Field with lowest stress

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m3unsure

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Out in the real world, which field do attendings find to have the lowest stress +/- realistically less working hours (50)?
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m3unsure said:
Out in the real world, which field do attendings find to have the lowest stress +/- realistically less working hours (50)?
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I don't know for sure, but I'm willing to bet Pathologists have a pretty incredible lifestyle.
 
I do about 3-4 hours of work a day, come and go as I please these days.
Dunno what your stress tolerance is.
 
m3unsure said:
Out in the real world, which field do attendings find to have the lowest stress +/- realistically less working hours (50)?
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Dermatology. For the most part, it tends to be a 9 to 5 job and there are few emergencies, if any.
 
I guess it might depend partly on what you love doing.


I think psych kinda fits that description.
 
Indeed it does. Every field has the potential to overwhelm and provide excessive stress. If you work hard and are well trained, that eliminates some of the problem. If you enjoy what you do, that eliminates a lot more. If you do neither and are just it for perceived benefits or advantages, it will likely be very stressful.
 
sikegeek said:
I guess it might depend partly on what you love doing.

I think psych kinda fits that description.
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ITA, and I find psych very low-stress because I enjoy it. But a lot of people in other areas of medicine find psych patients highly stressful to deal with, so I wouldn't unilaterally recommend the field as "low stress."

PM&R has a more socially well-adjusted patient population, few emergencies, not many patient deaths, and the hours are relatively regular and controllable, which is why I suggested it as a more generally "low stress" field. I'm sure the PM&R guys could identify the downsides for you though.
 
tr said:
ITA, and I find psych very low-stress because I enjoy it. But a lot of people in other areas of medicine find psych patients highly stressful to deal with, so I wouldn't unilaterally recommend the field as "low stress."

PM&R has a more socially well-adjusted patient population, few emergencies, not many patient deaths, and the hours are relatively regular and controllable, which is why I suggested it as a more generally "low stress" field. I'm sure the PM&R guys could identify the downsides for you though.
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Good point about psych. I liked the field a lot as a student but I swear it wore me down when I did the rotations. Good thing the hours were good so I could get home and take a nap. I think the emotional stress of psych was high for me. But to each their own.

As for PM&R I know little about the field though but I think working with quads and stuff would wear me down too. Just so sad and not much chance of making a huge difference.
 
This may sound a little odd but the anesthesiologists seem the most laid back and happy at the hospital that I work at.

I will go with PM&R being nice . . . at least I hope it will be for me.
 
TRAMD said:
This may sound a little odd but the anesthesiologists seem the most laid back and happy at the hospital that I work at.

I will go with PM&R being nice . . . at least I hope it will be for me.
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I wouldn't call anesthesiology low-stress though. It has its moments of pure terror. Even a routine induction has the potential to become a code within minutes. But, anesthesia can be a pretty cool field. Maybe those anesthesiologists really love what they do.
 
PM&R certainly beats OB/Gyn, Surgery, Peds & Medicine etc. in terms of lifestyle, at least for the most part. However, hours really vary depending on your practice. Some docs, especially those who are in an ortho practice, work 8-5 with minimal call responsibilities. I know others who are have pretty horrendous call schedules and work 7A-8P routinely, which isn't exactly cush. However, it is a field that allows for a certain amount of flexibility, so if you want to have a more humane schedule, you can. We do have the occasional patient die on our service--often it's a cancer pt who we're hoping to get strong enough to go home for home hospice. Depending on where you practice, you can have a rehab unit with patients on vents, patients on dialysis, and patients who are generally sick as $%^*, so you get lots of calls for CP, SOB & the usual medicine stuff.

I thought it would be a depressing field because of the TBIs, SCIs, strokes, etc., but it's surprisingly upbeat. When you have a patient who can't even sit upright when they come in but who can use the bathroom, feed & dress him or herself, and get around independently (or almost independently) by the time they leave, it's really amazing. Our motto is "adding life to your years" and most days you really do get to see that.

Dealing with the families can be really stressful, so if you don't like that part, it wouldn't be a good choice. In our group, we have 3 part-time attendings who work <50, but everyone else is definitely over 50.
 
What exactly would a PM&R doctor do on call? You speak of call schedule but I'm just imagining your admits would be of the planned variety. If a patient is sick enough to require in house call coverage than they shouldn't be in rehab.

Just wanted some clarification as I really don't know what PM&R is all about. Thanks
 
Pir8DeacDoc said:
What exactly would a PM&R doctor do on call? You speak of call schedule but I'm just imagining your admits would be of the planned variety. If a patient is sick enough to require in house call coverage than they shouldn't be in rehab.

Just wanted some clarification as I really don't know what PM&R is all about. Thanks
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On call: late admissions--often 6, 7, 8 PM; Saturday , Sunday admissions. Depending on where you work, the admissions may have been decided and accepted by a non-physician. For example, a nurse liaison (with a commission incentive) scours the surrounding countryside for a warm body (i.e. not dead yet) and accepts the patient for admission with the approval of the local CEO of the chain rehab hospital. The CEO is usually a SLP, PT, OT, etc. Their motto is "fill every bed" to maximize profit. The patient more often than not is a train wreck who has spent 2 weeks in the ICU and was moved to stepdown yesterday afternoon. He/she was scheduled to arrive at 3 PM but actually arrives at 7-7:30 PM. The discharge paperwork is incomplete and the list of medications is highly questionable. The "doctor" who dumped this unfortunate person on you is now unavailable since it is after hours and he is not on call. There is no discharge summary (which I believe is required by law). The patient is aphasic/demented/gorked/combative/of subnormal intelligence, etc. and therefore is unhelpful in obtaining a history. Oh yeah, the patient did arrive with copies of 50-200 (or more) barely intelligible chart pages that the unit secretary threw at you as she shouted, "Your admission is here." Unfortunately, progress notes from today and yesterday are missing. Oh, did I mention that the patient is a brittle diabetic and it's unclear when he received insulin or was given any nourishment. And his temp is 101.5, he's unable to urinate, and his nurse is unable to pass a urinary catheter. So much for planned admits.

When on call, nursing will call with reports of fever, chest pain (fairly frequently--patients are old with underlying cardiovascular disease), SOB, vomiting blood or a very large stinky, bloody stool, seizures (in the patient with a brain tumor), dislocation of the artificial hip, and sudden death (PE, MI, massive stroke, etc) You will often have to transfer patients ("discharge them") to the acute care hospital. I had 5 of these over the course of a few days while covering a 40 bed rehab unit (massive GI bleed in a patient on coumadin, massive PE in a patient on heparin prophylaxis, new onset symptomatic atrial fibrillation, urosepsis with true rigors, and a dislocation of a prosthetic hip). Oh and the amputee just fell on his stump and the dressing is saturated with bright red blood--of course there is a wound dehiscence at the suture line. It's 5 PM, the patient came from an outside hospital, and you must frantically try to reach his surgeon. In the midst of this, one of the nurses feels compelled to share this sure-to-turn your stomach tidbit: your colleague's 44yo stroke/brain injured patient apparently thought her feces was chocolate ice cream. Nursing spent a considerable amount of time cleaning out her mouth.:thumbdown:thumbdown:thumbdown: to inpatient rehab.
 
Low stress fields with good hours: (in no particular order) occupational medicine, public health, dermatology, radiation oncology (few true emergencies, you're generally not there when the patient dies, and the patient is not on your service), ophthalmology, nuclear medicine, medical genetics, outpatient PM&R doing musculoskeletal (EMG's, injections, IME's, etc.), outpatient focused psychiatry--for example, doing geriatric evals in the office and in nursing homes.
 
Nikiforos said:
On call: late admissions--often 6, 7, 8 PM; Saturday , Sunday admissions. Depending on where you work, the admissions may have been decided and accepted by a non-physician. For example, a nurse liaison (with a commission incentive) scours the surrounding countryside for a warm body (i.e. not dead yet) and accepts the patient for admission with the approval of the local CEO of the chain rehab hospital. The CEO is usually a SLP, PT, OT, etc. Their motto is "fill every bed" to maximize profit. The patient more often than not is a train wreck who has spent 2 weeks in the ICU and was moved to stepdown yesterday afternoon. He/she was scheduled to arrive at 3 PM but actually arrives at 7-7:30 PM. The discharge paperwork is incomplete and the list of medications is highly questionable. The "doctor" who dumped this unfortunate person on you is now unavailable since it is after hours and he is not on call. There is no discharge summary (which I believe is required by law). The patient is aphasic/demented/gorked/combative/of subnormal intelligence, etc. and therefore is unhelpful in obtaining a history. Oh yeah, the patient did arrive with copies of 50-200 (or more) barely intelligible chart pages that the unit secretary threw at you as she shouted, "Your admission is here." Unfortunately, progress notes from today and yesterday are missing. Oh, did I mention that the patient is a brittle diabetic and it's unclear when he received insulin or was given any nourishment. And his temp is 101.5, he's unable to urinate, and his nurse is unable to pass a urinary catheter. So much for planned admits.

When on call, nursing will call with reports of fever, chest pain (fairly frequently--patients are old with underlying cardiovascular disease), SOB, vomiting blood or a very large stinky, bloody stool, seizures (in the patient with a brain tumor), dislocation of the artificial hip, and sudden death (PE, MI, massive stroke, etc) You will often have to transfer patients ("discharge them") to the acute care hospital. I had 5 of these over the course of a few days while covering a 40 bed rehab unit (massive GI bleed in a patient on coumadin, massive PE in a patient on heparin prophylaxis, new onset symptomatic atrial fibrillation, urosepsis with true rigors, and a dislocation of a prosthetic hip). Oh and the amputee just fell on his stump and the dressing is saturated with bright red blood--of course there is a wound dehiscence at the suture line. It's 5 PM, the patient came from an outside hospital, and you must frantically try to reach his surgeon. In the midst of this, one of the nurses feels compelled to share this sure-to-turn your stomach tidbit: your colleague's 44yo stroke/brain injured patient apparently thought her feces was chocolate ice cream. Nursing spent a considerable amount of time cleaning out her mouth.:thumbdown:thumbdown:thumbdown: to inpatient rehab.
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These days, there is no reason to experience this after the PGY-2 year if you're in the right residency program.
 
Nikiforos said:
your colleague's 44yo stroke/brain injured patient apparently thought her feces was chocolate ice cream. Nursing spent a considerable amount of time cleaning out her mouth.:.
Click to expand...

You do realize that is actually a field of study within Japanese porn. Thats when you put on your entreprenuer hat and post pics on the web.

hellooo to moooonlighting...
 
I'd say cardiology and GI are pretty chill if you can come close to create a routine (note the word CLOSE since you have emergencies). If you really like them they can be chill, at least according to my attendings. Some cardiology attendings at my school leave around 5-5:30 PM. granted they come in at 7:30-8AM. Same for the GI guys.
 
I think one or two people made the most important point: it depends on what you love. I did PMR as a med student and my intense dislike made it incredibly stressful. Ditto for gas. If I had to get up at 6am every day, I would be a miserable human being.

In the ED, attendings work about 35 hours/week. Because I love what I do, I find it immensely UN-stressful. But the multitasking/etc gives other people hives. Its most important to pick something you love
 
Heard this old chestnut yesterday...

Q: What is the most common cause of death among radiologists?

...

A: Getting hit in the parking lot at 4:30pm by a pathologist.
 
drfunktacular said:
Heard this old chestnut yesterday...

Q: What is the most common cause of death among radiologists?

...

A: Getting hit in the parking lot at 4:30pm by a pathologist.
Click to expand...

I don't get it . . . what was the pathologist still doing there at 4:30 PM?
 
HMSBeagle said:
I'd say cardiology and GI are pretty chill if you can come close to create a routine (note the word CLOSE since you have emergencies). If you really like them they can be chill, at least according to my attendings. Some cardiology attendings at my school leave around 5-5:30 PM. granted they come in at 7:30-8AM. Same for the GI guys.
Click to expand...

If someone was trying to tell you that cardiology is low stress that someone was leading you a tad astray.
 
drfunktacular said:
Heard this old chestnut yesterday...

Q: What is the most common cause of death among radiologists?

...

A: Getting hit in the parking lot at 4:30pm by a pathologist.
Click to expand...

Or, getting hit in the parking lot at 3pm by an anesthesiologist.
 
Taurus said:
Or, getting hit in the parking lot at 3pm by an anesthesiologist.
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I am not sure that makes sense either. Usually being hit by a bicycle is not a fatal accident.
 
TRAMD said:
If someone was trying to tell you that cardiology is low stress that someone was leading you a tad astray.
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Totally agree. Cards pays a fortune, but they work for it. The training is pretty intense too.

I would put family medicine in there, esp if they use hospitalists and don't do OB. I know one who took call from a ski slope in Switzerland - made 200k/yr.

Urgent care - though it may be boring - is extremely low-stress too. 9-5. Basic charting. No call. No continuity. 140k.
 
I always figured that being a college health center physician would be pretty low stress. Patients are pretty easy since college are healthy and without significant medical problems, they all have insurance as mandated by the college. Most of your practice is STDs, routine infections, muscoluskeletal stuff, some ob/gyn. The kids with chronic conditions like Crohn's or whatever are seeing their own gastroenterologist and what not. I can see it being pretty nice life.
 
I don't know why you guys keep arguing about this. It's like how everyone confirms their own biases with selected anecdotes. To one person, the pathologist (or radiologist, or whatever specialty you don't like) leaving at 4:30 pm is emblematic of the field at large, whereas to another that's the exception to the rule. Every field has people who leave early, show up late, take long lunches, whatever. Most people in medicine think that their field is poorly understood in terms of the effort, time commitment, level of knowledge, etc, required to flourish. And they are all probably right. But they shouldn't then turn around and say another field (of which they know nothing about except the rumors floated around the hospital or their vast 4 week experience in it) is any different.

I spent 6 weeks in med school in a college health center. It was one of the highest stress experiences of my third year (more so than surgery), simply because I hated it. I would have gotten an ulcer after 3 months.
 
yaah said:
I don't know why you guys keep arguing about this. It's like how everyone confirms their own biases with selected anecdotes. To one person, the pathologist (or radiologist, or whatever specialty you don't like) leaving at 4:30 pm is emblematic of the field at large, whereas to another that's the exception to the rule. Every field has people who leave early, show up late, take long lunches, whatever. Most people in medicine think that their field is poorly understood in terms of the effort, time commitment, level of knowledge, etc, required to flourish. And they are all probably right. But they shouldn't then turn around and say another field (of which they know nothing about except the rumors floated around the hospital or their vast 4 week experience in it) is any different.

I spent 6 weeks in med school in a college health center. It was one of the highest stress experiences of my third year (more so than surgery), simply because I hated it. I would have gotten an ulcer after 3 months.
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Well, this may be true, but it's undeniable that some specialties work less hours than others. Thats not conjecture, that's fact. Also, ulcers are supposedly not caused by stress :)
 
i knew this thread was too good to last. i was really loving the humor. no one needs to get upset

personally, it seems to be derm where i'm at, with their clinic hours (last patient scheduled between 3:40 & 4:20), home call (mostly never going in), and a study day every week.
 
johnnywalker said:
i knew this thread was too good to last. i was really loving the humor. no one needs to get upset

personally, it seems to be derm where i'm at, with their clinic hours (last patient scheduled between 3:40 & 4:20), home call (mostly never going in), and a study day every week.
Click to expand...

I leave at 4:20 everyday. I can't exactly remember why though.
 
yaah said:
I don't know why you guys keep arguing about this. It's like how everyone confirms their own biases with selected anecdotes. To one person, the pathologist (or radiologist, or whatever specialty you don't like) leaving at 4:30 pm is emblematic of the field at large, whereas to another that's the exception to the rule. Every field has people who leave early, show up late, take long lunches, whatever. Most people in medicine think that their field is poorly understood in terms of the effort, time commitment, level of knowledge, etc, required to flourish. And they are all probably right. But they shouldn't then turn around and say another field (of which they know nothing about except the rumors floated around the hospital or their vast 4 week experience in it) is any different.

I spent 6 weeks in med school in a college health center. It was one of the highest stress experiences of my third year (more so than surgery), simply because I hated it. I would have gotten an ulcer after 3 months.
Click to expand...

There, there . . . [pats yaah on the back gently] . . . it must have been very traumatic for you to be face to face with actual people. They could have at least closed the blinds so all that sunlight wouldn't burn a hole in your d*mn retinas!
 
TRAMD said:
There, there . . . [pats yaah on the back gently] . . . it must have been very traumatic for you to be face to face with actual people. They could have at least closed the blinds so all that sunlight wouldn't burn a hole in your d*mn retinas!
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I don't know where people get this myth that pathologists don't have to deal with people. Don't really deal with patients, but deal with other doctors who are often much more difficult to deal with than patients.

I hated the college health center because my brain atrophied and the preceptor was obsessed with being everyone of his patients' best friend. He also LOVED procedures.
 
Rogue_Leader said:
I always figured that being a college health center physician would be pretty low stress. Patients are pretty easy since college are healthy and without significant medical problems, they all have insurance as mandated by the college. Most of your practice is STDs, routine infections, muscoluskeletal stuff, some ob/gyn. The kids with chronic conditions like Crohn's or whatever are seeing their own gastroenterologist and what not. I can see it being pretty nice life.
Click to expand...

Sounds like military practice...
 
I'm an internal med doctor.
My picks for least stressful would be:
1) derm (but INCREDIBLY) hard field to get in to
2) pathology (BUT they do have to worry about being sued if they screw up the diagnosis)
3) probably PM and R
4) I would say ophtho...you'd have to ask an ophtho though.
5) nobody seems to have mentioned radiology
6) urgent care, if you get good at it (though it's not really a "specialty" per se - can be staffed by family practice, internal med, ER docs, and perhaps peds)
7) ER, because they have fantastic hours for the most part. However, I would expect to still work some nights throughout your career, which isn't trivial. Also, they get some patients who can go south quick, especially if you are in a large ER/trauma center
8) anesthesia, BUT as mentioned above a patient can go south on them QUICK and they have to be there early in the a.m.
9) urology, BUT very very hard to get in (2nd only to derm in competitiveness for residency placement) AND you have to do a couple of years of tough surgical residency on the front end
10) oh yeah I probably should have put in neurology, though they have a tough first couple of years of residency.
11) ? plastics perhaps (like uro very hard to get a residency and tough first couple years of residency)
 
yaah said:
I don't know where people get this myth that pathologists don't have to deal with people. Don't really deal with patients, but deal with other doctors who are often much more difficult to deal with than patients.

I hated the college health center because my brain atrophied and the preceptor was obsessed with being everyone of his patients' best friend. He also LOVED procedures.
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Why do you even bother to dignify what they say with a response? Don't even sweat it. Whether or not they understand / choose to acknowledge, the fact of the matter remains that pathology services form the backbone of the healthcare system. And yes, pathologists do deal directly with patients, in addition to a myriad of other responsibilities. In our hospital, we have a very active cytopathology service which is responsible for both performing and interpreting FNAs.
 
PM&R, no doubt...

How much less stress can there be when all you do is make sure that paraplegics have decent poops and ortho pts go to their rehab appts?
 
A pathologist called me at 5:30 pm today. I nearly fell backwards out of my chair. Very nice guy though. I don't know if he was speaking directly to me, or rather talking to the slide lovingly, but it didn't matter. I appreciated the call.
 
fakin' the funk said:
PM&R, no doubt...

How much less stress can there be when all you do is make sure that paraplegics have decent poops and ortho pts go to their rehab appts?
Click to expand...

You're forgetting all the interventional spine/pain management procedures, EMGs, musculoskeletal ultrasound and sports medicine. But no, none of those things are particularly stressful either.
 
Disciple said:
You're forgetting all the interventional spine/pain management procedures, EMGs, musculoskeletal ultrasound and sports medicine. But no, none of those things are particularly stressful either.
Click to expand...

This post made me smile.
 
yaah said:
I don't know where people get this myth that pathologists don't have to deal with people. Don't really deal with patients, but deal with other doctors who are often much more difficult to deal with than patients.

I hated the college health center because my brain atrophied and the preceptor was obsessed with being everyone of his patients' best friend. He also LOVED procedures.
Click to expand...

It was only playful/sarcastic chiding. I see pathologists out and about with the public every weekday from 11-2 at the greasy restaurant across the street from the hospital.
 
TRAMD said:
It was only playful/sarcastic chiding. I see pathologists out and about with the public every weekday from 11-2 at the greasy restaurant across the street from the hospital.
Click to expand...

well slides and gross sections dont need orders for benedryl or maalox, so this affords a little extra time. :p
 
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