Emergency Medicine or Non-invasive cardiologist?

[plumber007]

I'll soon have to chose my electives and still haven't made up my mind with what I want to specialize in.
My biggest factor is lifestyle. Want to have a family and lots of kids. So, don't want to be work crazy hours. Do not want to do surgeries and no way practice IM all my life.

From my research, EM and non-invasive cardiologists make about the same money. EM, everyone I've talked to have said that they work 40-50 hours. But got mixed reviews about non-invasive cardio. Some say 60-80 hours/week but then you get 3-4 days off and so on. Pay is the same if we compare hourly rates rather than overall salary.

So, which one is better when comparing job security, salary, and lifestyle? Is my research right because there are crazy differences in pay and work hours on "the internet"

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[deleted245139]

First thing first... Do you want to be a cardiologist, or an emergency medicine doc. I'm not being obtuse... Don't choose the life style. Choose what job will make you happy.

 

[plumber007]

First thing first... Do you want to be a cardiologist, or an emergency medicine doc. I'm not being obtuse... Don't choose the life style. Choose what job will make you happy.

I like both. I like thinking on my feet and learning parts of everything, and I also like to read EKG and physiology of heart. I like them both equally and see myself doing either one of them my whole life. What I do know however is that I don't want to work in any other fields besides these 2. Especially not in Family medicine or OB/GYN.

 

[Dral]

As a newly minted attending I'll give you this advice...take it or leave it:

Let's not kid ourselves...very few of us were 5 year olds wanting to be cardiologists or radiation oncologists. Were more of us 5 year olds wanting to be doctors? Sure. Point is, most us aren't 'born' to do a certain field of medicine. There is a lot of plasticity there. Many of us could be perfectly happy doing several fields. So how to decide? Lifestyle, pay, and other things like that come into play and are IMPORTANT.

Don't let anyone give you the 'highroad' runaround of "Omg, you have to do what you absolutely totally love first...pick one...and not based on lifestyle or money, or you're an awful awful person!"

So yeah, again take with a grain of salt (I'm a Dermatologist/Dermatopathologist). My job isn't a low stress cakewalk, but it's also not nearly as high stress as being a trauma surgeon or PICU doc.

Anyway, it sounds like you have already realized this. My partial rant aside, you should definitely still focus on what you really see yourself doing....which it seems you have done. You have thought about what you like and why you like it. Good.

Now between those two. If you like diversity of things, I would say go with EM. You will still be seeing plenty of EKGs and dealing with cards stuff.

If you do like cards, think about how you like to be involved. If you like the acute care of it, go with EM. If you really want to follow with patients and see how your treatments work, go with cards. I will admit that I don't know as much about these fields to help you much more. For instance, I have no idea how much cards ICU/hospital time a non interventional cards doc needs to do (if at all).

G'luck.

 

[plumber007]

As a newly minted attending I'll give you this advice...take it or leave it:

Let's not kid ourselves...very few of us were 5 year olds wanting to be cardiologists or radiation oncologists. Were more of us 5 year olds wanting to be doctors? Sure. Point is, most us aren't 'born' to do a certain field of medicine. There is a lot of plasticity there. Many of us could be perfectly happy doing several fields. So how to decide? Lifestyle, pay, and other things like that come into play and are IMPORTANT.

Don't let anyone give you the 'highroad' runaround of "Omg, you have to do what you absolutely totally love first...pick one...and not based on lifestyle or money, or you're an awful awful person!"

So yeah, again take with a grain of salt (I'm a Dermatologist/Dermatopathologist). My job isn't a low stress cakewalk, but it's also not nearly as high stress as being a trauma surgeon or PICU doc.

Anyway, it sounds like you have already realized this. My partial rant aside, you should definitely still focus on what you really see yourself doing....which it seems you have done. You have thought about what you like and why you like it. Good.

Now between those two. If you like diversity of things, I would say go with EM. You will still be seeing plenty of EKGs and dealing with cards stuff.

If you do like cards, think about how you like to be involved. If you like the acute care of it, go with EM. If you really want to follow with patients and see how your treatments work, go with cards. I will admit that I don't know as much about these fields to help you much more. For instance, I have no idea how much cards ICU/hospital time a non interventional cards doc needs to do (if at all).

G'luck.

Your rant is actually how I feel when someone says "do what your heart says" I mean yeah I'd love to not work, buy a house at the beach and relax for the rest of my life. But that is not practical even if you have millions in your bank account because you will definitely go crazy with no work on hand to do.

So, thanks for your practical advice. Still looking to get an inside view on lifestyle of cardio non invasive vs EM

 

[Dral]

You may benefit from some lurking on the corresponding resident specific forums, if you haven't already.

 

[deleted245139]

Agree with Dral ^
Look at the sub-forums.

Look... at the end of the day, they are VERY different specialties with VERY different paths to the end.
1. EM is fast paced, hectic, 100 mph. You make heavy decisions with very little information, you are often subject to hind-sight, and you will constantly be second guessed. It is intense, and AMAZING. I mean... I'm biased. I love it. I couldn't do anything else.
- 1 hour in the ED is arguably 1.5 hours of work on a floor. Handily. You will go home tired, but fulfilled.
- residency is 3y. Then done. Then grind until you retire.

2. Cards
- 3y IM, REAPPLY, then 3y cards. 6y to the attending spot.
- depending on your job stucture, maybe more 'banker-type' hours, but you will work MUCH harder than that from what I understand.
- I can't comment more on it... not familiar enough.

Best advice
- shadow each a few times.
- see the down and dirty.
- I've always been a fan of this saying: ANY job breaks down as follows... 10% is amazing and reminds you why you went into it in the first place. 10% if horrible and makes you question everything you ever chose to do. 80% is the boring day in-day out grind. Find the job where that 80% gives you some satisfaction.

 

[plumber007]

Agree with Dral ^
Look at the sub-forums.

Look... at the end of the day, they are VERY different specialties with VERY different paths to the end.
1. EM is fast paced, hectic, 100 mph. You make heavy decisions with very little information, you are often subject to hind-sight, and you will constantly be second guessed. It is intense, and AMAZING. I mean... I'm biased. I love it. I couldn't do anything else.
- 1 hour in the ED is arguably 1.5 hours of work on a floor. Handily. You will go home tired, but fulfilled.
- residency is 3y. Then done. Then grind until you retire.

2. Cards
- 3y IM, REAPPLY, then 3y cards. 6y to the attending spot.
- depending on your job stucture, maybe more 'banker-type' hours, but you will work MUCH harder than that from what I understand.
- I can't comment more on it... not familiar enough.

Best advice
- shadow each a few times.
- see the down and dirty.
- I've always been a fan of this saying: ANY job breaks down as follows... 10% is amazing and reminds you why you went into it in the first place. 10% is horrible and makes you question everything you ever chose to do. 80% is the boring day in-day out grind. Find the job where that 80% gives you some satisfaction.

that was informative. I'll shadow a cardiologist and then a EM. Will see what I like better

 

[19772016]

Robin

Did you get any helpful information eventually?

 

[Willfrye027]

I have two uncles who are EM docs and work at shops with very different ideologies. One works 12 shifts a month, pretty much since becoming an attending (and all the other docs in his group do the same),. The other works 16-17 shifts. Some docs work less in his group but get a hard time for it. One of the (many) allures to EM for me is the flexibility. You can choose the life you want with EM. I also worked for a cardiologist who was like 70, and still worked 60 hours a week most weeks. He enjoys it, but the difference in lifestyle is clear to me.

 

[neoevolution]

I have two uncles who are EM docs and work at shops with very different ideologies. One works 12 shifts a month, pretty much since becoming an attending (and all the other docs in his group do the same),. The other works 16-17 shifts. Some docs work less in his group but get a hard time for it. One of the (many) allures to EM for me is the flexibility. You can choose the life you want with EM. I also worked for a cardiologist who was like 70, and still worked 60 hours a week most weeks. He enjoys it, but the difference in lifestyle is clear to me.

Are those 16-17 12 hour shifts?

 

[Willfrye027]

Are those 16-17 12 hour shifts?

8 or 10 hour shifts. But there is just a ton of variety in scheduling and stuff from what I have learned, those are just two examples. And the one working 12 shifts is also working 8-10 hour shifts.

 

[metopic]

You are going to spend twice as long in training, and spend twice as many hours at work as a cardiologist. That is both in practice and in training. EM is a great field, if you enjoy it.

EM and cardiology are very very different on a daily basis. Try both and see what you like.

But definitely do NOT choose cardiology in hopes of having a good lifestyle. It's not even in the same universe as the lifestyle of card's.