I'm interested in why you consider PM&R to have a very high burnout rate, DMB mentioned inpatient rehab, can someone expand on this? I am mainly interested in lifestyle, I don't care as much about the pay. Obviously the work itself has to be at least somewhat interesting to me, can you please elaborate on why you say PM&R entails a lot of psych. That would be good since I am interested in patients with depression and therapy for common depression and to be able to do that in PM&R would be great. The argument of interest vs lifestyle has no definitive answer and has pretty good points on both sides but I'm on the side of lifestyle. At this point in time, while I have had some cool experiences in third year, once it passes 5pm, I'm pretty much burned out and I'd rather spend the time doing what I enjoy outside of work. And I'm not about that weekend work life. At least from what I have heard, most PM&R residencies are pretty chill, what are the hours like in a typical PM&R residency from year 1 to 3? How much call is there and what does that usually entail? I can't imagine I'll burn out more in PM&R than in say IM or surgery. Other specialties I've considered include anesthesia and rads but they are lower on the list than derm, psych, and PM&R- anesthesia seemed a little too boring with little patient interaction and rads has little patient interaction as well. One reason I enjoy patient interaction is because I've always enjoyed teaching such as tutoring other students in college and I think that would translate well to teaching patient's about their disease process.
The data behind PM&R burnout is rather misleading. It's rare for PM&R to show up in most specialty comparison reports (especially salary) because we're such a small specialty and the response pool is likely to be small. So I don't think the data is accurate. Some inpatient doctors get burnt out because they're the sole inpatient provider and may have minimal or no help covering the unit/call. However, in my experience (ie., anecdotal, but across multiple academic, VA, and community hospitals/programs) burnout seems higher in the outpatient (particularly pain) population. I've met a total of one sort of burnt-out inpatient provider, and he was retirement age. The rest loved what they do, and had great lives.
Personally I really enjoy inpatient. I think it's more rewarding, more fun, and more relaxed. I did not get paged much in residency compared to intern year--it was great, the nurses and therapists just came over to the office to talk to us/ask us questions. I loved it--I hate my pager. Some days got busy with admits/consults, but I never felt in over my head, and I'm not the most efficient guy. I made an effort to enjoy being at work and chat with people during the day, whether with a co-resident, attending, nurse, therapist, or patient. Inpatient rehab is a very fun and exciting place to be. VA inpatient rehab, in particular, is the least stressful (unless dispo issues stress you out...) in my mind.
I felt I had a lot more control over my schedule on inpatient as well--you can decide how to structure your day. Granted, in residency, things like when your attending wants to round will give you less control, but in my mind it was still much better control (and for me less stressful) than seeing a whole day of patients scheduled in clinic. Plus outpatient attendings are much busier than they appear to be--they're working behind the scenes all the time to call patients about results of imaging/labs from the orders that we place. We just don't see that behind the scenes type of stuff. Still, many outpatient community physiatrists don't take call, so that's sure nice...
Ultimately, as others said above, it really comes down to doing what you want to do. If you spoke with every PM&R resident in the country, I'm willing to bet most would say they like outpatient rehab more and find it more enjoyable. The different areas of PM&R, like the different medical specialties, come with their own pros and cons, and it's all about personal fit. I would never consider going into a field of medicine that I didn't enjoy. What is interesting is the things you think matter in medical school change. Back then, I didn't think FM would be a good choice because I didn't want to deal mostly with HTN, DM, etc. And I didn't like peds because the well-child checks were kind of boring. But I find most of my enjoyment comes from talking with the other members of the rehab team, getting to know my patients, and following them over time. That's a big reason why I chose PM&R, and I'd chose it again, but in hindsight I could actually see myself happy in FM following the same patient for years and years and doing "boring" stuff like just adjusting BP meds. And if I could do ONLY well-child checks, well that would actually be a real blast, seeing those kiddos grow up.
To be honest, a lot of the exposure we get to different specialties in med school doesn't help all that much in making a truly informed decision. Fields like FM, peds, and psych are generally rewarding for the long-term relationships you build with patients, and you really can't get a good feel for that in medical school. Many people choose more "exciting" specialties like EM (highest rate of burnout), partly because they like the schedule, but then realize once they have a family that same schedule is the thing they hate. You really have to think hard about what really matters to you, and try to think about what will matter to you in 10 years. Medicine is too much work to be miserable.
I would encourage the OP not to apply to PM&R unless it's something they are excited about. I think if one is neutral about all specialties, then I think psych is the best choice. Great lifestyle, with the option to open up your own solo practice and do your own scheduling (all you need to do is rent a room in an office building--there's really minimal overhead), you can schedule yourself to work as much or little as you want (easier to do part-time with the lower overhead, assuming you are ok with a lower salary), and there are opportunities everywhere. I thought heavily about psych, but I wanted to do addiction psych and saw myself getting burnt out and cynical real fast, whereas in PM&R I saw myself remaining optimistic and hopeful, and happy, so it was an easy choice for me.