Something I just want to bring up. It is often debated on this forum (has been every since I was applying to med school 8 years ago and will be when I'm done with residency) whether you really have to be passionate about medicine and only medicine in order to go into the field and be happy, or whether you can go into the field and just enjoy it as a decent job that is one component of life. The result of threads on this topic is often that there are better easier ways to make more money with a better lifestyle. Often mysterious jobs such as "i-banking" or "corporate law" are brought up as alternatives. I just want to remind everyone here trying to make the decision right now that there are pathways within medicine that make it a well compensated, secure field with a damn decent lifestyle. Internal medicine, surgery, and their subspecialties are brutal and I think you have to truly love those fields to be happy in them. Family practice and primary care in general is filled with so much bullsh*t that it's hard to find a happy niche there. I've never run into a happy OB/GYN. However, there are several specialties which are, to be frank, just plain pleasant to practice and I think would be even if you don't see Osler as your soul-mate. A couple of these are even pretty easy to match into. Anesthesiology, pathology, radiology, radiation oncology, dermatology, these providers are generally content, and, if you just want a secure, high salaried job, I think they can't be beat. I think anyone would be hard pressed (assuming no major changes to the way the health care system is structured) to find better day-to-day job. Yes, med school and internship are brutal and painful, but the above fields themselves are merely hard. Conclusion: if you're one of the vast majority of people who have no passion in life and just want to make it from day-to-day, I wouldn't discourage you from entering medicine, just so long as you do it intelligently. Of course, if you're lucky enough to have a passion, do that. Life is too short.
whoa. edit: okay i'll elaborate. path: according to the path forums, there's too many residency spots open that doesn't support the job market. so it's a little harder to find a job in path than other specialties. rad: 240+ step I score for interview. nuff said. rad onc: i think research is pretty much a de facto requirement to go into rad onc. most who match have a phd. derm:
path, yeah sure of course the match rate is high. there's too many openings. http://forums.studentdoctor.net/showthread.php?t=579266
Match rates are actually higher now than they were in the late 90's, when there were 40% fewer positions.
Uhh... * People get into radiology without 240+ on step 1 * People get into derm without the perfect package, too There are match statistics available that show the range of scores and research experience among people matching in each specialty. As for "easy life," it all depends on the job you pick and not just the specialty. There are some sweet hospitalist jobs out there where you work only like 48 hrs per week. Outpatient primary care's hours are dictated by how much you want to make and what sort of patient populations you see. You should find something that you love to do for a career. If you're actually smart enough to get through medical school and residency, you are able to have your pick of careers.
oh and gas isn't exactly a walk in the park to match into. my point is this: there's some people who go into med school wanting to do a ROAD specialty but end up "settling" for primary care b/c of board scores, grades, etc. so yeah, i think you should at least LIKE medicine b/c you could probably end up in one of those "BS" specialities you mentioned.
could the OP..maybe rephrase what he/she is trying to say, because I am exactly one of those people sitting here on the fence about "should I continue to go through these science classes, or should I just jump out and go ace a bunch of humanities classes to get into law school" people...I just wana hear ya exactly
okay rads example was a bit of a hyperbole. my point is that rads is pretty competitive to be banking on getting into.
Hard to give specific advice without knowing some details about your specific situation. The other posters do have a point that the specialties I mentioned are not completely sure things, but a couple are pretty easily obtainable for the average student, and they are very pleasant, I would even say fun jobs. Take gas for example. According to match data from last year, 97% of those with board scores between 211-220 (actually below the US student average of 222) matched. Average salary is $300,000 (putting you in the top fraction of 1% of wage earners), hours are good, and I think it would even be pretty rewarding on a visceral level. After all, you are eliminating pain and save a fair share of lives when things are falling apart in the OR. Or take path. As others mentioned, their job market is tighter than most other medical fields right now, but if you read their board, most say when push comes to shove, they do actually get job offers and I'd venture to say their job market is a lot better than in most other fields in America right now. Good hours, pay, and an incredibly interesting knowledge base to learn about are associated. There are other specialties as well that are easy-ish (emphasis on the ish) to match into and are still just decent regular jobs such as allergy and immunology, a nice hospitalist gig, etc. Though, to be fair, the other posters have a point that most of the fields that are good for looking for job rather than a lifestyle choice are competitive to get into. Average step I for radiology is 235 which is at about the 70th percentile or so. However, 86% of those with a score between 211-220 still match so odds are still pretty good for getting in even if you're average to slightly below average. If you make it though, the reward seems awesome. Rads (my chosen field) is filled with cool toys, an incredible amount of interesting things to learn, relatively few bureaucratic issues, exciting, life-saving procedures should you want to do them, and job opportunities a-plenty. There's no guarantee with these fields though, and med school is very difficult. Much more so than I anticipated as an arrogant undergrad, so it's difficult to promise total security (even assuming medicine's place in society stays exactly the same). Comparing that to law though. Unless you go to a top 14 school, odds are small you'll ever approach the level of comfortable salary on the above fields will. And if you do get into one of those school, you'll have to become an associate at a top corporate law firm where work hours can be just as painful as a medicine residents, and also won't get better. Dentistry and pharmacy are also solid options for those looking for a good job they don't necessarily need an intense passion for going in. However, I guess the point I was trying to make was don't be put off by those who say you NEED to have only medicine/surgery in your heart to go to med school and stay sane. There are plenty of options for even the below average med students to come out better than the majority of those in other fields.
Clearly you can see what are the top tier residencies for match purposes. Note anesthesiology and EM are not among the top tier.
Great post OP. I could be happy in 1000 other jobs besides medicine. I chose medicine because it is a fulfilling career, it pays well, its stable, and it is intellectually challenging. Some people have more romantic reasons for choosing medicine--not me.
I don't want to enter medicine for solely for the salary, but for the intellectual stimulation, patient contact, most likely. Just wondering, how is the lifestyle of a pediatrics and pediatric specialties? I know that must greatly vary upon specialty, but just wanted to get an idea.
I...don't...understand... a medical student poster on SDN who is not overbearingly negative? What is the world coming to... -Roy
Interesting, informative thread. What's gas though? ps. Gut Shot, you have an awesome avatar. That scene broke me.
pediatrics is considered primary care. subspecialties aren't. so peds lifestyle, i imagine, would be a lot your PCP. shocking anesthesiology
I see EM being thrown around in this thread.. is that a lifestyle specialty? I figured it would be a slight step up from primary care (long long hours for comparably ****ty compensation). Please educate me if I'm wrong because it's a field that I am really interested in. -Roy
All of the doctors I work with here in the ER seem to have a pretty nice lifestyle. Four 10 hour shifts per week for most of them, and they work with one another to schedule vacations.
Oh damn, 4x10hr shifts, that sounds great. Are all EM positions like this or only the most sought after? How about compensation? Thanks for your input MadEvans, really eye opening stuff. edit: i see that you are a skateboarder too, I was just doing a really late night sesh and i just snapped my board in two trying to grind a bench right outside my apartment. story of my life.
I also want to say that my biggest fear about entering medicine is having to work 60+hr work weeks for the rest of my life. I really think medicine is for me and it would be a shame if I got stuck in a position where a majority of my week was spent working and say, not spending time with my family etc.
You could probably find the true "facts" of the matter by doing a search here on SDN in the doctor forums or even just on google, but most of my knowledge just comes from talking here with doctors. Much of what they say may be inaccurate for national averages, gross generalizations, and the like... but, I've gotten by fine by their advice so far. One doctor I know had instate tuition at a CA school then came to work over here. She says she made enough money (from her salary total) to pay off all of her loans within one year, assuming she had ZERO other expenses. May not be that much, but her saying it that way just made it sound amazing and very appealing. Sorry about your board. Us wood pushers are a minority in the pre-med realm... it's good to meet another one.
No, you'll be able to work it out I'm sure. A medical doctor degree is quite versatile... one of the docs here used to do medical journalism full time. It's not a restrictive degree that only allows you to do a few, certain things.
While some of what you write makes sense, I'd suggest that if you have no passion in life and just want to make it day to day, then medicine is an extraordinarily bad choice. It is not a good day to day job. It's a job that is hugely consuming -- will such up much of your twenties during school and residency, and then require you to put in long hours, always keep reading, always need to keep abreast of the changes in your field. You will never get to the point in your career when you can safely say, I'm done with the learning phase, now I can just put in a normal week and enjoy myself on the weekends. You will in all probability be working 60+ hours a week in almost any specialty, and expected to be informed on the various field specific articles/studies. It is simply not a good job to be putting in your time until you can go home. There are plenty of jobs where that's the mindset -- where you don't need to keep learning, don't need to put in crazy hours during training, aren't held to such liability, aren't expected to pass relicensing exams and keep up to date on current changes and developments. They aren't in the professions, but they exist in abundance. If your goal is to make it day to day, then that is a much smarter direction. As for telling folks -- you can always do a ROAD specialty -- that's just not going to be true for most of the class at most schools. I'm pretty sure I wouldn't advise someone looking at med schools to go if their sole goal was derm or rads. Because most likely they won't get it. About half of all folks going to med school are going to realistically have to decide between primary care, and other noncompetitive things. And a lot of the hours in those things aren't as good, nor is the pay as impressive. But if you are going into medicine because you like the idea of being a clinician, find it interesting, like working with people etc, then sure, it might be a good fit, because even on the down side you probably will be able to satisfy these sentiments. I don't think you need a "passion" for helping people, or have known since childhood that you wanted to be a surgeon, etc. But I do think that when you are picking a path that requires 4 weeks of schooling, plus 3-7 years of residency (during which you may be working 80 hour weeks), plus possibly a fellowship, before heading into a practice that still probably requires 60+ hour work weeks, you have to like it. You cannot look at it as a "live for the weekends" or get through day by day kind of job. This is going to be the majority of hours of your awake life for the rest of your life. You have to really like it. Folks who have no choices in life take the 9-5 jobs where they do something they don't care about and live for the weekends. They are basically "doing time" until they die. Folks who get into med school do have choices in their life, choices many americans don't. They are among the top educated folks in the country, with good grades and lots of doors open to them. When you are in that situation you HAVE to find something you enjoy and go with it. You are foolish if you figure -- well, this is safe and stable so I will "do my time" here. You are squandering the opportunity to find and do something you find enjoyable and fulfilling. Saying "I have no passion for anything" is really just saying you didn't take the time to figure out what you have passion for. Everyone has likes/dislikes -- you just have to spend enough time figuring out what they are. Lots of premeds don't, because the science courses, research and ECs eat up a lot of time in college. But it's a big mistake. Sorry, but I read the first post in this thread as a bit of a cop out by someone who didn't spend the time necessary to figure out where their passions lay.
I thought the hours were long in anesthesiology. Also, how much patient interaction is there? I'm looking at the primary care fields -- IM and peds -- because I love dealing with patients. I know residency will be tough, but I'm hoping I'll still have time for family as an attending.
I never understand why psychiatry isn't considered a lifestyle specialty. Granted it doesn't guarantee great hours with amazing pay like, say, dermatology, but most psychiatrists do pretty well on both those fronts. Those placing a higher premium on work hours tend to find salaried positions and work 40 hour weeks, while those who are willing to work more to make more usually go into private practice. Plus, as a U.S. medical student you are all but guaranteed to match into psychiatry, so there's no "I went to medical school to become an anesthesiologist and now I have to settle for primary care" dilemma. So, yeah, I want to go to medical school to become a psychiatrist and I am not at all worried about having to settle for something else. I think I know what the OP meant in saying you don't need a "passion" for medicine to make becoming a physician a smart career choice. Would I say, at this moment, that I have a passion for medicine? No. I have a passion for literary theory, but I do not particularly want to be an English professor who can't get tenured and is always wondering where the next teaching gig is going to come from. Do I think I would enjoy working as a psychiatrist enough to deal with all the attendant headaches and responsibilities (not to mention the insanely long and intense* training)? Yes, or I wouldn't be on this path in the first place. I think part of the problem is that the word "passion" has different meanings to different people. Some people use it to mean "something I would do all day long if I didn't have to get a job and could do whatever I wanted with my time." Those people get nervous when other people talk about the need for having a passion for medicine. The second group don't understand what the first group is so upset about, as they simply meant to say you should enjoy medicine if you decide to be a doctor. *Of course psychiatry is known for having one of the more manageable residencies-- yet another benefit to choosing this specialty.
I don't think the question is really should you go into medicine as just a way to twiddle the time away till you die. Rather, I think the question is how easy medicine is as a career to enjoy and how do you know if you'll enjoy it. It is very difficult to get a good sense of what clinical medicine will be like before you enter the field. Even my friends who had parents in the health care fields said they were surprised by what it was like. Given that many medical sub-fields require effectively 80+ hour a week until you die, going to medical school if you think you have to go into one of those is a huge gamble. On top of this, there as so many negative aspects to practice modern clinical medicine or surgery (mostly stemming from fatigue, but also including bureaucracy, ungrateful/uncompliant patients, lawsuits) that, in my personal opinion, it actually becomes the minority of people who can actually look past all this stuff and truly love what they do. If I were a pre-med today and I knew from advice that 1) it's very difficult to get a good sense of what medicine is like before you do it and 2) odds are you'll wind up hating day to day life, I would make the rational decision and not enter the field if I didn't have some romantic drive that compelled me to do it. Similarly, primary care fields is filled with so many daily hassles that despite the better lifestyle, most practitioners are pretty miserable, even with the good hours and decent salary (as compared to the vast majority of the population). What I've seen when working with the primary care folks is hours upon hours of arguing with insurance companies, massive amounts of paperwork and billing forms to fill out that need to be frantically written which can actually take up the majority of their day, and scores of patients who are just looking to get you to fill out their disability forms/perscribe pain meds/won't take their insulin/etc. It thus becomes difficult to enjoy your job. It's actually a bit of shame to me. My personal driving motivation in life is research, but after an academic career is over, I think I would quite like to go to a small down and be the local "doc," caring for the community. However, there seems so much hassle in primary career that I don't think I could deal with it all unless the system changes substantially. There are, on the other hand, fields of medicine that are easy for most of the population (at least the population applying to med school) to enjoy on a work-a-day basis. These fields are the ones mentioned above where you either get to focus on more on patient care like you would as a surgeon or internist without the fatigue and overwhelming lifestyle of a general surgeon, cardiologist, etc. These are fields like otolaryngology, ophthalmology, endocrine surgery, anesthesiology, etc. There are also fields like radiology and pathology that allow you to focus on learning and problem solving, which very much appeal to folks like me. Now, while many of these fields are difficult to get into (holy crap, have you looked at the derm match stats!), I think it does a disservice to paint them as impossibly difficult to get into. Hell, 70% of those with a board score between 180-190 got into gas and passing is 185, and most average US med students could probably match into ER or rads if they wanted to. The difficulty, of course, is how do you know if you'll be average? Well, you don't. Med school is really, really damn hard and your competing against really, really smart people. However, if you have average grades and MCAT scores along with a good work ethic, I don't think it's unreasonable to think you'll be average in med school. Outliers will of couse exist, but that's a risk I think is reasonable to take, especially compared to the uncertainty in other fields of human endevour these days. On a more philosophical note, I think the notion of passion is pushed a bit too hard on us. Back in the day, everyone seemed to advise me that I needed to spend two years on a desert ranch meditating to learn about myself and what I wanted to do. Well I did something along those lines, tried a lot of different jobs and fields, and what I learned was, well, I'm a pretty mellow guy who enjoys learning and could probably be happy doing most things. I now seem to have found my niche in the world and am pretty darn happy in it. Do I have the drive to do it every waking moment of the day? No, not really to be honest. Is it fun enough to spend 60 hours a week on without regret? Hell, yeah. I think there are a lot of opportunities in medicine like that. I do think you need that drive in certain areas of this field or you will be miserable, but there are certainly areas in medicine where if you just want a cool job, you can get that as well.
Let's see, take my opinion of these fields with a grain of salt as I know less about these fields, but based on my anecdotal experience so far: Peds: lot of the same headaches as primary care internal med and specialty internal med. However, practitioners seem happier for what appears to me to be three primary reasons: 1) hours seem (though I have no hard data on this) better, probably because there are fewer kids than adults around. 2) Bureaucracy seems reduced (it's seems harder for insurance companies to refuse things for kids). 3) Those who enter the field tend to be nice people who like kids and are just happy to be helping them, regardless of what else is going on around them. I actually think #3 is why insurance companies can get away with low-balling them on salary. ER: Shift work definitely makes lifestyles better. The usual model I see is 4 x 12 hour shifts a week. The patient population can be difficult to deal with, though and shifts can be very intense. Definitely one to try out to see if it fits though. Lot of burn out but I know many happy ER docs. Psych: Bit of a sleeper specialty that I think gets overlooked because of it's comparatively lower salary. The knowledge base is different to most of the rest of medicine which turns people off who were interested in the dynamics of the human body, and the crazy people turn a lot of med students off. Much fewer headaches than primary care medicine though, psychology is pretty darn interesting in its own way, good lifestyle, and decent salary, so I think it would be a good way to go.
Dude... what the freak are you talking about??? Outside of monetary compensation, one big issue that pulls a lot of people away from Peds (including myself) are the crazy parents. After speaking with two ER docs that switched into Rads, the shift-work lifestyle gets old very quickly (particularly when you're covering graveyard hours). You also have to deal with the high volume of BS patients that have no business being in the ER. Crazy patients = high maintenance patients. Spitters, punchers, biters, the pee-on-themself-ers... you name it, psych has it. There are positives and negatives to every specialty.
True, but some negatives are easier for most people to overlook in than others (100 hour week > crazy parents > dark room). Peds, ER, and Psych are probably middle of the road in this regard.
If I remember right, I read over on the EM board that the burn out rate is about the same (if not less) than other fields.
I was just trying to say that the "pleasant" specialties that OP was referring to are a bit difficult to obtain. Sorry if my post was incoherent.
so i really dont know much about match stats at all....but I am somewhat interested in EM and I was wondering just how difficult it is to match in EM. I know that today it is being considered more of a lifestyle specialty but I thought that it was still a "middle of the road" type of specialty as far as difficulty to match into it goes. any info greatly appreciated
look at post 12. it goes from competitive to noncompetitive from left to right, generally speaking. and some programs in a field are more competitive than others. for instance, categorical IM programs are more competitive than community IM programs b/c the former sends IM grads to more competitive fellowships like cards and GI.
Hey Enjoy and Madevans, I'm a fellow skateboarder too! We are a rare breed in the pre-med community for sure. And not to brag, but Bobby Worrest is one of my good friends...
Most med school grads could become a hospitalist or pediatric hospitalist if they wanted. You can have pretty good control of your hours there, and everybody knows that virtually anyone can get into IM or peds at least somewhere. I agree that advice of "Just be a radiologist or dermatologist and live the life!" is absurd for the majority.
Thanks to the OP for posting this. I am very passionate about medicine, so I don't mind the long hours and hard work that physicians face, but it bothers me a bit how some people on SDN make it seem as if physicians have absolutely no life. Like the OP, I think medicine is such a huge field that there's room for most science-oriented people to find something they'll enjoy. If you don't like science, though... I don't think medicine is for you. But you knew that already .
But is being a radiologist really "living the life?" I mean, there are all sort of emergency situations that need emergency imaging right, so you'd still have to be on call. Someone elaborate on this specialty's position as a "lifestyle" specialty.
^^ Radiology IS a lifestyle specialty. I mean, what else do you call working in your underwear? Well, in EM you can work in pajamas.
Oh ****, I would brag about that all day if I could.. the only thing I have is that I am close to some sweet skateparks in venice beach etc.. Haha being a skateboarder also means I have had quite a bit of experience with ortho surgeons. To keep to the topic, it seems like the ortho surg that has helped with my family's broken bones has quite a nice lifestyle, however he tells me the path to being an orthopedic surgeon is rocky. Could anybody elaborate? (doc and mad what do you ride if you don't mind me asking, and do you guys longboard too?)
ok. a few points are being overlooked here..... if you are counting on going into any of the "specialty" lifestyles ...you are forgetting that there is a HUGE step called training before you get to that point. you will be even more miserable than avg during med school and residency also, in today's career world - practically all paths that lead to a high degree of "job success" are intense. i-banking, law school, etc etc etc. so choose the intensity path that you at least enjoy. goodness....... how many of you have actually worked a full time job for several months that you DISLIKED? how was it? you really need to think about that when you think about going into medicine for only PRACTICAL reasons- stability, salary, etc..... as a personal anecdote, im fresh out of college- may 08 grad- and working an entry level job which i ABSOLUTELY hate. now, i started out thinking, so what? i'll enjoy myself on evenings and weekends, but soon realized that it doesnt work that way. its still completely blowsss to dislike your job, because you are there for a significant portion of your time. i think back to times in college that i may have been at the library on a saturday night- i have weekends completely free now i think back to times when i had to rush from my daily craziness to grab dinner as fast as possible and spend all night in the library- after 5 pm i'm free to do whatever i want now. so, even though my "lifestyle" is better now- i am still miserable. i am miserable because it is NOT FULFILLING to my entire existence. if you do something you truly enjoy, then even if it is longer and harder- you will STILLLLLL enjoy it. i enjoyed studying so i felt happier then than i do now with much more free time. also, please realize that there are far more options in medicine than i think most pre meds realize. as a woman, i have mulled over lifestyle issues as a physician and have talked to many female physicians. there is always a way to do it- sacrifices will be made. you are forgetting that physicians can have larger practices- larger as in more physicians- and split more days etc. sure, at the end of the day they may be making less, but like i said- sacrifices will need to be made.
It can be as shift work of a specialty as there ever was. Somebody is going to have to work overnight somewhere, but at the children's hospital I just rotated through, they send out some of their overnight imaging to some remote center, and the staff radiologists are just there during the day. The final reads all come from in-house staff. Virtually every specialty, except things like derm and PM&R, are going to have some component of overnight work. It's just more tolerable if you don't have to work overnight after working all day and you have to work the next day as well.
