How the hell to pick a specialty??

[HTxFrog]

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Where does everyone go to look up the average salaries by specialty? The allied physician website survey and the cejka website survey are the two I'm looking at right now and they vary dramatically on what they say for particular specialties. How the hell are we supposed to make an educated decision without even the most basic information on specialties? Also does anyone know of a good place to figure out what working conditions are like and future prognosis is for picking specialties? There has to be some accurate source for all this stuff but I just don't know what it is. Any help?

 

[OveractiveBrain]

Do not pick your specialty based on pay. you will (1) hate your life but be making 100 grand extra. The 50 take home will buy you a boat but not fix your soul. When youre 50 looking back, you may find how awful you feel about your "smart choice." And (2) Health Care reform = redistribution of wealth

You DO pick your specialty on one of three things. (1) Area of interest (i.e. I love the heart! = cards, or I hate people = radiology/path, or Primary Care sucks, it needs to be better = primary care) or (2) Experience. If you walk into an OR and spend 5 hours standing there doing nothing, sweating your ass off under those lights, retracting a rib for a surgery you cant see and you love it, Surgeon. If you cant wait to expound on the 37 potential diagnosis for the cause of this patient's cough and you love being in the hospital walking around, Medicine. If you have to pay to get girls, OB/GYN... I mean, if you want a mix of clinic and OR time and are willing to care for only women, OB/GYN. You got a 264 on your step 1? Derm/Optho/Urology. (3) Your parents are doing something and you want to take over the practice because you cant do anything on your own and you have to follow in their footsteps, literally on their coattails. This, like money, is a TERRIBLE reason to choose a specialty.

Experience is key. Finding some one you respect as a mentor is key. These people will influence your decision making.

Bottom line, you wont know until you experience something in your third year. If you have some bizzare predestined knowledge of Neurosurgery or Optho, get involved now.

 

[namethatsmell]

Which one resonates most with you?

Upper Left = Plastics
Upper Right = Ortho
Bottom Left = Derm
Bottom Right = Voodoo

Or you could listen to advice similar to what is posted above. Money is important, but since nobody knows how reimbursements will shift in the next 5-10-20 years, don't let it drive your decision too heavily.

 

[Dirt]

Where does everyone go to look up the average salaries by specialty? The allied physician website survey and the cejka website survey are the two I'm looking at right now and they vary dramatically on what they say for particular specialties. How the hell are we supposed to make an educated decision without even the most basic information on specialties? Also does anyone know of a good place to figure out what working conditions are like and future prognosis is for picking specialties? There has to be some accurate source for all this stuff but I just don't know what it is. Any help?

https://services.aamc.org/careersinmedicine/index.cfm?fuseaction=login.main

I pretty much use the AAMC careers in medicine site but my school provided us with membership. They list salaries for most specialties which are garnered from their own surveys as well as the MGMA (medical group management association) surveys.

In addition they provide some other helpful information regarding specialties such as what the patient population is like, what the common procedures/diagnoses are, what types of things are important to PDs in selecting candidates for interviews/the match etc.

As far as future outlook, that is something you are going to have a tough time finding because often times nobody really knows. Without a doubt the best approach is talking to people in the field.

Lastly, don't feel bad for considering money in your decision making process despite what some people say, just don't let it dominate your decision making process.

 

[HTxFrog]

First, I am a third year, so this is a decision coming up soon. I don't feel bad about considering money as one of the many factors I use when making my decision despite the ideological crap everyone says about it not mattering. If nobody cared about money then more people would be going into FP and less people into radiology. Anyways that is a topic for a completely different thread, and that is a thread that has been done one too many times already.

Second, that site looks good Dirt, thanks. I'm checking it out now.

Lastly a little bit more about what I myself am thinking. Basically, I like surgery, but my girlfriend is already getting upset about the hours during my surgical clerkship and I don't want medicine to ruin my life outside of work. Plus I'm not a huge fan of the hours either. I like ophtho, but I have been hearing the market is over saturated right now and so they aren't making **** any more. I like ortho too, but the hours seem like they suck from what I can tell. I know myself and if I look at my friends from school making twice as much as me after residency I'm going to be pissed off about it and it will bother me a lot regardless of lifestyle.
Anyways, if anyone knows of a surgical specialty with good lifestyle and money then let me know b/c that is what I want...

 

[Rollo]

First, I am a third year, so this is a decision coming up soon. I don't feel bad about considering money as one of the many factors I use when making my decision despite the ideological crap everyone says about it not mattering. If nobody cared about money then more people would be going into FP and less people into radiology. Anyways that is a topic for a completely different thread, and that is a thread that has been done one too many times already.

Second, that site looks good Dirt, thanks. I'm checking it out now.

Lastly a little bit more about what I myself am thinking. Basically, I like surgery, but my girlfriend is already getting upset about the hours during my surgical clerkship and I don't want medicine to ruin my life outside of work. Plus I'm not a huge fan of the hours either. I like ophtho, but I have been hearing the market is over saturated right now and so they aren't making **** any more. I like ortho too, but the hours seem like they suck from what I can tell. I know myself and if I look at my friends from school making twice as much as me after residency I'm going to be pissed off about it and it will bother me a lot regardless of lifestyle.
Anyways, if anyone knows of a surgical specialty with good lifestyle and money then let me know b/c that is what I want...

Why would it piss you off if your friends make twice as much as you after residency?

 

[COdoubleMO2theN]

First, I am a third year, so this is a decision coming up soon. I don't feel bad about considering money as one of the many factors I use when making my decision despite the ideological crap everyone says about it not mattering. If nobody cared about money then more people would be going into FP and less people into radiology. Anyways that is a topic for a completely different thread, and that is a thread that has been done one too many times already.

Second, that site looks good Dirt, thanks. I'm checking it out now.

Lastly a little bit more about what I myself am thinking. Basically, I like surgery, but my girlfriend is already getting upset about the hours during my surgical clerkship and I don't want medicine to ruin my life outside of work. Plus I'm not a huge fan of the hours either. I like ophtho, but I have been hearing the market is over saturated right now and so they aren't making **** any more. I like ortho too, but the hours seem like they suck from what I can tell. I know myself and if I look at my friends from school making twice as much as me after residency I'm going to be pissed off about it and it will bother me a lot regardless of lifestyle.
Anyways, if anyone knows of a surgical specialty with good lifestyle and money then let me know b/c that is what I want...

Uro, ENT

 

[J ROD]

Uro, ENT

bINGO!!

 

[J ROD]

First, I am a third year, so this is a decision coming up soon. I don't feel bad about considering money as one of the many factors I use when making my decision despite the ideological crap everyone says about it not mattering. If nobody cared about money then more people would be going into FP and less people into radiology. Anyways that is a topic for a completely different thread, and that is a thread that has been done one too many times already.

Second, that site looks good Dirt, thanks. I'm checking it out now.

Lastly a little bit more about what I myself am thinking. Basically, I like surgery, but my girlfriend is already getting upset about the hours during my surgical clerkship and I don't want medicine to ruin my life outside of work. Plus I'm not a huge fan of the hours either. I like ophtho, but I have been hearing the market is over saturated right now and so they aren't making **** any more. I like ortho too, but the hours seem like they suck from what I can tell. I know myself and if I look at my friends from school making twice as much as me after residency I'm going to be pissed off about it and it will bother me a lot regardless of lifestyle.
Anyways, if anyone knows of a surgical specialty with good lifestyle and money then let me know b/c that is what I want...

If you want surgery, then go for it!! If she really loves you, she will support you. Nuff said..........

 

[HTxFrog]

yeah urology and ENT are high on my list. I do ENT for 2 weeks starting monday so we'll see how that goes

 

[MossPoh]

So, you'd hate yourself with your friends making twice as much even if they were miserable, divorced and working ungodly hours after residency? It is ignorant to say finances don't matter, but it shouldn't be in the top 2 or 3 of your list.

 

[Dirt]

Anecdotally my priorities are as follows:

1. Can I see myself waking up every morning and doing this job in 5, 10, 15, 25 years. Obviously a lot of things fall under this umbrella.
2. What is the lifestyle, ie will I be able to spend time with my wife and kids.
3. Money.

 

[ryandote]

.

 

[blackadder]

Turns out that I don't want to do Radiology and it took me ALOT of thought and effort to realize that.

What specialty did ya end up picking?

 

[ArcGurren]

First, I am a third year, so this is a decision coming up soon. I don't feel bad about considering money as one of the many factors I use when making my decision despite the ideological crap everyone says about it not mattering. If nobody cared about money then more people would be going into FP and less people into radiology. Anyways that is a topic for a completely different thread, and that is a thread that has been done one too many times already.

Second, that site looks good Dirt, thanks. I'm checking it out now.

Lastly a little bit more about what I myself am thinking. Basically, I like surgery, but my girlfriend is already getting upset about the hours during my surgical clerkship and I don't want medicine to ruin my life outside of work. Plus I'm not a huge fan of the hours either. I like ophtho, but I have been hearing the market is over saturated right now and so they aren't making **** any more. I like ortho too, but the hours seem like they suck from what I can tell. I know myself and if I look at my friends from school making twice as much as me after residency I'm going to be pissed off about it and it will bother me a lot regardless of lifestyle.
Anyways, if anyone knows of a surgical specialty with good lifestyle and money then let me know b/c that is what I want...

What kind of self-esteem do you have that you'll get pissed off looking at what your friends are making? 😵

I'm in a similar position in any case. Urology or ENT are the good options but ENT is VERY hard to get into. Uro isn't as tough to get into but they select for personality.

 

[ryandote]

.

 

[gravitywave]

How the hell are we supposed to make an educated decision without even the most basic information on specialties? Also does anyone know of a good place to figure out what working conditions are like and future prognosis is for picking specialties? There has to be some accurate source for all this stuff but I just don't know what it is. Any help?

There is a magical place that has the info you seek. It's called...... the time in medical school between Step 1 and ERAS.

 

[Zoom-Zoom]

What kind of self-esteem do you have that you'll get pissed off looking at what your friends are making? 😵

I'm in a similar position in any case. Urology or ENT are the good options but ENT is VERY hard to get into. Uro isn't as tough to get into but they select for personality.

I know what he means. It has nothing to do with self-esteem. Maybe it has something to do with ego. Not sure, but I think I might feel the same way. I want a job that I love, don't get me wrong. I'd never pick a specialty just based on the money. But I also know that out in the real world I'd be making bank. Money is not just a material thing. Perhaps it's unfortunate, but in the western world money is often synonymous with opportunity. It's freedom, in a lot of ways. It has a tremendous impact on your life and your family's life and children's futures. It's not about materials, it's about options. And I'd be pissed if I saw that happen in my less-driven and often less "intellectually-capable" colleagues and not myself...because I'm driven and I get results...and if that happened, it'd be because I somehow "chose" that path. So yeah, I'd be pissed.

 

[mikedc813]

Your time is your most precious asset. This becomes more and more clear the older you get and as soon as you get married and have kids. 250k/yr working 40h per week as an EP just might be worth more than 500/yr working 60h per week as a radiologist. (I can do math, and I know that is double the money for 1.5x the hours.... but marginal value is at play here, folks).

It is SO tiring to hear the rote warcry: "Do what you love, not what makes money!" You must remember that money can buy you a house and put your kids in college and send your family on vacations.... and those are things that I definitely love more than working.

That said, it is different for everybody and you have to find the right combination of passion and lifestyle that suits YOU. My only piece of advice is: please, please, please get started early. I bounced through EVERY specialty on the planet and was convinced that I wanted to do Radiology on Sep 1st (the day your ERAS is due!). Turns out that I don't want to do Radiology and it took me ALOT of thought and effort to realize that. Start at the beginning of Med3 and see EVERY area you can until you figure it out. Something will eventually feel "right."

Good luck!

I agree with this overall. You certainly need to find something you find interesting that you would enjoy doing for the rest of your career, but there is a practical side you should consider as well. If you love something like ob/gyn or surgery where you're working all the time, you sacrifice time with your kids (if you have any), so that may not be the best thing in the end. Lifestyle is an important aspect to any residency program whether people want to admit it or not. I'd rather work fewer hours or take a less paying job to spend time with my family.

 

[Mace1370]

So, you'd hate yourself with your friends making twice as much even if they were miserable, divorced and working ungodly hours after residency? It is ignorant to say finances don't matter, but it shouldn't be in the top 2 or 3 of your list.

Money isn't in my top 2 or 3 reasons to choose a particular specialty, but to imply that there should be universal set of priorities for all future doctors is a little silly. Money matters more to some than others, and that's fine.

 

[CyberKnife19]

I agree with this overall. You certainly need to find something you find interesting that you would enjoy doing for the rest of your career, but there is a practical side you should consider as well. If you love something like ob/gyn or surgery where you're working all the time, you sacrifice time with your kids (if you have any), so that may not be the best thing in the end. Lifestyle is an important aspect to any residency program whether people want to admit it or not. I'd rather work fewer hours or take a less paying job to spend time with my family.

👍👍 Great minds think alike (and go into Radiation Oncology).

 

[muhali3]

👍👍 Great minds think alike (and go into Radiation Oncology).

How is Rad Onc btw, i've heard some people say it's a lifestyle specialty and some say it's not. The residency hours/week seem nice.

 

[Asklepian]

http://www.amazon.com/Ultimate-Choosing-Medical-Specialty-ebook/dp/B0026REAOC

This book is pretty sweet...

 

[naus]

What are the hours like for ENT anyway? Is it really better than the other surgical specialties (aside from Uro)? How is ENT call?

ENT seems pretty fascinating, except the ear tubes and tonsil part, which seems to dominate most of private practice.

I wish CT surgery didn't go through general surgery first.

 

[txprodigal]

What are the hours like for ENT anyway? Is it really better than the other surgical specialties (aside from Uro)? How is ENT call?

ENT seems pretty fascinating, except the ear tubes and tonsil part, which seems to dominate most of private practice.

I wish CT surgery didn't go through general surgery first.

integrated CT exists if you're interested btw

 

[slowbutsteady]

There is a magical place that has the info you seek. It's called...... the time in medical school between Step 1 and ERAS.

Yeah, but I am third year and will soon have to pick my 4th year schedule and electives. Knowing what I want to do is very important for those decisions, so I am feeling the pressure NOW to have some idea what I want.

 

[scrubswannabe]

So I'm a first year just reading this thread and I know I'm going to be in the EXACT same position two years from now when I have to decide on a specialty.

I want to do research this summer because I can and everyone says it's very helpful to start research early on. My question then is if you have no idea what you want to go into - and arent sure whether or not you want to do surgery even - how do you know what to do research in?

What did you all do? What would be most helpful? And I'm sorry- I don't mean to hijack the thread - I just think this is directly related and the best place to ask

 

[Mace1370]

So I'm a first year just reading this thread and I know I'm going to be in the EXACT same position two years from now when I have to decide on a specialty.

I want to do research this summer because I can and everyone says it's very helpful to start research early on. My question then is if you have no idea what you want to go into - and arent sure whether or not you want to do surgery even - how do you know what to do research in?

What did you all do? What would be most helpful? And I'm sorry- I don't mean to hijack the thread - I just think this is directly related and the best place to ask

No one expects all of your research to be in the same field, let alone the field you end up applying to.

Also, when you first start doing research you probably aren't going to start with a huge study. I would start with a case report to get your feet wet. Just find an area of medicine that interests you now (however superficial that interest may be) and do a case report in that area. These are very easy to do and there is probably even a physician at your school that could co-auther it and help you work through it. This is helpful because by the time you do make it to third or fourth year you will have this step under your belt and can do a larger research project in the field you are going to apply to.

 

[MossPoh]

Money isn't in my top 2 or 3 reasons to choose a particular specialty, but to imply that there should be universal set of priorities for all future doctors is a little silly. Money matters more to some than others, and that's fine.

I very clearly said it is ignorant to say it doesn't matter. 😉

The major point is that reimbursement is subject to much greater change than nearly any other factor in one's decision. When you look at a field like radiology, there has been huge sinusoidal patterns in payments/income. The real old school radiologists made bank for doing very very little relative to other specialties. Then, in the mid 60s to early 70s the technology stagnated for a little bit and the salaries dipped off. Anyone that was a good student would never dream of going into radiology. It was a "waste of your talent" as they told my dad. Then the CT came into the game and shortly thereafter MRI. All of a sudden, they were commanding huge amounts of money again but were still reading <100 cases a day. (80 MIGHT have been a busy day) The last 10-15 years, the technology has become so commonplace and so fast, that the money per case started to drop significantly. Obviously there aren't a bunch of starving radiologistis, but the docs in PP have to work significantly harder to net the same income they did back in the day. An AVERAGE day at the small hospital (where I also did usability research) was 110-115 cases per doc. That number would spike to around 180-200 cases on a really busy day, especially if someone else had to dip out.

The one thing that would make that increase in work tolerable is not the money as much as truly enjoying what they are doing. Is the money nice? Hell yea it is, but nearly every study shows that relative happiness begins to plateau around the 180-200k mark. There just isn't that much more you can provide for your family once you get above that level. A bigger boat, a nicer watch, higher end hotels, all the extras on your new car including the undercarriage spraying but the overall happiness derived from the experience doesn't improve much. I much rather have a Ferrari than a souped up corvette or bmw M3, but having driven all of them, I can say that the adrenaline rush when you punch it or whip around a corner suffices with all 3. 😛

 

[deuist]

I wish CT surgery didn't go through general surgery first.

There are several routes to CT. The most common is 5 years of gen surg, followed by 2-3 years of fellowship. The other options are:

1) 6 years of integrated CT surgery.

2) 5 years of integrated vascular surgery, followed by a CT fellowship.

3) 4 years of general surgery, plus 3 years of CT surgery.

 

[gravitywave]

Which one resonates most with you?

Upper Left = Plastics
Upper Right = Ortho
Bottom Left = Derm
Bottom Right = Voodoo

Or you could listen to advice similar to what is posted above. Money is important, but since nobody knows how reimbursements will shift in the next 5-10-20 years, don't let it drive your decision too heavily.

i totally picked voodoo, before looking at what they meant. haahaaaa