 300 applicants, match rate of 96%.

Everybody noticed and said hey look at this easy-to-match surgical subspecialty, I'll apply to that!

2019 match had 400 applicants and a match rate of 77%.

Everybody is always chasing the easiest of the attractive options, but it's a moving target.

It seems that it is already hard enough to decide, as a medical student, which residency to choose (it certainly isnt easy to change one's mind after having been accepted into a program), wouldnt everyone be much better off if those who have been dissatisfied (or worse) with their choice of residency would share that information !? Those who can would likely rank such a program lower and, one would hope, this information would get back to the residency program director to "encourage" improvement. I guess the same could be said about college students choosing a medical school. On the other hand, in both situations, there truly are limited options and, at some point, if one truly wishes to pursue a career in medicine, one might have to accept a medical school position or residency position that isnt quite at the top of one's list. For satisfaction and peace of mind, there should be a venue where people feel more comfortable "venting" about and sharing their perspective about these issues and, hopefully, those that follow in their foot-steps might be able to avoid unnecessary misery. This forum is, at least theoretically, anonymous.

 

[Chibucks15]

It seems that it is already hard enough to decide, as a medical student, which residency to choose (it certainly isnt easy to change one's mind after having been accepted into a program), wouldnt everyone be much better off if those who have been dissatisfied (or worse) with their choice of residency would share that information !? Those who can would likely rank such a program lower and, one would hope, this information would get back to the residency program director to "encourage" improvement. I guess the same could be said about college students choosing a medical school. On the other hand, in both situations, there truly are limited options and, at some point, if one truly wishes to pursue a career in medicine, one might have to accept a medical school position or residency position that isnt quite at the top of one's list. For satisfaction and peace of mind, there should be a venue where people feel more comfortable "venting" about and sharing their perspective about these issues and, hopefully, those that follow in their foot-steps might be able to avoid unnecessary misery. This forum is, at least theoretically, anonymous.

While I agree with your premise, its hard to know what's actually malignant and terrible and what is just people complaining about nothing. I know a lot of people around that complain about things that truly don't warrant the lashing they give it. This could end up being pretty bad for programs if anything gets out. Everyone likes and expects different things so its hard to have an honest review

 

[Espadaleader]

Only kinda related but I tell med students to think about what they hate most about their speciality choice. If you STILL want to do it, you have a keeper. The psychotic person, the violent person, the psychosocial issues, the trauma, the cursing, the pulse of the ED and inpatient floor... the lack of diagnostic certainty, the stigma. I love what I hate about psych. A dude I know that went into surgery said he would be a resident for life to be a surgeon. I didn’t get it until l found my field.