Radiology to IM?

[BabinskiReflex]

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I am a radiology resident considering switching to IM. I did a prelim medicine intern year at a "good" program. I wanted to get more input from people in IM to make sure I am not making a huge mistake. I generally like radiology but often cannot see myself doing the daily things that radiologists do. In other words being relatively isolated socially spending much of the day in a darkened room is what is making me have doubts. I also worry that this would only worsen in private practice where there is no teaching, conferences, or "readouts". I find myself focusing on my memories from my internal medicine year and the interesting patients that I had. In radiology I find many interesting and intellectually stimulating cases but the human factor is missing. Unlike most radiologists I actually enjoyed working with patients despite all the social issues and occasional a-holes you have to take care of (got my fair share during intern year). If I switch I know I would be losing a lot of potential income as radiologists make at least 50% or more than your avg IM doc. I would probably become a hospitalist although I am not so sure about the 7 on 7 off weeks with the 7 to 7 shifts and the longterm viability of keeping that schedule without burnout. On the flip side radiology is not the lifestyle field that people often joke about. With 24/7 radiology services and pressure to read more faster, it is a lot harder than most perceive. Maybe even harder than some IM jobs. I know that I would do relatively well in either field. I was well liked by my prelim IM program and have done well in radiology so far. One option would be to stick with radiology and do a field like IR where there is some patient contact although it is much less than IM. My resume is very good with top grades/honors. Anyone have any insight or want to snap me back into reality?

 

[anbuitachi]

why did you decide on radiology in the first place..? did you not know that radiologists stay in a dark room with minimal patient contact? from what you wrote, it sounds like you are leaning towards switching. and with the current radiology market, you probably wont much more than your average IM doc, at least not for a while, and radiology residency + 1/2 fellowship is a 6-7 year trip... might as well switch to IM and do a 3 year fellowship and make way more than radiologists and be happy at the same time

 

[Raryn]

I am a radiology resident considering switching to IM. I did a prelim medicine intern year at a "good" program. I wanted to get more input from people in IM to make sure I am not making a huge mistake. I generally like radiology but often cannot see myself doing the daily things that radiologists do. In other words being relatively isolated socially spending much of the day in a darkened room is what is making me have doubts. I also worry that this would only worsen in private practice where there is no teaching, conferences, or "readouts". I find myself focusing on my memories from my internal medicine year and the interesting patients that I had. In radiology I find many interesting and intellectually stimulating cases but the human factor is missing. Unlike most radiologists I actually enjoyed working with patients despite all the social issues and occasional a-holes you have to take care of (got my fair share during intern year). If I switch I know I would be losing a lot of potential income as radiologists make at least 50% or more than your avg IM doc. I would probably become a hospitalist although I am not so sure about the 7 on 7 off weeks with the 7 to 7 shifts and the longterm viability of keeping that schedule without burnout. On the flip side radiology is not the lifestyle field that people often joke about. With 24/7 radiology services and pressure to read more faster, it is a lot harder than most perceive. Maybe even harder than some IM jobs. I know that I would do relatively well in either field. I was well liked by my prelim IM program and have done well in radiology so far. One option would be to stick with radiology and do a field like IR where there is some patient contact although it is much less than IM. My resume is very good with top grades/honors. Anyone have any insight or want to snap me back into reality?

I know a couple people who switched, both actually went back do the program they did their prelim in. You could try calling up your old program director and asking their advice, you might just find out they have a spot for an extra second year next year.

 

[CptNemo]

why did you decide on radiology in the first place..? did you not know that radiologists stay in a dark room with minimal patient contact? from what you wrote, it sounds like you are leaning towards switching. and with the current radiology market, you probably wont much more than your average IM doc, at least not for a while, and radiology residency + 1/2 fellowship is a 6-7 year trip... might as well switch to IM and do a 3 year fellowship and make way more than radiologists and be happy at the same time

Yeah, from what I've seen, radiology isn't the same hot commodity that it was 10 years ago - this really surprised me when I first heard it, since when I was graduating med school, radiology was really hot and lots of ppl were chasing spots with insanely high board scores, coming from a top 10 school, etc. Now, I've seen some of them doing fellowships or moving out of state, since the local job markets is pretty saturated. I always liked IM, but radiology seemed like such a good deal, that for a while, I was kicking myself for not pursing that instead... the grass is always greener on the other side.

I don't know where you want to end up, but in major metro areas on the coasts, it may be easier to find a hospitalist job than a radiology job.

That being said, hospitalist jobs are highly variable. It depends on your group and how big/busy the hospital tends to be. Some will work you a lot, some are pretty chill; the latter will pay less. For me, after having stints of working 21+ straight days in residency and fellowship and sometimes being on q2 or q3 night pager call for months on end, 7 on/7 off (or some other permutation of shift work) actually sounds pretty good.

 

[DrAwesomo]

You will be taking a big pay cut. Radiologists' salaries are around 400K. Hospitalist are around 250k.

 

[DrBowtie]

Have you done Mammo? Could be the niche you're looking for.

 

[bashwell]

If you stay in radiology, I second mammo as another option.

If you go into IM, then maybe you could do something like cardiovascular imaging?

 

[path or no path]

You will be taking a big pay cut. Radiologists' salaries are around 400K. Hospitalist are around 250k.

That's true. However, that's for working essentially less than half the year. A place I am familiar with, has 3 weeks of paid vacation on top of 7 on/off. And many people are doing locus, so if you work hard, you can approach that 400 if you are motivated.

 

[Raryn]

You will be taking a big pay cut. Radiologists' salaries are around 400K. Hospitalist are around 250k.

You're overestimating Radiology salaries. And actually underestimating Hospitalist salaries in many markets.

 

[BabinskiReflex]

I have considered mammography. it is true that radiology salaries are down compared to several years ago. The graduating fellows that I know all started in the mid to low 200 s.

 

[gastrograffin63]

You should do what feels right for you personally. If you're having these doubts about Radiology, they may never go away (but they also may go away if you eventually get used to it). It's a difficult decision, but you only live once and if you want to be a physician in the more traditional sense, then I recommend pursuing IM. It is impossible to know how you will feel about this decision 10 years from now, some people say, "it's just a job, 10 years from now you will not care about what you're doing, you will be more focused on taking care of your children and making a living." Radiology may good in that aspect because it is shift work, once you clean up the list, you're done for the day, no patients can call you, you don't have to fill out insurance/disability paper work - that's why it is considered a great lifestyle field. The starting salaries are still generally higher than IM (but have been decreasing and IM can get paid more in certain specialties/practice models).
On the other hand, you can also have a decent lifestyle in an IM field, if you solely do outpatient medicine or work at a less-busy hospital, you can also have plenty of personal/family time.
It really boils down to "Do what you like", we are in a very privileged position to be able to choose our style/type of work, and especially because with what ever you choose, you will be happy and successful either way. If you stay in Radiology nobody will care and if you choose to switch to IM, also, nobody will care. The only person that will be affected is you. It is based on your own internal experience of the world and life. If you want to have fulfilling interactions with patients, then do IM. People that truly enjoy Radiology love imaging, they don't really care about talking to patients and formulating treatment plans, they gain fulfillment from solving complex imaging questions and helping/guiding referring providers.
Here is an inspiring article written by someone in a similar situation:
http://www.alliswellthateatswell.com/2012/10/road-less-traveled.html

 

[shark2000]

You should do what feels right for you personally. If you're having these doubts about Radiology, they may never go away (but they also may go away if you eventually get used to it). It's a difficult decision, but you only live once and if you want to be a physician in the more traditional sense, then I recommend pursuing IM. It is impossible to know how you will feel about this decision 10 years from now, some people say, "it's just a job, 10 years from now you will not care about what you're doing, you will be more focused on taking care of your children and making a living." Radiology may good in that aspect because it is shift work, once you clean up the list, you're done for the day, no patients can call you, you don't have to fill out insurance/disability paper work - that's why it is considered a great lifestyle field. The starting salaries are still generally higher than IM (but have been decreasing and IM can get paid more in certain specialties/practice models).
On the other hand, you can also have a decent lifestyle in an IM field, if you solely do outpatient medicine or work at a less-busy hospital, you can also have plenty of personal/family time.
It really boils down to "Do what you like", we are in a very privileged position to be able to choose our style/type of work, and especially because with what ever you choose, you will be happy and successful either way. If you stay in Radiology nobody will care and if you choose to switch to IM, also, nobody will care. The only person that will be affected is you. It is based on your own internal experience of the world and life. If you want to have fulfilling interactions with patients, then do IM. People that truly enjoy Radiology love imaging, they don't really care about talking to patients and formulating treatment plans, they gain fulfillment from solving complex imaging questions and helping/guiding referring providers.
Here is an inspiring article written by someone in a similar situation:
http://www.alliswellthateatswell.com/2012/10/road-less-traveled.html

1+.

It all depends on what you want to do to your life. Eventually, nobody even your family cares about your day to day job.

There are a few points I want to make based on real life experience as a private practice radiologist that may help you:

- Yes, I agree with people who tell you that you have to do something that you feel is right for you. However, it is almost impossible to know what the priorities of you life will be even 10 years from now. You have lived less than 30 years for now and 15 years of it was your childhood. How can you know your interests in life 20 years from now at your mid career?

- Having said that, take a look at the people around you. Despite all the interest and the passion that people talk about, FOR MOST PEOPLE and FOR MOST PHYSICIANS it will become a job eventually, sooner than later. As one of my attendings used to say, the interesting parts of your job will become boring and monotonous at best but the painful parts of your job will become MORE PAINFUL.

- As a radiologist in private practice, definitely I am biased but this is my opinion. I do 30%-40% of procedures in my practice including kyphoplasty, spine pain procedures and lots of non-arterial IR. Patient interaction is over-rated. Not that I don't like interacting with people but considering everything together, I think it is not worth it.

- As a person who is married to a cardiologist, I can tell you that almost all of them confess (at least to their family and friends) that they hate the lifestyle that comes with their field. On the other hand, there are some other aspects of their field that they like.

- Salaries fluctuate a lot of over time. Also there is a huge overlap between salaries. In a certain geographic location some specialties may make more than others and the opposite may be correct in another area. Right now, radiology salaries are comparable to IM subspecialties and the gap between specialist salaries and IM salaries is closing. But nobody knows what will happen to the salaries 10 years from now. At the end of the day, as a physician, you can make enough to have a decent life, no matter what field you choose.

- It is a very tough decision. As the above poster mentioned, you never know what will you think about your decision 10 years from now. You may be happy with it or you may regret it. However, at this point choose what you think is right for you NOW. You live once and choose what makes you happier. Also consider that there are certain people who get too obsessed with their choices. Don't get too obsessed and don't put too much thought into it. If you choose a certain medical field, you can always change your type of practice toward what you life. If you do IM, there are certain fields in IM that are way different than the others. The same for radiology.

- At the end of the day, choosing a medical field is a relatively random process. You will know about your field only after you finish training and enter practice. After a while, if you are smart enough you can shape your practice and find your interests. If not, you will regret the rest of your life about your choice (the grass is always greener on the other side).

The people who are happy with their job (or their life) are not happy because of their job (or their life) itself. They are happy because of their own personality and attitude (call it intelligence, smartness or ... ).

 

[bashwell]

Sorry this is more general philosophy of life than specific help, but in the hopes it might be helpful in some small way:

It's ideal but not always possible to balance passion with prudence. In general, though there are of course exceptions, the younger emphasize passion, while the older emphasize prudence.

The fault of the younger is they sometimes shoot for the stars and overshoot or undershoot. They miss their mark. But what's good about being young is if you veer off course into something you don't like, then there's still time to correct the trajectory. Just pick yourself up, shake it off, and go for something else. The passion and zeal of youth and zest for life is often encouraging and cheering to others as well.

However, the fault of the older is they are sometimes overly cautious. A bit hesitant. But you never get what you don't aim for, and sometimes the older fail simply for lack of trying. However, what's good about being older is you are in general "wiser" and more "knowledgeable" about the ways of the world, a lot more savvy about different choices and their consequences in life, probably because you have seen and experienced and know what it's like to get burned. And you are "wiser" in that since time is more of a premium as you age, you value the things that money can't buy such as time with your family, friends, etc.

That's also why I think it's a good idea to ask people at different stages in life for advice when for example trying to decide between specialties. Don't just ask fellow med students. Don't just ask residents. But also ask attendings. And also ask attendings who are 5, 10, even 15 yrs out. Because even within the same specialty, you can get a range of answers, depending on where someone is in life (among other things like personal background etc.).

 

[JP2740]

1+.

It all depends on what you want to do to your life. Eventually, nobody even your family cares about your day to day job.

There are a few points I want to make based on real life experience as a private practice radiologist that may help you:

- Yes, I agree with people who tell you that you have to do something that you feel is right for you. However, it is almost impossible to know what the priorities of you life will be even 10 years from now. You have lived less than 30 years for now and 15 years of it was your childhood. How can you know your interests in life 20 years from now at your mid career?

- Having said that, take a look at the people around you. Despite all the interest and the passion that people talk about, FOR MOST PEOPLE and FOR MOST PHYSICIANS it will become a job eventually, sooner than later. As one of my attendings used to say, the interesting parts of your job will become boring and monotonous at best but the painful parts of your job will become MORE PAINFUL.

- As a radiologist in private practice, definitely I am biased but this is my opinion. I do 30%-40% of procedures in my practice including kyphoplasty, spine pain procedures and lots of non-arterial IR. Patient interaction is over-rated. Not that I don't like interacting with people but considering everything together, I think it is not worth it.

- As a person who is married to a cardiologist, I can tell you that almost all of them confess (at least to their family and friends) that they hate the lifestyle that comes with their field. On the other hand, there are some other aspects of their field that they like.

- Salaries fluctuate a lot of over time. Also there is a huge overlap between salaries. In a certain geographic location some specialties may make more than others and the opposite may be correct in another area. Right now, radiology salaries are comparable to IM subspecialties and the gap between specialist salaries and IM salaries is closing. But nobody knows what will happen to the salaries 10 years from now. At the end of the day, as a physician, you can make enough to have a decent life, no matter what field you choose.

- It is a very tough decision. As the above poster mentioned, you never know what will you think about your decision 10 years from now. You may be happy with it or you may regret it. However, at this point choose what you think is right for you NOW. You live once and choose what makes you happier. Also consider that there are certain people who get too obsessed with their choices. Don't get too obsessed and don't put too much thought into it. If you choose a certain medical field, you can always change your type of practice toward what you life. If you do IM, there are certain fields in IM that are way different than the others. The same for radiology.

- At the end of the day, choosing a medical field is a relatively random process. You will know about your field only after you finish training and enter practice. After a while, if you are smart enough you can shape your practice and find your interests. If not, you will regret the rest of your life about your choice (the grass is always greener on the other side).

The people who are happy with their job (or their life) are not happy because of their job (or their life) itself. They are happy because of their own personality and attitude (call it intelligence, smartness or ... ).

So then when picking residencies, enjoying the clinical work should not be a factor at all? Lifestyle should be the only factor according to this. I made a mistake by picking a field I like?

 

[shark2000]

So then when picking residencies, enjoying the clinical work should not be a factor at all? Lifestyle should be the only factor according to this. I made a mistake by picking a field I like?

Please read my post again. This is one of the last paragraphs:

It is a very tough decision. As the above poster mentioned, you never know what will you think about your decision 10 years from now. You may be happy with it or you may regret it. However, at this point choose what you think is right for you NOW. You live once and choose what makes you happier....

My whole point was to encourage you to do what you think is correct for you now. However, also be wary that you will change a lot during your life.

 

[JP2740]

Please read my post again. This is one of the last paragraphs:



My whole point was to encourage you to do what you think is correct for you now. However, also be wary that you will change a lot during your life.

Right. It was an honest question though. You seemed to be saying what I posted did you not?

 

[shark2000]

Right. It was an honest question though. You seemed to be saying what I posted did you not?

Yes. I personally TRULY BELIEVE that you have to do what makes you happier, though your decision may necessarily seem the best one from an outside observer.

If you like IM, go for it. Lots of opportunities. The same for any other field.

As I also mentioned, don't think that a field by itself will make you happy or unhappy. Happiness and satisfaction is an inside job.