Heme/Onc vs Rheum

[vashka]

I'm an R2 very much undecided between heme/onc and rheum. Both have their pros and cons.

Heme/Onc: I find it more interesting than rheum and already have research in this field. However, I'm concerned with emotional burnout with the patient population and intensity of the fellowship as compared to rheum. Even after fellowship, I perceive heme/onc to be higher stress and work hrs than rheum, not sure if this is true. Onc patients are also unpredictable and I feel, higher acuity than rheum patients.

Rheum: Shorter and less intense fellowship than heme/onc? I also hear it is in demand but then I assume that finding a job in heme/onc would not be difficult either. I'd rather not deal with chronic pain patients. I am drawn to this field because the patients are really appreciative and I can see tangible effects of the meds. No current research in rheum yet.

All things being equal(namely the income), can you guys give me some advice here?

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[whoknows2012]

I'm an R2 very much undecided between heme/onc and rheum. Both have their pros and cons.

Heme/Onc: I find it more interesting than rheum and already have research in this field. However, I'm concerned with emotional burnout with the patient population and intensity of the fellowship as compared to rheum. Even after fellowship, I perceive heme/onc to be higher stress and work hrs than rheum, not sure if this is true. Onc patients are also unpredictable and I feel, higher acuity than rheum patients.

Rheum: Shorter and less intense fellowship than heme/onc? I also hear it is in demand but then I assume that finding a job in heme/onc would not be difficult either. I'd rather not deal with chronic pain patients. I am drawn to this field because the patients are really appreciative and I can see tangible effects of the meds. No current research in rheum yet.

All things being equal(namely the income), can you guys give me some advice here?

I can only speak to hem/onc and don’t have that much familiarity with compensation and work life balance of rheum. For hem/onc especially academic the pay is definitely not outta this world unless you’re in a smaller city or rural area. Hours aren’t crazy either. I would estimate that most of the attendings average 45-50 hours a week with solid tumors overall being on the lower end and leukemia/bmt on the higher end. There is definitely some risk for emotional burn out but to be honest it doesn’t seem to be a huge problem especially if you have a good support system and develop good relationships with your patients. I would agree that despite hours not being crazy there is definitely a lot of stress during the day to day that you probably wouldn’t have as much with rheum

 

[mdjo]

Rheum would definitely be a shorter and less intense fellowship. Just not as many emergencies or even very acute situations in general, so you don't get woken up in the night and your call isn't bad at most places. The kind of chronic pain patients we see are different from the kind of chronic pain patients in IM residency. They know they're not getting pain pills from you so it's just not the same butting heads I got during clinic in residency. It's more shared teamwork about which DMARD you think will work for them.

If you haven't done inpatient AND outpatient rheum rotations, highly recommend this to get a better feel for things. But ultimately if you just find H/O more interesting than Rheum, then you gotta do what will be more engaging for you.