Lifestyle/Income

[Dolphins1994]

Assuming you had the necessary research, step score and anything else to land any residency you'd want, which field in your opinion has the best Income:Lifestyle ratio if that was your top priority?? I know derm is high on the list, what others

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[Stagg737]

Cosmetic/aesthetic plastics

 

[libertyyne]

Do what you love, there are many people that end up hating what they are doing on a daily basis so even 40 hours seems like an eternity .

 

[Dr. Doctor MD]

Also:
GI (not hospital based, outpatient & colonoscopies)
Cosmetic Plastics
Elective Joint Ortho
Optho
Rad Onc
Uro-Gyn
Breast Oncology
Maternal Fetal Medicine
Cash Pay Psychiatry
Radiology
Anesthesia

EDIT:
Anesthesia (Controversial)
ED (Controversial)
Oncology (Added)

 

[anbuitachi]

Also:
GI (not hospital based, outpatient & colonoscopies)
Cosmetic Plastics
Elective Joint Ortho
Optho
Rad Onc
Uro-Gyn
Breast Oncology
Maternal Fetal Medicine
Cash Pay Psychiatry
Radiology
Anesthesia

I would not put GI on the list, if GI goes on the list, then all the high paying IM specialties needs to be on the list eg cards, heme onc.

100% NOT anesthesiology. One of the most worked field on average (right behind vascular surgery according to AAMC.org at 61 hrs). Tons of emergencies, overnight work. you will have no life style and be stressed. you will also be an employee and not your own boss unlike most of the above fields. You can maybe find a job with regular hours in a endoscopy center or surgery center but your boss will be GI docs / surgeons

One of the best income to lifestyle field is actually emergency medicine if you can tolerate the work setting. You literally work like a normal person (35 hrs a week), make one of the highest per hour salary in medicine (200++ per hour). shift work so you know when you are done and once you finish, you are done. shifts in large metropolitan EDs can be very busy, but you can easily find a more quiet ED and have a good time even at work! This is why fields like ED, psychiatry, PMR, are getting increasingly more competitive!

 

[InternistDO]

Anyone who says emergency medicine is a lifestyle specialty has clearly never worked rotating shift work, or possibly never actually been inside an ED. I'm not saying its a bad specialty, and there are definitely specialties that have it worse, but compared to derm or cosmetic plastics or total joint ortho it's not even in the same universe.

 

[anbuitachi]

Anyone who says emergency medicine is a lifestyle specialty has clearly never worked rotating shift work, or possibly never actually been inside an ED. I'm not saying its a bad specialty, and there are definitely specialties that have it worse, but compared to derm or cosmetic plastics or total joint ortho it's not even in the same universe.

really? because when i was in medical school, the EM recruitment meeting talked about how it is a lifestyle specialty. i guess none of those EM docs knew what they were talking about. onward to residency, i did a month of EM, 21 12hr rotating shifts. this is significantly more than what a EM attending would work, but it wasn't bad at all. i can imagine as an attending itd be even better since more days off. also, plenty of EM resident friends who love it and enjoys their life outside of work. they are literally the ones who post the most travelling pictures cause they actually have time..

obviously some people dislike the work environment, but i would 100% say its a lifestyle specialty for those that like working in the ED.

 

[Oso]

Perfect, I was just thinking that there weren't enough copies of this exact same thread on this website

 

[LoGo]

The trouble with your question comes down to whether you want to know the straight up highest ratio, or if you place relatively more value on your money ceiling or relatively more value on lifestyle. From a ratio perspective, and probably lifestyle wise as well (defined by hours worked in total, and lack of evening/weekend call) not much beats general derm practice. Pure cosmetic plastics can probably have a higher ceiling (by extension, so could pure cosmetic derm), but with that will almost certainly come a worse lifestyle than a general dermatologist (and pure cosmetic plastics/derm is not common). Other things with a high ceiling are ortho, neurosurgery, cardiology, rads but will work A LOT. Psych, PMR and EM have relatively low hours so the pay they make actually can work out well from a ratio perspective. On balance though, derm is king. You know this already.

 

[operaman]

Lots of good answers already here. I’ll simply add that there are many such fields within the surgical sub specialties as well depending on your practice setup. Also depends heavily on location - I know some primary care docs in smaller towns making very good money working 8-6 style hours.

All that to say you can probably carve out a lucrative laid back setup in almost any field assuming you have the right personality and business sense. Most important is what you actually enjoy doing, or what you least hate doing.

Ex: You can make a ton of money is cosmetic plastics, but then that’s a very difficult patient population and very demanding since they are paying top dollar out of pocket. Fillers and Botox are fun to do but could definitely get boring after awhile. But then again facial plastic surgeries are some of the more nuanced and intricate and challenging surgeries out there. Some people hate them because of this while others love it. If you enjoy the work of a cosmetic plastics practice then that’s a very lucrative and lifestyle friendly field, but if you despise your job and are miserable, you’ll wish you’d found some other lucrative field you actually kind of enjoyed.

 

[nlax30]

In my opinion this is kind of a useless question as what one considers a specific field’s perks and downsides are up to that individual. Ex: Whike working scattered ED shifts for $250+/hr may seem like a great balance to one person who doesn’t mind shift work and odd hours, it may seem like a horrible deal for someone else who sees shift work and off hour work as a negative.

One may certainly enjoy the potential financial reward of a cash based plastics practice however someone else may view dealing with that pt population as not worth the money.

Beauty is in the eye of the beholder....

 

[anbuitachi]

also it takes time to build up the practice. chances are you aren't going to finish residency and have patients lining up for you willing to pay you top dollars

 

[The Knife & Gun Club]

Yea as others have said, its possible to carve a high income + good lifestyle combo in most fields. However its much harder to do so wile also doing things you enjoy.

No you don't have to love every day of work (no one does), but after 3-9 years of residency many people have found things they really enjoy. Sacrificing a some salary or lifestyle for enjoyable work is common not just in medicine, but in most jobs.

 

[Tenk]

Anyone who says emergency medicine is a lifestyle specialty has clearly never worked rotating shift work, or possibly never actually been inside an ED. I'm not saying its a bad specialty, and there are definitely specialties that have it worse, but compared to derm or cosmetic plastics or total joint ortho it's not even in the same universe.

Sup. If you don’t think EM is a lifestyle specialty you are doing it wrong. It is by far and away the best life specialty because it gives you 50-60% of your days off.

 

[DrGoon]

psych is the new derm

 

[InternistDO]

Sup. If you don’t think EM is a lifestyle specialty you are doing it wrong. It is by far and away the best life specialty because it gives you 50-60% of your days off.

I'm not saying EM is a BAD specialty. But I think there are too many aspects of EM that aren't lifestyle-ish (the day/night flip, the patient population, metrics, stress, etc) to put it on the level of "unquestionably lifestyle specialities". I love EM, but you only have to go over to the EM forum here to see how burned out people can get on it despite the low hours.

All I'm cautioning against is diving into a specialty solely because of the promise of low hours and high hourly pay, because as others have said, if you don't actually like the day to day work even 30 hours a week can be a real grind.

 

[NickNaylor]

Money and lifestyle, while important, are not everything. IMO even higher on that list should be what you actually enjoy doing and molding that within your expectations for money/lifestyle. No matter what field you work in you're probably going to be working a lot - at least during residency - and there's a lot to be said for really enjoying the work that you're doing. I would argue that doing work that pays extremely well with relatively minimal hours that you hate is less ideal than working more, perhaps for less pay, but is something that you really enjoy doing.

 

[Frogger27]

Lots of good answers already here. I’ll simply add that there are many such fields within the surgical sub specialties as well depending on your practice setup. Also depends heavily on location - I know some primary care docs in smaller towns making very good money working 8-6 style hours.

All that to say you can probably carve out a lucrative laid back setup in almost any field assuming you have the right personality and business sense. Most important is what you actually enjoy doing, or what you least hate doing.

Ex: You can make a ton of money is cosmetic plastics, but then that’s a very difficult patient population and very demanding since they are paying top dollar out of pocket. Fillers and Botox are fun to do but could definitely get boring after awhile. But then again facial plastic surgeries are some of the more nuanced and intricate and challenging surgeries out there. Some people hate them because of this while others love it. If you enjoy the work of a cosmetic plastics practice then that’s a very lucrative and lifestyle friendly field, but if you despise your job and are miserable, you’ll wish you’d found some other lucrative field you actually kind of enjoyed.

Lets get a list of some of these (understanding there is variability but on average for the specialty):
ENT
Optho
Urology
Ortho- joints/possibly hand?
Breast
Colorectal
Bariatrics

 

[libertyyne]

Lets get a list of some of these (understanding there is variability but on average for the specialty):
ENT
Optho
Urology
Ortho- joints/possibly hand?
Breast
Colorectal
Bariatrics

Neurosurgery is a lifestyle specialty too, however the lifestyle is neurosurgery.

 

[CyrusHabs7695]

This is going to sound like a weird question but Im hoping somebody may know more than I do. Everybody knows about the big name plastic guys who do celebrities in the big markets like LA/South Florida, but does bariatric surgery also have that type of lifestyle?

 

[lagbydesign]

Lets get a list of some of these (understanding there is variability but on average for the specialty):
ENT
Optho
Urology
Ortho- joints/possibly hand?
Breast
Colorectal
Bariatrics

Yeah, hand is definitely there, as long as you can minimize hand call, lol. Any ortho subspecialty with a high ratio of outpatient cases will be closer to ''lifestyle".

 

[LBJLA23]

Radiology BY FAR. Whats better than making 400k+ a year to sit in a dark room from 8 am - 6 pm M-F, with occasional weekend call, looking at images? No better gig in medicine.

 

[jqueb29]

100% NOT anesthesiology. One of the most worked field on average (right behind vascular surgery according to AAMC.org at 61 hrs). Tons of emergencies, overnight work. you will have no life style and be stressed. you will also be an employee and not your own boss unlike most of the above fields. You can maybe find a job with regular hours in a endoscopy center or surgery center but your boss will be GI docs / surgeons

I see you’re an anesthesiologist as well so I’m certainly not going to discount your experience, but my experience has been very different. Perhaps it’s related to geographical location (not sure if you’re on one of the coasts but I’ve heard it’s rough there). The majority of the jobs I’ve heard about are pretty excellent in terms of pay, hours and vacation. They may not be in NYC or LA or San Fran, but they’re in solid medium sized cities that are plenty good for most folks.

That being said, I would say Pain is by far the best anesthesia lifestyle. It’s borderline derm-level of excellence.

 

[lagbydesign]

Radiology BY FAR. Whats better than making 400k+ a year to sit in a dark room from 8 am - 6 pm M-F, with occasional weekend call, looking at images? No better gig in medicine.

I think this should be balanced by the fact that for those hours, you are ON, specifically in private practice (where you're more often making that 400K+). It's pretty intense from what I hear. So you could call rads "lifestyle", but not relaxed by any means. A relaxed field might be something like gas (depends on practice set up), psych, allergy, rheum, clinic only ENT, or derm.

 

[LBJLA23]

I think this should be balanced by the fact that for those hours, you are ON, specifically in private practice (where you're more often making that 400K+). It's pretty intense from what I hear. So you could call rads "lifestyle", but not relaxed by any means. A relaxed field might be something like gas (depends on practice set up), psych, allergy, rheum, clinic only ENT, or derm.

Sure, you're working hard at your job. But lifestyle to me is all about balance. You work hard when you work (although not seeing patients is a HUGE plus), but you also get to enjoy life outside work with a regular schedule and 12 weeks vacation.

 

[Blunt Dissection]

Cosmetic/aesthetic plastics

I’ll add that the caveat to this is that elective plastics is notorious for dissatisfaction resulting in legal action. They almost always end with the physician being in the right, but they are stress inducing all the same.

 

[Horners]

We get this thread at least once a month... for those of you first time looking, it will most likely end up like this:

- EM flame war (it’s really chill vs it’s the hardest job on the planet).

- people touting that surgical sub specialities are actually the most chill after 7 years of training and 5 years of establishing yourself (you’ll love your 50s!)

- the occasional Psych/Pm&r is the new derm!!

- the occasional moral superiority guy “if you want a good lifestyle, why did you do medicine?!?! If you don’t sacrifice your life you don’t deserve to be here!!!!”

- some guy talking about academia (?!?!)

- The anesthesiology residents and attendings telling you to drop out and become a CRNA.

Of note... people who never post on these threads are dermatologists and plastic surgeons. I imagine they have trouble reaching WiFi from their yachts.


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[libertyyne]

We get this thread at least once a month... for those of you first time looking, it will most likely end up like this:

- EM flame war (it’s really chill vs it’s the hardest job on the planet).

- people touting that surgical sub specialities are actually the most chill after 7 years of training and 5 years of establishing yourself (you’ll love your 50s!)

- the occasional Psych/Pm&r is the new derm!!

- the occasional moral superiority guy “if you want a good lifestyle, why did you do medicine?!?! If you don’t sacrifice your life you don’t deserve to be here!!!!”

- some guy talking about academia (?!?!)

- The anesthesiology residents and attendings telling you to drop out and become a CRNA.

Of note... people who never post on these threads are dermatologists and plastic surgeons. I imagine they have trouble reaching WiFi from their yachts.


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They must not be very good dermatologists or plastic surgeons if their yachts dont have direct satellite uplinks.

 

[Tenk]

I'm not saying EM is a BAD specialty. But I think there are too many aspects of EM that aren't lifestyle-ish (the day/night flip, the patient population, metrics, stress, etc) to put it on the level of "unquestionably lifestyle specialities". I love EM, but you only have to go over to the EM forum here to see how burned out people can get on it despite the low hours.

All I'm cautioning against is diving into a specialty solely because of the promise of low hours and high hourly pay, because as others have said, if you don't actually like the day to day work even 30 hours a week can be a real grind.

Most of the people who burn out are doing it wrong. They are working too much, working in a malignant environment, living above their means, or a combination of the three. Once you cut your monthly expenditures, cut your hours, and enjoy tons of time off, the job is amazing. I took four vacations in the last 45 days while working full time. No other specialty allows that.

You are right though. Not everyone is suited to work in the ED. It can be stressful and shift work can really mess people up. But if you learn how to deal with these negatives as I have (mainly by working the bare bones minimum), the job becomes a blessing.

 

[NITRAS]

There are loads of ways to make money as a boarded physician. There are a ton of FM or IM docs that do clinic, cover a NH or SNF that make more than your average ED doc.

In my hospitalist group, there are those that do hospice, palliative care, coding and billing (both inside our system and outside). Now I don't consider these to be high income "lifestyle" actions. . . . But you can easily do it for 30 years.

Personally, I don't consider nights and swing shift to be "lifestyle". The shift work makes it easier to do vacations (4 vacations in 45 days. . . . I'd need a staycation to recover darn. ). I really enjoy my weeks on, weeks off, but I'd be hard pressed to call it a "lifestyle schedule." Basically working half the holidays puts you in dyssynchrony with average life.

 

[Mad Jack]

Inpatient psych can be a solid gig. I've I know plenty of people that pulled mid-300s for working 8-1 M-F, with every third or fourth weekend rounding. Not bad for averaging 28ish hours per week

 

[Gurby]

We get this thread at least once a month... for those of you first time looking, it will most likely end up like this:

- EM flame war (it’s really chill vs it’s the hardest job on the planet).

- people touting that surgical sub specialities are actually the most chill after 7 years of training and 5 years of establishing yourself (you’ll love your 50s!)

- the occasional Psych/Pm&r is the new derm!!

- the occasional moral superiority guy “if you want a good lifestyle, why did you do medicine?!?! If you don’t sacrifice your life you don’t deserve to be here!!!!”

- some guy talking about academia (?!?!)

- The anesthesiology residents and attendings telling you to drop out and become a CRNA.

Of note... people who never post on these threads are dermatologists and plastic surgeons. I imagine they have trouble reaching WiFi from their yachts.


Sent from my iPhone using SDN mobile

I am very impressed by the insight you are displaying as a pre-med and 1-year SDN member.

 

[SterlingMaloryArcher]

People keep saying cosmetic plastics but not really

 

[Horners]

I am very impressed by the insight you are displaying as a pre-med and 1-year SDN member.

Hahaha I appreciate that. I’m 3rd year medical student though. If a residency doesn’t accept me, I’ll try my hand at stand up for the medical community.


Price of the ticket correlates to medical speciality...
Plastic surgeons: $1000/ticket
Pediatricians: we’ll hand you $20 for coming.


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[nimbus]

People keep saying cosmetic plastics but not really

I’ve spoken to a couple of cosmetic surgeons who have $10-20k weekly overhead. It is not a low stress situation.

 

[atomi]

Rad Onc but only if you are literally willing to live in the middle of nowhere where there is dial up internet, a dollar general, and a gas station that doubles as the only grocery store.

 

[jdh71]

I think the days of working very little and getting a gigantic paycheck in medicine are gone for basically all specialties.

No matter what you go into you'll work hard for every thin dime.

What does "lifestyle" mean anyway? Simply "not at work"?

 

[operaman]

Lets get a list of some of these (understanding there is variability but on average for the specialty):
ENT
Optho
Urology
Ortho- joints/possibly hand?
Breast
Colorectal
Bariatrics

ENT is what I know best. In that I’ve seen legit job offers for fresh otology grads in the 600-700k range in good locations. Those are typically 4-5 days a week usually working reasonable hours save for the long skull base cases. Minimal call and absence of many true ear emergencies. Personally much more interesting than other lifestyle fields.

From ent you can do cosmetic facial plastics. I’ve seen first year offers in the 4-500 range in decent cities and know some recent grads making substantially more.

ENT in general tends to be more lifestyle friendly and with decent demand. It’s no derm but it’s also more fun imo. Highest offer I’ve seen for a fresh grad was 1 mil but in a very rural undesirable location. I know a number of private guys who take no hospital call and work 4 day weeks. Lots of potential for ancillary income in private practice also tends to help people do very well. I know a number of partners in bigger groups making 7 figures. This is definitely in the upper percentiles for the field but doable if you’re willing to do what it takes to make this happen.

 

[Oso]

We get this thread at least once a month... for those of you first time looking, it will most likely end up like this:

- EM flame war (it’s really chill vs it’s the hardest job on the planet).

- people touting that surgical sub specialities are actually the most chill after 7 years of training and 5 years of establishing yourself (you’ll love your 50s!)

- the occasional Psych/Pm&r is the new derm!!

- the occasional moral superiority guy “if you want a good lifestyle, why did you do medicine?!?! If you don’t sacrifice your life you don’t deserve to be here!!!!”

- some guy talking about academia (?!?!)

- The anesthesiology residents and attendings telling you to drop out and become a CRNA.

Of note... people who never post on these threads are dermatologists and plastic surgeons. I imagine they have trouble reaching WiFi from their yachts.


Sent from my iPhone using SDN mobile

One of the greatest pieces of writing I have ever seen, wow.

Hahaha I appreciate that. I’m 3rd year medical student though. If a residency doesn’t accept me, I’ll try my hand at stand up for the medical community.

Price of the ticket correlates to medical speciality...
Plastic surgeons: $1000/ticket
Pediatricians: we’ll hand you $20 for coming.


Sent from my iPhone using SDN mobile

 

[SterlingMaloryArcher]

I’ve spoken to a couple of cosmetic surgeons who have $10-20k weekly overhead. It is not a low stress situation.

That's what I'm saying. Plastic surgery is quite the hustle and does far from the highest paying surgical specialty.

 

[emergentmd]

These discussions are such a waste of time. It gives very little insight as everyone has a different definition of lifestyle that changes with your current situation.

EM has a great lifestyle if what it can offer is what you are looking in a lifestyle. When I first started as an attending and not married it was great. A perfect field. Work overnight was fine, slept in the next day. Flipping was not hard. But once you have kids it completely changes the dynamics. You will miss 2 weekends in a month. Working overnight is difficult as you will be awoken by the kids when they wake up. Its also harder to do when you get older. So it went from the perfect field to a more difficult situation.

EM is a great lifestyle if:
You want to have a 3 yr residency, and come out making 350K/yr. This was BIG to me. After a long haul in med school, I didn't want to extend residency much more than 3 yrs.
You want nothing to do with the business side of medicine and just want to be an employee.
You want to work only 12-15 dys a month and be completely detached from clinical/business side of medicine the rest of the month
You want to be able to take a week long trip every month
You like to be off days when everyone is working to run errands, go downtown
You like to go to work not during peek hours on most of your shifts
You want to work almost anywhere in the country
You want to move to different places anytime you want in your career

EM is not a great lifestyle if
You want to work a 9-5 job most of the days
You want to own your own business and make your own decisions
You want to see your kids on all holidays and weekends
You want to never do Nights again


Every specialist I have talked always have complaints of their fields. Every specialists I talked to envy my schedule. Its the typical grass is greener. I envy some aspects of their lives too.

I think Derm is a great lifestyle field and only 4 yrs of residency or 5-6 yrs with a fellowship. But that is not practical for the vast majority of students to get into so its a nonstarter for the masses
ENT/ortho/some other surg specialty is great but its a again hard to get into and not practical for the majority. Plus its 5 yrs plus any fellowship. Plus once you set up a practice, its very difficult to move and set up another practice in another area. Most ENT docs I know the past 20 yrs are still in the same city b/c its not practical to start over.

The rest does not even come close to the lifestyle EM/money

IM/Peds/FM - same 3 yrs residency, 9-5 but the pay is not even close while working more hours
Hospitalist - same 3 yrs, hours are just as variable, work more hours, still do overnights but less pay
Gas - Hours sucks, call, more hours, pay similar
Rad - Not the your father's lifestyle job. Still crappy hours, more hours, 5+ yrs residency
Most IM specialities - Still have call, long hours, longer residency/fellowship, pay similar
Gen Surg - 5 yrs residency, long hours, still have call, pay similar
OB - Prob the field that mimics residency that I could think of. Still have call and can be up all night. I have friends who still have their 9-5 clinic, take call, then back to their 9-5 clinic the next day. What a beatdown.

Overall, if I could go back 20 yrs ago and I could get into any field, the only one I would go into is Derm if you are taking into what I consider lifestyle (pay, total hours work a month, what are the work hours, ease of travel, ease of job location, ease of taking vacations, ease of moving to another city)

 

[Newyawk]

Isnt anyone considering the fact that 3x as many med students are entering EM now and the salaries are very likely to decrease due to increasing supply? In NY most EM people ive met already only make 200-250 working full time in hospitals with the worst patients

 

[emergentmd]

This is with all specialty. When things are great everyone wants to go into said field. No different than anything that drives economics.

If you can sell a bottle of water that cost you 25 cents to make/distribute and you can sell it for $10/bottle every pop up will start to make water. Once you can only sell it for 26 cents, only the ones with no other options will make water.

Its all about supply and demand which is what life revolves around.

 

[AsianPersuasion]

I won't go into strictly outpatient based or non-surgical specialties even if it pays a mil a year. Absolutely not. Surgery or bust. I will still pick vascular even it's the lowest paid specialty.

 

[Blanky]

We get this thread at least once a month... for those of you first time looking, it will most likely end up like this:

- EM flame war (it’s really chill vs it’s the hardest job on the planet).

- people touting that surgical sub specialities are actually the most chill after 7 years of training and 5 years of establishing yourself (you’ll love your 50s!)

- the occasional Psych/Pm&r is the new derm!!

- the occasional moral superiority guy “if you want a good lifestyle, why did you do medicine?!?! If you don’t sacrifice your life you don’t deserve to be here!!!!”

- some guy talking about academia (?!?!)

- The anesthesiology residents and attendings telling you to drop out and become a CRNA.

Of note... people who never post on these threads are dermatologists and plastic surgeons. I imagine they have trouble reaching WiFi from their yachts.


Sent from my iPhone using SDN mobile

I am very impressed by the insight you are displaying as a pre-med and 1-year SDN member.

YESSSSSS!!!

 

[CyrusHabs7695]

I won't go into strictly outpatient based or non-surgical specialties even if it pays a mil a year. Absolutely not. Surgery or bust. I will still pick vascular even it's the lowest paid specialty.

 

[Horners]

I won't go into strictly outpatient based or non-surgical specialties even if it pays a mil a year. Absolutely not. Surgery or bust. I will still pick vascular even it's the lowest paid specialty.

Tell us more! Please elaborate, why is that?


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[Dro133]

Tell us more! Please elaborate, why is that?


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Probably because he's a masochist is my guess.

 

[AsianPersuasion]

Probably because he's a masochist is my guess.

I do enjoy Japanese Rope Bondage.

 

[Dro133]

I do enjoy Japanese Rope Bondage.

Your username suddenly makes a lot more sense