Love cardiology but the lifestyle is making me hesitant.

[Frostheat]

Hello, everyone

I'm a non-US medical student in my intern year (Matching occurs after 8 months of internship here). I loved my IM rotation in medical. Loved the complexity of ruling out differential diagnoses and managing complex cases in the wards. Clinic was a bit boring as most patients were following up so 90% was just continuing the prescription, changing the dose, or adding/removing a drug. I love the knowledge base of IM. I like that I know a lot about most of the systems in the human body and how they interact with each other. However, at the same time I also would like to work with my hands. Intellectually stimulating cases are my thing but not using my hands may make me feel like I am not doing everything I can. Of course, if I didn't have a subspecialty in mind I wouldn't have picked IM as my first choice. I loved cardiology. The physiology is so interesting to me and I like the physics aspect of it. The pathology is interesting to me as well. It has procedures like echo, stress ECG, and cath.

That being said, I also value my life outside of work. I can work hard during my working hours, but after that I'd like to focus on my own life. Do you really need to sacrifice life outside of work being a cardiologist? I don't like the aspect of being called at night for something. This hesitancy somehow brought me to ENT. I shadowed an ENT attending for a week and it seems like his workload is not that high. Surgeries are mostly simple and not time-consuming. Clinic is "active" with tons of procedures to diagnose and treat. No nasty oncalls from what I've seen (Foreign bodies were like 90% of cases). It seemed pretty chill to me, honestly. The ENT residents I met did say that it was difficult like all residencies but they seem pretty chill as well (And a bit sleep deprived). Admittingly, ENT's knowledge is new to me and I never before cared for that area in the human body. I forgot my ENT anatomy that I learned in my preclinical years so I couldn't really appreciate the operations that I attended.

ENT is a lot more competitive than IM just like in the US, but here the focus is more on the national licensing exam scores and LORs. There isn't a huge focus on research (Which I lack in the ENT department). Cardiology isn't the only IM subspecialty that I'm interested in. Heme/Onc and pulm/CC are ones I think are interesting too but not nearly enough as cardiology. I think heme/onc would have a good lifestyle but I'm not sure.

---

Members don't see this ad.

 

[timpview]

Personally I think ENT and urology are hidden gems but maybe the grass is greener.

lifestyle in cardiology can be fine if you do general cardiology and large group (10-15 cardiologists).. 2-3 nights of call a month (with many big groups having post call days) is manageable for most

for me, it’s nights, weekends and doing procedures on actively dying patients (or pts that an die in a split second) that add stress to my life.

take that away and for me personally I could do any job in medicine (gen cardiology, endocrinology, Im, nephrology, etc) pretty stress free

so yes.. some can have a good lifestyle but most don’t imo.. though many that don’t don’t seem to care that they don’t. It attracts that type...

 

[Frostheat]

2-3 night calls a month doesn't seem too bad but from what I understood from you it is depending on the place you work at? I mean 2-3 nights seems like a low number but it still doesn't sit right with me.

 

[timpview]

Yes depends if you find a large group that equally shares call. So yes 2-3x month is best case scenario and probably only encompasses <10% of real world jobs (again isolated to general cards).. u might find some EP jobs that take minimal to no call but no guarantee there either.

so yes, if lifestyle is paramount than forget cardiology. A lot better options out there -

 

[cards67]

Depends hugely on the job, hospital, practice setup, etc. but gen cards and even EP call doesn't have to be all the bad. Call few nights per month, 1 weekend every 2 months. Hospitalist/ICU as primary that can (and should) take care of most things, especially overnight, and protect their specialists. Certainly much better lifestyle than I was led to believe as a med student. But across town cardiologist are sometimes primary and like to be consulted about everything.

ENT can be the same too. I'm not sure why ENT would entirely be spared from call or emergencies, even post-op stuff. ENT friend has probably one of the worst setups. Hospital employed, a couple colleagues, lots of turnover, always on call, gets called about everything, often primary on his own patients, no support from hospital. Yet another ENT friend in PP has a pretty good setup from what I gather. Then another ortho friend is the only hand person in their hospital and is on call everyday. It really varies.

And it's not just call but day to day OR or cath lab time. Add-ons, delays, emergencies, cases running long, etc.

Gen cards can be a pretty decent lifestyle. But most specialties take call of some sort. Otherwise best bet is hospitalist or something. But I wouldn't necessarily choose a specialty based on potential call burden, especially a specialty I'm not interested in.

 

[Frostheat]

Depends hugely on the job, hospital, practice setup, etc. but gen cards and even EP call doesn't have to be all the bad. Call few nights per month, 1 weekend every 2 months. Hospitalist/ICU as primary that can (and should) take care of most things, especially overnight, and protect their specialists. Certainly much better lifestyle than I was led to believe as a med student. But across town cardiologist are sometimes primary and like to be consulted about everything.

ENT can be the same too. I'm not sure why ENT would entirely be spared from call or emergencies, even post-op stuff. ENT friend has probably one of the worst setups. Hospital employed, a couple colleagues, lots of turnover, always on call, gets called about everything, often primary on his own patients, no support from hospital. Yet another ENT friend in PP has a pretty good setup from what I gather. Then another ortho friend is the only hand person in their hospital and is on call everyday. It really varies.

And it's not just call but day to day OR or cath lab time. Add-ons, delays, emergencies, cases running long, etc.

Gen cards can be a pretty decent lifestyle. But most specialties take call of some sort. Otherwise best bet is hospitalist or something. But I wouldn't necessarily choose a specialty based on potential call burden, especially a specialty I'm not interested in.

It's not like I'm completely disinterested in ENT. I find some things interesting. As interesting as cardiology? Not really. Internal medicine residency is actually 4 years here and you can't apply for fellowship during residency. ENT is 5 years residency. With ENT I can take my time to apply for fellowship but with IM I don't think I will like staying as internist for a couple of years.