EM or Radiology?

[MD Dreams]

I need you help.

I've excluded all other specialties and now I'm down to these two options. If I go the radiology route, I want to do interventional. Please give me your honest input. Pluses, minuses, good, bad, anything. Here are the pros and cons as I see it:

ER Pros:
1. Residency more attainable for me
2. I like knowing about everything, being a well rounded physician
3. Love procedures
4. Good lifestyle
5. No continuity of care
6. No call
7. Shorter residency, much less likely to get burnt out before starting practice

ER Cons:
1. Afraid too much like primary care
2. Concerned I'll become bitter and jaded after dealing with drug seeking, malingering patients
3. Have to cator to anyone who walks through the door

IR Pros:
1. Love procedures
2. Sick money
3. May not have the patient headaches that ER has
4. Will also have a lot of knowledge, but not as practical (wouldn't know what to do if I saw a person on the street with X symptoms)

IR Cons:
1. Considerably harder to get into
2. Would I enjoy 4 years of diagnostic radiology?
3. Many routine procedures vs. few fun high-end procedures
4. Outlook of future
5. More demanding life style

Please help. Thanks in advance.

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[kungfufishing]

such similar specialties (?)

After reading your post, my gut says you like rads better. Go do that.

 

[EctopicFetus]

I need you help.

I've excluded all other specialties and now I'm down to these two options. If I go the radiology route, I want to do interventional. Please give me your honest input. Pluses, minuses, good, bad, anything. Here are the pros and cons as I see it:

ER Pros:
1. Residency more attainable for me
2. I like knowing about everything, being a well rounded physician
3. Love procedures
4. Good lifestyle
5. No continuity of care
6. No call
7. Shorter residency, much less likely to get burnt out before starting practice

ER Cons:
1. Afraid too much like primary care
2. Concerned I'll become bitter and jaded after dealing with drug seeking, malingering patients
3. Have to cator to anyone who walks through the door

IR Pros:
1. Love procedures
2. Sick money
3. May not have the patient headaches that ER has
4. Will also have a lot of knowledge, but not as practical (wouldn't know what to do if I saw a person on the street with X symptoms)

IR Cons:
1. Considerably harder to get into
2. Would I enjoy 4 years of diagnostic radiology?
3. Many routine procedures vs. few fun high-end procedures
4. Outlook of future
5. More demanding life style

Please help. Thanks in advance.

Under ER cons I would also say that having to work holidays and weekends is a con..

Beyond that its up to you. You know the pros and cons all thats left is picking a route. Also I dont know how hard the IR fellowships are. Cause if you think you might not like str8 up rads this is something to consider. I know that if you want rads and are even an avg EM candidate you can match rads. 2 people from my not so prestigious school matched rads with around 220 and 1 matched with below 210. Also none of these people had any hook ups. Now I know matching EM is easier but its not like you are going for derm or Uro...

Good luck with the decision.

 

[BKN]

I need you help.

I've excluded all other specialties and now I'm down to these two options. If I go the radiology route, I want to do interventional. Please give me your honest input. Pluses, minuses, good, bad, anything. Here are the pros and cons as I see it:

ER Pros:
1. Residency more attainable for me
2. I like knowing about everything, being a well rounded physician
3. Love procedures
4. Good lifestyle
5. No continuity of care
6. No call
7. Shorter residency, much less likely to get burnt out before starting practice

ER Cons:
1. Afraid too much like primary care
2. Concerned I'll become bitter and jaded after dealing with drug seeking, malingering patients
3. Have to cator to anyone who walks through the door

IR Pros:
1. Love procedures
2. Sick money
3. May not have the patient headaches that ER has
4. Will also have a lot of knowledge, but not as practical (wouldn't know what to do if I saw a person on the street with X symptoms)

IR Cons:
1. Considerably harder to get into
2. Would I enjoy 4 years of diagnostic radiology?
3. Many routine procedures vs. few fun high-end procedures
4. Outlook of future
5. More demanding life style

Please help. Thanks in advance.

I usually suggest to a student who says should I do EM or Radiology? "If you even need to ask, do Radiology." They are usually attracted to the "life style". EM is far from a life style specialty. If you're going to stay up all night 1/2 the time the rest of your career seeing drunks and other people that nobody else will take care of, you need to be doing it because you need to be doing it. I would find radiology, even IR terminally dull. So would most EPs.

Same thing for EM vs derm, path, anesthesia, etc.

 

[OSUdoc08]

I need you help.

I've excluded all other specialties and now I'm down to these two options. If I go the radiology route, I want to do interventional. Please give me your honest input. Pluses, minuses, good, bad, anything. Here are the pros and cons as I see it:

ER Pros:
1. Residency more attainable for me
2. I like knowing about everything, being a well rounded physician
3. Love procedures
4. Good lifestyle
5. No continuity of care
6. No call
7. Shorter residency, much less likely to get burnt out before starting practice

ER Cons:
1. Afraid too much like primary care
2. Concerned I'll become bitter and jaded after dealing with drug seeking, malingering patients
3. Have to cator to anyone who walks through the door

IR Pros:
1. Love procedures
2. Sick money
3. May not have the patient headaches that ER has
4. Will also have a lot of knowledge, but not as practical (wouldn't know what to do if I saw a person on the street with X symptoms)

IR Cons:
1. Considerably harder to get into
2. Would I enjoy 4 years of diagnostic radiology?
3. Many routine procedures vs. few fun high-end procedures
4. Outlook of future
5. More demanding life style

Please help. Thanks in advance.

IR Cons:
6. Aspermia

ER Pros:
8. Fertility

 

[turtle md]

I came into med school wanting EM. During the first few months of my final year, I thought maybe Rads would be better - kush, $$$, etc. But then I realized that Rads is BORING. I so wish that I would like it, so if you have any positive feeling for it, do Rads. As for me, I found I could not (even though I tried to force myself ).

 

[DrQuinn]

IR Cons:
6. Aspermia

ER Pros:
8. Fertility

Hahahahahah

 

[Koil Gugliemi]

I thought a bit about the same choice...I'm doing rads. Boring is as boring does. ER can be pretty damn boring too, depending on what type of situation you're in. I mean the demented NH patient "just not acting right" with urospepsis, and drunks are only so interesting. Everyone will post all their stories about tubing people and flying, but the average ED doc outside of big hospitals doesn't fly, and sees bread and butter cases.

Same is true about rads, sure it can be boring to look at the completely stupid and irrelevent ICU chest films or the 10 millionth head CT for "headache", but I personally found I like rads procedures more than I+D of butt abcesses (though I really liked sewing lacs in the ED - - I found it very calming, kind of a zen thing). I personally could be happy doing only diag. rads, assuming I'm doing the usual procedures (most rads, not only the IR guys, do biopsies, drainages, etc). OR I could change my mind and do academic neurointerventional radiology. I like the technology stuff too.

If you can't decide, do a month of each at a good place and you'll just find yourself saying "aahhh this is what I want". It'll either be as you're walking in to do your O/N shift in the ED, or it'll be sitting in a dark room while some radiologist is reading normal chest-xrays.

I know that this is long and rambling...I guess I'm in a chatty mood. One funny thing you'll observe if you do both rotations is the animosity that exists between rads and ER. All the ER guys will say "you want to be a radiologist? - why not be a real doctor" and then they'll tell you that a radiologist's favorite plant is the hedge...hahahahahah never heard that one before. On the other hand in rads everyone will tell you that the ED should just have the CT scanner installed in the waiting room so that we could scan everyone because the ED guys can't diagnose a hangnail without a CT "just in case", and that CT is the new physical diagnosis. When in fact the two fields kind of need each other...

Another similarity is the idea of being the one to first see the diagnosis. I like the whole idea of seeing unselected pathology. In the ED a headache can be a person who just wants some percocet, or could be the first symptom of a GBM, same is true with films in rads - you often get to make the diagnosis pretty conclusively, and it's often not suspected clinically. I don't know if many people think about that way, but it's something that appealed to me in both fields.

Good luck, both fields are fun IMHO, but rads won for me.

 

[ERMudPhud]

I thought a bit about the same choice...I'm doing rads. Boring is as boring does...
...Good luck, both fields are fun IMHO, but rads won for me.

That might be the best post on the subject and on relations between us and them I've seen in a long time.

 

[DW3843]

I thought a bit about the same choice...I'm doing rads. Boring is as boring does. ER can be pretty damn boring too, depending on what type of situation you're in. I mean the demented NH patient "just not acting right" with urospepsis, and drunks are only so interesting. Everyone will post all their stories about tubing people and flying, but the average ED doc outside of big hospitals doesn't fly, and sees bread and butter cases.

Same is true about rads, sure it can be boring to look at the completely stupid and irrelevent ICU chest films or the 10 millionth head CT for "headache", but I personally found I like rads procedures more than I+D of butt abcesses (though I really liked sewing lacs in the ED - - I found it very calming, kind of a zen thing). I personally could be happy doing only diag. rads, assuming I'm doing the usual procedures (most rads, not only the IR guys, do biopsies, drainages, etc). OR I could change my mind and do academic neurointerventional radiology. I like the technology stuff too.

If you can't decide, do a month of each at a good place and you'll just find yourself saying "aahhh this is what I want. It'll either be as you're walking in to do your O/N shift in the ED, or it'll be sitting in a dark room while some radiologist is reading normal chest-xrays.

I know that this is long and rambling...I guess I'm in a chatty mood. One funny thing you'll observe if you do both rotations is the animosity that exists between rads and ER. All the ER guys will say "you want to be a radiologist? - why not be a real doctor" and then they'll tell you that a radiologist's favorite plant is the hedge...hahahahahah never heard that one before. On the other hand in rads everyone will tell you that the ED should just have the CT scanner installed in the waiting room so that we could scan everyone because the ED guys can't diagnose a hangnail without a CT "just in case", and that CT is the new physical diagnosis. When in fact the two fields kind of need each other...

Another similarity is the idea of being the one to first see the diagnosis. I like the whole idea of seeing unselected pathology. In the ED a headache can be a person who just wants some percocet, or could be the first symptom of a GBM, same is true with films in rads - you often get to make the diagnosis pretty conclusively, and it's often not suspected clinically. I don't know if many people think about that way, but it's something that appealed to me in both fields.

Good luck, both fields are fun IMHO, but rads won for me.

well said
everyone should read this.

 

[bartleby]

While I loved playing in IR in med school, keep in mind that most IR-trained people in private practice are lucky if they spend 50% of their time doing procedures. Some people I've met spend considerably less. The thought of spending any time doing diagnostic radiology is a total buzz-kill as far as I'm concerned.

If you aren't interested in getting your hands dirty or dealing with people, just shoot for rads.

 

[bigfrank]

IR Cons:
6. Aspermia

ER Pros:
8. Fertility

And I was wondering how you had chalked up the ridiculous number of 5,500+++ posts in just a little over 2.5 years.