IR and DR have essentially equalized in competitiveness

[odyssey2]

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Looking at the NRMP charting outcomes released this year, DR match rate is 83% and IR's is 81%, average matched Step scores are equivalent between the two at 245 and 253 Step 1/2, respectively, and they hold a nearly identical AOA rate among the matched (19% vs 20% DR and IR). DR was once known as a universal "backup" for IR residents but I don't think that is any longer the case. Has the hype for IR died down, and that combined with DR's rise in popularity made the two fields equivalent in competitiveness?

 

[Cognovi]

Yes

 

[NDcienporciento100]

It turns out a subset of people like making 500k +/year with between 9-20 weeks vacation. In some cases they don’t even have to leave there house!

 

[qxrt]

DR has a lot going for it currently. Ability to work from home, hot job market with increasing salaries and ability to find a job in virtually any location, and desk job without having to deal with clinical medicine/seeing patients.

The IR job market is tougher - it's good too, but not nearly as easy to find a job in certain toughest markets as DR is. Plus, you are tied down to the area near the hospital where you work - can't do IR remotely.

I think it's not so much that IR is getting less popular, it's more that DR is currently difficult to beat in terms of perks for many people.

 

[.Asterion]

Current DR resident who was interested in IR as a medical student. Very glad I went with DR. I love procedures and whatnot but IR lifestyle is trash and 99% of private practice IR docs aren't doing interesting oncology cases--they're doing boring port management or draining tiny abscesses surgery doesn't want to deal with after 5pm on Friday.
Also IR has very little political power in the hospital which means people can dump whatever one you and if there's disagreement the CEO will tell you to do it (example about, stuff dumped on you after 5pm on Friday).
DR has none of these problems and private practices are desperate for DR docs to do IR-light in between reading cases so if you like procedure you can still get your fix in DR.

 

[NDcienporciento100]

DR is a great field for those that love the imaging aspect. Right now the DR job market is fire. You can find total remote jobs making 500k 1 week on 2 weeks off.

IR is completely different. You have to be excited about trying to build a practice and work to build it. Work and effort that your dr colleges will care little for. There often times interested in whatever makes there list smaller unfortunately. For this reason more and more IRs are going to work for a hospital, or work/start OBLs or go academic. Good luck trying to do high end ir in some little Dr group you will have an up hill battle on all fronts, the hospital your partners none of them will be happy about it. Big groups that cover big hospitals like it or not have contracts that say you get to read the very profitable negative 20 yo brain mri but you also have to be available for the emergent tips. So like it or not DR if you want those big hospital contracts you have to hire competent IR.

 

[ZJz4]

Looking at the NRMP charting outcomes released this year, DR match rate is 83% and IR's is 81%, average matched Step scores are equivalent between the two at 245 and 253 Step 1/2, respectively, and they hold a nearly identical AOA rate among the matched (19% vs 20% DR and IR). DR was once known as a universal "backup" for IR residents but I don't think that is any longer the case. Has the hype for IR died down, and that combined with DR's rise in popularity made the two fields equivalent in competitiveness?

It is also one cycles worth of data.

 

[SeisK]

It is also one cycles worth of data.

Two cycles, same year. The fellowship match was also abysmal with 50% of programs unfilled.

 

[GoPelicans]

Current DR resident who was interested in IR as a medical student. Very glad I went with DR. I love procedures and whatnot but IR lifestyle is trash and 99% of private practice IR docs aren't doing interesting oncology cases--they're doing boring port management or draining tiny abscesses surgery doesn't want to deal with after 5pm on Friday.
Also IR has very little political power in the hospital which means people can dump whatever one you and if there's disagreement the CEO will tell you to do it (example about, stuff dumped on you after 5pm on Friday).
DR has none of these problems and private practices are desperate for DR docs to do IR-light in between reading cases so if you like procedure you can still get your fix in DR.

Is this still true? Feels like most places IR is relief upon to do basically everything involving a needle (besides mamo)

 

[guytakingboards]

Is this still true? Feels like most places IR is relief upon to do basically everything involving a needle (besides mamo)

In my group, they love if a non-IR person can sit in a hospital body seat and knock out the US/CT-guided biopsies/drains in addition to GI fluoro. Gives the schedulers alot more flexibility. Sometimes the IR rads get stuck in big vascular or biliary cases and there needs to be someone else to knock out the simpler cases.

 

[SeisK]

In my group, they love if a non-IR person can sit in a hospital body seat and knock out the US/CT-guided biopsies/drains in addition to GI fluoro. Gives the schedulers alot more flexibility. Sometimes the IR rads get stuck in big vascular or biliary cases and there needs to be someone else to knock out the simpler cases.

I like the idea of doing procedures, but I would need to be part of the regular schedule like the rest of them. I’m not going to do procedures only when the IR is busy or unavailable. I’m happy to do it then too, but that means I’m going to be part of the regular scheduled cases when there ISNT a backup need.

 

[Tiger100]

Is this still true? Feels like most places IR is relief upon to do basically everything involving a needle (besides mamo)

That's a new trend. In many practice, even upper GIs and anything fluoro is done by IR.

 

[Splenda88]

As a hospitalist, I regret not doing DR... I like my job but I still think patient interactions are overrated since 70%+ don't care about their health.

DR and GI are arguably the best specialties in medicine in term of $$$ and lifestyle.

In my small city, there a couple GI docs that ONLY scope outpatient from 8-1pm M-Thur. I was told that brings 350-400k/yr by someone that is close to one of these docs.

 

[forchinet121]

As a hospitalist, I regret not doing DR... I like my job but I still think patient interactions are overrated since 70%+ don't care about their health.

DR and GI are arguably the best specialties in medicine in term of $$$ and lifestyle.

In my small city, there a couple GI docs that ONLY scope outpatient from 8-1pm M-Thur. I was told that brings 350-400k/yr by someone that is close to one of these docs.

The best specialty by far in terms of lifestyle and money is ophthalmology specifically retina surgery

 

[Tiger100]

The best specialty by far in terms of lifestyle and money is ophthalmology specifically retina surgery.

It is an extremely saturated field.

Derm is the best by far.

 

[CherryRedDracul]

Also IR has very little political power in the hospital which means people can dump whatever one you and if there's disagreement the CEO will tell you to do it (example about, stuff dumped on you after 5pm on Friday).

That was a huge sticking point for me that became very apparent to me during residency training and a big reason why I stuck with DR rather than go the ESIR route.

 

[qwerty89]

The IR Hospitalist: Hospital MVP or Glorified Trash Collector? – Line Monkey MD

linemonkeymd.com

 

[bronx43]

It is an extremely saturated field.

Derm is the best by far.

Derm can be saturated too in many places, especially with the influx of PE and midlevels… not to mention the high volumes and often difficult to please patient population.

Would take GI and DR all day everyday over derm.

 

[ProReduction]

It is an extremely saturated field.

Derm is the best by far.

Yeah I had to do a quadruple take when I read this. Retinal surgeons are well-paid, but with more and more of them being employed and with PE take-overs they can be doing 30-40 cases per day and are extremely busy. It is true conveyor belt work. I would not consider this a great lifestyle but to each their own. You can make just as much money with a more chill lifestyle in many other fields.

 

[GadRads]

Yeah I had to do a quadruple take when I read this. Retinal surgeons are well-paid, but with more and more of them being employed and with PE take-overs they can be doing 30-40 cases per day and are extremely busy. It is true conveyor belt work. I would not consider this a great lifestyle but to each their own. You can make just as much money with a more chill lifestyle in many other fields.

What fields offer a chill lifestyle and good remuneration?

 

[forchinet121]

Yeah I had to do a quadruple take when I read this. Retinal surgeons are well-paid, but with more and more of them being employed and with PE take-overs they can be doing 30-40 cases per day and are extremely busy. It is true conveyor belt work. I would not consider this a great lifestyle but to each their own. You can make just as much money with a more chill lifestyle in many other fields.

Name 3 other fields where you can make as much as a retina surgeon (1M) while working less (40hrs a week)

 

[ProReduction]

Name 3 other fields where you can make as much as a retina surgeon (1M) while working less (40hrs a week)

I know 2 retina surgeons on the conveyor belt. Neither makes 1 million a year and both work way more than 40 hours a week. I'd love to know where these numbers are coming from, so please share. They live in LA and NYC and average 120+ cases a week, 500k-800k per year, 7-9 years out of training. They routinely work 10 hour days 5 days a week. I'm sure they would jump ship for 1 mill and a 40 hour work week, assuming it is not in the midwest or south.

 

[forchinet121]

I know 2 retina surgeons on the conveyor belt. Neither makes 1 million a year and both work way more than 40 hours a week. I'd love to know where these numbers are coming from, so please share. They live in LA and NYC and average 120+ cases a week, 500k-800k per year, 7-9 years out of training. They routinely work 10 hour days 5 days a week. I'm sure they would jump ship for 1 mill and a 40 hour work week, assuming it is not in the midwest or south.

How Much do Retina Specialists Make?

Curious to get input on what you heard new grads make. I've heard that it's not uncommon to earn $600,000 out of fellowship... although these were anecdotal and there is no way to know if those numbers are true. Many people view it as the most lucrative field in ophthalmology. Kind of sounds...

forums.studentdoctor.net

 

[ProReduction]

Only two or so posters mentioned that it is common to clear 7 digits in Retina, and one of the two mentioned seeing 65+ patients per day. The consensus from the thread was that 7 digits is not common for Retina. Again, to each his own, but there is nothing chill about seeing 65 patients per day, no matter how quickly you see them.

I like to answer these types of queries with actual data, not vague posts. It is well known in CA that both UCLA and UCI health systems are "eat what you kill" payment models for physicians, where a MD can approach private practice numbers elsewhere in the country. I ran the number for all the Retina specialists at UCLA and UC Irvine. I even excluded the two physicians that are clearly junior and making around 300k, to better reflect mid to late career salary. Before saying "that is academics", just know that at UCLA and UCI proceduralists commonly make more than private practice physicians in SoCal:

Data: [695855,697238,776845,514783,323138,529823,1056000,427881,708928]
Min: $323,138
Max: $1,056,000
Mean: $636721
SD: $216,808

You can do the same at Transparent California

 

[forchinet121]

Only two or so posters mentioned that it is common to clear 7 digits in Retina, and one of the two mentioned seeing 65+ patients per day. The consensus from the thread was that 7 digits is not common for Retina. Again, to each his own, but there is nothing chill about seeing 65 patients per day, no matter how quickly you see them.

I like to answer these types of queries with actual data, not vague posts. It is well known in CA that both UCLA and UCI health systems are "eat what you kill" payment models for physicians, where a MD can approach private practice numbers elsewhere in the country. I ran the number for all the Retina specialists at UCLA and UC Irvine. I even excluded the two physicians that are clearly junior and making around 300k, to better reflect mid to late career salary. Before saying "that is academics", just know that at UCLA and UCI proceduralists commonly make more than private practice physicians in SoCal:

Data: [695855,697238,776845,514783,323138,529823,1056000,427881,708928]
Min: $323,138
Max: $1,056,000
Mean: $636721
SD: $216,808

You can do the same at Transparent California

The consensus was if you’re a partner you should not be making less than 7 figures and that is for 40 hours a week give or take

 

[Tiger100]

Derm can be saturated too in many places, especially with the influx of PE and midlevels… not to mention the high volumes and often difficult to please patient population.

Would take GI and DR all day everyday over derm.

The consensus was if you’re a partner you should not be making less than 7 figures and that is for 40 hours a week give or take

"IF you are a partner"
Ask a new grad about it.

Just to give you an example in Radiology: If you become a partner in a radiology group who owns its own imaging equipment, you can easily make high 6 figures. Out of 100 radiology jobs, only 7-8 are like that and those jobs are usually in small towns in midwest. In coastal areas, these kind of groups still exist but never offer partnership or some of them have 8-9 years partnership tracks.

 

[forchinet121]

"IF you are a partner"
Ask a new grad about it.

Just to give you an example in Radiology: If you become a partner in a radiology group who owns its own imaging equipment, you can easily make high 6 figures. Out of 100 radiology jobs, only 7-8 are like that and those jobs are usually in small towns in midwest. In coastal areas, these kind of groups still exist but never offer partnership or some of them have 8-9 years partnership tracks.

The consensus was if you want to be partner you can be and it’s achievable for any retina grad given they are flexible with location, etc

 

[ProReduction]

"IF you are a partner"
Ask a new grad about it.

Just to give you an example in Radiology: If you become a partner in a radiology group who owns its own imaging equipment, you can easily make high 6 figures. Out of 100 radiology jobs, only 7-8 are like that and those jobs are usually in small towns in midwest. In coastal areas, these kind of groups still exist but never offer partnership or some of them have 8-9 years partnership tracks.

Thank you. What med students and current residents do not understand is that in medicine there are only two ways to make 7 figures:

1) You bust your butt. If you are a proceduralist, this means doing tons of procedures. This means you are working hard. You are not working 40 hours a week. If you are a non-proceduralist, you see a ton of patients. Not 20 per day but 40+ per day. This means you are working hard. You are not working 40 hours a week. Granted, it is possible for almost any specialist to clear 7 figures this way.

2) You "own" something, either the practice or ancillary services that generate revenue (surgicenter, staffing, etc.). Wearing the crown makes you a business owner, something that very few doctors are trained to manage. As mentioned previously, the power-holders that already own these things set up barriers to keep you, the non owner MD, in your place and on the conveyor belt making money for them. Yes, there are more opportunities in rural areas than in NYC, LA, Miami.

There is no free lunch in medicine. If you are making 7 figures then you are working for it or have assumed the burden and reward of ownership. Any "get rich quick" phenomenon in medicine (Dialysis centers in the 1990s, Sleep studies in the early 2000s, LASIK now) crashes in time.

 

[forchinet121]

Thank you. What med students and current residents do not understand is that in medicine there are only two ways to make 7 figures:

1) You bust your butt. If you are a proceduralist, this means doing tons of procedures. This means you are working hard. You are not working 40 hours a week. If you are a non-proceduralist, you see a ton of patients. Not 20 per day but 40+ per day. This means you are working hard. You are not working 40 hours a week. Granted, it is possible for almost any specialist to clear 7 figures this way.

2) You "own" something, either the practice or ancillary services that generate revenue (surgicenter, staffing, etc.). Wearing the crown makes you a business owner, something that very few doctors are trained to manage. As mentioned previously, the power-holders that already own these things set up barriers to keep you, the non owner MD, in your place and on the conveyor belt making money for them. Yes, there are more opportunities in rural areas than in NYC, LA, Miami.

There is no free lunch in medicine. If you are making 7 figures then you are working for it or have assumed the burden and reward of ownership. Any "get rich quick" phenomenon in medicine (Dialysis centers in the 1990s, Sleep studies in the early 2000s, LASIK now) crashes in time.

As a surgical specialist partner you own part of a surgery center which makes a portion of your income, that’s why the partners are making 1M+

 

[ProReduction]

As a surgical specialist partner you own part of a surgery center which makes a portion of your income, that’s why the partners are making 1M+

Incorrect. A small minority of surgeons own surgical centers as part of their practice partnership. "Partner" usually means owning a portion of the clinical revenue sans ancillary revenue. With PE taking over, that minority is shrinking.
I'm also wondering why a newly graduated Psych resident claims to have expertise on the logistics of any private practice operation, especially Retinal Surgery, only quoting anecdotes read online and without any data to justify his/her statements. Cite data or practice for 10 years before bringing anecdotes.

 

[forchinet121]

Incorrect. A small minority of surgeons own surgical centers as part of their practice partnership. "Partner" usually means owning a portion of the clinical revenue sans ancillary revenue. With PE taking over, that minority is shrinking.
I'm also wondering why a newly graduated Psych resident claims to have expertise on the logistics of any private practice operation, especially Retinal Surgery, only quoting anecdotes read online and without any data to justify his/her statements. Cite data or practice for 10 years before bringing anecdotes.

I have several family members that are surgical specialists all of whom share intimate financial information, I am wondering why a neurologist seems to think he knows about surgeon income, if you think online salary data is accurate I have a bridge to sell you

 

[ProReduction]

I have several family members that are surgical specialists all of whom share intimate financial information, I am wondering why a neurologist seems to think he knows about surgeon income, if you think online salary data is accurate I have a bridge to sell you

Once you've been in practice for 10 years you will have met hundreds of doctors. You will have seen them go through all practice settings: academic vs community, employed vs self-employed, private practice pre-partner vs partnership. You will learn a lot. You will see many drop out of the private practice pre-partner track and never make partner. You will see many practices sold to PE right out from under the pre-partner physicians. In short, you will be better informed, and you will have more than just a few "family members" on which to base your claims. You will know hundreds of surgical specialists personally. They are not shy about sharing financial information.

You should also look up Transparent California (I gave you the link) before talking about "online salary data" being inaccurate. By law, all UC system employees have to have their salaries made publicly available. This data is analyzed and curated onto Transparent California. So by law it must be accurate.

Lastly, as a Neurologist I actually interface with Retinal Specialists all the time on CRAO, BRAO, retinal hemorrhage, etc. I talk to them about their practice logistics.

 

[forchinet121]

Once you've been in practice for 10 years you will have met hundreds of doctors. You will have seen them go through all practice settings: academic vs community, employed vs self-employed, private practice pre-partner vs partnership. You will learn a lot. You will see many drop out of the private practice pre-partner track and never make partner. You will see many practices sold to PE right out from under the pre-partner physicians. In short, you will be better informed, and you will have more than just a few "family members" on which to base your claims. You will know hundreds of surgical specialists personally. They are not shy about sharing financial information.

You should also look up Transparent California (I gave you the link) before talking about "online salary data" being inaccurate. By law, all UC system employees have to have their salaries made publicly available. This data is analyzed and curated onto Transparent California. So by law it must be accurate.

Lastly, as a Neurologist I actually interface with Retinal Specialists all the time on CRAO, BRAO, retinal hemorrhage, etc. I talk to them about their practice logistics.

You're claiming to know hundreds of surgeons personally as a neurologist? Lol just stop, you can believe whatever helps you sleep at night bud

 

[ProReduction]

You're claiming to know hundreds of surgeons personally as a neurologist? Lol just stop, you can believe whatever helps you sleep at night bud

Yes. I've worked with over 70 Neurosurgeons alone, without counting other surgeons. This is common in NCC, where you also work closely with Trauma/Gen Surg, Ortho, ENT, Ophtho. Want to know how many of those 70 NS own a surgicenter?

Zero.

You haven't countered any of the data-based points. You are ignoring facts and responding with "my family tells me this though". I'll leave the readers that use logic to form their own opinions.

 

[forchinet121]

Yes. I've worked with over 70 Neurosurgeons alone, without counting other surgeons. This is common in NCC, where you also work closely with Trauma/Gen Surg, Ortho, ENT, Ophtho. Want to know how many of those 70 NS own a surgicenter?

Zero.

You haven't countered any of the data-based points. You are ignoring facts and responding with "my family tells me this though". I'll leave the readers that use logic to form their own opinions as arguing with a fool only proves there are two.

I am not talking about surgeons employed by hospitals who obviously don’t own their own surgery center. I’m talking about private practice surgeons in a group. I linked a thread with several retina surgeons talking about how 7 figures is common in private practice once your partner and becoming partner is the expectation in the right practice which isn’t hard to achieve.

 

[gyngyn]

Kindly make points without name-calling and personal attacks.
Some posts have had such content removed.