Current MS3 having a career crisis and would value insight.
I have been targeting ENT since I entered med school. I am very music-minded and have loved the idea of working with performing arts population through laryngology or generally restoring appreciation for music/human voice through otology. I love working with my hands (pianist), and I've particularly enjoyed the smaller, more precise surgeries as opposed to the big, bloody cases. Being in the OR has always been more exciting to me than medicine floor work. I admittedly also weigh compensation quite highly, and being able to reasonably achieve 400-600k as an ENT is attractive. There is an ego component to becoming a surgeon as well that I don't think I would satisfy in most other specialties, and even aside from the OR, watching an ENT resident come down to the floor, intubate a difficult patient, and get a round of applause certainly scratches a certain ego itch. I also enjoy being on the grind, running around, seeing a lot of patients (have also been very interested in EM), so the idea having a rigorous residency/attending life wasn't very off-putting at first.
HOWEVER, I am already feeling the burnout on my clinical rotations. The idea of needing to take an extra research year in med school and then have 70-80+ hour weeks in a 5-year ENT residency is now extremely daunting. As exciting as the OR is now, I know I will lose this starry-eyed perspective and it will eventually become work like any other job - same with my interest in being on the go constantly. I am already feeling the physical burden on my back and shoulders as a young 20 something in the OR, and thus I am really considering my long-term health going into anything surgical. I have many interests outside of medicine (music, literature, etc.), and I value time with my family and friends highly, and although I've talked to many new ENT attendings who talk about how much better it gets, the vacations they're taking etc., I also hear about how the grind, while it gets easier, doesn't every really stop with anything surgical.
Psychiatry has unexpectedly become very attractive to me. I have always been interested in psych, and it was my favorite pre-clinical course, but I chalked this up to it being a generally interesting field at cursory glance (e.g. psychology being the most popular major), and it being a relatively easy pre-clinical course. However, I loved my rotation (inpatient psychotic disorders). Patients were interesting, interviewing was more rewarding than I expected it to be, and although the young attending seemed pretty stressed, watching him finish rounds at 12 and then "chill" in his office for the rest of the day was alluring compared to the OR grind (or even the ENT clinic running through 15 min. patient encounters 9 to 5). I've realized that actually talking to patients has been one of the most rewarding part of every rotation (although likely influenced by the relative incompetence of doing real medicine as a student). Since reassessing how sustainable my love for the grind is, I am very attracted to the lighter residency and attending hours of psych. I am also somewhat entrepreneurial minded (really enjoyed free-lancing in my gap year) and the ability to do self-owned PP is very attractive.
However, I question whether I will be satisfied not cutting, whether I will satisfy my stupid ego without the title of surgeon, whether I will regret the opportunity cost of going for a lower paying specialty, if I'll regret choosing to work with a generally unhealthy as opposed to healthy population, and whether I will feel conflicted not knowing if I chose psych for the right reasons or if I simply wanted an easier road.
Overall, I am trying to value intellectual curiosity and satisfaction with the actual duties of the specialties themselves. In this regard, I feel like I am equally intellectually interested in both, and although I enjoy the invasiveness of surgery, I do feel that psych (as opposed to other nonsurgical specialties) does approximate this feeling due to the intimate nature of psychiatric illness. That being said, since going through the clinical year grinder, I am realizing how important time and my compensation for said time is. Considering lifestyle and compensation is naturally where more conflict arises. I don't know if my physical and mental health can sustain an ENT residency, and even if I can push through, attending lifestyle as a psychiatrist seems clearly lighter and more malleable than ENT both in time and intensity (particularly physically). However, the compensation is clearly better. I am very conflicted on how to weigh the significantly more demanding residency and somewhat more demanding attendinghood of ENT against the significantly greater earning potential. Am I stupid to weigh income heavily in this situation given that psych salaries seem to have improved to a reasonably achievable 300k base for 40 hrs? If I want to can I reasonably work 55 hours in psych with a base job + per diem/locums and satisfy my desire for the grind but also reasonably achieve 400-450k salary?
I appreciate any thoughts on how this reads from another perspective (maybe it's obvious what I should do), as well as any thoughts on making an objective comparison between these two fields.
I have been targeting ENT since I entered med school. I am very music-minded and have loved the idea of working with performing arts population through laryngology or generally restoring appreciation for music/human voice through otology. I love working with my hands (pianist), and I've particularly enjoyed the smaller, more precise surgeries as opposed to the big, bloody cases. Being in the OR has always been more exciting to me than medicine floor work. I admittedly also weigh compensation quite highly, and being able to reasonably achieve 400-600k as an ENT is attractive. There is an ego component to becoming a surgeon as well that I don't think I would satisfy in most other specialties, and even aside from the OR, watching an ENT resident come down to the floor, intubate a difficult patient, and get a round of applause certainly scratches a certain ego itch. I also enjoy being on the grind, running around, seeing a lot of patients (have also been very interested in EM), so the idea having a rigorous residency/attending life wasn't very off-putting at first.
HOWEVER, I am already feeling the burnout on my clinical rotations. The idea of needing to take an extra research year in med school and then have 70-80+ hour weeks in a 5-year ENT residency is now extremely daunting. As exciting as the OR is now, I know I will lose this starry-eyed perspective and it will eventually become work like any other job - same with my interest in being on the go constantly. I am already feeling the physical burden on my back and shoulders as a young 20 something in the OR, and thus I am really considering my long-term health going into anything surgical. I have many interests outside of medicine (music, literature, etc.), and I value time with my family and friends highly, and although I've talked to many new ENT attendings who talk about how much better it gets, the vacations they're taking etc., I also hear about how the grind, while it gets easier, doesn't every really stop with anything surgical.
Psychiatry has unexpectedly become very attractive to me. I have always been interested in psych, and it was my favorite pre-clinical course, but I chalked this up to it being a generally interesting field at cursory glance (e.g. psychology being the most popular major), and it being a relatively easy pre-clinical course. However, I loved my rotation (inpatient psychotic disorders). Patients were interesting, interviewing was more rewarding than I expected it to be, and although the young attending seemed pretty stressed, watching him finish rounds at 12 and then "chill" in his office for the rest of the day was alluring compared to the OR grind (or even the ENT clinic running through 15 min. patient encounters 9 to 5). I've realized that actually talking to patients has been one of the most rewarding part of every rotation (although likely influenced by the relative incompetence of doing real medicine as a student). Since reassessing how sustainable my love for the grind is, I am very attracted to the lighter residency and attending hours of psych. I am also somewhat entrepreneurial minded (really enjoyed free-lancing in my gap year) and the ability to do self-owned PP is very attractive.
However, I question whether I will be satisfied not cutting, whether I will satisfy my stupid ego without the title of surgeon, whether I will regret the opportunity cost of going for a lower paying specialty, if I'll regret choosing to work with a generally unhealthy as opposed to healthy population, and whether I will feel conflicted not knowing if I chose psych for the right reasons or if I simply wanted an easier road.
Overall, I am trying to value intellectual curiosity and satisfaction with the actual duties of the specialties themselves. In this regard, I feel like I am equally intellectually interested in both, and although I enjoy the invasiveness of surgery, I do feel that psych (as opposed to other nonsurgical specialties) does approximate this feeling due to the intimate nature of psychiatric illness. That being said, since going through the clinical year grinder, I am realizing how important time and my compensation for said time is. Considering lifestyle and compensation is naturally where more conflict arises. I don't know if my physical and mental health can sustain an ENT residency, and even if I can push through, attending lifestyle as a psychiatrist seems clearly lighter and more malleable than ENT both in time and intensity (particularly physically). However, the compensation is clearly better. I am very conflicted on how to weigh the significantly more demanding residency and somewhat more demanding attendinghood of ENT against the significantly greater earning potential. Am I stupid to weigh income heavily in this situation given that psych salaries seem to have improved to a reasonably achievable 300k base for 40 hrs? If I want to can I reasonably work 55 hours in psych with a base job + per diem/locums and satisfy my desire for the grind but also reasonably achieve 400-450k salary?
I appreciate any thoughts on how this reads from another perspective (maybe it's obvious what I should do), as well as any thoughts on making an objective comparison between these two fields.
Last edited: