There are a few things you need to really look at when picking a specialty:
1) Do I like the work?
2) Do I like the money?
3) Do I like the hours/lifestyle?
4) Can I get a job in a place I want to live?
As you get older, money will likely mean the least in this equation (within reason). If you wanted sports ortho, and went FP, instead, you’re talking about a big money difference. The differences between OB/gyn, FP, general IM, Psych, Anesthesia, and General Surgery (no bariatrics), will be not be enough to make a HUGE difference in your standard of living.
If you’re married, and your spouse is from the same rural area, having to go somewhere else for a job can be a HUGE stress on the marriage. Think hard about it.
Also, keep in mind that an FP in a rural area (low cost of living) can probably live as well as an Anesthesiologist making a good deal more in an urban or expensive suburban setting.
I did the “rural” thing for about 6 months, years ago. It was what I had always wanted to try, and one of the reasons I went into medicine, so I could have a big farm/ranch, and live in a small town.
This was a “town” of about 20k people, but was 1-1/2 to 2 hours from any large city. It was pretty much a NIGHTMARE.
The surgeons were spotty (quality) and there were only a few. Translation, you had to pick your battles, and ended up putting up with some questionable behavior, both personal and professional. We’d have (on a Tuesday/Wed) a pretty sparse schedule for Friday. Then, a couple of the ortho Docs would throw on 3-4 knees/hips on obese/htn/diabetic pt’s who hadn’t seen a Doc in years, with ?? EKG’s, and you’d end up hustling trying to get these pt’s preop clearance, in 2 days, rather than the surgeons just showing the common courtesy of scheduling them 2-3 WEEKS out.
Very slow surgeons. Questionable surgical talent. Patients with poor medical care. The patients in town with good money made a point to drive the 100 miles to the “good” hospital.
I had one partner, and there were also 4 CRNA’s. Becsuse of a mickey mouse surgery center in town, we BOTH had to be there during the week. That meant once every two weeks (alternating weekends), I could actually leave town. Otherwise, you were stuck there, and you had to find your OWN locums to actually get a full week off (at a cost of $10-$12k).
Add to that the fact that you either end up (in a rural area) with CRNA’s who either don’t want you there, or are so incompetent that you HAVE to be there and bail them out constantly. The hospital wasn’t that busy, but you could NOT get away from it.
I left the place for a “suburban” job, and for the past 10 years have worked in a “city” of about 200k, with a coverage area of 500k plus.
It’s hard to find a good anesthesiology rural job. Not impossible, but hard.
Decide what you want more, to live in a rural area, or to be an anesthesiologist. If you really want Anesthesia, consider small cities of 100-200k. You’ll find good jobs, that make good use of your skills, while still living in an area with a “small town feel”.
It’ll be a compromise, but you’re simply not going to have as much luck trying to be an Anesthesiologist (or a pedi endocrinologist, or an Infectious Disease Doc) in a rural area.
In the meantime, don’t take my word for it. Call some if these small hospitals. Ask to speak with the head of “physician recruitment” or the hospital CEO (they are much more involved with recruiting physicians in small hospitals), and see what they have to say. They may even promise you money if you have any interest in primary care.
I wish you the best, and am not trying to rain on your plans, but consider what I said above.
Money, area, lifestyle/hours, marriage. These will ALL come into play regarding “job satisfaction”, NOT just the “work” itself. Good luck.
