Is it really unwise to make a specialty choice partially based on lifestyle aspects of the training?

[Dro133]

---

Members don't see this ad.

I've read many times on here that you shouldn't pick a specialty based on the lifestyle of the training, as training is only temporary, but rather based on what interests you the most. However, does it make sense to at least partially base the decision on the lifestyle of the residency?

For example, I'm an MS3 and I have always been interested in the pathology of cancer, and I have also enjoyed working with patients with cancer in the clinic. It's still early for me, but for that reason I'm currently leaning towards oncology or pathology. I find pathology super interesting, especially from a research perspective, but I feel that I may miss the patient interaction side of things. However, I also know that I don't do well working 6 days a week -- having one day off just isn't enough time to make me feel like I have my $hit together, see the people that are important to me, recharge my batteries, etc., and that would be the deal for 3 years of IM residency + fellowship. On the other hand, in pathology I'd essentially have normal 5 day weeks, which, even if it may not be as "fulfilling" as being the primary provider for patients, would probably be more sustainable.

So, does it make sense to take lifestyle considerations of training into account when deciding on a specialty, or should one make the decision purely based on interest in a specialty?

Any responses are greatly appreciated!

 

[DubbiDoctor]

It definitely makes sense to consider the lifestyle different specialties offer. There's more to life to work, and you shouldn't choose a specialty that would make you miserable just because it interests you the most. The reason, I assume, that dermatology, every cycle, is the or one of the most competitive specialties is not that skin pathology is uniquely fascinating.

 

[anbuitachi]

I've read many times on here that you shouldn't pick a specialty based on the lifestyle of the training, as training is only temporary, but rather based on what interests you the most. However, does it make sense to at least partially base the decision on the lifestyle of the residency?

For example, I'm an MS3 and I have always been interested in the pathology of cancer, and I have also enjoyed working with patients with cancer in the clinic. It's still early for me, but for that reason I'm currently leaning towards oncology or pathology. I find pathology super interesting, especially from a research perspective, but I feel that I may miss the patient interaction side of things. However, I also know that I don't do well working 6 days a week -- having one day off just isn't enough time to make me feel like I have my $hit together, see the people that are important to me, recharge my batteries, etc., and that would be the deal for 3 years of IM residency + fellowship. On the other hand, in pathology I'd essentially have normal 5 day weeks, which, even if it may not be as "fulfilling" as being the primary provider for patients, would probably be more sustainable.

So, does it make sense to take lifestyle considerations of training into account when deciding on a specialty, or should one make the decision purely based on interest in a specialty?

Any responses are greatly appreciated!

Don't do it just based on interest. That's terrible advice. Lifestyle definitely matters. There are many fields with good lifestyle during residency and beyond

 

[Frogger27]

Don't do it just based on interest. That's terrible advice. Lifestyle definitely matters. There are many fields with good lifestyle during residency and beyond

1. Derm
2. ????

 

[mvenus929]

I think choosing a specialty based on the lifestyle aspects of the training is less than ideal, because it is a temporary thing. Choosing a specialty based on lifestyle period is reasonable.

 

[Donald Juan]

Like said above, residency is temporary so the lifestyle during residency shouldn't be your top priority. It would be better to get through a difficult residency to do something you ultimately love that has a great lifestyle versus do an easy residency for an ultimate job you hate, but that dichotomy is usually not the case.

I think you should also consider that not every residency program within a given specialty is the same volume or hours during training. IM especially (since you mentioned it) seems to have a very wide difference in how strenuous the programs are.

 

[Perrotfish]

I've read many times on here that you shouldn't pick a specialty based on the lifestyle of the training, as training is only temporary, but rather based on what interests you the most. However, does it make sense to at least partially base the decision on the lifestyle of the residency?

For example, I'm an MS3 and I have always been interested in the pathology of cancer, and I have also enjoyed working with patients with cancer in the clinic. It's still early for me, but for that reason I'm currently leaning towards oncology or pathology. I find pathology super interesting, especially from a research perspective, but I feel that I may miss the patient interaction side of things. However, I also know that I don't do well working 6 days a week -- having one day off just isn't enough time to make me feel like I have my $hit together, see the people that are important to me, recharge my batteries, etc., and that would be the deal for 3 years of IM residency + fellowship. On the other hand, in pathology I'd essentially have normal 5 day weeks, which, even if it may not be as "fulfilling" as being the primary provider for patients, would probably be more sustainable.

So, does it make sense to take lifestyle considerations of training into account when deciding on a specialty, or should one make the decision purely based on interest in a specialty?

Any responses are greatly appreciated!

Most doctors will tell you that you should consider lifestyle afte training as part of your decision (though not all of it). You need to like what you do, but it's a lot easier.to like 30 hours per week of something than 60.

You will probably see a 50:50 split about whether to consider length of training in your decision. I think a difference of more than 1 year in training length should probably factor into your decision but that's me. Training tends to suck, careers.tend to be 40 years, and each additional 2 years of training is another 5% of your career that will suck.

Almost everyonewill tell you not to think too much about lifestyle in training when making your decision. If only because your lifestyle will probably suck no matter what you choose. There are lots of brutal FM and path residencies. For that matter you don't even necessarily want a cushy residency. Training hard in residency can save you a lifetime of stress later.

 

[trobinsonmd]

Don't do it just based on interest. That's terrible advice. Lifestyle definitely matters. There are many fields with good lifestyle during residency and beyond

totally agree with this. I placed a lot of importance on lifestyle and ended up going into derm and I love it... if you are into cancer and if you have the step score, look into rad onc, they work 9-5 and can do a good amount of their work from home... it is a fantastic specialty

 

[VA Hopeful Dr]

totally agree with this. I placed a lot of importance on lifestyle and ended up going into derm and I love it... if you are into cancer and if you have the step score, look into rad onc, they work 9-5 and can do a good amount of their work from home... it is a fantastic specialty

No. Their job market sucks something fierce.

 

[trobinsonmd]

No. Their job market sucks something fierce.

if one is willing to move to somewhere like Oklahoma or something of the like, there is great money to be made... if one wants to live in nyc or sf, they can pretty much forget about finding a job in rad onc... should've mentioned that... the pay for the amount of hours is almost unbeatable if you find the right gig though

 

[VA Hopeful Dr]

if one is willing to move to somewhere like Oklahoma or something of the like, there is great money to be made... if one wants to live in nyc or sf, they can pretty much forget about finding a job in rad onc... should've mentioned that... the pay for the amount of hours is almost unbeatable if you find the right gig though

I mean if you say so. There's no way I know a rad onc guy whose trying to find a new job and can't get anything other than locums.

 

[trobinsonmd]

I mean if you say so. There's no way I know a rad onc guy whose trying to find a new job and can't get anything other than locums.

my sample size is small so I may not have the best grasp of the job market, I have one friend in Maine who just finished residency and got a great offer, and another friend near Tulsa who also just got an offer. n=2 is probably too small to extrapolate and make claims about the market as a whole, but I think if someone is open-minded and willing to move anywhere, it is possible to find a good gig

 

[VA Hopeful Dr]

my sample size is small so I may not have the best grasp of the job market, I have one friend in Maine who just finished residency and got a great offer, and another friend near Tulsa who also just got an offer. n=2 is probably too small to extrapolate and make claims about the market as a whole, but I think if someone is open-minded and willing to move anywhere, it is possible to find a good gig

And that's likely true, but that's a far cry for the rest of medicine when it comes to jobs. Pretty much everyone else can find a job most anywhere.

 

[colbgw02]

i think it's fine to factor lifestyle while training into one's decision making, but i also think medical students tend to overemphasize it, probably because we're always so focused on the next step (residency). and also probably because, psychologically, 3-6 years is a much longer time period when you're in your 20s (no judgment there; i was the same way).

it think there's also an ivory tower effect because so many students spend so much many years at university hospitals and seeing the work hours of their faculty. there can be a wide gulf in lifestyle between academic and private practice, and i imagine that gulf is in both directions.

 

[Oso]

If you think you'd be interested/happy with both but also value lifestyle/normal work hours ... then I would seriously consider path.

 

[atomi]

1. Derm
2. ????

Rad onc, psych, PM&R, path, are all relatively low-hour residencies in general (however there will always be malignant exceptions in this list and especially cush programs in other specialties not on this list e.g., there are some very chill FM programs)

It's 3-7 years of your life, so yes, you can't discount lifestyle. If you have young kids and go into surgical training, then you pretty much will miss half of their formative years.

 

[atomi]

And that's likely true, but that's a far cry for the rest of medicine when it comes to jobs. Pretty much everyone else can find a job most anywhere.

I would expect a precipitous drop in rad onc applicant numbers and quality over the next few years. It's been 2-3 years since rad onc job market concerns became mainstream among medstudents and premeds, which is just enough time to start seeing the effects. Impossible to believe anybody going into that field at this point isn't aware of the extremely competitive job markets on the coasts and big cities. Unlike the rads job market lull 7-8 years ago, which tanked applicant numbers/quality and then quickly rebounded, the rad onc problem (for multiple factors) has no end in sight. They'll be in a recession for a while.

 

[DubbiDoctor]

I would expect a precipitous drop in rad onc applicant numbers and quality over the next few years. It's been 2-3 years since rad onc job market concerns became mainstream among medstudents and premeds, which is just enough time to start seeing the effects. Impossible to believe anybody going into that field at this point isn't aware of the extremely competitive job markets on the coasts and big cities. Unlike the rads job market lull 7-8 years ago, which tanked applicant numbers/quality and then quickly rebounded, the rad onc problem (for multiple factors) has no end in sight. They'll be in a recession for a while.

I was surprised to see how competitive Rad Onc applicants were in 2018 charting outcomes: 247 average step 1, 35% AOA. Interesting article on the topic - seems that graduates can get jobs - just not where they want to.

 

[atomi]

I was surprised to see how competitive Rad Onc applicants were in 2018 charting outcomes: 247 average step 1, 35% AOA. Interesting article on the topic - seems that graduates can get jobs - just not where they want to.

IIRC total numbers of applicants were way down, like 210 applicants for 190 spots or something. I think they are seeing the number crunch already, which happens first. There is still self-selection. If things continue, there won't be enough high step1 score/AOA applicants to fill all spots, spots will go unfilled, and people will start applying with lower scores (self-selection will stop).

 

[Dro133]

totally agree with this. I placed a lot of importance on lifestyle and ended up going into derm and I love it... if you are into cancer and if you have the step score, look into rad onc, they work 9-5 and can do a good amount of their work from home... it is a fantastic specialty

Thanks for the replies, everyone. It sounds like most people are saying that there's nothing wrong with leaning towards a specialty that's lifestyle friendly, as long as the work is still interesting. I think that's my mindset as of now as well.

I've definitely thought about rad onc a lot lately; the combination of great lifestyle, great reimbursement, patient contact and heavy research emphasis makes it seem like a really good fit. However, the job market does worry me, and I don't know if I'd like my career being so entirely dependent on one treatment modality. I think I like the idea of being a pathologist and being involved in the background as to figuring out which treatment modalities are best for which individual tumors based on genomics, imaging, etc. But it's still early, and there's definitely a lot of exploring left to do.

 

[mimelim]

Rad onc, psych, PM&R, path, are all relatively low-hour residencies in general (however there will always be malignant exceptions in this list and especially cush programs in other specialties not on this list e.g., there are some very chill FM programs)

It's 3-7 years of your life, so yes, you can't discount lifestyle. If you have young kids and go into surgical training, then you pretty much will miss half of their formative years.

Don't forget IM...

 

[Rads4lyfe]

1. Derm
2. ????

Rads is pretty chill during and after residency. Most days are 8-5 with majority of weekends off. Solid pay as an attending per most compensation reports.

 

[atomi]

Don't forget IM...

LOL. Well, if you can survive 3 years of "hell on earth" 🙄, the allergy guys might have the cushiest life of us all.

Rads is pretty chill during and after residency. Most days are 8-5 with majority of weekends off. Solid pay as an attending per most compensation reports.

I left rads off my list because there are many programs that will work you very hard including constant nights and weekends, not just a consistent 8-5 M-F as in the others. But yes, definitely some chill programs out there. Most radiologists I know wouldn't consider their employeed gig all that chill as they are really pushed to read, read, read for many many hours in a row.

 

[M1i]

Two questions.
1) I noticed some anesthesia residency programs quote some pretty decent hours as well (around 60 hours, which would be ideal) is that common for anesthesia or just the few choice programs I looked at?
2) Is there any correlation between the intensity (hours and work load, not necessarily how malignant the program is) of the program and the training/education received? Meaning would it be wrong to assume you would receive more training at an institute where you worked more...

 

[Rads4lyfe]

LOL. Well, if you can survive 3 years of "hell on earth" 🙄, the allergy guys might have the cushiest life of us all.



I left rads off my list because there are many programs that will work you very hard including constant nights and weekends, not just a consistent 8-5 M-F as in the others. But yes, definitely some chill programs out there. Most radiologists I know wouldn't consider their employeed gig all that chill as they are really pushed to read, read, read for many many hours in a row.

Most university programs don't have THAT many nights/weekends. Some small community programs with 2 residents per class can feel like sweat shops though.

As an attending, sure it can be busy at work...but working ~50 hours/week with 8-12 weeks vacation and getting paid 300-400k/year is pretty sweet.

 

[cubsrule4e]

I've read many times on here that you shouldn't pick a specialty based on the lifestyle of the training, as training is only temporary, but rather based on what interests you the most. However, does it make sense to at least partially base the decision on the lifestyle of the residency?

For example, I'm an MS3 and I have always been interested in the pathology of cancer, and I have also enjoyed working with patients with cancer in the clinic. It's still early for me, but for that reason I'm currently leaning towards oncology or pathology. I find pathology super interesting, especially from a research perspective, but I feel that I may miss the patient interaction side of things. However, I also know that I don't do well working 6 days a week -- having one day off just isn't enough time to make me feel like I have my $hit together, see the people that are important to me, recharge my batteries, etc., and that would be the deal for 3 years of IM residency + fellowship. On the other hand, in pathology I'd essentially have normal 5 day weeks, which, even if it may not be as "fulfilling" as being the primary provider for patients, would probably be more sustainable.

So, does it make sense to take lifestyle considerations of training into account when deciding on a specialty, or should one make the decision purely based on interest in a specialty?

Any responses are greatly appreciated!

You have to go with what you would be most happy with long term. If you cant see yourself working happily without the patient interaction then you have to go with onc over path, despite the training it may take to get there. In addition, as an oncologist you can still do all of the things a pathologist can from an "interest" standpoint, including research, but if you go pathology theres no way to get that comprehensive patient care youre looking for. Being miserable for a few years is nothing like being miserable for the rest of your life and/or starting training all over again because you misinterpreted your career goals the first time. Speaking from an Ophthalmology standpoint, we get slaughtered in our first year of training because the learning curve is so steep and theres just so much knowledge you have to accrue to become competent. I would bet you a majority of first year ophtho residents would say they thought about quitting or changing specialties at least once during their training because its just that rough at first. Waking up multiple times in the middle of the night to go sew up an eyeball was definitely not ideal for my lifestyle, but you do it and get through it. Now I work 36 hours a week with minimal call doing what I love. You have to go with your passion for what you are truly interested in despite the road it might lead you. The worst possible thing I can imagine is being in a different field and hating my life each and every day just because I didnt want to suck it up for a couple years to learn what I needed. There are also always differences in the actual residency programs, and you can try to find the one that is most suited to your personality and lifestyle needs.

 

[Raryn]

No. Their job market sucks something fierce.

And that's likely true, but that's a far cry for the rest of medicine when it comes to jobs. Pretty much everyone else can find a job most anywhere.

Pathology job market is pretty lousy as well.

 

[kelminak]

Pathology job market is pretty lousy as well.

If I remember correctly, pathology had the lowest ratio for applicants to residency spots this year. They’re struggling tremendously.

 

[oneiroi]

It's not that unreasonable. Consider if 3-7 years of a brutal residency/fellowship burns you out so much you can't actually enjoy the job when you finish. Conversely, don't pick derm for the hours if you hate skin.