EM or Anesthesia?

[nimbus]

---

Members don't see this ad.

We did not know if things were going to turn around. Things has not turned around for pathology, for instance.

Path is doing fine. My best friend’s wife is an academic pathologist. All her fellows get jobs. Another good choice if you are interested.

 

[Splenda88]

Path is doing fine. My best friend’s wife is an academic pathologist. All her fellows get jobs. Another good choice if you are interested.

Fellows!

 

[Splenda88]

How do you know the rad one market will get better in 5 years?

 

[nimbus]

Fellows!

Yes. They have fellowships... just like every single ophthalmologist, radiologist, orthopedist, and General surgeon that has joined the staff of my hospital in the last 10 years. If you don’t want to do a fellowship, none of those specialties are for you. Be a hospitalist or an EM doc.

 

[nimbus]

How do you know the rad one market will get better in 5 years?

Because no medical specialty has ever stayed down forever.

 

[ace_inhibitor111]

You are contradicting yourself. First you point out the AAMC made an inaccurate prediction. They didn’t. Then you also say you can make “reasonable predictions based on available data.”

Time and again these predictions have been wrong. That’s just a matter of chance. If you make a prediction, you are predicting one outcome out of an infinite numbers of possibilities. If there are changes, nobody can predict the direction of the change. The safest course of action is to choose a specialty that truly interests you.

It’s not a contradiction. I’m pointing out how many academic physicians believe only the feel-good, positive data without being real and critically analyzing the market themselves. If the number of anesthesiologists increased by 3x do you still think things will just work out, that “you can’t predict what will happen” LOL. Surely there’s a point where it’s pretty clear what will happen and I think a 30% increase is more than enough to make a difference.

 

[Splenda88]

Yes. They have fellowships... just like every single ophthalmologist, radiologist, orthopedist, and General surgeon that has joined the staff of my hospital in the last 10 years. If you don’t want to do a fellowship, none of those specialties are for you. Be a hospitalist or an EM doc.

But the specialties you listed do NOT need a fellowship or fellowships to get a job. Fellowship(s) for path is a defacto requirement now to get a job. Check the path forum.

 

[nimbus]

But the specialties you listed do NOT need a fellowship or fellowships to get a job. Fellowship(s) for path is a defacto requirement now to get a job. Check the path forum.

Yeah they do unless they want to work in bumf*ck nowhere. If you don’t want to do a fellowship, anesthesia, primary care, ob/gyn, hospitalist, and EM are realistic options.

 

[nimbus]

It’s not a contradiction. I’m pointing out how many academic physicians believe only the feel-good, positive data without being real and critically analyzing the market themselves. If the number of anesthesiologists increased by 3x do you still think things will just work out, that “you can’t predict what will happen” LOL. Surely there’s a point where it’s pretty clear what will happen and I think a 30% increase is more than enough to make a difference.

Okay I’m sure your predictive abilities are better than the AAMC. Your predictions are better than those of people who get paid to study manpower. IMO both parties are more than likely going to be incorrect.

 

[ace_inhibitor111]

Okay I’m sure your predictive abilities are better than the AAMC. Your predictions are better than those of people who get paid to study manpower. IMO both parties are more than likely going to be incorrect.

The AAMC have shown time and time again that they have no idea what they’re doing. They’re the ones after all who invented the SVI and are proposing to make Step 1 pass/fail thinking it will reduce student stress. I’m more inclined to believe sources like the BLS which show that growth in physician employment is much lower Physicians and Surgeons : Occupational Outlook Handbook : U.S. Bureau of Labor Statistics.

Also, I bet you (and many other physicians) never actually read the data that the AAMC are reporting. The graphs show that there’s a physician shortage if we don’t consider NP/PAs as part of the provider workforce lmao. The reality is that growth in midlevels is increasing dramatically and most patients don’t know/care about the difference. The more realistic trajectory, which is also shown in their models assuming growth in NP/PAs remains constant, shows a surplus of physicians in the future.

 

[CidHighwind]

It won’t be in 10 years. A shortage of radonc docs is almost guaranteed in 5 years. This pattern has played out many times in the past.

But they’re saying that patients will need fewer treatments now. So less patient encounters and more docs means a worse job. Didn’t you read that one post by the unhappy Radonc, guy sounded like the job made him suicidal.

 

[nimbus]

The AAMC have shown time and time again that they have no idea what they’re doing. They’re the ones after all who invented the SVI and are proposing to make Step 1 pass/fail thinking it will reduce student stress. I’m more inclined to believe sources like the BLS which show that growth in physician employment is much lower Physicians and Surgeons : Occupational Outlook Handbook : U.S. Bureau of Labor Statistics.

Also, I bet you (and many other physicians) never actually read the data that the AAMC are reporting. The graphs show that there’s a physician shortage if we don’t consider NP/PAs as part of the provider workforce lmao. The reality is that growth in midlevels is increasing dramatically and most patients don’t know/care about the difference. The more realistic trajectory, which is also shown in their models assuming growth in NP/PAs remains constant, shows a surplus of physicians in the future.

I’ve been following physician manpower for the past 30 years and lived through multiple cycles of alarmist bad predictions. If you believe your own post why are you in medical school?

 

[InternistDO]

Tell that to the AAMC, who predicted a “physician shortage” 10-15 years ago that everyone believed. How can physicians blindly believe this and yet refuse to do their own analysis and advocate for themselves?

You can make reasonable predictions based on available data. What happens when you increase medical student enrollment by 35% in the span of a decade? Substantial increase in competition for residency spots obviously, and look, that’s what we have now. If the number of residency spots in EM rapidly increases, we can look at what happened to rad onc or path and reasonably discern that things are not going to be good. Colonoscopies not being paid? Well come on, there’s a difference between a reasonable prediction and a ridiculous one.

I guess I don't really know what point you're trying to make, other then a generic SDN rant about how medicine is dying.

You'll be an attending for most likely 25+ years, and a lot can and will change in that time. You can pick a specialty you enjoy, or you can try and crunch the numbers and read Reddit and SDN and try and figure out the perfect cost benefit analysis. But my guess is you aren't going to do any better than the AAMC, which is to say not very well, and you might pick a field that RadOncs itself in 10 years regardless, or some massive healthcare reorganization could happen that completely changes which fields are lucrative. Might as well try to pick something you enjoy so you can enjoy the ride before we're all replaced by robot NPs or whatever the internet thinks is the next big threat to the profession.

 

[nimbus]

But they’re saying that patients will need fewer treatments now. So less patient encounters and more docs means a worse job. Didn’t you read that one post by the unhappy Radonc, guy sounded like the job made him suicidal.

Meh, the rad onc docs I know in real life are happy and rich.

 

[CidHighwind]

Meh, the rad onc docs I know in real life are happy and rich.

They’ve probably came in”back in the day” when it was easier to get a job. I’m sure a new grad that wants to be comfortable in the Midwest would only have moderate difficulty doing so. That said, why do it? Had a friend that was considering it, talked him out of it and told him that he is smart, has a bright future, and that I cared about him. Don’t go into a dead specialty. He decided to make a much better career move and applied to urology.

But the specialties you listed do NOT need a fellowship or fellowships to get a job. Fellowship(s) for path is a defacto requirement now to get a job. Check the path forum.

It’s true for radiology. Need a fellowship to work anywhere desirable. Hear it’s the same for pretty much everything worth doing. Only real reason to do IM over FM is the fellowship options.

 

[ace_inhibitor111]

I guess I don't really know what point you're trying to make, other then a generic SDN rant about how medicine is dying.

You'll be an attending for most likely 25+ years, and a lot can and will change in that time. You can pick a specialty you enjoy, or you can try and crunch the numbers and read Reddit and SDN and try and figure out the perfect cost benefit analysis. But my guess is you aren't going to do any better than the AAMC, which is to say not very well, and you might pick a field that RadOncs itself in 10 years regardless, or some massive healthcare reorganization could happen that completely changes which fields are lucrative. Might as well try to pick something you enjoy so you can enjoy the ride before we're all replaced by robot NPs or whatever the internet thinks is the next big threat to the profession.

I don’t know how I can make it any more simple for you. My argument is:

“We should stop expanding EM and anesthesia residencies, there is no shortage and doing so will be detrimental to future physicians. Along with that, stop medical school expansion, we’ve already overdone it and are paying the consequences.”

Easy.

 

[CidHighwind]

I don’t know how I can make it any more simple for you. My argument is:

We should stop expanding EM and anesthesia residencies, there is no shortage and doing so will be detrimental to future physicians.

Easy.

I agree with you, but just to play devils advocate, how can those specialties not have a shortage when they’re FM docs doing EM’s job and nurses doing anesthesia’s job?

 

[ace_inhibitor111]

I agree with you, but just to play devils advocate, how can those specialties not have a shortage when they’re FM docs doing EM’s job and nurses doing anesthesia’s job?

Two separate issues. There might have been a shortage of EM physicians 5-10 years ago and so some EDs were taken up by FM docs, but they make up the vast minority of the workforce. The gap is rapidly decreasing and we’re still increasing residency spots without giving the market time to settle.

For CRNAs, they aren’t being hired due to lack of anesthesiologists, but rather because they handle simple cases cheaply.

 

[Rekt]

The residency expansion for EM hasn't even hit the job force yet because of how quickly the expansion exploded. There's going to be at least a couple hundred new docs graduating per year in the next 2-4 years on top of the already 1500 doc graduate surplus. Despite the advice/warnings on SDN people will still do whatever they want. I think anyone planning on EM should at the very least explore other options.

 

[shemer77]

EM > Anest IMO but if you really like the OR maybe anesthesia would be better