Internal Medicine Subspecialties...

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Cardiology - might as well have been a surgeon

Nephrology - aces and arbs all day

GI - scope scope scope

Pulmonary/CC - ?

Beyond these basic stereotypes, what are the pros and cons of these fields? I am interested in all four, but don't know how it will play out in the long run. Does anyone out there know enough about any one of these careers to comment?

For example, I have been on nephrology rotation the past few weeks and it seems like a great field, except for the sick sick sick dialysis patients. Is it worth going into nephrology despite these patients who have 20-30 complicated diseases and end up in the hospital very frequently?

Same goes for the other specialties? How do they compare in terms of hours, patient population, what physicians going into that field are looking for, and other pros/cons???

Please help!
Thanks.

 

[Annette]

Cardiology - might as well have been a surgeon
Nephrology - aces and arbs all day
GI - scope scope scope
Pulmonary/CC - ?

Beyond these basic stereotypes, what are the pros and cons of these fields?
. . . .

How do they compare in terms of hours, patient population, what physicians going into that field are looking for, and other pros/cons???

Please help!
Thanks.

Kind of broad, but I'll give it a stab.

There are several types of cardiologists. The general cardiologist specialized in the medical managment- few procedures, mainly older patients. Clinic hours. EP specializes in ablations, pacemaker, AICD implants- lots of procedures, mainly older patients, longer hours than clinic, but not so bad. Interventional cardiologists- lots and lots of procedures, long unpredicatable hours, in high demand, mega bucks, mainly older patients.

Nephrologists can specialize in transplantion as well as "general" nephrology. Some procedures (placing catheters for HD). Can have some very sick patients, can be interesting pathology.

GI's can specialize in hepatology as well as doing scopes, scopes, and more scopes. Most patients get well, but those that don't are really sick. Can also specialize in transplant. Scoping pays well (there aren't enough GI's to do all the recommended screening colonoscopies.) Wide range of patients.

Pulm/CC can be divided out. Pulm can be pretty much office based if you want. A moderate amount of procedures, some patients get better, but the majority only stablize or get worse. Wide range of patients. Can also include sleep medicine in here as well, which is a burgeoning specialty. Wide range of patients, office based, can have minimal patient contact if that is what you want.

CCM can be done without pulmonology, but it is not common. Lots of procedures, very sick patients. Can have long hours, wide range of patients. Interesting pathology. Lot of end of life care.

Heme/onc- wide range of patients, mainly office based, can have long hours. Can have very sick patients. Likely will be more in demand with the babyboomers getting older.

Rheumatology- FIBROMYALGIA (I didn't like my rheum rotation). Interesting pathology, wide range of patients. Mainly office based, get called a lot on the-what-the-hell-is-this? cases.

Endocrinology- wide range of patients, but tend to have limited ranges of pathology. Some procedures if you want to do them. Can have long hours. Very much in demand.

General practice- can set own hours, wide range of patients (you can fire the ones you can't stand.) Can have long hours. In high demand, but some would say this is because of poor reimbursement/ unfavorable work enviroments. Uncertain furture with competition from midlevels.

Hospitalist- not really a specialty, yet. Sees patients only in the hospital. Set hours, in demand. Somewhat of a "lifestyle" specialty. Can have long hours depending on set up. Wide range of patients, whom you can't really fire.

Chosing a specialty can be difficult. You need to remember to differentiate the attending vs the specialty vs the location. You may like the specialty because of the attending, or you may hate the way a specialty is practiced in a particular area. Do you best to talk with as many attendings as you can about the specialties. Check out the national societies as well to get more information.

 

[drfunktacular]

Thanks for that insight, Annette.

Could you add your impressions of ID to your post?