How terrible is IM residency really

[JPSmyth]

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Yes, but it's an exhausting 7 on.

The hospitalists I know spend the first day off dealing with leftover paperwork/patient stuff, the next 1-2 days recovering mentally, then have like a day or two to actually enjoy themselves before spending the last day dreading and trying to rest up for going back on.

And that says nothing about those with academic/research commitments which absolutely destroy the week off.

Suffice to say it only sounds easy to those who haven't done it. There's a reason burn out is very high among hospitalists

Man I have been trying to make a list of specialities that I might like and every single one is either at risk for having a terrible job market, the lifestyle sucks, etc. So many negatives! all that's left is derm, of course the most competitive specialty lol

Granted I take everything I rad on SDN with a grain of salt

 

[Osteoth]

Man I have been trying to make a list of specialities that I might like and every single one is either at risk for having a terrible job market, the lifestyle sucks, etc. So many negatives! all that's left is derm, of course the most competitive specialty lol

Granted I take everything I rad on SDN with a grain of salt

Have been feeling the same way. One of the things I need to keep reminding myself is that we're in medical school now, everyone here is smart, educated, patient, hard working, etc etc.

If there was a magic pill everyone would take it, and they do in derm. Just gotta figure out:
1. Can you get there? 2. If not, then what?

 

[michaelrack]

I

As a cardiologist, you'll have job security, great pay, prestige, patients actually get better because of your intervention. Within cardiology alone, there are procedure heavy options both peripherally and coronaries, critical care, imaging, preventive cards, transplant, electrophysiology, and even cardio-oncology. On top of all that it is one of the most research heavy and evidence based speciality. Can do mostly inpatient or mostly outpatient or a mix of both. Of course there are negatives to cards also (getting called for a chest pain rule out by ER at 3 AM in a 30+ yo with a negative troponin x2).
.

The chest pain with normal troponin is being admitted to the hospitalist with possible cardiology consult during normal business hours

 

[JPSmyth]

Have been feeling the same way. One of the things I need to keep reminding myself is that we're in medical school now, everyone here is smart, educated, patient, hard working, etc etc.

If there was a magic pill everyone would take it, and they do in derm. Just gotta figure out:
1. Can you get there? 2. If not, then what?

I just don't know if I can achieve a 250+ step 1 score and 12 publications and AOA. I already worked so hard to get into med school I don't want to kill myself trying to be top of the class to match derm.

 

[cactusman]

I just don't know if I can achieve a 250+ step 1 score and 12 publications and AOA. I already worked so hard to get into med school I don't want to kill myself trying to be top of the class to match derm.

It's not 12 pubs, NRMP includes abstracts and presentations in that number. Also I think it's around half in AOA since AOA mostly just shows you're high-achieving.
Still super tough of course.

 

[ThreeCheers]

Man I have been trying to make a list of specialities that I might like and every single one is either at risk for having a terrible job market, the lifestyle sucks, etc. So many negatives! all that's left is derm, of course the most competitive specialty lol

Granted I take everything I rad on SDN with a grain of salt

It isn't just SDN blather in this case though. Talk to any hospitalist and you'll get the same answer. I know some that even arranged for a different schedule (e.g. work 3-4 days then get 3-4 days off) later in their careers because 7-on-7-off was too exhausting.

 

[Mad Jack]

The only people who ever say stuff like this are premeds and med students who've never actually seen or worked a hospitalist schedule

When I was working the night shift this morning and we had 6 admits pending to start, I understood why so many physicians commit suicide. I can't imagine living the hospitalist life forever. One, two, three years tops. It isn't a forever job.

 

[Mad Jack]

It isn't just SDN blather in this case though. Talk to any hospitalist and you'll get the same answer. I know some that even arranged for a different schedule (e.g. work 3-4 days then get 3-4 days off) later in their careers because 7-on-7-off was too exhausting.

7 on 7 off is awful. You may as well be working on the road, because you're completely disconnected from the normal world, and doubly so if you're on nights.

 

[JPSmyth]

It's not 12 pubs, NRMP includes abstracts and presentations in that number. Also I think it's around half in AOA since AOA mostly just shows you're high-achieving.
Still super tough of course.

Some current M3s I know going into derm tell me that the new normal is to take a research year to make yourself competitive. I don't want to devote 5 years of my life to a specialty with a 77% match rate lol. I would rather pick something that is more attainable for myself. It seems that at least half of all med students want to do derm, and from match lists I see 1-2 students per school end up successfully matching in derm

 

[DrfluffyMD]

Derm is not that good. Sure, the hours are good, the pay is ok, but have you looked into how many patients they see a day?

10 minute appointments. Seeing that many people a day, day in and day out might as well be working at McDonalds.

 

[WingedOx]

I just don't know if I can achieve a 250+ step 1 score and 12 publications and AOA. I already worked so hard to get into med school I don't want to kill myself trying to be top of the class to match derm.

Half the people gunning for derm in my med school class made me want do ask them, "do you even LIKE dealing with skin diseases, or are you just not capable of seeing your life as anything but an exercise in constant ladder climbing?"

 

[JPSmyth]

Derm is not that good. Sure, the hours are good, the pay is ok, but have you looked into how many patients they see a day?

10 minute appointments. Seeing that many people a day, day in and day out might as well be working at McDonalds.

RVUs are high for derm no? Good reimbursement with 40 hour weeks and no or very minimal call. Derm ranks highest with happiness, job satisfaction, lowest in burnout and pretty much every possible metric measured in physician surveys. If you hate clinic then it isn't for you, but there's clearly a reason why it is the most competitive specialty.

 

[JPSmyth]

Half the people gunning for derm in my med school class made me want do ask them, "do you even LIKE dealing with skin diseases, or are you just not capable of seeing your life as anything but an exercise in constant ladder climbing?"

I think they just want high pay, low hours. Just like every other American

 

[Osteoth]

Half the people gunning for derm in my med school class made me want do ask them, "do you even LIKE dealing with skin diseases, or are you just not capable of seeing your life as anything but an exercise in constant ladder climbing?"

I never understand this question. Why do you care?

If the individuals in question are smart, hard working and dedicated enough to get the board scores, do the research, kiss the asses etc etc, then whats wrong if they don't have some dying passion for psoriasis?

Why is passion a pre-requisite for anything? Whats wrong with just being a professional and doing your job to the best of your ability?

 

[DrfluffyMD]

I think they just want high pay, low hours. Just like every other American

High pay and low hours sounds good, but if there is something I learned about radiology vs interventional, it's what you do in those hours count.

Yeah, I could have been a mammographer and do 40 hour weeks reading mammograms and such with no call, but it would absolutely bore me to the skull.

Derm is the same thing. Hell, I actually had the step scores for derm (above 250 for both) but the idea of seeing 50 people a day for skin complaints absolutely numb my skull. Just ain't my cup of tea.

 

[DrfluffyMD]

I never understand this question. Why do you care?

If the individuals in question are smart, hard working and dedicated enough to get the board scores, do the research, kiss the asses etc etc, then whats wrong if they don't have some dying passion for psoriasis?

Why is passion a pre-requisite for anything? Whats wrong with just being a professional and doing your job to the best of your ability?

Passion is definitely not a pre requiste for anything, problem is that if you no have passion for you do, medicine can become really boring.

You only live once and boring just don't cut it.

 

[JPSmyth]

High pay and low hours sounds good, but if there is something I learned about radiology vs interventional, it's what you do in those hours count.

Yeah, I could have been a mammographer and do 40 hour weeks reading mammograms and such with no call, but it would absolutely bore me to the skull.

Derm is the same thing. Hell, I actually had the step scores for derm (above 250 for both) but the idea of seeing 50 people a day for skin complaints absolutely numb my skull. Just ain't my cup of tea.

I definitely understand that. I am a non-trad med student and I have learned before med school that free time is something that I value ahead of many other considerations. Also my debt burden is high, so compensation is important as well. So hours and pay are paramount for me, but I obviously need to find a job that I will enjoy doing for 50+ hours per week for the next 20+ years.

Procedure heavy DR fellowships and IR are both fields I definitely want to look into because they seem interesting with good compensation

 

[DrfluffyMD]

For me, diagnostic work is nonstop and just tires me out. Doing routine procedures relaxes me. It's a personality thing.

 

[Osteoth]

Passion is definitely not a pre requiste for anything, problem is that if you no have passion for you do, medicine can become really boring.

You only live once and boring just don't cut it.

Oh I 100% agree, I just find that the tone when people bring up passion in regards to fields like dermatology often seems to come from a place of spite that individuals who aren't passionate about their chosen occupation are working harder/getting better scores & placement than those with passion.

Not saying thats the tone the person I quoted took, but a general observation, which led to my question.

 

[ERDOC555]

Some current M3s I know going into derm tell me that the new normal is to take a research year to make yourself competitive. I don't want to devote 5 years of my life to a specialty with a 77% match rate lol. I would rather pick something that is more attainable for myself. It seems that at least half of all med students want to do derm, and from match lists I see 1-2 students per school end up successfully matching in derm

Yeah that's pretty much the same at my school. Probably 10-20 want derm, half of those apply, less than half of those who apply match. I think I read somewhere that half of derm applicants took research years, which seems absurdly high, but it makes sense.

Derm is not that good. Sure, the hours are good, the pay is ok, but have you looked into how many patients they see a day?

10 minute appointments. Seeing that many people a day, day in and day out might as well be working at McDonalds.

Glad you realize this, most people don't. Derm sees the most patients per day out of likely any specialty. It may be an 8 to 5 job, but those hours are tough, not to mention all the charting afterwards.

Half the people gunning for derm in my med school class made me want do ask them, "do you even LIKE dealing with skin diseases, or are you just not capable of seeing your life as anything but an exercise in constant ladder climbing?"

Unfortunately I'd say it's at best 50/50 , but probably more like one third/two thirds when it comes to who actually likes derm. I know a lot of people who know nothing about the field and just want it because it's "prestigious" or has "good hours"

 

[ErenJaeger]

I've used the search bar but I can't seem to find the thread on reviewing personal statements for im residency. Please help.

 

[DrfluffyMD]

Yeah that's pretty much the same at my school. Probably 10-20 want derm, half of those apply, less than half of those who apply match. I think I read somewhere that half of derm applicants took research years, which seems absurdly high, but it makes sense.



Glad you realize this, most people don't. Derm sees the most patients per day out of likely any specialty. It may be an 8 to 5 job, but those hours are tough, not to mention all the charting afterwards.



Unfortunately I'd say it's at best 50/50 , but probably more like one third/two thirds when it comes to who actually likes derm. I know a lot of people who know nothing about the field and just want it because it's "prestigious" or has "good hours"

You guys definitely earned it. I can never deal with seeing that many people a day.

I think an academic IR attending do maybe 10-20 moderate to big cases a day. I rather have that.

 

[WingedOx]

I never understand this question. Why do you care?

If the individuals in question are smart, hard working and dedicated enough to get the board scores, do the research, kiss the asses etc etc, then whats wrong if they don't have some dying passion for psoriasis?

Why is passion a pre-requisite for anything? Whats wrong with just being a professional and doing your job to the best of your ability?

Eh, none of my business what people do. (sips tea)

But the "I can just slug thru a job in medicine so long as the hours are good" is just as delusional as the "my life is going to suddenly be awesome once I'm a doctor" stuff that gets posted in pre-allo. Having burned out doctors isn't really in anyone's best interest.

Hell, I have better hours than just about every attending who posts here and could seriously ramp up my $$ intake by taking a PP gig, but there aren't a lot of people here gunning to do what I do...though psych does seem to attract types who seem to go into it because it'll be cushy when you're done with residency, and those people kinda scare me.

 

[DrfluffyMD]

Eh, none of my business what people do. (sips tea)

But the "I can just slug thru a job in medicine so long as the hours are good" is just as delusional as the "my life is going to suddenly be awesome once I'm a doctor" stuff that gets posted in pre-allo. Having burned out doctors isn't really in anyone's best interest.

Hell, I have better hours than just about every attending who posts here and could seriously ramp up my $$ intake by taking a PP gig, but there aren't a lot of people here gunning to do what I do...though psych does seem to attract types who seem to go into it because it'll be cushy when you're done with residency, and those people kinda scare me.

Psych needs the most amount of caring and passion in my opinion.

It's easy for a surgeon or a proceduralist to be only motivated by the disease process. I mean, to be crude, I will be working on folks who are still and noninteractive.

It's a whole other matter to work with diseases minds.

 

[Osteoth]

Eh, none of my business what people do. (sips tea)

But the "I can just slug thru a job in medicine so long as the hours are good" is just as delusional as the "my life is going to suddenly be awesome once I'm a doctor" stuff that gets posted in pre-allo. Having burned out doctors isn't really in anyone's best interest.

Hell, I have better hours than just about every attending who posts here and could seriously ramp up my $$ intake by taking a PP gig, but there aren't a lot of people here gunning to do what I do...though psych does seem to attract types who seem to go into it because it'll be cushy when you're done with residency, and those people kinda scare me.

Yeah but at the same point its fairly arrogant for anyone to assume they know what will make an individual burnt out over a career. I definitely know some docs that get off on the ability to make gobs of money in private practice, and some that love the work that they do but make pennies. Its exceedingly difficult to generalize about other people's lives, so I find the entire premise flawed.

 

[anbuitachi]

IM is not bad at all. Its tougher than the cush residencies like derm, but its probably still one of the easier residencies. First its only 3 years. Shortest length possible for a residency. Your hours are also not bad, with electives and clinic time. Your patients are likely not actively trying to die on you, cause those go to the ICU and you dont do much ICU

 

[JPSmyth]

IM is not bad at all. Its tougher than the cush residencies like derm, but its probably still one of the easier residencies. First its only 3 years. Shortest length possible for a residency. Your hours are also not bad, with electives and clinic time. Your patients are likely not actively trying to die on you, cause those go to the ICU and you dont do much ICU

Glad to hear someone say this, it seems as though most people think IM residency is torture. I'm sure intern year is bad but the next two should be manageable. Thanks for the insight

 

[zero0]

Man I have been trying to make a list of specialities that I might like and every single one is either at risk for having a terrible job market, the lifestyle sucks, etc. So many negatives! all that's left is derm, of course the most competitive specialty lol

Granted I take everything I rad on SDN with a grain of salt

Not even derm. I'd rather dig coal than do clinic all day.

 

[masaraksh]

Eh, none of my business what people do. (sips tea)

But the "I can just slug thru a job in medicine so long as the hours are good" is just as delusional as the "my life is going to suddenly be awesome once I'm a doctor" stuff that gets posted in pre-allo. Having burned out doctors isn't really in anyone's best interest.

Hell, I have better hours than just about every attending who posts here and could seriously ramp up my $$ intake by taking a PP gig, but there aren't a lot of people here gunning to do what I do...though psych does seem to attract types who seem to go into it because it'll be cushy when you're done with residency, and those people kinda scare me.

Psych is cushy in residency too

 

[takeurmeds02]

I mean I'm already crazy so after 9 years of an MD/PhD working like a dog, I figure I'll make it through 6 more years of clinical training (IM + Hem/Onc). I do wish Hem/Onc would just be it's own thing like rad onc lol.

Oh God, that crushed my soul..

 

[Stagg737]

Psych needs the most amount of caring and passion in my opinion.

It's easy for a surgeon or a proceduralist to be only motivated by the disease process. I mean, to be crude, I will be working on folks who are still and noninteractive.

It's a whole other matter to work with diseases minds.

The disease process is actually something that I find very fascinating about psych, especially because I feel like it may be the field with the most research potential in terms of increasing our understanding of the disease processes and why/how exactly the treatment modalities are effective.

 

[eteshoe]

Oh God, that crushed my soul..

Gotta love the grind man