How “difficult” certain specialties are guess who wins!

[Brigade4Radiant]

Physician Task Load and the Risk of Burnout Among US Physicians in a National Survey

Cognitive task load can affect providers’ ability to perform their job well and may contribute to burnout.The researchers evaluated whether task load,…

www.sciencedirect.com

It seems Urology is pretty difficult as a specialty there is such a huge shortage of them the AUA cut about half of their residency positions

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[EctopicFetus]

EM is dying. We can reject this notion if we wish but this will be at our own peril. I talk to a bunch of med students and I tell them not to waste their careers. IM sure many wont listen but I would go 10/10 HAM on my kids if they said they wanted to do EM. Other kids think they are special and other than steering them hard another way in the end it is their choice.

 

[Birdstrike]

I've been saying for years that EM is the hardest specialty in Medicine, like on this thread from 2019. What do I get in response? Nothing but disagreement.

But it's true. It's so frustrating to hear people in EM sell themselves short, rationalize the abuse they take, vastly underestimate their value and the tremendous hard work they do, only to have them private message me years down the road in desperation looking for advice on how to get out.

EM is the hardest specialty in Medicine and nothing else is even close!

I always believed it, but only when I got out and see EM from the outside in, do I know with all of my being that it is true. Furthermore, we now have the data to prove it.

When you walk in EM, you dodge poison arrows, on a tightrope set afire.

 

[bky3c]

I'm sure there's a lot I don't understand about the inner workings of other specialties, but I'm always amused when people in other specialities finally "get" something EM-specific that makes it harder than they had realized. Like the time my neurologist friend asked me why it's so hard to get EM docs to go to meetings, and I asked if she likes to go to meetings at 2am or on her day off. For her, it was just an extended break with a free meal. I also had a hospitalist gasp over my shoulder at the long list of patients on my computer screen one day, and she asked who all those people were. I explained that those were the patients I had seen so far that shift; I just hadn't called her about most of them. You don't know what you don't know, and it's hard to know until you're actually doing the job. Unfortunately, that is true for students as much as it is for other types of physicians.

 

[BulgeDaTwine]

You’ll get as many opinions about which specialty is the hardest as there are ways to define “hard”.

EM is grueling for the inconsistent hours, tiresome factor dealing with all the people - patients, consultants, admin - and certainly being the second most knowledgeable about pretty much every specialty on offer in the hospital is an investment of time and experience.

But “hard” ? It’s not technically hard . Surgery subspecialties beat us there. Difficult to get into? Certainly not anymore.

These discussions about what is hardest seem silly to me. I guess it’s fodder for those who need the ego boost.

At this stage of my career I want something that I enjoy, compensates reasonably, and doesn’t have tremendous external pressures to conform to arbitrary standards and guidelines malaligned with patient and provider experience. Emergency medicine used to be the first two and debatably the last. Now I score it rarely, marginal, and hahahahaha respectively.

 

[Brigade4Radiant]

Surgical specialties are hard to get into because the money and lifestyle
Derm beats most int that definition.

EM has such a high burnout rate because it’s hard

 

[timpview]

The “hardest” specialty arguments imo boils down to who is doing high acuity or high stress work in a sleep deprived state (so basically who’s working nights and dealing with actively dying patients) and how much time there is for recuperation (shift based vs call). Add in hospital dependent jobs for the loss of autonomy and control.

No way ER is not top 3-5 (ER, cards, critical care, nsgy)

And btw i think Urology with ASC ownership or doing easy/quick low-risk outpt clinic procedures is the best deal in medicine right low. outpt GI in 2nd place

 

[GatorCHOMPions]

I've been saying for years that EM is the hardest specialty in Medicine, like on this thread from 2019. What do I get in response? Nothing but disagreement.

But it's true. It's so frustrating to hear people in EM sell themselves short, rationalize the abuse they take, vastly underestimate their value and the tremendous hard work they do, only to have them private message me years down the road in desperation looking for advice on how to get out.

EM is the hardest specialty in Medicine and nothing else is even close!

I always believed it, but only when I got out and see EM from the outside in, do I know with all of my being that it is true. Furthermore, we now have the data to prove it.

When you walk in EM, you dodge poison arrows, on a tightrope set afire.

Having been on the other side like you it is just so true. There is much easier money to be made in the outpatient proceduralist world. I can understand why ortho and neurosurgery are relatively low on the list. People talk up the hourly rate of EM a lot but you can fairly easily get to $250+/hour in a bunch of other specialties, and $300+/hour with some hard work, but still not as hard as EM.

 

[Birdstrike]

66% Emergency Medicine Burnout Tax

Another lie of omission concealed from pre-meds and medical students is that there’s a 66% burnout tax on all work you do, every dollar you make, and every day off, in EM.

Your $250/hr often won’t feel like it was worth it. You’ll leave shifts thinking $750/hr might not be enough.

Your 30-hr week isn’t going to feel like 30 hrs. It’s going to take the physical, emotional and spiritual toll of chronic, repeated, 90-hr weeks at any other job.

Even your “abundant days off,” will be subject to this tax. The hangover from nights and circadian rhythm dysphoria will bleed into and out of, each stretch of time you have off. 4 days off, isn’t 4 days off. It’s one, maybe two.

Think of everything that is potentially good about EM. Subject it to the 66% EM burnout tax. You will pay a 66% physical, emotional, and spiritual tax and every hour, day and year you spend in Emergency Departments.

This doesn’t apply to other specialties, jobs or careers; only EM.

Post this on the door, screen and whiteboard of every EM interest group, textbook, presentation, and doctors lounge. Not posting this, should be considered a violation of workplace rules and regulations, subject to a $100,000 fine and/or 10 years in prison.

 

[GonnaBeADoc2222]

66% Emergency Medicine Burnout Tax

Another lie of omission concealed from pre-meds and medical students is that there’s a 66% burnout tax on all work you do, every dollar you make, and every day off, in EM.

Your $250/hr often won’t feel like it was worth it. You’ll leave shifts thinking $750/hr might not be enough.

Your 30-hr week isn’t going to feel like 30 hrs. It’s going to take the physical, emotional and spiritual toll of chronic, repeated, 90-hr weeks at any other job.

Even your “abundant days off,” will be subject to this tax. The hangover from nights and circadian rhythm dysphoria will bleed into and out of, each stretch of time you have off. 4 days off, isn’t 4 days off. It’s one, maybe two.

Think of everything that is potentially good about EM. Subject it to the 66% EM burnout tax. You will pay a 66% physical, emotional, and spiritual tax and every hour, day and year you spend in Emergency Departments.

This doesn’t apply to other specialties, jobs or careers; only EM.

Post this on the door, screen and whiteboard of every EM interest group, textbook, presentation, and doctors lounge. Not posting this, should be considered a violation of workplace rules and regulations, subject to a $100,000 fine and/or 10 years in prison.

Much easier said than done, but try to find a job with no nights and a staffing model that makes it easy to slack off.

The job still blows, and I don't make SDG money, but I don't want to rage quit every day.

 

[Fox800]

Much easier said than done, but try to find a job with no nights and a staffing model that makes it easy to slack off.

The job still blows, and I don't make SDG money, but I don't want to rage quit every day.

Kaiser? VA?

 

[forchinet121]

Physician Task Load and the Risk of Burnout Among US Physicians in a National Survey

Cognitive task load can affect providers’ ability to perform their job well and may contribute to burnout.The researchers evaluated whether task load,…

www.sciencedirect.com

It seems Urology is pretty difficult as a specialty there is such a huge shortage of them the AUA cut about half of their residency positions

View attachment 373846

Kind of a stupid chart tbh, it has psychiatry as median mental demand..

 

[BoardingDoc]

Kind of a stupid chart tbh, it has psychiatry as median mental demand..

I'm not sure why that makes it stupid. These numbers are all self reported by physicians in various specialties. Are you trying to say that psych should be listed as more mentally taxing than the median or less?

 

[forchinet121]

I'm not sure why that makes it stupid. These numbers are all self reported by physicians in various specialties. Are you trying to say that psych should be listed as more mentally taxing than the median or less?

More..have you tried doing therapy..or talking to most psych patients…

 

[BoardingDoc]

More..have you tried doing therapy..or talking to most psych patients…

I haven't tried doing therapy. I do speak with psych patients on a daily basis. They are frequently annoying AF. That said, I don't see talking with them about their issues to be mentally taxing so much as occasionally frustrating. That doesn't equate to high mental demand in my mind (or evidently in the mind of the psychiatrists who took this survey). My view is that the mental demand column seems to be more or less what I would have guessed it would be. NSGY seemed a little lower than I would have guessed and path seems higher though I freely admit I have no direct experience working as a pathologist or a neurosurgeon.

 

[sloh]

Kind of a stupid chart tbh, it has psychiatry as median mental demand..

Agreed, there's way too much subjectivity to these questions and answers to take anything more granular away from the chart other than what is really really obvious: EM has huge mental, physical, time, and effort demand.

Should they rank #1 wrt sum PTL? Who cares lol. The point is many pre-meds, medical students, and residents don't have a realistic conceptualization of what being an EM attending is actually like.

 

[90sportsfan]

This list is interesting, and seems pretty accurate, but there are definitely a few head-scratchers. Neurosurgery and Ophthalmology being near the bottom lol????

 

[deuist]

This list is interesting, and seems pretty accurate, but there are definitely a few head-scratchers. Neurosurgery and Ophthalmology being near the bottom lol????

Ophthalmology residencies are rough, but private practice ophthalmologists who are not taking call for a hospital have good hours. Glaucomflecken mentions his easy lifestyle from time to time.