IMPD

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GI and Cards remained highly competitive, as usual.

Pulm/Crit has rocketed past Heme/Onc to #3, clearly with the possibility of surpassing GI.

Heme/Onc a solid match.

Nephro is falling as fast as Pulm/Crit is rising. How will training programs survive? (hint: some won't)

Rheum/Allergy/Endo remain steadily popular and moderately competitive. Allergy maybe slightly more popular than the other two.

Geriatrics and ID still looking for someone, anyone, to love them.
 

Raryn

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GI and Cards remained highly competitive, as usual.

Pulm/Crit has rocketed past Heme/Onc to #3, clearly with the possibility of surpassing GI.

Heme/Onc a solid match.

Nephro is falling as fast as Pulm/Crit is rising. How will training programs survive? (hint: some won't)

Rheum/Allergy/Endo remain steadily popular and moderately competitive. Allergy maybe slightly more popular than the other two.

Geriatrics and ID still looking for someone, anyone, to love them.
I was always under the impression that Allergy was excessively competitive and the only reason we don't consider it up there with cards/gi was that the number of spots (and thus people) is an order of magnitude less. Is that not actually the case?
 
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I was always under the impression that Allergy was excessively competitive and the only reason we don't consider it up there with cards/gi was that the number of spots (and thus people) is an order of magnitude less. Is that not actually the case?
I think your perception is true. Also, based on some actual numbers...

"GI was at the top of the heap, followed by pulm/cc, followed by endo, then CARDIO, rheum, nephro, ID...". I'll post the actual numbers referenced in this email once I understand their source.
 

IM2GI

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I think your perception is true. Also, based on some actual numbers...

"GI was at the top of the heap, followed by pulm/cc, followed by endo, then CARDIO, rheum, nephro, ID...". I'll post the actual numbers referenced in this email once I understand their source.
Cardio was below endo...? I find that hard to believe.
 

gutonc

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Cardio was below endo...? I find that hard to believe.
I don't. Lifestyle sucks and they're getting killed on procedure reimbursement.
 

IM2GI

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I don't. Lifestyle sucks and they're getting killed on procedure reimbursement.
I suppose. Anecdotally cards seemed much more popular again this year from the programs I know. Probably 7-10:1 applicant ratio.
 

gutonc

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I suppose. Anecdotally cards seemed much more popular again this year from the programs I know. Probably 7-10:1 applicant ratio.
I don't think that's a particularly good measure of popularity simply because it only measures the number of applications a specific program gets. So if last year everybody was applying to 10 programs and now they're all applying to 20, any given program will appear to have 2x the number of applicants this year, but that doesn't necessarily reflect the # of people in the Match overall.

I will say that I have no idea what the numbers are for this year so I may be wrong about the overall number of applicants. Waiting on IMPD to share.
 

nephappl

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Agree, do not have access to #s either. Please post the ones for Nephrology
Thanks
 
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So, these are the rations of applicants/spots. This is clearly influenced by how many applications each applicant makes, but I think it does still give some idea of where the specialties are at in terms of both perceived and real popularity.

.......
41% of ID fellowships didn't fill and 47% of nephrology spots didn't fill.

Ratio of NRMP applicants to positions in the Match
1.88 GI
1.47 Pulm/Crit
1.40 Endo
1.37 Cardio
1.07 Rheum
0.85 Nephro
0.81 ID

No data for Allergy, it's not technically in the specialty Match.

I'm still not sure what to make of this data per se, except that I assume is derived from NRMP numbers.
 

IM2GI

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.......
41% of ID fellowships didn't fill and 47% of nephrology spots didn't fill.
.
eye opening numbers. Shows that IM residents in today's age will not put up with extra training and blindly continue on the default path without the prospect of increase pay, good job opportunities and lifestyle improvements.

If decision makers think the solution is to hurt the other more popular subspecialites, IM is in a dangerous spot.
 
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Can't get the NRMP website to give up the numbers. The numbers I quoted above are from a colleague who may have better access or simply better understanding of the system. What amazes me is that more PDs don't have a good understanding of current trends and continue to ask questions like "Is it true that ID isn't popular?"

Oh wait! Got it.

1.30 Heme/Onc.

In Nephrology, 64 programs went unfilled. Below is a list of unfilled programs per specialty

Cardiovascular Disease - 3
Endocrinology - 17
Gastroenterology - 8
Hematology and Oncology - 9
Infectious Disease - F 54
Interventional Pulmonology - 3
Nephrology - 64
Pulmonary/Critical Care - 2
Rheumatology - 15
 

IMDoc607

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Can't get the NRMP website to give up the numbers. The numbers I quoted above are from a colleague who may have better access or simply better understanding of the system. What amazes me is that more PDs don't have a good understanding of current trends and continue to ask questions like "Is it true that ID isn't popular?"

Oh wait! Got it.

1.30 Heme/Onc.

In Nephrology, 64 programs went unfilled. Below is a list of unfilled programs per specialty

Cardiovascular Disease - 3
Endocrinology - 17
Gastroenterology - 8
Hematology and Oncology - 9
Infectious Disease - F 54
Interventional Pulmonology - 3
Nephrology - 64
Pulmonary/Critical Care - 2
Rheumatology - 15
Maybe I'm missing something but cardio had the least that went unfilled yet was less competitive than endo? Not buying it.

*unless I'm misunderstanding you??? popularity doesn't always equate to competitiveness. So am I misreading when people are saying endocrine is more competitive than cardio?
 

obiwan

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you know its bad for nephrology when more and more of those finishing fellowship end up just doing hospitalist work as I know people are doing... in our class of 50ish only 2 went on for nephro
 
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Don't think the ratios tells the whole story for popularity as there are a lot more spots in some subspecialties compared to others. I would think cards still has the largest number of applicants and therefore more popular. i suspect it's still cards gi and hem/onc.
 

jdh71

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listen to the cardio fanboys apologize for the numbers . . .

hehe
 

IMDoc607

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Nobody ap
listen to the cardio fanboys apologize for the numbers . . .

hehe
Nobody is apologizing but I find it hard to believe that endocrine is more competitive than cardio....GI yes but nothing else. I mean if you're tying competitive to salary which I see some people are then cardiology still is top.

Anyway, I would love to see a drop off in cardiologists but that's wishful thinking. I notice one thing about sdn as I cruise across different forums. Everyone claims no one in their fellowship got offered jobs less than X amount of money yet the averages released by MGMA etc don't hold up to these offers. I guess only the people want to brag mention their $$$.
 

jdh71

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I don't know which areas youve been cruising but all my offers were completely consistent with MGMA but I was also looking for an employed spot.

The thing to remember about MGMA is that it is a survey. Voluntary. Lots of docs don't give a rip, don't fill it out. Furthermore, at least for internal medicine specialties, it's a survey largely representative of what you can make as an employee, not what you can make in private practice which varies wildly and can easily double MGMA numbers (but you're WORKING for every thin dime of that).

So why would people want to do endo and not cards? Probably because cardio sucks. Diabetes kind of sucks too but it's relatively straight forward and while contributes to all manner of chronic illness you are not responsible for the few endocrine emergencies. You have very light call. You can work virtually no weekends. And the compensation is fair for that kind of life style.

Why endo? Lol. What NOT endo?! My favorite patients to see these days are COPD. Slam dunk. Next.
 
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IMDoc607

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I don't know which areas youve been cruising but all my offers were completely consistent with MGMA but I was also looking for an employed spot.

The thing to remember about MGMA is that it is a survey. Voluntary. Lots of docs don't give a rip, don't fill it out. Furthermore, at least for internal medicine specialties, it's a survey largely representative of what you can make as an employee, not what you can make in private practice which varies wildly and can easily double MGMA numbers (but you're WORKING for every thin dime of that).

So why would people want to do endo and not cards? Probably because cardio sucks. Diabetes kind of sucks too but it's relatively straight forward and while contributes to all manner of chronic illness you are not responsible for the few endocrine emergencies. You have very light call. You can work virtually no weekends. And the compensation is fair for that kind of life style.

Why endo? Lol. What NOT endo?! My favorite patients to see these days are COPD. Slam dunk. Next.
Sounds good to me. I am glad to hear its MGMA standards since they had cardio at close to 500K for interventional. Friend of mine just got offered a job in the midwest (Michigan) for $561,000 first year. Glad to hear that.

Thanks...Pulm/CC is really cool to but not my thing.
 

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GI and Cards remained highly competitive, as usual.

Pulm/Crit has rocketed past Heme/Onc to #3, clearly with the possibility of surpassing GI.

Heme/Onc a solid match.

Nephro is falling as fast as Pulm/Crit is rising. How will training programs survive? (hint: some won't)

Rheum/Allergy/Endo remain steadily popular and moderately competitive. Allergy maybe slightly more popular than the other two.

Geriatrics and ID still looking for someone, anyone, to love them.

What is the reason for the upswing in Pulm /CC? Are there some new type of reimbursements that I am unaware of that is making this a more popular specialty?

Usually when specialties see an upswing there is either a financial or lifestyle reason for it. I understand there will always be people who LOVE pulm / CC and would do it regardless of the income / lifestyle but shouldn't that number of people remain about constant? An upswing like this is expected if there was some other reason people were now doing it. The upswing that was seen for GI and radiology in the early 2000's was directly related to reimbursements. Yes, I realize fewer people want to do outpatient medicine but still..........

The pulm part can make for a decent lifestyle but not sure I understand how the CC part is a lifestyle friendly specialty. In the private community, these docs are often paged all night long by their sicker than heck patients by ICU nurses and ER docs and frequently have to come in for the crashing patient. Of course this is different at the big teaching hospitals where the fellows are running a lot of the show.....but in the community this surely doesn't seem like a lifestyle gig.

Understandable how something like nephrology which has low pay (comparably to other specialties and to hospitalist) and bad lifestyle is on the down fall and ID which has low pay. Understandable how endo and rheum are on the upswing with great lifestyle regardless of pay.......but interesting how pulm / CC is becoming the new cardiology all of sudden and has even leap frogged heme / onc.
 

nephappl

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Excellent point
Here our PCCM docs have a hectic week every 4th as the cover ICU full time 24 X7 for 7 days + inpatient consults + procedures. In th non ICU weeks they do clinic , sleep ,PFTs reading etc. I know they are well paid though
One point is their job market is better than many medical specialties but their QOL is bad at laest every 4th week
Nephrology is in a different field, unless you really really really LOVE it there is no reason to go for it
 

inspirationmd

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What is the reason for the upswing in Pulm /CC? Are there some new type of reimbursements that I am unaware of that is making this a more popular specialty?

Usually when specialties see an upswing there is either a financial or lifestyle reason for it. I understand there will always be people who LOVE pulm / CC and would do it regardless of the income / lifestyle but shouldn't that number of people remain about constant? An upswing like this is expected if there was some other reason people were now doing it. The upswing that was seen for GI and radiology in the early 2000's was directly related to reimbursements. Yes, I realize fewer people want to do outpatient medicine but still..........

The pulm part can make for a decent lifestyle but not sure I understand how the CC part is a lifestyle friendly specialty. In the private community, these docs are often paged all night long by their sicker than heck patients by ICU nurses and ER docs and frequently have to come in for the crashing patient. Of course this is different at the big teaching hospitals where the fellows are running a lot of the show.....but in the community this surely doesn't seem like a lifestyle gig.

Understandable how something like nephrology which has low pay (comparably to other specialties and to hospitalist) and bad lifestyle is on the down fall and ID which has low pay. Understandable how endo and rheum are on the upswing with great lifestyle regardless of pay.......but interesting how pulm / CC is becoming the new cardiology all of sudden and has even leap frogged heme / onc.

So I am in the middle of doing research on the private practice Intensivist jobs and quite a few places have Hospitalists covering for you at night with you only getting called when it is truly beyond what they can handle. A strong Hospitalist group can be worth their weight in gold and make for a solid lifestyle in a critical care only position. Also you have to remember that at community hospitals the acuity is not usually going to approach that of the MICU at a tertiary care facility. The patients may be sick but it on average it won't be anything that a fully trained intensivist is going to have a hard time with. Also Critical Care is moving towards shift work at a lot of places with compensation upwards of $2000-$2500 for a 12 hour shift. So higher acuity, more procedures, and sizable cash compared to admitting CP r/o, Grandma "fall down go boom", grunt work for surgeons, and dealing with rocks for less. Hmm...let me think.

If you are only in a closed ICU then it seems that the lifestyle is a bit more rough but with the market wide open in Critical Care you can easily find a job that suits your lifestyle desires. Pulm-CC is a good deal right now. If I wouldn't have 4 boards to take and have to eat 2 more years I would consider doing it.
 

dozitgetchahi

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You're asking the wrong question. Why do YOU think endo shouldn't have such a strong showing?
Because everything I've ever heard about endo is that it's an uncompetitive, poorly paid subspecialty? I always hear it mentioned in the same breath as rheum and ID etc.

If something's changed, I'm all ears. I think I'd enjoy doing endo.
 

gutonc

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What is the reason for the upswing in Pulm /CC? Are there some new type of reimbursements that I am unaware of that is making this a more popular specialty?

Usually when specialties see an upswing there is either a financial or lifestyle reason for it. I understand there will always be people who LOVE pulm / CC and would do it regardless of the income / lifestyle but shouldn't that number of people remain about constant? An upswing like this is expected if there was some other reason people were now doing it. The upswing that was seen for GI and radiology in the early 2000's was directly related to reimbursements. Yes, I realize fewer people want to do outpatient medicine but still..........

The pulm part can make for a decent lifestyle but not sure I understand how the CC part is a lifestyle friendly specialty. In the private community, these docs are often paged all night long by their sicker than heck patients by ICU nurses and ER docs and frequently have to come in for the crashing patient. Of course this is different at the big teaching hospitals where the fellows are running a lot of the show.....but in the community this surely doesn't seem like a lifestyle gig.

Understandable how something like nephrology which has low pay (comparably to other specialties and to hospitalist) and bad lifestyle is on the down fall and ID which has low pay. Understandable how endo and rheum are on the upswing with great lifestyle regardless of pay.......but interesting how pulm / CC is becoming the new cardiology all of sudden and has even leap frogged heme / onc.
jdh will do a better job of answering this than I will but here's my take. I think PCCM is on the upswing not because things are suddenly better compensation-wise there, but that it's getting bad other places, primarily procedural (GI and Cards).

It's easy for an insurance company to deny payment for a cath or device or colo when it's not completely within guidelines. It's a lot harder to deny payment for dropping a tube, throwing in a TLC (under US guidance of course) and billing for 90 minutes of CC time in a critically ill patient. And while your ICU time may be kind of hairy, a lot of the jobs are hospitalist-like in their on/off scheduling. And a fair number of PP and hospital employed groups are moving to a subspecialist model of sorts. The group I'm most familiar with (5 hospital system, employed PCCM group) employs both CCM and PCCM docs. The pulm folks are about 50/50 general/subspecialist with a Pulm HTN person, a couple of interventional guys, 2 sleep folks, a CF specialist and a transplant person (they don't actually do transplant at that hospital but they see a lot of the f/u from U of Famous Transplant up north).

I personally see CCM as a lifestyle specialty the way that EM is a lifestyle specialty. Work your ass off when you're on but be completely off when you're off...and get paid pretty well to do it.
 

dozitgetchahi

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What is the reason for the upswing in Pulm /CC? Are there some new type of reimbursements that I am unaware of that is making this a more popular specialty?

Usually when specialties see an upswing there is either a financial or lifestyle reason for it. I understand there will always be people who LOVE pulm / CC and would do it regardless of the income / lifestyle but shouldn't that number of people remain about constant? An upswing like this is expected if there was some other reason people were now doing it. The upswing that was seen for GI and radiology in the early 2000's was directly related to reimbursements. Yes, I realize fewer people want to do outpatient medicine but still..........

The pulm part can make for a decent lifestyle but not sure I understand how the CC part is a lifestyle friendly specialty. In the private community, these docs are often paged all night long by their sicker than heck patients by ICU nurses and ER docs and frequently have to come in for the crashing patient. Of course this is different at the big teaching hospitals where the fellows are running a lot of the show.....but in the community this surely doesn't seem like a lifestyle gig.

Understandable how something like nephrology which has low pay (comparably to other specialties and to hospitalist) and bad lifestyle is on the down fall and ID which has low pay. Understandable how endo and rheum are on the upswing with great lifestyle regardless of pay.......but interesting how pulm / CC is becoming the new cardiology all of sudden and has even leap frogged heme / onc.
The simple answer is that pulm/CC pays well and is actually in demand, which is something that cannot necessarily be said about the other popular subspecialties. Cards is saturated. Heme/onc is apparently saturated. GI is getting there. For most people, not being able to find a decent paying job anywhere but rural Montana after the end of fellowship is kind of a dealbreaker.

I don't follow your reasoning for the other specialties either. Last I checked, ID/rheum/endo/nephro were *all* considered to have a 'good lifestyle', although this was not enough to make them competitive in the past - mostly because of low pay. Why have endo and rheum suddenly broken away from the pack? I thought pay for all these fields was still lousy (somebody please correct me if I'm wrong).
 

gutonc

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I don't follow your reasoning for the other specialties either. Last I checked, ID/rheum/endo/nephro were *all* considered to have a 'good lifestyle', although this was not enough to make them competitive in the past - mostly because of low pay. Why have endo and rheum suddenly broken away from the pack? I thought pay for all these fields was still lousy (somebody please correct me if I'm wrong).
Pay is a little better for Rheum and Endo than for being a PCP (probably much better for rheum if you do a lot of procedures) and the hours and workload are often much better. There's also something to be said for being able to say "see your PCP to work on this, that and the other thing, I'm here to help manage your goutabetes and that's all". I do it all the time in my specialty and it makes my life much easier.
 

jdh71

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jdh will do a better job of answering this than I will but here's my take. I think PCCM is on the upswing not because things are suddenly better compensation-wise there, but that it's getting bad other places, primarily procedural (GI and Cards).

It's easy for an insurance company to deny payment for a cath or device or colo when it's not completely within guidelines. It's a lot harder to deny payment for dropping a tube, throwing in a TLC (under US guidance of course) and billing for 90 minutes of CC time in a critically ill patient. And while your ICU time may be kind of hairy, a lot of the jobs are hospitalist-like in their on/off scheduling. And a fair number of PP and hospital employed groups are moving to a subspecialist model of sorts. The group I'm most familiar with (5 hospital system, employed PCCM group) employs both CCM and PCCM docs. The pulm folks are about 50/50 general/subspecialist with a Pulm HTN person, a couple of interventional guys, 2 sleep folks, a CF specialist and a transplant person (they don't actually do transplant at that hospital but they see a lot of the f/u from U of Famous Transplant up north).

I personally see CCM as a lifestyle specialty the way that EM is a lifestyle specialty. Work your ass off when you're on but be completely off when you're off...and get paid pretty well to do it.
I'm a bit disappointed in some ways to see the increase in interest because this means all the lazy, money chasing puke, I only went into IM for card/GI fan-boy types may start swarming the specialty and this means I may have to work with lazy idiots in 4 to 5 year. Though the group I'm joining will smell that particular brand of person a mile way. Up to this point the specialty attracted people who wanted to do this, not people looking to get fat paid.

But why the uptick? Because things got better when the private practice groups sold out and started working shifts. Your no longer responsible at many places for covering 3 ICUs all over town because your pulmonary group contracted it that way. You're now responsible for your 12 hours and then you go home and shut off your pager. Done places have night coverage as a shift, other places use the hospitalists who are on all night anyway to admit into the MICU, only calling the critical care staff for important things.

All the played jobs I looked at you work half the year. 184 shifts. And I was looking for half critical care, half pulmonary. These jobs were all starting between 330 and 390. Pulm/crit is one of the few specialties that has seen a rise in pay, while most of the others have seen a decline. Further we are in short supply almost everywhere. Helping us out is the push from hospitals to have intensivist trained people staffing the units during the days.

It all adds up.
 

IMDoc607

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I'm a bit disappointed in some ways to see the increase in interest because this means all the lazy, money chasing puke, I only went into IM for card/GI fan-boy types may start swarming the specialty and this means I may have to work with lazy idiots in 4 to 5 year. Though the group I'm joining will smell that particular brand of person a mile way. Up to this point the specialty attracted people who wanted to do this, not people looking to get fat paid.

But why the uptick? Because things got better when the private practice groups sold out and started working shifts. Your no longer responsible at many places for covering 3 ICUs all over town because your pulmonary group contracted it that way. You're now responsible for your 12 hours and then you go home and shut off your pager. Done places have night coverage as a shift, other places use the hospitalists who are on all night anyway to admit into the MICU, only calling the critical care staff for important things.

All the played jobs I looked at you work half the year. 184 shifts. And I was looking for half critical care, half pulmonary. These jobs were all starting between 330 and 390. Pulm/crit is one of the few specialties that has seen a rise in pay, while most of the others have seen a decline. Further we are in short supply almost everywhere. Helping us out is the push from hospitals to have intensivist trained people staffing the units during the days.

It all adds up.
Why the animosity towards cardiology and GI? How can you accuse a cardiologist of being lazy?
 

jdh71

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Why the animosity towards cardiology and GI? How can you accuse a cardiologist of being lazy?
Lol. No there is a certain "type". You should know as a PD. this doesn't apply to all of them or even most of them. My favoritist homie from residency is going to be starting her interventional fellowship this summer. May god have mercy on her soul.

And one if the best docs I ever worked with. Of want her to take care of my mom.
 

IMDoc607

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Lol. No there is a certain "type". You should know as a PD. this doesn't apply to all of them or even most of them. My favoritist homie from residency is going to be starting her interventional fellowship this summer. May god have mercy on her soul.

And one if the best docs I ever worked with. Of want her to take care of my mom.
I am a cards fellow. I don't understand why you feel so negative towards cardiology. Not only is it paid very well its also constantly advancing. I enjoy what I do and I respect other fields something you don't seem to do. I give a lot of credit to pulm/crit physicians as I feel they deserve to be paid better than they actually are. I wouldn't feel so bad for your friend entering her interventional year because when she graduates she'll have a nice salary waiting for her especially if she goes into the right markets. As I said, two of my friends got offers that were great. One was $450,000 plus $200,000 in loan repayment and the other one was $561,000 with $50,000 sign on. Both of them are new grads. I feel we are going off topic here tho. Its not all about the money but since you have mentioned it plenty of times calling us "pukes."

Glad you found a good job for yourself and you seem to enjoy pulm.
 
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rokshana

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depending on where and how you practice, Endo makes in the range of 180-220k , so not in the range of cards, GI, or hem/onc has the potential to make, but decent and lifestyle is good…usually week days, no or little call…which rarely will have you come into the hospital in the middle of the night.

And the DEMAND is there…again depending on the market (the NE sucks its so saturated with docs in general), but there are places that there is maybe one endocrinologist and looking for people…heck i had a job before i even matched…my hometown has one endocrinologist who is looking to retire in 5-7 years…i can join him the minute i finish fellowship...
 

jdh71

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I am a cards fellow.
Want a cookie? Lol

Way to miss the point and be a knee jerk douche. I'll let you go back and try to process that I wasn't talking about everyone, but I was probably talking about you. Make that money son. And keep sending me them dyspneas you can't fix with a stent!
 
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Because everything I've ever heard about endo is that it's an uncompetitive, poorly paid subspecialty? I always hear it mentioned in the same breath as rheum and ID etc.

If something's changed, I'm all ears. I think I'd enjoy doing endo.
In private practice in the right area you can have an extremely good lifestyle and decent salary. You won't make 500k but you could make 250-300k if you really wanted to...endo friends claim that at least
 

Instatewaiter

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I'll let you go back and try to process that I wasn't talking about everyone, but I was probably talking about you. Make that money son. And keep sending me them dyspneas you can't fix with a stent!
Damn cardiology fellows.

Also, I'm pretty sure all dyspnea is fixed with a stent.
 
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Instatewaiter

But... there's a troponin
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And the DEMAND [for endo]is there…again depending on the market (the NE sucks its so saturated with docs in general), but there are places that there is maybe one endocrinologist and looking for people…heck i had a job before i even matched…my hometown has one endocrinologist who is looking to retire in 5-7 years…i can join him the minute i finish fellowship...
Gonna be honest this kinda befuddles me. Realistically there's not a whole lot of endo that a half decent internist can't take care of. And what's left probably wouldn't be enough to make a living off of. I guess internists now adays don't want to be bothered with diabetes and thyroid issues.

Rheum is like the black box of medicine. Cards and GI have their procedures that take training to learn. Onc changes so much and we don't get a lot of training during gen IM residency that I can see the need. But endo? **** 50% of IM residency is dealing with endo issues.
 
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IMDoc607

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Want a cookie? Lol

Way to miss the point and be a knee jerk douche. I'll let you go back and try to process that I wasn't talking about everyone, but I was probably talking about you. Make that money son. And keep sending me them dyspneas you can't fix with a stent!
Wasn't trying to be a douche. Unless I misread your post you said "You should know as a PD." I was just clarifying that I was not a program director. In fact, you're the one being a douche in this whole thread. Constantly saying negative things towards cardiologists and gastroenterologists. I have said nothing but nice things about pulm/crit and give them a lot of respect. You obviously have an axe to grind so go ahead and continue to do so. Have fun doing bronchs and reading PFT's.
 

Raryn

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Wasn't trying to be a douche. Unless I misread your post you said "You should know as a PD." I was just clarifying that I was not a program director. In fact, you're the one being a douche in this whole thread. Constantly saying negative things towards cardiologists and gastroenterologists. I have said nothing but nice things about pulm/crit and give them a lot of respect. You obviously have an axe to grind so go ahead and continue to do so. Have fun doing bronchs and reading PFT's.
My advice? Unclench. He didn't say anything bad about cardiologists or gastroenterologists as a group. JDH just said there does exist a portion of the IM resident population who only applied IM so that they could be cards/GI physicians, for the sole reason that they earn a lot of money. He was badmouthing THOSE people, who might not be dedicated to their subspecialty of interest for any other reason. Many of them do end up getting fellowships, many do not.

You cannot say that people like that don't exist, and JDH was just saying he would prefer the same phenomenon does not happen in his preferred subspecialty (pulm/cc). The actual sniping cards vs pulm that this thread is devolving into is absolutely worthless.
 
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Raryn

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Ratio of NRMP applicants to positions in the Match
1.88 GI
1.47 Pulm/Crit
1.40 Endo
1.37 Cardio
1.30 Heme/Onc.
1.07 Rheum
0.85 Nephro
0.81 ID
With regards to the actual discussion of the topic at hand, one thing to remember when gauging competitiveness is that the denominator is pretty radically different for these specialties. The data doesn't seem to be available for this year, but last year there were 433 gi spots, 463 p/cc spots, 251 endocrine spots, 781 cards spots, 508 heme/onc spots, 195 rheum spots. I presume the numbers aren't significantly changed this year.

So an extra .88 applicants/spot for GI was an extra 380 people. An extra .47 applicants/spot for pulm was 218 people. 100 extra people for endocrine, 289 extra people for cards, 152 extra people for heme/onc, 14 extra people for rheum. A swing of just 20/30 people (of the ~6000 categorical ACGME medicine residents graduating every year) in the smaller specialties can produce big differences in competitiveness by the above measure, and some of it is probably just statistical flukes based on the year. For example, if rheum and endo swapped places on the above list next year or the year after, this would not be surprising, because it would represent a move of <1% of the IM population.

I'm waaaaay too lazy to run the numbers to see if the above is statistically significantly different than any other year, or even if there are significant trends over the past few years. The only one I'd bet is significant is that GI seems to be getting more and more competitive every year.
 
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jdh71

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Wasn't trying to be a douche. Unless I misread your post you said "You should know as a PD." I was just clarifying that I was not a program director. In fact, you're the one being a douche in this whole thread. Constantly saying negative things towards cardiologists and gastroenterologists. I have said nothing but nice things about pulm/crit and give them a lot of respect. You obviously have an axe to grind so go ahead and continue to do so. Have fun doing bronchs and reading PFT's.
I do have to admit my mistake with your name and IMPDs on this thread and my phone.

Again, I haven't said anything negative towards cardiologists and gastroenterologists, you just suck at reading comprehension - there is a context here and if you could slow down and put some cream on your hurt ass you might be able to see the point I'm trying to make. Do I have to spell it out for you? Are you so dense it makes it that hard to see? I thought cards only took the best?? Lol.

And why would I have an axe to grind I'm doing what I want. I do have fun dong bronchs, PFTs are arguably probably about the easiest way to make money on a test and interpretation, and I will also continue to 1) demonstrate there is no pulmonary problem and you can have your dyspnea back in your cards clinic, and 2) take care of the patients you are too good to take care of in the ICU, following the successful placement of a stent (and ostensibly after highfiving your cardio buddies before hopping your beamer and going to the golf course) ;) @Instatewaiter knows what I'm talking about!
 

jdh71

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My advice? Unclench. He didn't say anything bad about cardiologists or gastroenterologists as a group. JDH just said there does exist a portion of the IM resident population who only applied IM so that they could be cards/GI physicians, for the sole reason that they earn a lot of money. He was badmouthing THOSE people, who might not be dedicated to their subspecialty of interest for any other reason. Many of them do end up getting fellowships, many do not.

You cannot say that people like that don't exist, and JDH was just saying he would prefer the same phenomenon does not happen in his preferred subspecialty (pulm/cc). The actual sniping cards vs pulm that this thread is devolving into is absolutely worthless.
I NEVER sniped cards - though I did see the snipes back. Heh.

And I'm glad to see that my rather obvious point, was obvious.
 

IMDoc607

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I do have to admit my mistake with your name and IMPDs on this thread and my phone.

Again, I haven't said anything negative towards cardiologists and gastroenterologists, you just suck at reading comprehension - there is a context here and if you could slow down and put some cream on your hurt ass you might be able to see the point I'm trying to make. Do I have to spell it out for you? Are you so dense it makes it that hard to see? I thought cards only took the best?? Lol.

And why would I have an axe to grind I'm doing what I want. I do have fun dong bronchs, PFTs are arguably probably about the easiest way to make money on a test and interpretation, and I will also continue to 1) demonstrate there is no pulmonary problem and you can have your dyspnea back in your cards clinic, and 2) take care of the patients you are too good to take care of in the ICU, following the successful placement of a stent (and ostensibly after highfiving your cardio buddies before hopping your beamer and going to the golf course) ;) @Instatewaiter knows what I'm talking about!
Despite your insults, your posts are fun to read. Sounds good...glad you enjoy pulm
 

jdh71

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You have to use a lot of lube and topical anesthetic.
 
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Raryn

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I half wish the IM forum did what some of the others do and moved off-topic posts to a separate thread. This is actually an interesting topic otherwise.
 

rokshana

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Gonna be honest this kinda befuddles me. Realistically there's not a whole lot of endo that a half decent internist can't take care of. And what's left probably wouldn't be enough to make a living off of. I guess internists now adays don't want to be bothered with diabetes and thyroid issues.

Rheum is like the black box of medicine. Cards and GI have their procedures that take training to learn. Onc changes so much and we don't get a lot of training during gen IM residency that I can see the need. But endo? **** 50% of IM residency is dealing with endo issues.
no IM SHOULD be dealing with much of diabetes and simple hypothyroidism…but the number of consults i get from the Gen Med service and the PCPs out there for referral to the diabetes or the endo clinic say they either don't want to or are uncomfortable with doing so…always a bit awe struck when a i get a call from the inpatient gen med or hospitalists services for DM management...