I think it is because endo falls into the non-procedural, "intellectual" subspecialties of IM, along with rheum, ID, and allergy/immuno (to some extent) which means less $$. Not much improvement in bank compared to general IM. Of course there are always plenty of exceptions, but the big winners are GI and cards. I think nephro, heme/onc, pulm/cc are second tier (with h/o being ahead of the other two), then the others. The competitiveness of getting a fellowship spot generally follows this trend as well, although allergy is tough with not many spots and better income potential than the other "intellectual" specialties. I agree there are some cool things in endo, but, like any area of medicine, it has its trouble spot, which would be all the diabetes (in my mind anyway). If you like the brittle diabetics with all the complications, then endo is cool indeed. If you only think panhypopituitarism is cool, then beware. In my experience, endocrinologists are among the most thorough and compulsive of internists and do enjoy the intellectual aspects of their work.
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