Thanks for replies. To clarify (mostly for myself) my current reservations not in any particular order (and bare with me bc this is still forming in my head and most of it yes, very naive based on 6-7 weeks of observation + 1 year of internship + 1 MS4 rotation)
1) re: CaptKirk's post, I sort of thought that way for a while but I have seen enough examples in the past few weeks where it worked differently and rads did guide important decisions. But along the same vein, the radiologist is very much a generalist (maybe just in this stage of my training) and so yes, often times you are less knowledgeable.
2) very related to #1 I see the senior radiology residents and attendings have a lot of "knowledge" about seemingly obscure info. But it strikes me as superficial knowledge... often a laundry list of possible diagnoses but without deeper understanding of pathophys and often times without desire to understand pathophys. B/c it doesnt matter, their job is to provide dx or list of poss dx. Just as a matter of respect of what knowledge means to me, is understanding. And I get a sense that the pulmonologist understands lung physiology and pathology more than the chest radiologist.
3) I'm a physician-scientist and want to continue along that trajectory. I am interested in research geared toward "discovery" and less excited about "development." There are few examples out there of successful phsycian-scientists, fewer still in radiology, and I'm very hard-pressed to find ones who do "discovery" type research. Distinction is not always black and white but there is an important difference (at least for me).
4) I hated my IM intern year, and felt very resentful a lot of the time for all of the time I was being dragged away from my family. It should have been aparent to me though that for all of the anger I had during last year, I never was angered/annoyed by the patients--and I had plenty of pain in the ass patients. I was annoyed at nurses, at consults, at my chief residents, at my department head, at the radiologists (often by the way). There were plently of patients I did not like; but really, I liked to be the one giving people information good news or bad. I felt like it was my responsibility. Every once in a while I do fluoro and its like a breath of fresh air to talk to patients, get the story, teach them some things, show them some pictures. That said, its not my responsibility to get the HPI right or to deal with the results of the test, so it is DEFINITELY an easier job.
5) It seems cool (but very rare) to be an awesome clinician. I did see some examples of those in my IM program. I think I went to medical school to feel comfortable/confident to handle situations when people around me need help. Not from altruistic reason. Just made me feel better. Radiologists are so critical--the backbones of the hospital. But it's very different from the reason I went into medical school.
6) I like the idea of my son having a pediatrician for a dad more than the idea of my son having a radiologist for a dad. Dont know where that is coming from, but seems to be something I keep coming back to.
7) I'm good at treating people with respect. Not very good at a lot of other things. But I do think I'm good at least at that. I can treat doctors with respect as a radiologist, but I feel like it is a bit like a wasted muscle.
8) re: another CaptKirk thought. I do think radiologists around me are not my kind of people. Really, cross the board medical people are not so much my kind of people. But I think back at intern year and tehre were definitely cooler people around me then--though bigger pool of people obviously.
9) I like to teach. Lots of teaching in rads, true. But I think I liked teaching patients/families more than teaching other doctors.
10) I like to think of myself as a consult as a radiologist. But most of the rest of the hospital does not seem to think that way. In some ways they're right b/c maybe I need more clinical time b/4 I really call myself a consult.
....
Anyway, enough for now. Happy to hear more thoughts, appreciate everyones input. For med students out there, keep doing your homework, but a disclaimer, I'm absolutely not the right person to listen to since I'm only 6-7 weeks into this thing, I maybe very different from you, I'm probably just having 2nd thoughts related to grass is always greener type of thing...