IM Subspecialties with good lifestyle

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

nanobot1

Full Member
10+ Year Member
Joined
May 8, 2013
Messages
13
Reaction score
0
MS3- So I am pretty set on IM mainly because I like the variety and thinking aspect. But I also want something with good lifestyle and time to do other activities (ie research, teaching)
Any advice or input on any of the following IM Subspecialties:

Allergy and Immunology
Rheumatology
Endocrinology
Hematology/Oncology

Members don't see this ad.
 
Last edited:
MS3- So I am pretty set on IM mainly because I like the variety and thinking aspect. But I also want something with good lifestyle and time to do other activities (ie research, teaching)
Any advice or input on any of the following IM Subspecialties:

Allergy and Immunology
Rheumatology
Endocrinology
Hematology/Oncology
Most of them don't pay as well and require added years of training. Why not just work less hours in IM?
 
It seems like general IM gets dumped with lot of patients that other specialties don't want to handle. Also don't want to get stuck referring to other specialists in the end.
I don't mind the lower salary and wouldn't mind doing one of above subspecialties plus general IM in the mix too. I have seen attendings who have done both.
 
Members don't see this ad :)
Most of them don't pay as well and require added years of training. Why not just work less hours in IM?

they still get paid a lot tho... maybe endo not so much but allergy/hem, onc is paid pretty well... 200k+ easily maybe even 300k for hem onc
 
they still get paid a lot tho... maybe endo not so much but allergy/hem, onc is paid pretty well... 200k+ easily maybe even 300k for hem onc
I think Oncology is a lot closer to 350-400k. Medscape puts the average at 330, and that seems super low. I've seen other numbers floating around that are much higher.
 
MS3- So I am pretty set on IM mainly because I like the variety and thinking aspect. But I also want something with good lifestyle and time to do other activities (ie research, teaching)
Any advice or input on any of the following IM Subspecialties:

Allergy and Immunology
Rheumatology
Endocrinology
Hematology/Oncology
If you want to research and teach, then I assume you want to be in an academic or university setting. Depending on where you are, research and teaching don't necessarily mean a good lifestyle. It's not like you just casually do some cancer "research" here and there, not if you want to do good research, move up the academic ladder, and all that stuff.

I think you can have a good lifestyle in any IM subspecialty, or just general IM, not just those four. Even in cardiology and pulm/ccm which are usually the ones considered to have the worst lifestyles. You will just have to tradeoff not making that much money. Or you will have to set up your practice the right way and have your partners agree. For example, in pulm/ccm you can do mostly outpatient pulm for a good lifestyle. Actually pulm only is not a bad choice if you only care about lifestyle. The ICU is hard though.

I think Allergy and Immunology, Rheumatology, and Endocrinology can all eventually reach $275K-$300K with a decent lifestyle, unless you want to work in someplace like California or NYC. These three probably do have the best lifestyle (almost all outpatient, regular hours, few emergencies, minimal call, etc.). Hematology/Oncology can eventually reach $400K or more with a decent lifestyle, unless you want to live in a place like NYC, but depending on your personality it might be difficult to deal with cancer patients, there's probably more of a call burden than the other three.
 
OP: "What are the subspecialties with the best lifestyles? I'm not really worried about how much it pays."
SDN: "Yeah hold your horses there OP money is the only thing we're interested in talking about so we're going to just make a bunch of vague estimates on what you would make in each of those fields."

Anyway, seems like you've got all the lifestyle subspecialties listed. The other IM subspecialties tend to end up with a worse lifestyle unless you "set it up right" but it seems like the typical doctors in cards/gi/etc do not end up being able to "set it up right".
 
If you want to research and teach, then I assume you want to be in an academic or university setting. Depending on where you are, research and teaching don't necessarily mean a good lifestyle. It's not like you just casually do some cancer "research" here and there, not if you want to do good research, move up the academic ladder, and all that stuff.

I think you can have a good lifestyle in any IM subspecialty, or just general IM, not just those four. Even in cardiology and pulm/ccm which are usually the ones considered to have the worst lifestyles. You will just have to tradeoff not making that much money. Or you will have to set up your practice the right way and have your partners agree. For example, in pulm/ccm you can do mostly outpatient pulm for a good lifestyle. Actually pulm only is not a bad choice if you only care about lifestyle. The ICU is hard though.

I think Allergy and Immunology, Rheumatology, and Endocrinology can all eventually reach $275K-$300K with a decent lifestyle, unless you want to work in someplace like California or NYC. These three probably do have the best lifestyle (almost all outpatient, regular hours, few emergencies, minimal call, etc.). Hematology/Oncology can eventually reach $400K or more with a decent lifestyle, unless you want to live in a place like NYC, but depending on your personality it might be difficult to deal with cancer patients, there's probably more of a call burden than the other three.
out of curiosity, when you say "unless you want to live in california or NYC", what are you qualifying? you're saying the pay would be different, or the hours would be different? and how so?
 
I've never thought of heme/onc as a "lifestyle" subspecialty of IM as I would the other 3 listed in the OP.
 
I think Oncology is a lot closer to 350-400k. Medscape puts the average at 330, and that seems super low. I've seen other numbers floating around that are much higher.
mgma says closer to 430.

Endocrine and rheum are 250's . Seems a little counterproductive to train more to get paid less as Papa has some loans to pay, but different strokes .
 
What about GI?

For GI it depends whether you are private or academic. I hear private practice may not be so bad just scoping one day and clinic on other day. On academic side I always see GI attendings running back and forth between clinic, hospital, and doing endoscopies.
 
mgma says closer to 430.

Endocrine and rheum are 250's . Seems a little counterproductive to train more to get paid less as Papa has some loans to pay, but different strokes .

Endocrine and rheu docs see only 12-15 pts/day and work 4 days per week to hit those numbers though. But, there are other specialties out there allowing you to have the same lifestyle and slightly more income for just 4 years of training after med school.
 
Members don't see this ad :)
mgma says closer to 430.

Endocrine and rheum are 250's . Seems a little counterproductive to train more to get paid less as Papa has some loans to pay, but different strokes .
Agree... But being a PCP sucks.

Can hospitalist make 300k working ~50 hrs/wk?
 
Agree... But being a PCP sucks.

Can hospitalist make 300k working ~50 hrs/wk?
I think they can. 2 week on 2 week off 300K in the midwest is pretty standard from my understanding. The mgma data indicates 250-279. It is also 3 years old.
 
  • Like
Reactions: W19
I think they can. 2 week on 2 week off 300K in the midwest is pretty standard from my understanding. The mgma data indicates 250-279. It is also 3 years old.

If you do a week on, you're likely going to work about 10hrs a day, if seeing an average of 15 a day assuming you're admitting and DC 3 a day for 18 encounters. That's ideal but it can vary and you might be closer to 14 to 20 encounters a day.
That's about 7-12hrs of actual work a day. You can make much more than all of those specialties. If you work 3x 7 on/off weeks a year at 150/hr your gross pay is 468k a year if your contract assumes you're there 12h a shift.
 
Last edited:
If you do a week on, you're likely going to work about 10hrs a day, if seeing an average of 15 a day assuming you're admitting and DC 3 a day for 18 encounters. That's ideal but it can vary and you might be closer to 14 to 20 encounters a day.
That's about 7-12hrs of actual work a day. You can make much more than all of those specialties. If you work 3x 7 on/off weeks a year at 150/hr your gross pay is 468k a year if your contract assumes you're there 12h a shift.
im unsure how sustainable that is considering the 90th percentile for 3-7 years out of residency is 350 for hospitalists. I know a few people who do week on week off and frankly they are exhausted after the week and recuperate for a day or two after the week just to get back to baseline.
 
out of curiosity, when you say "unless you want to live in california or NYC", what are you qualifying? you're saying the pay would be different, or the hours would be different? and how so?

NYC and much of California are oversaturated markets for physicians. As a result you will make less money and will work much harder and be in constant competition with established docs. If you are in a procedure based specialty, you may see a "loosening" of indications for a procedure as well
 
Actually rotated in Endo and rheum... Rheumatology is more chill I think compared to Endo..but it depends where you work and if it's inpt...my Endo rotation I did in pt and they got a good list of consults..rheum not so much..it's more clinic, which is what I mostly observed...

Sent from my Moto G (5) Plus using SDN mobile
 
I was under the impression that heme/onc can be close to as demanding as GI/cards at times... not so cush like the rheum/allergy/Endo/ID areas.


Sent from my iPhone using SDN mobile
 
I was under the impression that heme/onc can be close to as demanding as GI/cards at times... not so cush like the rheum/allergy/Endo/ID areas.

How so? I thought those subspecialties that involve procedures (GI, Cards, Pulm/CC) tend to be more demanding. But I can see Heme/Onc being a little busier than rheum/allergy/Endo with overnight calls but nothing to have to come into hospital overnight.
 
Heme/Onc =/= Outpatient cancer visits. They probably (because idk) deal with sickle cell patients, inpatient chemo complications (infections, pain, neuro, etc), etc.
 
Last edited:
Heme/Onc =/= Outpatient cancer visits. They probably (because idk) deal with sickle cell patients, inpatient chemo complications (infections, pain, neuro, etc), etc.

I’m sure it varies but most of the heme oncs I saw did very little in patient. It was actually like pulling teeth getting them to see some families in the ICU because they were never at the hospital. Granted this was a well established group so they weren’t fighting for patients but they had great hours. Some only 4days/week, maybe ~20 patients/day.
 
GI

You scope outpatient only M-Thur (8a-1pm) and you will make at least 300k/yr. I know a couple of docs in my town who do that.
 
Last edited:
Most of them don't pay as well and require added years of training. Why not just work less hours in IM?
Agree.

There are 2 hospitalists at my shop that work ~9 days for every 28 days. They bank a little over 200k/yr based on our rate.
 
Agree.

There are 2 hospitalists at my shop that work ~9 days for every 28 days. They bank a little over 200k/yr based on our rate.
What part of country is this? That sounds like a very good deal for only 9 days of work every 28 days. Is it open or close icu and how many patients they carry/ admit each day?
 
What part of country is this? That sounds like a very good deal for only 9 days of work every 28 days. Is it open or close icu and how many patients they carry/ admit each day?
Southeast. Semi open ICU (we don't take care of patients on vent and you can always ask the intensivist to co-manage with you). No procedures, no codes,. Average 16-17 patients with usually 1 admit per day.

The contract is 7 days on and 21 days off for 165k/yr, but they always need people to work; therefore, you can work an extra 2-3 days per month to make an additional 40k+ if you want to.
 
Top