IM is an awesome specialty. I'm a PGY2, I take 4 ICU calls a month on elective/ambulatory rotations at my program. I work like a dog. At the end of the day, I don't see myself doing anything else.
From an intellectual standpoint, I think IM and its subspecialties provide the most fulfillment. For example, I had a lady on call the othernight, platelets 14k, didn't budge from 4 jumbo units of platelets, actively dropping hgb, peritoneal catheter ain't draining jack, hypotensive, maps in the 40's. The decision - give her more platelets to drop a line or not. TTP vs DIC? TTP - platelets kill her, DIC platelets help her. Where else are you going to see that kind of complexity?
From money standpoint, well yea, I'm not gonna be the millionaire neurosurgeon or ortho guy, but I sure as hell ain't gonna be in the wellfare check line either. And I'll actually have time to enjoy the modest amount of money I make vs the ortho guy coming on sat night, evaluating if some dude has a broken neck after he got wasted and plowed his escalade w/ 22 in. spinners into a pole while trying to floss it to get some chicken-heads in front of the club.
I got a buddy who's gonna start being a hospitalist at one of our hospitals getting offered 215k starting, 7 on/7off. You basically work half a year and make 215k! I know of a former resident who's an attending at another one of our university hospitals, 207k, 7on7off, cap of 15 admissions. He also does moonlighting/primary care on some of his off days. Probably banks over 300k at least, and he doesn't take in-house call, works bout 40-50 hrs a week, takes weekend call i think 1/6.
I know some private hospitalist attendings who have attested to making 500k a year. Now those guys run their service like a factory. One guy has residents run one service while he runs his own seperate service. Another guy makes probably 300k a year, but I honestly don't know how much he makes total because he has his own micro-brewery and apparently has the most popular beer in korea, or so he claims.
I agree from others that I think our generation is all about "cash-money" now in the easiest form or fashion. Nobody wants to work for it anymore and I think its a societal thing not just limited to medicine.
If sitting around staring at screens with shadows on them calling it maybe pneumonia vs actelectasis, making 300-400k is your thing, so be it. But if you like managing complex patients that nobody else wants to touch, aka the "nonsurgical candidate", and making decisions that do affect people's livelihood, IM and all its specialties is the shiz.
)
