great points about neurosurg/ct surgery about but was wondering what your thoughts are on urology and ENT?? esp. compared to ortho. thanks.
I think the biggest travesty in medical education is the extremely limited amount of time one has to experience the medical specialties and make a decision on what they will do for the rest of their career. Because of the limited time, I was only able to experience Ortho, Neuro, CT, Plastics, GenTrauma, General surgery. I did not rotate on ENT, Urology, or Ophtho. The reason was I didn't have enough general interest in those areas to justify passing up a rotation on the other ones I did. I also thought I would prefer 3 OR days and 2 Clinic instead of 2 OR days and 3 clinic (and I still do).
I can say that every urologist I've met has been really great and happy with their lives. They seem to have a good variety in their work and most really enjoy what they do. They also seem to have a good work/life balance. Urology is one of those fields that unless something turns you onto it (like a family member or mentor as a urologist) you never really think about it.
My perception of ENT is very similar to that of Urology. I didn't spend much time at all with any ENT's but I felt that they were very happy with their careers as well. Ultimately I didn't have enough initial interest to justify using a rotation on it.
Without having actually spent time in urology or ENT, any comparisons I can make would be anecdotal at best. However, I do feel safe to make a few observations:
1. Relatively few emergencies. This is probably what determines lifestyle more than anything else. Ortho may have a few more emergencies to come in for, but in general most things in ENT, Urology, and Ortho can wait until the morning. You may be a little more likely to come in on a call night for Ortho than the other two, but ultimately it is very manageable (especially if you are not at a level 1 trauma center or if you have residents).
2. Lots of elective procedures. Having a practice based on elective procedures is nice for a few reasons. 1. Less emergencies. 2. More predictable days. 3. Building an elective practice by having a great bedside manner and good report with other physicians (for referrals) seems like it would be very rewarding to me (still just a resident so I don't know this first hand). Instead of a treadmill of work, it feels like you are working toward something when people actively seek you out and you become well known in your community.
3. Doing something people will pay cash for. I'm pretty sure ENT has the most things people will and can pay cash for. But I would say all 3 have a handful of operations that people can and will pay for. I don't know where the future of healthcare is going, but this is nice to have this to serve as a hedge against reimbursement cuts.
4. Plenty of outpatient work. Rounding sucks. All specialties have plenty of operations where the patients go home. But all have plenty of big whacks if you are into that. You can tailor your practice to fit what you are looking for.
5. Patients love you. Its pretty common to hear someone say they love their ENT, their orthopaedist, and to a lesser extent their Urologist (lesser only because they are less likely to talk about problems in that area). Its a great feeling.
6. Patients will see you for multiple things. People are more likely to have multiple conditions in their lifetime that necessitate the care of these specialties (because they deal with more common ailments). For this reason you see them several times for different issues and I think its always nice to see a familiar face in clinic, and it reaffirms your hard work and good bedside manner. It also makes you feel appreciated.
These are just a few things I can think of off the top of my head based on my observations. Like I said before, I did not rotate on ENT or Urology, but I do think these similarities are pretty accurate. I hope some of this helps.
