I absolutely love learning about medicine. I always read my clerkship books cover to cover. I liked answering questions, being a consultant, and didn't really mind getting "pimped." The only time I really didn't enjoy medicine or felt close to miserable was when I had to see inpatients, do physical examinations, listen for long periods of time to patients, and stay up all night on call. I also must add, that I need a balance b/w work and life. I am not an intense person- and I hate working all the time. I have interests outside of medicine. And, I become an unhappy camper when I feel like my "free" time is compromised. Knowing all this, I'm wondering what specialties people would suggest for me. Any advice?
Luv to learn & talk about medicine, but don't like patient care
- Thread starter Siamese
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You sound like me. If you like diagnosing>>>patient management, then pathology or radiology is for you. Both have potential to be lifestyle fields.
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Tough it out through the residency of your choice and then do research. You will have 75% protected time for research and educational activities and no more than 25% clinical responsibility. Your job will pretty much be 9-5.
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I agree with radiology, or perhaps pathology.
If the OP tries to "tough it out" through 3+ years of a residency involving patients, he/she will be miserable and likely wouldn't make it to a faculty position, because you can't get good evals as a resident just by answering pimp questions or reading about medicine.
If the OP tries to "tough it out" through 3+ years of a residency involving patients, he/she will be miserable and likely wouldn't make it to a faculty position, because you can't get good evals as a resident just by answering pimp questions or reading about medicine.
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Depending on how much you hate staying up all night, radiology might not be for you.
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What specialties don't require staying up all night throughout residency?
The only ones I can think of are dermatology, and rad onc., and possibly pathology. Staying up all night reading films seems like it would be less onerous for the OP than staying up all night answering nurse pages, doing admissions and talking with patients and their families like the OP would have to do if he/she does peds, medicine or surgery.
The only ones I can think of are dermatology, and rad onc., and possibly pathology. Staying up all night reading films seems like it would be less onerous for the OP than staying up all night answering nurse pages, doing admissions and talking with patients and their families like the OP would have to do if he/she does peds, medicine or surgery.
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If you really are kept up all night by constant nurses' pages, etc., then I agree that reading imaging studies seems tame in comparison. But how often are you continuously being annoyed when on that type of call? I'm sure it happens, but my point is that you are exponentionally more likely to get rest on call as a pediatric, medicine, or even surgical resident than in radiology. Radiology call is non-stop; I frequently don't get out of my chair for any longer than to go to the bathroom for 10-12 hours straight. The only call I've taken that compares to radiology call is in a busy ICU or on a trauma surgery service. Then again, for every trauma patient, there's a radiologist awake reading the dozens of trauma CTs, so I'm not sure that one should even count.
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Pretty much every single one actually.
I'm not saying that rads call is a cakewalk but I'm pretty sure that at most academic institutions it's not q3 or q4 like it is for med/surg/peds. At my institution, the rads folks have qResident call and that includes the reading (but not interventional) fellows as well so it's something like 2-3x a month (seniors and fellows don't do weekends). I will agree that you're basically chained to your monitor from 6p - 8a while on call and that can get old fast.
But you never get the 3am call for colace on a patient who's sleeping soundly but, the nurse just noted (while doing the once per shift chart check between sudoku and facebook) that Mr. Jones in room 29 hasn't pooped today.
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Point taken, but that's not what we're discussing. The OP indicated an unwillingness to stay up all night. If the OP stated an unwillingness to take call Q3-4, then you'd be completely correct. Even though he or she would almost certainly take call less frequently in radiology, I'd be willing to bet he or she would stay up all night a lot more often in radiology than the vast majority of other residencies.
I'm not trying to argue that radiology call or radiology residency is easier or harder than any other residency. I'm just trying to point out that if you have a specific aversion to staying up all night, then there are better specialties for you than radiology.
What are people's thoughts on family medicine? Is the residency intense, or on the level of Internal medicine? Is the call bad? When I did the rotation, I really enjoyed the outpatient setting. It didn't seem too intense, and the residency is relatively short (which is a plus, considering I have other pursuits outside of medicine and time to devote to those ventures is an issue for me.)
If you hate patient care and "like being a consultant" , family medicine is a phenomenally stupid idea. FP's are never the consultant and pretty much see patients continuously.
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Actually, on medicine call I more often than not got zero sleep on a 30 hour call/shift. that is the truth. Almost 100% of the time it was true as an intern, whereas as a senior resident you might get a couple hours sleep. But you have to be there for 30 hours continuously. I know it might be hard for some to believe that interns get almost continuous nurse pages or are doing things all night, but it's the truth. I'm sure it probably varies by hospital/program, but most services @my hospital were like that. The only call where I ever got to sleep more than 10 minutes or so as an intern was hem/onc call, where a lot of patients are just there getting chemo, etc. and nurses take care of a lot of stuff.
I think a lot of the frequent nursing calls come down to the fact that the nurses knew that we were in house. Also, when you are crosscovering 30-50 patients who are not yours, you are getting calls about all those as well. And when you take admissions all night when you get that 3a.m. admission then it's going to take at least an hour-ish to get that taken care of (if you are an efficient intern), along with/in between crosscover pages and questions about your other old patients and other new admissions you'd taken earlier in thenight.
I stayed up on radiology call as a 4th year med student...no offense, but it's nothing like medicine call. They do have to concentrate a lot and try to make sure and not miss stuff on the films, however. It is really important that we have folks in house at night who are reading films in the ER reading room, and they do work hard and what they do is important. It's just not the same as running around the hospital all night, talking w/family members, doing H and P's and putting out fires (hypoxic, SOB crosscover patient, etc.). I think medicine or peds call would annoy the OP a lot more than radiology call.
I think a lot of the frequent nursing calls come down to the fact that the nurses knew that we were in house. Also, when you are crosscovering 30-50 patients who are not yours, you are getting calls about all those as well. And when you take admissions all night when you get that 3a.m. admission then it's going to take at least an hour-ish to get that taken care of (if you are an efficient intern), along with/in between crosscover pages and questions about your other old patients and other new admissions you'd taken earlier in thenight.
I stayed up on radiology call as a 4th year med student...no offense, but it's nothing like medicine call. They do have to concentrate a lot and try to make sure and not miss stuff on the films, however. It is really important that we have folks in house at night who are reading films in the ER reading room, and they do work hard and what they do is important. It's just not the same as running around the hospital all night, talking w/family members, doing H and P's and putting out fires (hypoxic, SOB crosscover patient, etc.). I think medicine or peds call would annoy the OP a lot more than radiology call.
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Fair enough. As you mentioned, I think there must be a lot of inter-hospital variability. I know the peds and medicine overnight residents routinely get sleep at my institution, and the intern on general surgery does as well. I, on the other hand, only got a few seconds of sleep last night because I fell asleep on my computer's keyboard.
I would also submit that watching someone else work on call as a medical student doesn't even approximate the mental energy spent by an on-call radiologist. I'll never convince anyone of this unless they've actually experienced it, but interpretting and dictating heinous study after heinous study can really wipe a person out.
Suffice it to say that the experiences are pretty different by nature but at least have the potentional to be equally draining.
I would also submit that watching someone else work on call as a medical student doesn't even approximate the mental energy spent by an on-call radiologist. I'll never convince anyone of this unless they've actually experienced it, but interpretting and dictating heinous study after heinous study can really wipe a person out.
Suffice it to say that the experiences are pretty different by nature but at least have the potentional to be equally draining.
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Family medicine = "listen for long periods of time to patients" medicine.
Your outpatient rotation is not like residency. You'll have inpatient Medicine, Paeds, Surg and O&G and family doctors pride themselves on being all up in their patient's life. Good family doctors are like another family member. It's actually the worst possible choice based on what you said in the first post.
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It sounds like the OP is more interested in the academics of medicine and not the art of it. I'm kind of confused about why you went to med school if you don't want to spend time with patients. You could have just bought all the medical text books and read them at home without having to pay 30-40k a year and take tests. Medicine isn't like other professions, it requires a lot of self sacrifice. Someone did you a great disservice if they didn't tell you before you applied that it would involve talking to people who are sick and scared, and spending a great deal of your "free" time at the hospital.
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I agree that the radiology residents at my program stayed up all night (we were a Level 1 trauma center) and stayed after hours to get all their dictations done and studies reviewed with the attendings.
However, it does sound like you had an unusual experience or a very small quiet hospital if your IM and surgery residents (especially interns) were getting sleep regularly. DF paints a fairly realistic picture, IMHO. It was not unusual to go without sleep, eating, even sitting down for 30+ hours at a stretch. You can and will be paged by nurses for the most mundane things and over and over again. The pages can be non-stop.
But nearly all residents work hard and as you note, this isn't a contest to see who or what type of work is the worst.
The OP may be happier doing something like path which would have less overnight call, patient contact, doing physical exams or other things that would cut into his free time. However, it is still a residency which requires a LOT of commitment and studying even outside of the hospital, so I suppose it depends on how much free time the OP needs.
Reading some of the responses, I realize I should have been more clear about "not liking patient care." I do love medicine and learning. I actually do like seeing patients, but not complex cases, the critically ill, or cases that require me being in the hospital all day. When I said I liked being a consultant, I meant in reference to patients. I like being a consultant to patients. I like teaching them about medicine. Also in the context of being a medical student and having to study and take call, I grew annoyed with rotations that were demanding & didn't give me enough time to learn, read, or even have a life. I actually did a FM rotation in the outpatient setting and LOVED it. I dealt with a lot of basic conditions (HTN, DM, obesity), got to do some procedures, and all in all had a great time. The pace was good, and I liked that FM seemed to have a lot of flexibility in how you could practice. Unfortunately it seemed that many physicians were steering me away from FM (and primary care). I have heard docs complain about working like slaves, fighting with insurance companies, not getting paid enough for services, mountains of paperwork that eat into actual time to see patients, and the "business side of medicine" that can suck the life out of a primary care doc. This has absolutely terrified me. For many of the above reasons, I got cold feet about the specialty. I'm also apprehensive because of my own lack of knowledge about the business side of medicine, considering I would prefer have a private practice. I must be honest too that I really don't like call (I LOVE my sleep, LOL), but I know I would be willing to stay awake if I loved my specialty choice. Are family docs able to set up practices with no call? As far as Pathology, I never had any exposure to it, so I'm not sure. Do pathologists even see patients? But anyways, when I commented about not liking patient care, I didn't mean that I don't like seeing patients per se.
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Dude/Dudette,
You wanna take care of pts with HTN, DM, obesity, minor procedures, not see complex cases or critically ill pts, sleep through nights, take an 8 hour shift, teach patients, read, have a life...
Simple...
Be a nurse and work in an outpatient clinic. You won't have to fight with insurance companies, you'll get paid plenty for what you know and do, there will be some paperwork involved so you'll have to tough that out, and you won't have to have a clue about the "business side of medicine". It's the perfect solution for you.
Stay away from FM, or pathology for that matter! I wouldn't want you taking care of any of my family not knowing how to care for complex pts, or pts that may require a bit more of your precious time. Unless you set up a practice where you only see healthy young people, for whom you write out the odd prescription for an antibiotic or OCPs, you're going to have to deal with more complex issues, and it doesn't sound like that's up your alley.
You wanna take care of pts with HTN, DM, obesity, minor procedures, not see complex cases or critically ill pts, sleep through nights, take an 8 hour shift, teach patients, read, have a life...
Simple...
Be a nurse and work in an outpatient clinic. You won't have to fight with insurance companies, you'll get paid plenty for what you know and do, there will be some paperwork involved so you'll have to tough that out, and you won't have to have a clue about the "business side of medicine". It's the perfect solution for you.
Stay away from FM, or pathology for that matter! I wouldn't want you taking care of any of my family not knowing how to care for complex pts, or pts that may require a bit more of your precious time. Unless you set up a practice where you only see healthy young people, for whom you write out the odd prescription for an antibiotic or OCPs, you're going to have to deal with more complex issues, and it doesn't sound like that's up your alley.
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I agree -- the OP is seeking a job that doesn't exist. FPs do see "bread and butter" garden variety issues 90% of the time, but as a result insurance companies compensate them poorly per patient and they end up having to work long hours to make do. So in FP, you often will be working long hours, for low pay, and will be deeply involved in business and insurance issues on a daily basis. Hospitalists can work the good hours, but definitely deal with complex and critically ill patients. Rads and Path tend to have less patient contact, but you don't seem to want that in your latter post, and there will be overnights (and in rads you will do a intern year). I think you really needed to research medicine before you got this far. This is most often a long houred profession, in which you are dealing with sick people, and compensated through insurance reimbursements. If you want to work short hours, counsel not very sick people, and not have to deal with business or insurance issues, I think what you want is not really to be a physician.
Your question reads like -- I want a pet dog, but not one with fur, not one that eats meat, and one that never goes to the bathroom -- what kind of dog should I get?
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I disagree that this person can't find a place in medicine. The OPs history reads like mine. I loved learning about every aspect of medicine. I did not enjoy the non-stop parade of non-compliant patients and the asinine calls in the middle of the night.
Anyway, I found pathology and l love it - most days. The only relatively burdensome call we take is blood bank/transfusion medicine. This call is taken from home even in most residencies, and I was only exceedingly rarely kept up all night coordinating pheresis procedures or red cell exchanges. More commonly you will be woken up once or twice, but I promise you that it is easier to fall asleep in your own bed than any call room. The impact on my personal life is nominal relative to other fields, and that's the way I like it.
Anyway, I found pathology and l love it - most days. The only relatively burdensome call we take is blood bank/transfusion medicine. This call is taken from home even in most residencies, and I was only exceedingly rarely kept up all night coordinating pheresis procedures or red cell exchanges. More commonly you will be woken up once or twice, but I promise you that it is easier to fall asleep in your own bed than any call room. The impact on my personal life is nominal relative to other fields, and that's the way I like it.
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Path would be the obvious choice but now the OP has "recanted" somewhat and say he/she does like patient contact. The question is whether or not there is enough as a Pathologist to satisfy.
I agree with the others that it sounds like he wants the clinical duties of a physician without the hours or the work. Another option would be a cash only practice, since the details of paperwork (which you cannot escape regardless of your specialty) and insurance seem to trouble the OP. If you are competitive enough and like interacting with patients, a boutique FM practice (it can be done in certain areas of the country), Derm, Plastics, etc. would be appropriate choices although difficult to get into and set up.
If you are absolutely terrified by the reality of the business of medicine, you need to take a step back. Pathology, Rads, whatever you choose, will have business aspects you have to pay attention to. Even if you choose an employed position where you aren't doing the day to day "fighting with the insurance companies", you still have to watch the bottom line, make sure you are billing enough to earn your salary. This is a reality.
You can always hire someone to do all that stuff for you but in the end if you aren't getting paid for what you do, its because you didn't pay enough attention to what the billers and coders are doing.
I agree with the others that it sounds like he wants the clinical duties of a physician without the hours or the work. Another option would be a cash only practice, since the details of paperwork (which you cannot escape regardless of your specialty) and insurance seem to trouble the OP. If you are competitive enough and like interacting with patients, a boutique FM practice (it can be done in certain areas of the country), Derm, Plastics, etc. would be appropriate choices although difficult to get into and set up.
If you are absolutely terrified by the reality of the business of medicine, you need to take a step back. Pathology, Rads, whatever you choose, will have business aspects you have to pay attention to. Even if you choose an employed position where you aren't doing the day to day "fighting with the insurance companies", you still have to watch the bottom line, make sure you are billing enough to earn your salary. This is a reality.
You can always hire someone to do all that stuff for you but in the end if you aren't getting paid for what you do, its because you didn't pay enough attention to what the billers and coders are doing.
I'm just a 4th year, I'm constantly reminded by those who have finished residency and are well into their career path that residency was much harder than their current lifestyles. Obviously, this doesn't apply to all specialties or individuals, but I'm seen many examples of individuals who have tailored their career to the lifestyle they are looking for (much easier to do in some specialties than others). So, my perspective has always been to choose the medicine I love the best, then think about money and lifestyle. (As long as your ok with not being at the top percentile in money-making, you CAN choose those things, or at least I have seen many physicians do so. They are financially comfortable and have created the lifestyle they want).
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If you wish to stay within the realm of clinical medicine, then I agree that a specialty like pathology might suit you well. However, I'd encourage you to explore the world of non-clinical medicine. There are some incredibly interesting opportunities for physicians who have passions outside of the hospital.
Sounds like nurse practicioner is your calling man.
Relatively controlled hours and don't have to deal with the more time-consuming patients. Plus you can still know medicine
Yeah, patient care and night call will be annoying.
But damn, you're like everyone who wants something for nothing. You're not anyone more special or interesting than everyone else putting their time in
Relatively controlled hours and don't have to deal with the more time-consuming patients. Plus you can still know medicine
Yeah, patient care and night call will be annoying.
But damn, you're like everyone who wants something for nothing. You're not anyone more special or interesting than everyone else putting their time in
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