Least stressful specialty?

[Horticulture]

What would you say is the least stressful specialty?

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[yaah]

The one that someone else is doing. Seriously.

They all have their moments. People will argue and say theirs is worse or better, but it all depends on your personality and likes. If you love the OR and quick decision making, surgery is not going to be stressful for you. I find pathology to be not very stressful but it certainly has its moments - trying to make an accurate diagnosis on a tiny bit of tissue with people standing over you is not without it's worries.

 

[johnny_blaze]

derm!!!!! just b/c i'm crap at it

 

[prominence]

if you know what you're doing and enjoy it, i think psychiatry is one of the lesser stressful specialties (generally speaking). but without a moment's notice, you can have emergencies (as with most, if not, all other specialties).

 

[b&ierstiefel]

What would you say is the least stressful specialty?

a specialty where you:

(i) work a fewer amount of hours
(ii) get paid the most amount of money
(iii) do work that is interesting to you

 

[Skip Intro]

I'd have to say, on the whole, anesthesiology offers the best stress/reimbursement ratio (but, I'm a little biased). You focus on one patient (i.e., problem) at a time. There are moments of terror, but there are hours of boredom too. Probably the biggest stress is the difficult surgeon who wanted to start the GB 20 minutes ago and you've got a 450lb patient trying to do an awake intubation on the table (and I was involved in such a case during med school). That's stress. Otherwise, low key. And, at least right now, it pays pretty damn well. Or, maybe you'll have to check with me again in 4 years.

Just my $0.02.

-Skip

 

[OldPsychDoc]

if you know what you're doing and enjoy it, i think psychiatry is one of the lesser stressful specialties (generally speaking). but without a moment's notice, you can have emergencies (as with most, if not all other specialties).

I must not know what I'm doing then...because I'm finding plenty of stress here!

 

[dWiz]

I must not know what I'm doing then...because I'm finding plenty of stress here!

is there such a thing as emergency in psych? just curious

 

[liveandlearn]

yes, suicide being a major emergency in psych. ;-)

 

[OldPsychDoc]

is there such a thing as emergency in psych? just curious

neuroleptic malignant syndrome
agitated, belligerent patients who are about to hurt someone
frantic patients of all stripes, with or without suicidality
other services who just want our patients off their service...(just kidding)

 

[OldPsychDoc]

is there such a thing as emergency in psych? just curious

Also--the question wasn't what specialty has the most emergent conditions, but what specialty is most stressful. Those are very different issues!

 

[Dire Straits]

PM&R
occupational medicine

 

[Daniel575]

I suppose reumatology, revalidation medicine, clinical genetics, occupational medicine make a chance... Also ophtalmology and ENT, but that's just my personal opinion.

 

[unregistered]

I suppose reumatology, revalidation medicine, clinical genetics, occupational medicine make a chance... Also ophtalmology and ENT, but that's just my personal opinion.

I wouldn't put ENT on the list of least stressful specialties. The otolaryngologist is often called upon to assist with difficult airways, and many of our own patients have airway issues as well. These can result in some pretty stressful situations.

 

[njbmd]

Hi there,
My vote for less stressful would be Preventive Medicine. No emergencies and no stress. Good pay and few hours. You can even work from home.
njbmd

 

[IlianaSedai]

The one you enjoy the most.

I am not in the least stressed out by acuity or procedures. I am, however, stressed out by my complete inability to keep track of a constant barrage of consults, nursing home phone calls, case management, social work, and so on. Some people are the other way around. So we choose what suits us.

The other thing that makes work stressful is the personalities of your co-workers. Some of that is specialty dependent, but much of it is really institution-dependent. IMO, any specialty can be a good one if you have good people to work with.

 

[Philo Beddo]

neuroleptic malignant syndrome
agitated, belligerent patients who are about to hurt someone
frantic patients of all stripes, with or without suicidality
other services who just want our patients off their service...(just kidding)

Other than neuroleptic-malignant syndrome, which a psychiatrist is not going to admit to the hospital by themselves anyway, there is no psych "emergency" that can't be solved with haldol or ativan.

Philo

hippocritis.com <---medical satire for residents and medical students

 

[WilcoWorld]

Other than neuroleptic-malignant syndrome, which a psychiatrist is not going to admit to the hospital by themselves anyway, there is no psych "emergency" that can't be solved with haldol or ativan.

Philo

hippocritis.com <---medical satire for residents and medical students

"Solved" huh? That's a rather short-sighted use of the word IMO.

 

[fun8stuff]

"Solved" huh? That's a rather short-sighted use of the word IMO.

it's a "joke", lol

 

[Ergo]

The one you enjoy the most.

I am not in the least stressed out by acuity or procedures. I am, however, stressed out by my complete inability to keep track of a constant barrage of consults, nursing home phone calls, case management, social work, and so on. Some people are the other way around. So we choose what suits us.

The other thing that makes work stressful is the personalities of your co-workers. Some of that is specialty dependent, but much of it is really institution-dependent. IMO, any specialty can be a good one if you have good people to work with.

To me, surgery is fun- quick, decisive rounds, procedures, research; inpatient medicine with its slow rounds, complex elderly patients and paperwork is very stressful.

 

[JudoKing01]

I think that has a part of it, but I definately think that personality is a big factor. I've seen some surgeons that are great, love their work, wouldn't do anything else, and they get stressed out in the OR when a little bleeder pops up. But then today for example, starting a roux-en-y gastric bypass, the surgeon opened up the colon by accident and feces went all over the place. He didn't flinch or anything. I think personality has a LOT to do with it.

 

[turtle md]

I agree with Ergo, Internal Medicine was my most stressful med student clerkship. Sooooo boring.... EM may seem like it would be stressful, but at least I am never bored .

 

[Leukocyte]

Most stressfull clinicals

1)OB/GYN (more stressfull if you are a male)
2)General Surgery
3)Pediatrics (Getting a "good" H&P can be challenging. Parents are breathing done your neck. Abuse confrontations and calling Child services).
4)IM

Least Stressful:

1)Psychiatry
2)Family Medicine
3)Anesthesiology
4)Radiology

 

[Laryngospasm]

I'd have to say, on the whole, anesthesiology offers the best stress/reimbursement ratio (but, I'm a little biased). You focus on one patient (i.e., problem) at a time. There are moments of terror, but there are hours of boredom too. Probably the biggest stress is the difficult surgeon who wanted to start the GB 20 minutes ago and you've got a 450lb patient trying to do an awake intubation on the table (and I was involved in such a case during med school). That's stress. Otherwise, low key. And, at least right now, it pays pretty damn well. Or, maybe you'll have to check with me again in 4 years.

Just my $0.02.

-Skip

Ill respectfully disagree with you on anesthesiology being low stress. I dont think putting a healthy OB patient to sleep for a crash C-section, watching her O2 sat drop to 70 in about 15 seconds while you struggle to get an airway (all the while thinking in the back of your mind that the most common cause of mortality from anesthesia during pregnancy is failure to get an airway..) is low stress. Nor is trying to replace the eight liters of blood that were lost during a 3 minute period from a ruptured aneurysm, while the surgeon tries to put humpty back together again low stress. An awake intubation on 405 lb patient, while the impatient surgeon looks on, pales in comparison. IMHO the only people that think anesthesia is low stress are either not anesthesiologists, or have not done it long enough to realize it yet.

 

[Smurfette]

Ill respectfully disagree with you on anesthesiology being low stress. I dont think putting a healthy OB patient to sleep for a crash C-section, watching her O2 sat drop to 70 in about 15 seconds while you struggle to get an airway (all the while thinking in the back of your mind that the most common cause of mortality from anesthesia during pregnancy is failure to get an airway..) is low stress. Nor is trying to replace the eight liters of blood that were lost during a 3 minute period from a ruptured aneurysm, while the surgeon tries to put humpty back together again low stress. An awake intubation on 405 lb patient, while the impatient surgeon looks on, pales in comparison. IMHO the only people that think anesthesia is low stress are either not anesthesiologists, or have not done it long enough to realize it yet.

you know what they say about anesthesia..."hours of sheer boredom punctuated by moments of sheer terror!"

 

[BEN MD FRCS]

I wouldn't put ENT on the list of least stressful specialties. The otolaryngologist is often called upon to assist with difficult airways, and many of our own patients have airway issues as well. These can result in some pretty stressful situations.

DON"T THINK THEY WOULD CALL YOU FOR AN AIRWAY

 

[salmonella]

I think the least stressful specialties are ones that have the most future job security. With the mid-level professionals propping up everywhere, it's stressful to just think how they may, in the near future, replace you. Consider:

ophthalmologist vs optometrist
anesthesiologist vs CRNA
psychiatrist vs psychologist
PM &R vs Doctor of Physical Therapy
Primary care physician vs NP/PA

 

[GasEmDee]

neuroleptic malignant syndrome
agitated, belligerent patients who are about to hurt someone
frantic patients of all stripes, with or without suicidality
other services who just want our patients off their service...(just kidding)

Yeah but those are not "stressful" emergencies.
There is one simple treatment for NMS.
The suicidal patient needs to be restrained, and then after that, you have all the time in the world to intervene on the underlying problem. And the MD need not even be there for that.

 

[blanche]

Yeah but those are not "stressful" emergencies.
There is one simple treatment for NMS.
The suicidal patient needs to be restrained, and then after that, you have all the time in the world to intervene on the underlying problem. And the MD need not even be there for that.

Yes, true, but then again the 'stress' of psych probably is of a different character than a specialty like gas (pt is crashing, what do i have to do NOW)

For a psychiatrist, you have to be vigiliant of what sort of harm a pt could get him/herself into, or do to others. I'm no shrink, but I would guess the stress of being the one in charge of unstable pts, who may be capable of turning violent on you, killing themselves, murdering that ex-spouse that they come and talk to you about every week, etc etc. could really weigh on you.

There was a psychiatrist in the Washington area who was beaten to death by a pt earlier this year. I won't have that sort of stress going into pediatrics!

 

[GasEmDee]

IMHO the only people that think anesthesia is low stress are either not anesthesiologists, or have not done it long enough to realize it yet.

Couldnt have said it better or more succintly myself.

 

[deleted87716]

IMO, all specialties are potentially stressful...the big difference lies in the types of stressors you'll encounter on a regular basis.

If a constant stream of life-or-death decisions makes your blood run cold, don't do EM, critical care, or gas. If the fear of missing something makes you lie awake at night, don't do path or rads. If the endless stream of problems, big and small, that you encounter in primary care makes you pull your hair out, don't do FM or peds. If the possibility of being sued freaks you out, don't do OB-Gyn or neurosurgery.

No matter what field you go into, you can expect stress. As long as you manage your stress, you'll be fine. It also helps to like your job.

 

[swpm]

Probably the biggest stress is the difficult surgeon who wanted to start the GB 20 minutes ago and you've got a 450lb patient trying to do an awake intubation on the table (and I was involved in such a case during med school). That's stress.

You're kidding me. That's not stress.

Stress might be an unexpected difficult airway and a desaturating patient, or maybe an "oh ****" from the other side of the curtain followed by "we just nicked the aorta", not some whiny bitch of an impatient surgeon standing there looking at you or fidgeting.

 

[Surgeon24]

Stress is relative for everyone. What I might find stressful, you might don't give a crap. I can be stressed out when my car is breaking down, someone else might not give a crap.

You need to find something that you enjoy doing.

Also, 0 stress isn't the best option. Boredom can quickly eat you out if you don't have any stress/challenge from your work. Being depressed because of your job isn't better than having some moments of stress here and there.

 

[TheMightyAngus]

I think the least stressful specialty is ones that have the most future job security. With the mid-level professionals propping up everywhere, it's stressful to just think how they may, in the near future, replace you. Consider:

ophthalmologist vs optometrist
anesthesiologist vs CRNA
psychiatrist vs psychologist
PM &R vs Doctor of Physical Therapy
Primary care physician vs NP/PA

Do you have any evidence at all for:

- physicians losing their jobs because they are being replaced by mid-level professionals?

- physicians having trouble finding jobs because mid-level professionals are so in demand?

- a trend of medical students not entering specialties because of threats of mid-level professionals taking over a certain field?

- physicians losing sleep because they are losing turf wars to mid-level professionals?

 

[swpm]

- a trend of medical students not entering specialties because of threats of mid-level professionals taking over a certain field?

Take a look at what happened to anesthesiology in the 90s. Fear of CRNAs taking over significantly contributed to creating an era when residency programs went unfilled. It wasn't until a couple years ago that anesthesiology started to become a competitive specialty again.

While those fears never materialized, it's not like the AANA isn't still trying to make the sick dream of independent CRNAs a reality.

If not, then stop with all "the sky is falling!" bull$hit.

The sky isn't falling, but few people doubt that the ceiling on future earnings is coming down, in part because mid-levels are encroaching on territory traditionally served by physicians.

 

[mlw03]

i think hospice medicine/palliative care has to be relatively low stress. the patients are terminal, so you know they are eventually going to die. and even if the patient is not DNR, they're probably at home when that happens and the hospice doc won't be the one dealing with that.

 

[TUCOMSam]

I think the least stressful specialty is ones that have the most future job security. With the mid-level professionals propping up everywhere, it's stressful to just think how they may, in the near future, replace you. Consider:

ophthalmologist vs optometrist
anesthesiologist vs CRNA
psychiatrist vs psychologist
PM &R vs Doctor of Physical Therapy
Primary care physician vs NP/PA

If PM&R were simply the same work as what PT does, I'd agree with you on that, but since PT is more UNrelated than related to PM&R, this is a HUGE stretch. Besides, many states now require PT's to earn their DPT to practice as a PT, so just because a PT is a "DPT" doesn't make them "closer" to that of a physiatrist. I'm sure similar arguments could be made for your other loose associations, but I'm not as familiar with those specialities.

 

[radonc]

radiation oncology

 

[3dtp]

radiation oncology

. . . right up until you have a 23 y.o with an oral tongue squamous cell carcinoma that should be curable recur at the margin of your treatment field and there's not a thing you can do about it now that you've given full dose to the oral cavity.

. . . or the radiation induced soft tissue sarcoma in the now 30 year old you radiated for a Hodgkin's as a child.

. . .or the destruction of the optic chiasm after the stereotactic radiosurgery procedure that got just a little too close.

. . . or having to tell your patient that they have a recurrence of their cancer with little hope of further treatments able to help their conditions.

There is no doubt that anytime dangerous processes and procedures are used, against potentially life threatening illnesses, that sometimes these procedures will work, and sometimes they will not. And when they don't, be it an anaphylactic reaction to an antibiotic or a "nicking of an artery" or a failure to intubate timely, significant stress in all areas of medicine.

Psych emergency? The depressed patient with a pistol pointed at her former boss with 3 clips of ammunition on her belt calling the psychiatrist up on the telephone to let 'em know what she's about to do.

So, pick the specialty, pick the stress you can live with. For radiation oncology, it's delayed gratification, delayed stress. For surgery, it's there's feces all over the place from the inadvertently opened bowel, so let's clean it up right now! stress. And so on.

 

[sddoc]

Least stressful clinical = vacation month...

 

[Miami_med]

Whatever speciality you don't do. The grass is always greener.

 

[outofhere]

I am surprised how people think psychiatry can be so simplistic. It isn't just about NMS, a suicidal patient, or any of the situations named above. To be a psychiatrist is also being sponge for people's feelings, whether consciously or unconsciously, and THAT, is what I find exhausting. To be constantly on the look out for projection/projective identification, and to do the most therapeutic thing.
I am also surprised that people think anesthesia or rad onc can be least stressful: we are talking about life or death, and each decision is very important.
I think, all specialties have their days of high stress and days of lower stress. The work that is MOST stressful is parenting. Even retirement is viewed as stressful by experts who study retirees.

 

[8744]

I suppose reumatology, revalidation medicine, clinical genetics, occupational medicine make a chance... Also ophtalmology and ENT, but that's just my personal opinion.

What in the fourth and fifth levels of ice-cold hell is "revalidation medicine?"

 

[8744]

Stress is relative for everyone. What I might find stressful, you might don't give a crap. I can be stressed out when my car is breaking down, someone else might not give a crap.

You need to find something that you enjoy doing.

Also, 0 stress isn't the best option. Boredom can quickly eat you out if you don't have any stress/challenge from your work. Being depressed because of your job isn't better than having some moments of stress here and there.

Right. I'm on call tonight in the ICU and have intubated two patients, put in two central lines, a femoral line, and two radial areterial lines as well as getting a few potentially disasterous admissions. And I'm not stressed in the least. In fact, your Uncle Panda has finally found a rotation where call is, if not exactly a hoot, tolerable.

But having to keep track of all the preventive medicine things in Family Medicine clinic had me climbing the walls. I literally became sick to my stomach contemplating another day of that clinic.

 

[deleted109597]

What in the fourth and fifth levels of ice-cold hell is "revalidation medicine?"

I don't know, but it sounds pretty sweet. Sort like what they did in Austin Powers. No, wait, that was reanimation. Who knows then.

 

[deleted87716]

What in the fourth and fifth levels of ice-cold hell is "revalidation medicine?"

I think that's the field where you just tell your patients to say, "I'm good enough, I'm smart enough, and gosh darn it, people like me!"

(And no, smartass, that's not FM. )

 

[SLUser11]

Whatever speciality you don't do. The grass is always greener.

Bingo.

Being a physician isn't a low stress occupation, no matter what you do.

It is amazing how little insight some residents choose to have regarding their co-residents in different specialties.

I just recently started perusing the "general residency issues" forum, and what I'm finding is a bunch of threads where a comparison of specialties comes up, followed by some bashing and counter-bashing from residents in different specialties with the "man, you don't even know what I go through, man!" bullcrap.

The worst part, in my opinion, is the specialty "Mad Libs" that goes on, when someone comes back with, "Oh yeah! You think my job is easy?!? What about when a (extreme of age) year-old comes in to (office/ER/OR/ICU) with a (difficult and rare condition only your specialty is qualified to handle) and needs a (line/operation/hug/intubation/etc)????? You won't be thinking it's easy then!!!!!"

Please STFU.

(Stop The Fighting which is Unnecessary)

 

[cchoukal]

Stress is relative for everyone. What I might find stressful, you might don't give a crap. I can be stressed out when my car is breaking down, someone else might not give a crap.

You need to find something that you enjoy doing.

Also, 0 stress isn't the best option. Boredom can quickly eat you out if you don't have any stress/challenge from your work. Being depressed because of your job isn't better than having some moments of stress here and there.

He said boredom can "eat you out." Awesome.

 

[Trisomy13]

. . . right up until you have a 23 y.o with an oral tongue squamous cell carcinoma that should be curable recur at the margin of your treatment field and there's not a thing you can do about it now that you've given full dose to the oral cavity.

. . . or the radiation induced soft tissue sarcoma in the now 30 year old you radiated for a Hodgkin's as a child.

. . .or the destruction of the optic chiasm after the stereotactic radiosurgery procedure that got just a little too close.

. . . or having to tell your patient that they have a recurrence of their cancer with little hope of further treatments able to help their conditions.

i find these situations to be sad, not stressful.


and to whomever thinks psych is not without stress, you have not had a diagnosed schizophrenic talk crazytalk to you for 20 minutes then stand up and slam the door shut with you still in the room. so that's why they say to sit between the patient and the door... oops... "just restrain him" ok.. as soon as security gets the door unlocked, hopefully sometime before mr. crazyeyes peels my skull like an orange and makes my skin into a lampshade.

 

[SLUser11]

and to whomever thinks psych is not without stress, you have not had a diagnosed schizophrenic talk crazytalk to you for 20 minutes then stand up and slam the door shut with you still in the room.

Mad Libs case-in-point.