Psych PGY-1 Considering Re-Applying For Anes - Seeking Perspectives

[deleted1061998]

I say that last bit as a guy who picked cardiothoracic anesthesia and ICU over pain fellowship. Some days man...

can you comment on the pain lifestyle provided that you can deal with the patients(essentially psyc patients)? what is a typical week like and hours worked on average etc?

---

Members don't see this ad.

 

[Nivens]

can you comment on the pain lifestyle provided that you can deal with the patients(essentially psyc patients)? what is a typical week like and hours worked on average etc?

Take this with a grain of salt as I'm not a pain doc, but the clinical work seems to be 9-5 or 8-4 or whatever. From what I can tell it's the administrative work that then determines the rest of your day, which is highly dependent on your support staff setup, your efficiency throughout the workday, the types of patients you see, etc. I have friends in pain that manage to fit most of it in as they move from patient to patient, and some who always seem to be staying late to finish up. Weekends are up to you, and are probably tied to whether you see inpatients as part of your practice.

Remember, no one is going to pay you a million dollars a year to sit on your @$$, in any specialty. Exceptions I'm sure exist, but the >90% MGMA guys/gals are working >90%ile hours as a general rule.

 

[deleted1061998]

Take this with a grain of salt as I'm not a pain doc, but the clinical work seems to be 9-5 or 8-4 or whatever. From what I can tell it's the administrative work that then determines the rest of your day, which is highly dependent on your support staff setup, your efficiency throughout the workday, the types of patients you see, etc. I have friends in pain that manage to fit most of it in as they move from patient to patient, and some who always seem to be staying late to finish up. Weekends are up to you, and are probably tied to whether you see inpatients as part of your practice.

Remember, no one is going to pay you a million dollars a year to sit on your @$$, in any specialty. Exceptions I'm sure exist, but the >90% MGMA guys/gals are working >90%ile hours as a general rule.

50th percentile pain is still plenty and it seems to reimburse better per hour than general anesthesia, but again you have to tolerate it. What made you choose cardio thoracic over pain?

 

[Nivens]

50th percentile pain is still plenty and it seems to reimburse better per hour than general anesthesia, but again you have to tolerate it. What made you choose cardio thoracic over pain?

The complete answer to that is complicated, and to really get it you'd have to be familiar with me and my personality, but suffice it to say I was just happier in the cardiac OR than the pain clinic. The cardiac/ICU people were just "my people". I really struggled with the decision for about a year, but when I allowed myself to simplify it in those terms the answer was pretty obvious. I also got a big clue when I sat down to really dig into some pain literature and couldn't get excited, whereas learning about hemodynamics and different cardiac disease states was something I really enjoyed.

I was joking before when I said "Some days..."- I'm happy with my decisions. However, I can tell you the thrill of putting in a big line (even an ecmo cannula), or hanging a bunch of blood or pushing a gallon of epi is not nearly what it was, and I haven't been doing this that long. You've got to find the sweet spot between not selling out/selling your soul (so you can look yourself in the mirror) and giving up the TV doctor fantasy.

 

[dabears505]

Please dont make such a bad decision.

 

[Candidate2017]

Just please don't be that psychiatrist who does "cash only" because most people who are really really struggling with serious psych issues can't afford those fees. I find psychiatrists who only treat the patients who can afford $200-300 an hour to be doing the psych community a disservice. Maybe do some kind of sliding scale or weekend work where you help out poorer inpatients or something or bill out of network if you feel the insurance company is screwing you or something.

This isn't the reality.

Poor people in America wear Air Nikes and have iphones. Tiny Tim would be shocked at our "poverty." Plenty of your tax dollars go to clinics that serve the poor and severely mentally ill. Your taxes also go to Medicaid/care, which pays thousands of dollars per day for an inpatient stay as well as several thousand dollars for a 30 day supply of the newest antipsychotic.

Also, $300/hr cash is pretty cheap when you look at it as $150/month for monthly 30 minute visits to a psychiatrist. Some of which can be submitted to insurance. The average middle class family's cable/internet/cell bill costs more.

 

[Candidate2017]

I'm a psych PGY-1 in my mid 30s at a mid-tier academic program. Not super competitive numbers wise, but I'm a USMD and think I would have a shot at my current institution, my med school institution, and hopefully other lower tier programs.

So far, I'm just not a fan of psychiatry. My job has been in a dank, dreary inpatient psych ward at a safety net hospital in an urban city center. I don't feel like a doctor: listening to these nonsensical, intoxicated/recovering, and/or truly mentally ill patients and basically looking to see what they were prescribed last time and re-starting it or making minor adjustments with the same few drugs isn't challenging or interesting. Some of the patients' pathology is truly interesting to observe but already the novelty is wearing off. There's no gratification or satisfaction in anything I've done so far. Most of all, I miss using my hands and doing procedures.

Surgery if you want procedures and patient thanks. Anesthesiology personalities don't require thanks.

Since you are interested in psychology, I will say your ego is being narcissistically injured by the reality of what being a doctor is: caring for ill, super sick, marginalized, mean, smelly people who are their own worse enemy and will likely never improve. Not all are like this but guess who gets the privilege of dealing with those patients? You, the lowly intern. Its your job to be in the trenches with literal piss, poop, vomit, and blood to learn from the very sick, whether psych or any other specialty.

 

[Nivens]

who are their own worse enemy

I certainly hear this. A lot of truth in that statement.

 

[deleted1061998]

This isn't the reality.

Poor people in America wear Air Nikes and have iphones. Tiny Tim would be shocked at our "poverty." Plenty of your tax dollars go to clinics that serve the poor and severely mentally ill. Your taxes also go to Medicaid/care, which pays thousands of dollars per day for an inpatient stay as well as several thousand dollars for a 30 day supply of the newest antipsychotic.

Also, $300/hr cash is pretty cheap when you look at it as $150/month for monthly 30 minute visits to a psychiatrist. Some of which can be submitted to insurance. The average middle class family's cable/internet/cell bill costs more.

since you seem like a math guy do you seriously believe psyc makes $300 an hour? LOL well here's some math for you:

300 x 40 x 48 = $388,000. psyc makes no where NEAR that. average is 250 - 300K

 

[deleted697127]

since you seem like a math guy do you seriously believe psyc makes $300 an hour? LOL well here's some math for you:

300 x 40 x 48 = $388,000. psyc makes no where NEAR that. average is 250 - 300K

Not sure about his math but I definitely don’t believe your math...

 

[deleted1061998]

Not sure about his math but I definitely don’t believe your math...

whats so hard to not believe? he is claiming $300 an hour x 40 hours a week x 48 weeks per year. do you not know how to use a simple calculator...

 

[chocomorsel]

This isn't the reality.

Poor people in America wear Air Nikes and have iphones. Tiny Tim would be shocked at our "poverty." Plenty of your tax dollars go to clinics that serve the poor and severely mentally ill. Your taxes also go to Medicaid/care, which pays thousands of dollars per day for an inpatient stay as well as several thousand dollars for a 30 day supply of the newest antipsychotic.

Also, $300/hr cash is pretty cheap when you look at it as $150/month for monthly 30 minute visits to a psychiatrist. Some of which can be submitted to insurance. The average middle class family's cable/internet/cell bill costs more.

Well now you are generalizing all poor people. Not all behave the same way. There are plenty of them who shop at dollar general and don’t wear Nike’s. They are really trying to make ends meet.
$300 a month for an employed person who makes 25-30k a year is a lot of money. And if they are severe it’s gonna cost way more than that. And hopefully they do get some kind of grants.

Let’s not generalize how all poor people behave. Even then they still need help. Have you heard of bipolar patients doing stupid things with their money?

 

[chocomorsel]

I absolutely do. Additionally, I make it a point to know the names of the housekeeping staff, maintenance people, and cafeteria employees. Most other physicians ignore these important individuals but HOMIE DON'T PLAY THAT.

I don’t. But I don’t have a home base. At my previous job in a small hospital I did .
And my parents were both housekeepers so I am always friendly to the ones I see as well.

 

[Kr#36]

since you seem like a math guy do you seriously believe psyc makes $300 an hour? LOL well here's some math for you:

300 x 40 x 48 = $388,000. psyc makes no where NEAR that. average is 250 - 300K

That average is pulled down by psych having a disproportionate amount of docs that work far fewer hours than almost all other specialties. It is far from crazy for even a somewhat hard working psychiatrist to pull 388

 

[deleted1061998]

That average is pulled down by psych having a disproportionate amount of docs that work far fewer hours than almost all other specialties. It is far from crazy for even a somewhat hard working psychiatrist to pull 388

according to careers in medicine psyc works an average of 47 hours/wk and according to mgma the mean is roughy 270k a year. not saying its not possible but definitely not the "average"

 

[DirtDocMD]

Let’s put it this way, psychiatrists aren’t at risk for starvation. Also, they are rarely working nights, weekends, or holidays. They’re also not begging insurance companies to get “approval” for procedures, and they don’t need a hospital (usually) or fancy equipment/studies to do their job.

They can also do their job, at their pace, and easily past the age of 70, without anyone hassling them about “turnover times”.

Look at ALL the angles. Money, hours, lifestyle, autonomy (from hospitals/management groups/insurance, intellectual challenges. Also consider that fast/sexy (much like relationships), sounds great at 25, but at 45, the “drama” wears thin....

 

[Candidate2017]

according to careers in medicine psyc works an average of 47 hours/wk and according to mgma the mean is roughy 270k a year. not saying its not possible but definitely not the "average"

MGMA is for hospital numbers. Most psychiatrists don't work in hospitals. Of those who do, many round in the AM then leave in the afternoon to round at another hospital or work at their private clinic. Two incomes. Others bring down the numbers due to working part time.

Again, $300/hr cash is relatively cheap. Compare that to this telepsych TV doc in a box company that charges $99 cash per 15 minute follow up: Psychiatry
The MBA crowd seems to like it though and poured nearly $200 million into it last month.

BTW I think your calculator is broken.

 

[UnoMas]

MGMA is for hospital numbers. Most psychiatrists don't work in hospitals. Of those who do, many round in the AM then leave in the afternoon to round at another hospital or work at their private clinic. Two incomes. Others bring down the numbers due to working part time.

Again, $300/hr cash is relatively cheap. Compare that to this telepsych TV doc in a box company that charges $99 cash per 15 minute follow up: Psychiatry
The MBA crowd seems to like it though and poured nearly $200 million into it last month.

BTW I think your calculator is broken.

The AMC of Psychiatry.

This is definitely grass is always greener kind of mentality if you quickly browse through their sub.

Characteristics of a good outpatient job

Salary? Call? Sign On Bonus? Patient Load? Non-compete? Schedule? I know everything is fair game but I have no idea what the market can bear in negotiation. So I just want a good baseline.

forums.studentdoctor.net

Most outpatient jobs are 160-250k for 40 hours/week, 6 weeks vacation, seeing 10-15 patients a day.
Anesthesiology clinical Instructor at my residency program works 40 hours a week with minimal call and 6 weeks vacation makes more than that supervising 2 rooms. Granted the work in anesthesia is more stressful compared to psych.

It sounds good in theory but how many physicians are savvy enough to open a practice that has enough patients to see at $300/h. That's like me expecting to get a good practice practice job in Newport Beach with no partnership track after I graduate.

There's a thread from a guy chronicling opening his own psych private practice and it does not look as simple as some people in this thread make it out to be Practice in Progress

I'd rather do Chronic Pain from Anesthesia (if I could stomach the patients). Similar patient population, similar hours, better pay, more interesting subject.

 

[deleted1061998]

MGMA is for hospital numbers. Most psychiatrists don't work in hospitals. Of those who do, many round in the AM then leave in the afternoon to round at another hospital or work at their private clinic. Two incomes. Others bring down the numbers due to working part time.

Again, $300/hr cash is relatively cheap. Compare that to this telepsych TV doc in a box company that charges $99 cash per 15 minute follow up: Psychiatry
The MBA crowd seems to like it though and poured nearly $200 million into it last month.

BTW I think your calculator is broken.

no you're just delusional thinking psyc is a "gold mine". you are cherry picking examples like an idiot to make your point while i provided data from reliable sources. telepsyc makes $100 an hour according to all the psychiatrists i rounded with. MGMA is not just hospital employees so again idk where you are getting your info from. Anesthesia makes roughly 25% more an hour per the numbers....Make arguments using facts and logic not "my best friend's neighbor owns a $5million dollar house and drives a bentley and does psyc". The link you provided is laughable you know how much actually goes to the psychiatrist...like the post above me said this is an AMC type situation

 

[anbuitachi]

no you're just delusional thinking psyc is a "gold mine". you are cherry picking examples like an idiot to make your point while i provided data from reliable sources. telepsyc makes $100 an hour according to all the psychiatrists i rounded with. MGMA is not just hospital employees so again idk where you are getting your info from. Anesthesia makes roughly 25% more an hour per the numbers....Make arguments using facts and logic not "my best friend's neighbor owns a $5million dollar house and drives a bentley and does psyc". The link you provided is laughable you know how much actually goes to the psychiatrist...like the post above me said this is an AMC type situation

the point is, there are a LOT of psychiatrists who charge pretty much CASH. i remember when i was an intern many years ago, i had trouble getting psychiatry appointments for my patients because they dont take insurance. when you are working with cash, you have room to charge very high prices.

in anesthesia, that is 99% not an option. the max you are getting is the crappy rates your insurance is paying you for.

 

[deleted1061998]

the point is, there are a LOT of psychiatrists who charge pretty much CASH. i remember when i was an intern many years ago, i had trouble getting psychiatry appointments for my patients because they dont take insurance. when you are working with cash, you have room to charge very high prices.

in anesthesia, that is 99% not an option. the max you are getting is the crappy rates your insurance is paying you for.

despite those crappy rates anesthesia still pays more PER HOUR. if one goes pain they will make twice as much as psyc with the same hours and autonomy. You are also disregarding the fact that there is a lot of note writing in psyc which slows down the day. 8 hour days are more like 6 and you are only reimbursed for those 6. the money in medicine has and always will be in procedures not sitting and talking.

 

[Prehealth1011]

despite those crappy rates anesthesia still pays more PER HOUR. if one goes pain they will make twice as much as psyc with the same hours and autonomy. You are also disregarding the fact that there is a lot of note writing in psyc which slows down the day. 8 hour days are more like 6 and you are only reimbursed for those 6. the money in medicine has and always will be in procedures not sitting and talking.

How much does Anesthesia pay per hour? I'm just curious and have no bones to pick here.
I saw a chart somewhere on sdn that showed hourly income for every speciality, and Anesthesia wasn't there.

 

[anbuitachi]

despite those crappy rates anesthesia still pays more PER HOUR. if one goes pain they will make twice as much as psyc with the same hours and autonomy. You are also disregarding the fact that there is a lot of note writing in psyc which slows down the day. 8 hour days are more like 6 and you are only reimbursed for those 6. the money in medicine has and always will be in procedures not sitting and talking.

what
how much per hour do you think anesthesia make

 

[Arch Guillotti]

how much per hour do you think anesthesia make

Depends on what qualifies as an hour. An hour of work, an hour of being in the hospital on call and doing nothing, an hour of being at home but being on call, etc.

 

[deleted697127]

The minimum MD only anesthesia makes for an actual hour of time adjusting for base units and assuming horrible turnover time would probably 5-6 units per hour x $22 per Medicare unit. If you assume a 66 year old patient with HTN going for screening colonoscopy that takes 20 minutes, and take the rest of the hour for turnover you’d still get just over $100 an hour. The high we can make is obviously much higher.

Insurance mix absolutely dominates your take home pay arguably more so than even casemix. FYI for those of you in AMCs, you’re getting the same Medicare reimbursement rate as the rest of the country, but the rate insurance companies pay your AMC is NOT the reason your pay is lower. It’s the AMC taking their cut.

 

[anbuitachi]

Depends on what qualifies as an hour. An hour of work, an hour of being in the hospital on call and doing nothing, an hour of being at home but being on call, etc.

well when im on call, even if theres 'nothing' , i cant leave. so i call that work. i dont have the freedom of doing what i want, seeing my family, sleeping in my bed, etc. so that's work to me. unless you think it counts as prison instead

 

[Hot_Sauce]

Hey all, thanks for the many responses - seriously. I'm gonna take my time to read through them, contemplate, and then respond (maybe psych really is for me )

As far as some points brought up multiple times - I am interested in pain. However it's alot harder to get into from psych. There are some alums from my program that have gone that route and an attending at my place that is pain boarded, so it's possible, but that doesn't mean easy. Many programs won't even consider psych applicants. And I'm not even sure if I would like it for the reasons some of you all have mentioned. If I stick with psych, hopefully I'll be able to do a Pain elective in PGY-2.

As far as compensation, I actually went to a tele recruitment fair yesterday (they promised a visa gift card to attend so I figured why not, but made you talk to 15! different recruiters). Most places wouldn't tell me any hard salary numbers but said they would have their dedicated psych recruiter get back to me. FQHC were offering like 270k + benefits. Highly doubt this position would be more than 40, 45 hours/week MAX. Private systems around here around 300 for mix of inpatient/outpatient, more money for extra call (from home) and inpatient shifts on weekends. One private system offering 400 + relocation + signing bonus for a very reasonable schedule in a rural area 2 hours from a metro and a 25 mile radius where I couldn't do my own PP on the side. If I went this route I could do telepsych if the patients were 25 miles away, and I've seen recruiter ads for $200/hour telepsych on weekends and evenings, but those are just ads so who knows.

If I had to use my gestalt, I'd say Anes pay on average pays like Idk 20-30% more in this area based off what I've seen and heard. As far as pay per hour, I'm sure Anes is higher but I don't think its by a huge amount. The flip side is the nights, weekends, etc. I also know personally a PP psych in a multi-doc practice in the area who does make in the 6s and has plenty of time off to enjoy the fruits of his labor. I'm bringing this up to offer up some data, and to say that I don't think the pay difference matters that much if I truly like one field significantly more than the other, ie., big diff if I were Peds vs. Anes for example or ortho v. psych.

I agree that Anes has a much more tangible skill-set than 'sitting and talking,' and procedures will always pay more than clinic. However I am reminded of what my chair of plastic surgery told me in medical school "the most valuable parts of a surgeon are above his wrists," meaning that the medical-decision making, and subsequently the liability of bad outcomes, are what differentiated physicians from other healthcare professionals. I personally think psych has been and will continue to be on the rise because so many other health outcomes are dependent on mental health. In my state, suicides and overdoses count for the majority of deaths in people under 60 - both well within psych's wheelhouse. Don't get me wrong, I love that Anes are specialists. They are pain and airway specialists, and COVID has really reminded everyone of the tremendous value they have in our society (and maybe giving it some extra shine in my eyes too). It really sounds exciting, and I really miss anatomy and procedures in psych. Anyway thanks again for all the replies, please keep 'em coming!

 

[Hot_Sauce]

He’s going into pain. Should tell you a lot.

Yeah I guess it tells me he didn't like Anes as much as he thought? Or he's indecisive like me lol.

 

[Hot_Sauce]

I switched from PM&R to anesthesia for roughly the same reasons as you described. I am very satisfied and happy with my choice so far. I’d bet that anesthesia is the most switched into specialty, there’s a reason behind that. FWIW I’ve spoken to many people who switched into anesthesia before I switched myself, and have never heard anyone regret it. If you’re really willing to go through the brutal process of switching specialties to do something, chances are you already know your answer.

One of the big reasons I want to switch is missing of procedures, anatomy, and a physical aspect to my practice. Don't you get all that in PMR?

 

[Hot_Sauce]

The comment about your circadian rhythm made me laugh. I can tell you there is nothing normal about my circadian rhythm after usually working overnight 1-2 nights a week, occasional week of night float, getting called in at odd hours. Staying up late and getting up early. Anesthesia is likely not much if any more friendly to your circadian rhythm IME.

Also, you must remember that in 10-15 years no matter what you do, it will be a job and likely not much more. It will be routine and have annoying things and things you enjoy. Having flexibility in that job is likely priceless. Do you think accountants talk about how much they LOVE their spreadsheets and balancing the budget or doing the company's taxes? Heck no. But they likely consider it to be a steady and reliable job that they can be good at and that can support them financially. So the excitement of certain things can wear off and in the end you need a good job that pays the bills and supports you and your family's endeavors. This is just my thoughts.

Appreciate your perspective thanks.

 

[Candidate2017]

no you're just delusional thinking psyc is a "gold mine". you are cherry picking examples like an idiot to make your point while i provided data from reliable sources. telepsyc makes $100 an hour according to all the psychiatrists i rounded with. MGMA is not just hospital employees so again idk where you are getting your info from. Anesthesia makes roughly 25% more an hour per the numbers....Make arguments using facts and logic not "my best friend's neighbor owns a $5million dollar house and drives a bentley and does psyc". The link you provided is laughable you know how much actually goes to the psychiatrist...like the post above me said this is an AMC type situation

I was wondering why you were so bent on turning this into a specialty vs specialty pissing contest. Oh of course, youre a med student!

Forgive me, I'm just someone on the job hunt. Also, my friends, friends’ parents, classmates, former seniors, attendings, and attendings’ spouses who are psychiatrists must be lying to me about numbers. If you must, look up your local PP psychiatrists. Their rates are listed on their websites or psychologytoday.com.

Anyway, take it back to the student forum. I'm just here chilling in the virtual OR lounge. Please don't detract from OPs topic further.

Every specialty has its pros/cons and fit for different personalities, as well as ability to make a good income. It doesn't matter what gas makes compared to psych or whoever. The specialty has to fit the person. Every physician has an important role here, and we all work hard for our money (some harder than others) and I respect my gas peeps and all the hard work they do.

OP, I loved anesthesiology as a med student. I did procedures left and right, intubated all day, everyday. I was very sad on my last day knowing I would never work in the OR again. But ultimately, sleeping in, working regular hours, no call, no weekends, controllable schedule, no pager, ability to easily start a practice and not work for The Man were more important.

 

[Hot_Sauce]

if you dont want to take a hit to your circadian rhythm, you need to run far far away from anesthesia. In terms of residency, anesthesia residents work just as many night shifts as ED residents, except your total hours will be more than EDs. When i was resident, there were months when I did 7 Overnight calls (either 7am to 7am 24 hour shifts, or 3pm to 7am shifts), in addition to 6 'late' calls, where you go from 7am to ~10-11pm. The remaining days were regular days (7am to 6pm)

As an attending it varies depending on your job, but that can be said for ED as well. You can easily work in a urgent center if you really want and have better hours. I'm working at a major academic center now and this month alone i worked ten overnight shifts, with the remaining days left being regular day shifts or late shifts (til 11pm or so). So i can safely say my circadian rhythm is shot

ok, that is not super encouraging. thanks for sharing this point. I didn't know the hours as a resident, and attending, were that bad. I'm still gonna shadow here bc if I love it, I love it, but really appreciate your perspective, thanks.

 

[Hot_Sauce]

Don't discount psych until you've done outpatient clinics. It can be immensely satisfying to see people thrive with the help of psychotherapy/psychopharmacology. You often don't see that side of psychiatry on an inpatient ward.

I was in a similar situation in Australia. In our training system, you spend a year or two as a house officer before getting onto a training programme as a registrar. I started off wanting to do psych and spent 6 months on a very busy inpatient psych ward. It was awful -- mainly for the same reason you mention: I didn't feel very accomplished. Progress measured in inches sorta thing.

Then I started clozapine clinic. I saw people who were quite functional and generally very grateful for my help. It was a similar vibe in the bipolar clinic too. The drugs often work, and you are "doing things," but it's your words and personality that do the heavy lifting. Very rewarding. 9-5 schedule too.

I ended up switching to a critical care pathway, and now I'm a fairly advanced ICU/ED dual trainee (with almost a year of anaesthesia under my belt). I work with my hands a lot, but procedures get pretty routine and even boring. I promise you the wow factor really dies down after your 100th central line. What keeps me going is the rush of a good resuscitation, which is often quite cerebral. It's like crack to me, just need another hit.

What doesn't get routine is shift work, being on call, missing holidays, and the stress of making life and death decisions. I love my job, but it really does suck. I'm not sure how I'm going to sustain this in my 50s and 60s. And that hurts to say because I've devoted my 20s and 30s to training for this job.

Really appreciate this response, thank you. So I guess if you could go back and stick with that rewarding outpatient psych job where you were able to help people, and you could work into your 70s, or stick with your ICU/ED job - which would you choose and why? I'm afraid of always regretting not doing that exciting, fun, procedural specialty I envisioned when I wanted to go into medicine. Live life to the fullest and all that.

 

[Hot_Sauce]

Surgery if you want procedures and patient thanks. Anesthesiology personalities don't require thanks.

Since you are interested in psychology, I will say your ego is being narcissistically injured by the reality of what being a doctor is: caring for ill, super sick, marginalized, mean, smelly people who are their own worse enemy and will likely never improve. Not all are like this but guess who gets the privilege of dealing with those patients? You, the lowly intern. Its your job to be in the trenches with literal piss, poop, vomit, and blood to learn from the very sick, whether psych or any other specialty.

Well said, sir.

 

[Hot_Sauce]

I feel like this bears repeating every year: specialty/subspecialty selection is not a multiple choice exam. There is no right (and wrong) answer. Depending on the day, your mind will naturally overstate the benefits of one field while minimizing the downsides, and vice versa. Then maybe the next week you flip the two. I think the reason people (including a younger me) struggle with this so much is they feel if they just talk to enough people and gather enough information, the correct choice will become clear. I can tell you the opposite was true for me, it only got more difficult the more I examined it.

That being said, I think if you truly can’t decide, bet on whatever is going to give you the best lifestyle. Eventually every procedure that seems cool now will get old, and sooner than you think, I promise. If you set yourself up for more time outside the hospital later in life, you can fill a greater proportion of your week with stuff that actually makes you happy/healthy/fufilled.

Thank you for the thoughtful reply. I definitely hear what you're saying, about the choice becoming harder not easier with more information.

 

[deleted1061998]

I was wondering why you were so bent on turning this into a specialty vs specialty pissing contest. Oh of course, youre a med student!

Forgive me, I'm just someone on the job hunt. Also, my friends, friends’ parents, classmates, former seniors, attendings, and attendings’ spouses who are psychiatrists must be lying to me about numbers. If you must, look up your local PP psychiatrists. Their rates are listed on their websites or psychologytoday.com.

Anyway, take it back to the student forum. I'm just here chilling in the virtual OR lounge. Please don't detract from OPs topic further.

Every specialty has its pros/cons and fit for different personalities, as well as ability to make a good income. It doesn't matter what gas makes compared to psych or whoever. The specialty has to fit the person. Every physician has an important role here, and we all work hard for our money (some harder than others) and I respect my gas peeps and all the hard work they do.

OP, I loved anesthesiology as a med student. I did procedures left and right, intubated all day, everyday. I was very sad on my last day knowing I would never work in the OR again. But ultimately, sleeping in, working regular hours, no call, no weekends, controllable schedule, no pager, ability to easily start a practice and not work for The Man were more important.

actually not a med student but nice try to detract from how stupid your salary argument is. Just letting OP know the official numbers for salary not what your friend of a friend claims he makes. I also agree with OP that psyc is one scam of a field with everything being extremely subjective. When I was a student on psyc I felt that the vast majority of peoples problems stemmed from the social situations they were in as opposed to some sort of "mental disease" and rarely do people get better.

Also funny how you claim you are a psyc resident yet you act to know so much about an entirely different field. I have the luxury of doing a pain fellowship and I too can be an owner and set my own hours and have my own practice and patient population while making twice as much as you.

Lastly, for someone claiming to be on the job hunt posting that virtual psyc link truly showed how business illiterate you are believing what they charge is also your take home pay.

No pissing contests just facts for your simple inbred brain. Just wanted to tell OP that it wasnt all doom and gloom as people on here would make him believe.

 

[Kr#36]

ok, that is not super encouraging. thanks for sharing this point. I didn't know the hours as a resident, and attending, were that bad. I'm still gonna shadow here bc if I love it, I love it, but really appreciate your perspective, thanks.

I think its pretty fair to say that guy has an exceptionally bad contract. Residents at the program nearest me dont even work that many overnights a month. Certainly not the norm for an attending.

 

[anbuitachi]

I think its pretty fair to say that guy has an exceptionally bad contract. Residents at the program nearest me dont even work that many overnights a month. Certainly not the norm for an attending.

It varied depending on rotation and year. In my last year, i was doing fewer overnight calls, but the calls can be more challenging. The programs near me all have a good # of overnights. Even if I do as few as 4 Overnight/month, thats 1 per week, which spans 2 days. So its still tough not the sleep cycle

 

[hebel]

I definitely wouldn't make this decision based on your experience in what you describe as a dank, dreary, tertiary care inpatient psych unit. Outpatient psych and other settings can be a completely different world.

 

[Arch Guillotti]

Keep it professional please or the thread will be closed. Thanks.

 

[chocomorsel]

actually not a med student but nice try to detract from how stupid your salary argument is. Just letting OP know the official numbers for salary not what your friend of a friend claims he makes. I also agree with OP that psyc is one scam of a field with everything being extremely subjective. When I was a student on psyc I felt that the vast majority of peoples problems stemmed from the social situations they were in as opposed to some sort of "mental disease" and rarely do people get better.

Also funny how you claim you are a psyc resident yet you act to know so much about an entirely different field. I have the luxury of doing a pain fellowship and I too can be an owner and set my own hours and have my own practice and patient population while making twice as much as you.

Lastly, for someone claiming to be on the job hunt posting that virtual psyc link truly showed how business illiterate you are believing what they charge is also your take home pay.

No pissing contests just facts for your simple inbred brain. Just wanted to tell OP that it wasnt all doom and gloom as people on here would make him believe.

You need to learn how to talk to people without constantly putting them down and attacking.

Stop acting like your experiences and what you read on some salary website makes you right. Apparently almost every year we make the highest paid specialty in a few surveys and “make“ about $280K-300k average.

Good luck in pain. Serves you right. Those patients will treat you exactly how you need to be treated as you rake in “double” a shrinks salary.

 

[chocomorsel]

OP, come back and update us in ten years. If you switch I highly, highly doubt you won’t regret it. You will likely end up a cog in the wheel for some AMC overload.

 

[deleted1061998]

You need to learn how to talk to people without constantly putting them down and attacking.

Stop acting like your experiences and what you read on some salary website makes you right. Apparently almost every year we make the highest paid specialty in a few surveys and “make“ about $280K-300k average.

Good luck in pain. Serves you right. Those patients will treat you exactly how you need to be treated as you rake in “double” a shrinks salary.

I'll voice my opinion how I please. No need to learn anything. MGMA is the gold standard for salaries that is used by physicians to negotiate contracts so I highly doubt full time anesthesiologists are making 300K a year. Giving OP a different perspective and I honestly agreed with how he felt when I was a student rotating through psyc. All the benefits stated for psyc are also available in pain, with even the same patient population, so I will enjoy it.

 

[ArteryStudyPainting]

^ Don't they say people unwilling to learn are a danger?

Cranky boi.

 

[chocomorsel]

I'll voice my opinion how I please. No need to learn anything. MGMA is the gold standard for salaries that is used by physicians to negotiate contracts so I highly doubt full time anesthesiologists are making 300K a year. Giving OP a different perspective and I honestly agreed with how he felt when I was a student rotating through psyc. All the benefits stated for psyc are also available in pain, with even the same patient population, so I will enjoy it.

Your view is not the only and right view. There are plenty of other views.

Your experience isn’t the only and right one. I know psychiatrists who rake it in. And I know some working for mental health clinics making $250K.

So STFU talking to people like they are idiots and calling them idiots and inbreds because they have different experiences and views from yours. And working with manipulative, drug seeking, addicted personalities does not equate to the whole variety of psychiatric patients. You can be a psych and never have to work with those patients. If you can’t argue with people without putting them down then you got some learning to do jerk.

Does that language compute better for you? More up your alley?

 

[deleted1061998]

Your view is not the only and right view. There are plenty of other views.

Your experience isn’t the only and right one. I know psychiatrists who rake it in. And I know some working for mental health clinics making $250K.

So STFU talking to people like they are idiots and calling them idiots and inbreds because they have different experiences and views from yours.

Does that language compute better for you? More up your alley?

Since you decided to come at me, damn someone must still be bitter about their divorce. No wonder he left you if this is how you argue. Now how about you STFU and know your place.

 

[chocomorsel]

Since you decided to come at me, damn someone must still be bitter about their divorce. No wonder he left you if this is how you argue. Now how about you STFU and know your place.

You sound exactly like the man I left. Immature, angry and narcissistic. Who can’t have a disagreement without putting someone down in order to make themselves feel better. It all stems from INSECURITY.

Grow the **** up.

 

[deleted1061998]

You sound exactly like the man I left. Immature, angry and narcissistic.
Grow the **** up.
Please tell me what my place in life is.

Seems like that one got to you. Now go back to being a cog taking orders. I actually did something about my unsatisfaction instead of telling others on SDN to STFU and constantly complain about how much my life sucks. Enjoy your life, I bet he is enjoying it even more now

 

[IMGASMD]

You sound exactly like the man I left. Immature, angry and narcissistic. Who can’t have a disagreement without putting someone down in order to make themselves feel better. It all stems from INSECURITY.

Grow the **** up.

I put him on ignore a while ago. I am not sure who or what he is. Regardless, a troll of some sort.

He made plenty of comments in DO student forum, but claimed not a Med student. He was concerned that his physical exam portion of his test was not going to happen. I am thinking he’s finding a “technicality” so he’s not lying.

Hasn’t said he’s a resident nor attending. It would be a good day if he’s still in undergrad. Even as a fellow, I hope he will get the patients he yearns and deserves.

 

[Arch Guillotti]

Locking thread. No reason to get so testy.