postbacpremed87

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What specialty do you pursue when nothing really excites you? I thought about Pathology for the longest time but the job market has me scared. I will be in my mid 30s after a 4 year residency and will just want to be done at that point. I don't want to worry about finding a job at age 35. I am a 3rd year on clinical rotations and have done well so far (honored IM) and have a decent Step 1 (239). I honestly just want a job with a good income (250k+) and one that has a stable job market. Do you know anyone that was kind of meh about medicine after a while and just went into something for stability/good money/good time off? Any suggestions?
 

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You could go into IM to postpone your decision about whether or not to further specialize (cards, GI, etc).
Hmm... doesn't sound like he would want that

I will be in my mid 30s after a 4 year residency and will just want to be done at that point.
 
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What specialty do you pursue when nothing really excites you? I thought about Pathology for the longest time but the job market has me scared. I will be in my mid 30s after a 4 year residency and will just want to be done at that point. I don't want to worry about finding a job at age 35. I am a 3rd year on clinical rotations and have done well so far (honored IM) and have a decent Step 1 (239). I honestly just want a job with a good income (250k+) and one that has a stable job market. Do you know anyone that was kind of meh about medicine after a while and just went into something for stability/good money/good time off? Any suggestions?
Ive been talking to a lot of people about this. I think I don't like medicine in general. At least not as much as I thought and people have suggested psych. Once you get past the stigma I think a lot of people could love it. Low risk, low stress, pay is great (225ish but MOST people in the surveys work part time), culture in residency seems awesome. Something to think about. I sure am.
 
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postbacpremed87

postbacpremed87

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Ive been talking to a lot of people about this. I think I don't like medicine in general. At least not as much as I thought and people have suggested psych. Once you get past the stigma I think a lot of people could love it. Low risk, low stress, pay is great (225ish but MOST people in the surveys work part time), culture in residency seems awesome. Something to think about. I sure am.
It's high on my list.
 
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It's high on my list.
People have also suggested anesthesia and radiology to me.

I think both take a special type of personality and hard to know whether you fit that bill without exposing yourself to it. They exist outside of the normal grind of IM and more "mediciny" specialties like neuro. They have their own problems for sure and you'd have to go into them with eyes wide open.

I saw you post in the neuro subforum and I don't know if you have done your neuro rotation yet but its really just medicine as it affects the brain so if you are "meh" on medicine then neuro might not be for you. However, neuro topics can be interesting enough to offset that. It is for me. Keep in mind that the hours are longer, the call is bad, a fellowship is often mandatory pushing things to 5 years, and after all that the compensation isn't great. Before anyone signs up for neuro I hope they really know that its for them.
 

Mad Jack

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Ive been talking to a lot of people about this. I think I don't like medicine in general. At least not as much as I thought and people have suggested psych. Once you get past the stigma I think a lot of people could love it. Low risk, low stress, pay is great (225ish but MOST people in the surveys work part time), culture in residency seems awesome. Something to think about. I sure am.
The patient population is the hard part though. Not everyone is cut out for dealing with psych patients day in and day out.
 

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Ive been talking to a lot of people about this. I think I don't like medicine in general. At least not as much as I thought and people have suggested psych. Once you get past the stigma I think a lot of people could love it. Low risk, low stress, pay is great (225ish but MOST people in the surveys work part time), culture in residency seems awesome. Something to think about. I sure am.


I'm just gonna drop this here for no reason in particular.
 
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postbacpremed87

postbacpremed87

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People have also suggested anesthesia and radiology to me.

I think both take a special type of personality and hard to know whether you fit that bill without exposing yourself to it. They exist outside of the normal grind of IM and more "mediciny" specialties like neuro. They have their own problems for sure and you'd have to go into them with eyes wide open.
I want a clear cut path where my residency gets me the job. I really don't want to tack on fellowships. That's why a 4 year Psych residency is appealing. 4 years and then done - no need for extra training. I also have exposure to Psych through extracurriculars. Yes the pay in Psych is lower, but compared to what? Psychs pay blows away most non-medicine jobs and even a few medicine ones.
 
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postbacpremed87

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Because you can only deal with mental illness day in and day out for so long before you lose your mind.
If they are getting on your nerves you can always finish your visit and then leave, sip coffee in your office, type your note, and then move on to the next. I keep telling myself that they can't help it and I always wonder how they got here to this point.
 

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If they are getting on your nerves you can always finish your visit and then leave, sip coffee in your office, type your note, and then move on to the next. I keep telling myself that they can't help it and I always wonder how they got here to this point.
Personally I don't find it draining, but many people that go into psychiatry have no love of psychiatric patients and ended up in the field because they weren't competitive enough for anything else. The patient population is no joy to deal with when it wasn't what you wanted to do in the first place.
 
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postbacpremed87

postbacpremed87

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Personally I don't find it draining, but many people that go into psychiatry have no love of psychiatric patients and ended up in the field because they weren't competitive enough for anything else. The patient population is no joy to deal with when it wasn't what you wanted to do in the first place.
I think that people have become more empathetic in the last few years.... I mean look at the rise in applications to Psychiatry residency. :rolleyes:
 

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If they are getting on your nerves you can always finish your visit and then leave, sip coffee in your office, type your note, and then move on to the next. I keep telling myself that they can't help it and I always wonder how they got here to this point.
Do you have any experience in psych? You could say the same thing about any other specialty, just ignore your patients and sip coffee in your office. You'll also have the nurses calling you all day because your inpatients are bashing their head against the wall and throwing feces around, and your outpatient stopped their bipolar meds because they felt so wonderful, but now they are spiraling down in the worst depression. Ignore them long enough (and the other doctors consulting you when their patient is suicidal) and you're out of a job. An MD isn't a free license to print money.
 

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I think that people have become more empathetic in the last few years.... I mean look at the rise in applications to Psychiatry residency. :rolleyes:
There are more US graduates than ever, and psych has hardly ticked up in competitiveness over the years. It's more of a function of the spot:candidate ratio than anything IMO.
 
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If they are getting on your nerves you can always finish your visit and then leave, sip coffee in your office, type your note, and then move on to the next. I keep telling myself that they can't help it and I always wonder how they got here to this point.
That is a very naive view of medicine and psychiatry. You don't just get to leave if the patient is getting on your nerves. Maybe you do if you're the med student, but when you're the one actually managing and responsible for the patient's medical care, that's not a luxury you get to have.
 
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postbacpremed87

postbacpremed87

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Do you have any experience in psych? You could say the same thing about any other specialty, just ignore your patients and sip coffee in your office. You'll also have the nurses calling you all day because your inpatients are bashing their head against the wall and throwing feces around, and your outpatient stopped their bipolar meds because they felt so wonderful, but now they are spiraling down in the worst depression. Ignore them long enough (and the other doctors consulting you when their patient is suicidal) and you're out of a job. An MD isn't a free license to print money.
Some experience but not extended periods of experience (read months).
 
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postbacpremed87

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That is a very naive view of medicine and psychiatry. You don't just get to leave if the patient is getting on your nerves.
I didn't mean leave the patient mid sentence. I meant finish the interaction professionally and then decompress over a cup of hot Java. What gives?
 

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I'd go with EM. Solid pay, 3 year residency and you don't bring your work home with you. It has a high burn out rate, which I honestly don't understand. I know several EPs that work 3 days/week and are out golfing, fishing or drinking on their off days. Maybe it's because of the little downtime there is during a shift?
 

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I'd go with EM. Solid pay, 3 year residency and you don't bring your work home with you. It has a high burn out rate, which I honestly don't understand. I know several EPs that work 3 days/week and are out golfing, fishing or drinking on their off days. Maybe it's because of the little downtime there is during a shift?
The cases can be intense, there's little downtime, the schedule can be erratic as shift work tends to be, and then there's all the paperwork and all the i's and t's you have to dot and cross. And when your beds are full and you have 50+ people in the waiting room, it doesn't end.

There's a really good documentary on Netflix called Code Black (not the TV show, it's a documentary that inspired the TV show) that was directed by a 4th year med student doing an away rotation in LA County ED. They do a great job of showing both the things that drew them to EM and the things that make it really hard and draining.


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It's really hard to decide what you want to do when you don't have much exposure to things. There are obviously people who do these jobs and get through, but I think a lot of the attrition is due to people coming in with an idealistic or naive view of the specialty. Find a mentor in the specialty you're considering and pick their brain. Find out why they like what they do and what sucks about what they do. Maybe that specialty is for you and it ends up being great, but then you went into it informed about what's to come.
 
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ConfusedChemist

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This is interesting. Why do you think this is?
because it's a common back-up, so there's probably way, way more people in it who didn't want to be and/or didn't know what they were getting in to.
Stats don't change you as an individual, keep that in mind
 

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OP, if you want to do path, do path. Its honestly a relatively straightforward choice. You will mostly be dealing only with other physicians and scientists (and of course administrators). The job market isn't great, but its not nearly as bad as people are saying, at least in my area. Certain big cities are going to be saturated, but if all you want is a good paying job, they're around, you just have to look and be willing to move.

Ismet also hit the nail on the head. A lot of med students make decisions about what to go into on whims or idealism. Look into the field, really learn what people in it love and what people hate, and if the things they hate seem bearable and the things they love are what you want to do for the rest of your life, go for it. Also be sure to look at burn out. Everyone is running to EM right now, its not for me, and one of the reasons is burnout.
 

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I'd go with EM. Solid pay, 3 year residency and you don't bring your work home with you. It has a high burn out rate, which I honestly don't understand. I know several EPs that work 3 days/week and are out golfing, fishing or drinking on their off days. Maybe it's because of the little downtime there is during a shift?
Probably lack of fulfillment. Your outcomes are measured in satisfaction scores and patient throughput rather than accuracy and quality of care. You don't get follow-up to see how the patients fared, except for the usual customers who come back again when they're either a) out of narctocis again or b) intoxicated beyond functioning. Couple that with your rather limited scope of practice because of specialists/administration boxing you in at academic centers or liability at more outlaying referral ERs. Finally, the lifestyle is great for a young doc who can handle the swings from days to nights and back again. Your back starts aching and your sleep becomes more of a necessity than a luxury and eventually the lifestyle is a drag. Sure, many ER docs still love it, but many burn out.
 

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I want a clear cut path where my residency gets me the job. I really don't want to tack on fellowships. That's why a 4 year Psych residency is appealing. 4 years and then done - no need for extra training. I also have exposure to Psych through extracurriculars. Yes the pay in Psych is lower, but compared to what? Psychs pay blows away most non-medicine jobs and even a few medicine ones.
The salary surveys of psych doc I have seen show that they work ~40 hrs/wk, so if one is willing to work more hours (~50), you probably can break in the 300s in term of salary.
 

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There are more US graduates than ever, and psych has hardly ticked up in competitiveness over the years. It's more of a function of the spot:candidate ratio than anything IMO.
Let's see what the next 'charting the outcomes' will say...
 

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How often does this burnout myth regarding EM need to be dispelled?

http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview#page=2

Every single specialty is between 40%-55% burnout rate. It seems half of everyone, regardless of specialty, hates what they do. Burnout should not be a reason that you choose not to do EM. If you like EM or are interested in it, give it a shot.
wow if u cant see how EM is in a unique position suited for burnout then just lol @ u
 

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Why hasnt anyone mentioned FM? <50 hour easy weeks, 250k income, possibly 4 days a week, 3 year easy residency? Sounds pretty good...
 
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sloh

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If nothing interests you much, lifestyle should probably move up a couple places on your priority list. Perhaps, it should be #1. There are a couple specialties that are more likely to confer to you normal hours, not wrecking your circadian rhythm, and reasonable job prospects post-training. Ones that jump out to me are psychiatry, PM&R, derm (although very competitive)

I'd throw outpatient FM in there but unless you run a DPC/Concierge, you'll likely have to churn through patients every 15 minutes while deferring most of your documentation for after work (uncompensated labor btw)
 

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Your Step 1 is a bit on the low side, but Derm certainly fills most of your criteria. I realize this thread has just become people hyping their own specialties, and I'm clearly no different here, but it's 4years of residency, job security/good money, and good lifestyle.
 

ConfusedChemist

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Why hasnt anyone mentioned FM? <50 hour easy weeks, 250k income, possibly 4 days a week, 3 year easy residency? Sounds pretty good...
THIS. Plus the huge amount of versatility of practice if you want it, i.e. obs, geriatrics, rural emerg... you can basically make your practice whatever it is you want