It seems like 1/2 of the IM applicants want to do GI...

[W19]

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In every interview I have been, about half of the applicants want to do GI. Why? I thought cardio was the most popular fellowship and from my observation, it's even behind PCCM. Is cardio loosing its mojo or it is just a coincidence that I interviewed with other applicants who want to do GI and PCCM?

 

[DNC127]

Millennials only want them lifestyle specialties.

 

[W19]

56 hrs/wk (according to CIM) is not what I would consider a lifestyle specialty.

 

[Brawndo2016]

Poop is sexy? Maybe that's it?

 

[Anti-PD1]

Yeah 1/2 want cardio, 1/2 want GI

"You are fishing the diamonds out of the buttocks, every day!"

 

[W19]

$$$ and lifestyle - what every field's competitiveness comes down to

Yeah... I understand the $$$ to be honest, but as I said 56 hrs/wk on average is up there though

 

[ERDOC555]

In every interview I have been, about half of the applicants want to do GI. Why? I thought cardio was the most popular fellowship and from my observation, it's even behind PCCM. Is cardio loosing is mojo or it is just a coincidence that I interviewed with other applicants who want to do GI and PCCM?

I don't believe most of the hours per week surveys I've seen online. I think they're highly inconsistent and easily biased. How do you truly measure this metric? Time with patients?, Charting? Admin? Business? Academic vs Private? Just plain lies? (Every old person likes to tell us how hard they used to work or exaggerate how terrible things used to be in their time)

The few GI's I've met all work derm/psych hours, scoping people all week and having clinic from 9-5 M-F. Obviously there's some call and emergencies do happen, but far less often than Cards. All that while making 400k to 500k. They always look happy and chill. Bottom line, I don't think the new generation of GI docs are working 56 hours per week.

Compare that to Cards who have much worse call and sicker patients. They work much worse hours for the same 400k-500k. Almost all my classmates say they want to do GI for exactly the same reasons I've said and everyone else has said here. Our generation of doctors values lifestyle and money more than ever before.

 

[W19]

@Dermpire

Good for them! I am glad not every physician is living up to SDN standards...

 

[DBV]

I don't get why people want to vilify people who want good money and good hours. Call it what you want but you get one life to live. GI for dayyyysssss

 

[zero0]

I don't believe most of the hours per week surveys I've seen online. I think they're highly inconsistent and easily biased. How do you truly measure this metric? Time with patients?, Charting? Admin? Business? Academic vs Private? Just plain lies? (Every old person likes to tell us how hard they used to work or exaggerate how terrible things used to be in their time)

The few GI's I've met all work derm/psych hours, scoping people all week and having clinic from 9-5 M-F. Obviously there's some call and emergencies do happen, but far less often than Cards. All that while making 400k to 500k. They always look happy and chill. Bottom line, I don't think the new generation of GI docs are working 56 hours per week.

Compare that to Cards who have much worse call and sicker patients. They work much worse hours for the same 400k-500k. Almost all my classmates say they want to do GI for exactly the same reasons I've said and everyone else has said here. Our generation of doctors values lifestyle and money more than ever before.

Well to be fair, medicine is more of a business than ever before.

 

[libertyyne]

judging by the number of millenials wantign to do surgical subspecialites, i dont think lifestyle plays much into their selection

Yeah, If millennials just wanted easy hours and more pay there wouldnt be the amount of competition there is for Gen surg, which is almost like the exact opposite of less hours and substantially more pay.

 

[KnuxNole]

Personally, scoping people would turn me off for GI, then again I don't like procedures and don't like doing them. The GI docs I know seem fairly happy, they scope and have office and usually don't have to come in to the hospital for call while making good $$.

 

[Peach Newport]

Millennials only want them lifestyle specialties.

Did you read House of God? The idea of IM residents aspiring to the GI lifestyle was a theme there too, and that was almost 50 years ago. Millennials ain’t no different.

 

[DNC127]

Did you read House of God? The idea of IM residents aspiring to the GI lifestyle was a theme there too, and that was almost 50 years ago. Millennials ain’t no different.

Its been on my to-do list for a long while now lol haven't actually read it yet though!

 

[IslandStyle808]

In every interview I have been, about half of the applicants want to do GI. Why? I thought cardio was the most popular fellowship and from my observation, it's even behind PCCM. Is cardio loosing is mojo or it is just a coincidence that I interviewed with other applicants who want to do GI and PCCM?

Brah seriously, GI is the most competitive IM sub-specialty you can even see it in the NRMP data (data has shown fluctuating competition I'll admit). The lifestyle and money is better than cardiology (hours are still more brutal in cardio).

 

[Matthew9Thirtyfive]

Personally, scoping people would turn me off for GI, then again I don't like procedures and don't like doing them. The GI docs I know seem fairly happy, they scope and have office and usually don't have to come in to the hospital for call while making good $$.

Scoping people is fun. Except for uppers—especially when they “forgot” they ate a breakfast burrito an hour before the scope.

 

[zero0]

Brah seriously, GI is the most competitive IM sub-specialty you can even see it in the NRMP data (data has shown fluctuating competition I'll admit). The lifestyle and money is better than cardiology (hours are still more brutal in cardio).

I'm surprised A&I doesn't get as much love, comparable salary and lifestyle minus all the fecal-oral transmission. A straight heme fellowship would also be great but the hours are a little higher.

 

[TypeADissection]

I wouldn't consider GI a lifestyle specialty. We call them often for ERCPs and they get pounded by IM for UGIBs, detorsion of colonic volvulus, etc. They work a lot. They are also well compensated for their time and effort. But I don't think it's a coast of a specialty by any stretch of the imagination. Their scope days are busy and there are always add-ons.

 

[MSTP18]

Yeah 1/2 want cardio, 1/2 want GI

"You are fishing the diamonds out of the buttocks, every day!"

I love Dr. Poo so much.

LEXUS!!!

 

[IslandStyle808]

I'm surprised A&I doesn't get as much love, comparable salary and lifestyle minus all the fecal-oral transmission. A straight heme fellowship would also be great but the hours are a little higher.

A PM&R doc I shadowed said to me "with the way salary is for PM&R, I don't know why you want to do it, you should do A&I instead." She was stating from a more work per hour stance, but don't get me wrong she did love PM&R.

 

[libertyyne]

A PM&R doc I shadowed said to me "with the way salary is for PM&R, I don't know why you want to do it, you should do A&I instead." She was stating from a more work per hour stance, but don't get me wrong she did love PM&R.

according to the MGMA data the salary difference is less than 2k@3-7 years for PM&R vs A&E. What was she talking about?

 

[W19]

A PM&R doc I shadowed said to me "with the way salary is for PM&R, I don't know why you want to do it, you should do A&I instead." She was stating from a more work per hour stance, but don't get me wrong she did love PM&R.

I did not know the average salary for A&I was that high though (350k). I guess when GI become impossible to get in, A&I will be the next thing.

 

[VA Hopeful Dr]

I'm surprised A&I doesn't get as much love, comparable salary and lifestyle minus all the fecal-oral transmission. A straight heme fellowship would also be great but the hours are a little higher.

Allergy doesn't make anywhere close to GI money.

 

[zero0]

A PM&R doc I shadowed said to me "with the way salary is for PM&R, I don't know why you want to do it, you should do A&I instead." She was stating from a more work per hour stance, but don't get me wrong she did love PM&R.

If I wanted $$ and was gonna do 5 years I'd do PMR -> pain over IM -> A&I. Pain patients tho... Personally I'd give it to A&I all things considered. Hard to beat those virtually nonexistent stress levels.

Allergy doesn't make anywhere close to GI money.

Idk I remember seeing some per hour compensation figures that came pretty close. I usually trust MGMA for my money but their sample size for A&I docs was pathetic. I've heard some numbers personally from working docs that lead me to suspect they're low-key stacking paper to the ceiling.

 

[IslandStyle808]

according to the MGMA data the salary difference is less than 2k@3-7 years for PM&R vs A&E. What was she talking about?

Not sure myself. I'm wondering if the people who report under PM&R are the same ones who have a pain fellowship or spine fellowship, this jacks up their salaries.

 

[IslandStyle808]

If I wanted $$ and was gonna do 5 years I'd do PMR -> pain over IM -> A&I. Pain patients tho... Personally I'd give it to A&I all things considered. Hard to beat those virtually nonexistent stress levels.

Idk I remember seeing some per hour compensation figures that came pretty close. I usually trust MGMA for my money but their sample size for A&I docs was pathetic. I've heard some numbers personally from working docs that lead me to suspect they're low-key stacking paper to the ceiling.

100% agree. Yeah I would not want to go through IM just to get a A&I fellowship. I would rather go PM&R and then do pain/spine, because if I fail to get a fellowship at least I am in a field I actually like to do.

 

[libertyyne]

Not sure myself. I'm wondering if the people who report under PM&R are the same ones who have a pain fellowship or spine fellowship, this jacks up their salaries.

There is a seperate category for pain. There is a 40kish difference in median with A&I being higher and closer to the mean . But still it doesnt seem like extremely large difference considering the extra years of training.

 

[IslandStyle808]

There is a seperate category for pain. There is a 40kish difference in median with A&I being higher and closer to the mean . But still it doesnt seem like extremely large difference considering the extra years of training.

There is a separate category, but they maybe doing a lot more PM&R with some pain, so they may have put their compensations as a PM&R doc instead of non-anesthesia pain. However, I don't have the more recent reports so I don't know the current numbers.

You are right though if you look at PM&R w/ fellowship and A&I (5 vs. 5 years), they still make a comparable salary.

 

[nanobot1]

Any thoughts about Rheumatology? That's also a great lifestyle like A&I

 

[libertyyne]

Any thoughts about Rheumatology? That's also a great lifestyle like A&I

almost a 100k difference in median salaries between Rheum and PM&R/A&I. IF you are looking at that genetics might be appealing to you as well.

 

[TypeADissection]

There's a lot of practice variability in GI. Do you know if your'e calling the same GI every time? You don't know how many days each individual is covering consults like that and even then that practice is different than others.

I'm sure there is a lot of variability. But I'm basically calling the same GI attendings and only two of them do the advanced stuff. Once in a blue moon some of the surgery attendings will take GI call and those guys are getting hammered everyday with really stupid consults. The group here is really busy. These dudes work. If someone was young, ambitious, wanted a lucrative career and be busy right at the start, this would be the kind of place to begin. Cheers.

 

[Redpancreas]

Money and lifestyle are a factor, but as people have said, GI isn't exactly Derm life (heck Dermatology is probably not even "Derm life"), but it seems like less call and slightly less, but great pay. What really had me interested is the procedural component as well as the sheer variety. You deal with so many organs, so many pathologies (ambulatory GERD, cancer, ID, motility, autoimmune, etc.), and there's a good amount of procedures. I think it's got fulfilling in every single criteria people look for whether it's pay, lifestyle, making an immediate difference, using complex clinical thinking, etc. In reality I'm sure it's not as amazing at is seems, but nothing really is at the end of the day. Also if you want to do Interventional Cardiology properly, it's PGY-8 these days...so there's that.

 

[mimelim]

I'm sure there is a lot of variability. But I'm basically calling the same GI attendings and only two of them do the advanced stuff. Once in a blue moon some of the surgery attendings will take GI call and those guys are getting hammered everyday with really stupid consults. The group here is really busy. These dudes work. If someone was young, ambitious, wanted a lucrative career and be busy right at the start, this would be the kind of place to begin. Cheers.

I know a dozen or so GI guys, all private and none work like that. They all clock in about 45-55 hours/week. Not too many emergencies either. I assume you are at an academic center?

 

[TypeADissection]

I know a dozen or so GI guys, all private and none work like that. They all clock in about 45-55 hours/week. Not too many emergencies either. I assume you are at an academic center?

Yes. Which is actually a good reminder to those in the early stages of education/training, that working in an academic center isn't necessarily reflective of life in a community setting.

 

[wegh]

I don't get why people want to vilify people who want good money and good hours. Call it what you want but you get one life to live. GI for dayyyysssss

But the reality is that few of those people will actually get GI, isn't it? Hope they have backups they are happy with

 

[Neopolymath]

But the reality is that few of those people will actually get GI, isn't it? Hope they have backups they are happy with

I'm interested in other things so it doesn't really matter, but the nail in the coffin for IM for me was the fact that I could get stuck in IM purgatory forever if I didn't match into the fellowship I wanted. I think this prevents a noteworthy number of otherwise good students from even considering IM subspecialties.