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deleted647155
I was wondering if anyone has decided between radiology or dermatology in med school...if so, what made you choose radiology? Thank you!
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The two fields deep down are similar. You use your eyes and words to describe lesions, from which the differential emerges. "There are erythematous papules in a christmas tree distribution" vs "There is a T1 hypointense, T2 hyperintense lesion with an enhancing rim". Derm sees patients with all the inherent joys and sorrows related to that, while radiology may or may not, depending on if you are an interventionalist. Derm can opt out of the insurance system, because demand is so high for their services, and they only deal with skin, so you can actually have a comprehensive visit in 15 minutes. Radiology unfortunately can't, and battles constant forces that insist we are not worth paying for, even though the practice of modern medicine would grind to a halt if Radiology wasn't worth practicing.
I strongly considered dermatology, and while my life would have been better in dermatology, radiology was a better fit for my interests.
I strongly considered dermatology, and while my life would have been better in dermatology, radiology was a better fit for my interests.
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deleted564680
IMO, Derm is too boring. It's a pure opinion from my personal experience but 90% of the stuff is same old same old. Radiology is much more variety. Like above poster though, there are similarities between the two.
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deleted647155
thank you so much for sharing! i agree, derm and radiology are similar in many aspects which is why im having such a difficult time choosing between the two...I like the technology in radiology but I also like reading abiut dermatology...
Lifetyle: Derm wins big time. Radiology is a 24/7 service.
Salary: Rads has a little higher average salary, but Derm has higher potential. Anyway, both pay well and the difference is not significant.
Job availability: Derm wins. Right now, derm has a much better job market.
Risk of malpractice: Derm wins.
Flexibility: Derm wins.
Intellectual: It is like comparing my house in Malibu beach with your condo in Michigan.
Diversity: It is like comparing my Ferrari with your Honda civic 2004.
Being on the front edge of technology: No need to say anything.
Bottom line: If you look at it as a JOB that pays well, has a good lifestyle and has less hassles, DERM WINS without any doubt. In fact, nothing in medicine beats Derm if you are looking for a balance between salary, hours, lifestyle, job market and ...
But it is too boring. If you can tolerate it, good for you. Go for it. It is no joke. In none of these fields you are going to retire after 10 years. See whether you can do acne, rash and eczema 90% of the time on 50 patients a day without a definite diagnosis the rest of your life or not. "If it is dry make is wet. If it is wet, make it dry." and add a topical steroid to it. Obviously, this is simplification. But this is most of what you will do. If you do MOHS it pays very well, but there is no guarantee that its extremely high salaries will stay the same in the next 30 years and also you have to cut 15 moles a day the rest of your life .
I am happy with my career now and if I wanted to do it again, I would definitely choose radiology again. But as I said above derm is a better gig than radiology or any other field in medicine. However, it needs its personality. I personally could not do it. But if someone is happy and satisfied doing derm, good for them and I envy them (not that I wanted to be a dermatologist. I wish radiology had been similar to derm in terms of hours, pay/hour and flexibility).
Salary: Rads has a little higher average salary, but Derm has higher potential. Anyway, both pay well and the difference is not significant.
Job availability: Derm wins. Right now, derm has a much better job market.
Risk of malpractice: Derm wins.
Flexibility: Derm wins.
Intellectual: It is like comparing my house in Malibu beach with your condo in Michigan.
Diversity: It is like comparing my Ferrari with your Honda civic 2004.
Being on the front edge of technology: No need to say anything.
Bottom line: If you look at it as a JOB that pays well, has a good lifestyle and has less hassles, DERM WINS without any doubt. In fact, nothing in medicine beats Derm if you are looking for a balance between salary, hours, lifestyle, job market and ...
But it is too boring. If you can tolerate it, good for you. Go for it. It is no joke. In none of these fields you are going to retire after 10 years. See whether you can do acne, rash and eczema 90% of the time on 50 patients a day without a definite diagnosis the rest of your life or not. "If it is dry make is wet. If it is wet, make it dry." and add a topical steroid to it. Obviously, this is simplification. But this is most of what you will do. If you do MOHS it pays very well, but there is no guarantee that its extremely high salaries will stay the same in the next 30 years and also you have to cut 15 moles a day the rest of your life .
I am happy with my career now and if I wanted to do it again, I would definitely choose radiology again. But as I said above derm is a better gig than radiology or any other field in medicine. However, it needs its personality. I personally could not do it. But if someone is happy and satisfied doing derm, good for them and I envy them (not that I wanted to be a dermatologist. I wish radiology had been similar to derm in terms of hours, pay/hour and flexibility).
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Derm clinic can be hectic, but the acuity is obviously very low. It also ends at the end of business hours.
The examinations are very different obviously. In radiology you see the inner workings of people through imaging. In dermatology, you see every inch someone's skin, which means their entire boy. Most skin conditions are probably primary, but some are definitely sequelae of systemic disease.
I think in derm you get a lot of people with means or worried well. In radiology, you get lots of the sickest people around (and sometimes dead people).
The examinations are very different obviously. In radiology you see the inner workings of people through imaging. In dermatology, you see every inch someone's skin, which means their entire boy. Most skin conditions are probably primary, but some are definitely sequelae of systemic disease.
I think in derm you get a lot of people with means or worried well. In radiology, you get lots of the sickest people around (and sometimes dead people).
Don't over simplify things. I spend 30-40% of my time doing procedures.
I think it is a very hard decision for a medical student to decide whether he/she want to see patients or not. There is a very brief encounter with reality of patient care during MS3.
The above is mostly true but there are exceptions. For instance I work in an outpatient only radiology practice. My hours are Mon-Fri 7:30-5. No nights, no weekends. Salary low to mid 300s. SoCal. It is high volume though (100+exams/day, I only take 30-40 minute lunch break). General rads with good mix of msk, neuro, body, mammo. these types of practices are becoming less common but they still exist. You just have to do some extra research to find them. One big problem in rads is the emergence of large mega corp like Radnet and Simonmed. I recommend finding the smaller mom and pop practices though they are becoming less common.
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While well intentioned, I think this post is rather inaccurate. I think it is highly inaccurate to say that in general Rads salaries are greater than derm. And I say this as someone who was a Rads resident so no bias or anything against Rads. I think Rads is great and an essential specialty in today's complex medical system. Nevertheless, it is nonetheless true that Radiology is not what it was 8-10 years ago. Volume has increased incredibly, it is absolutely breakneck speed, job availability is limited, particularly if there is a concern for geographical areas or no night jobs/night hawk type positions. The job market in Derm is WIDE open - whether you want to work in downtown Manhattan or podunk USA you will find a high paying job. Sure, many derms see a large number of patients - I think 80 is an exaggeration, but between 30-50 is probably correct. However many many many derms run cosmetic only practices where they make a killing, and it's not uncommon to see million dollar practices where it's cold hard cash, 4 day work week 8-5 exclusively. Even for those derms who do some general work, many also do some cosmetic portion, where their MAs/assistants do the vast majority of the work whether it be lasers, botox, body slimming stuff, etc. So the amount of money the AVERAGE dermatologist makes is more often than not significantly higher than what Radiologists make, even more during these difficult times for Rads. A dermatologist can open his/her own practice and be at full speed prob within 6 months - good luck doing that as a Radiologist. One of the raeson there is such a large demand in derm is not only that they maintain a small supply of spots for residencies, but also there is a very large # of derms who exclusively do cosmetics - which in turn creates a dire need for general/medical derms. Of the people in my own med school, for example, about 5 of my class went into derm, with 4 of them going into cosmetics exclusively. Nothing wrong doing that per se, but it does create a tremendous amount of financial potential and easy of work load that is not available in any other specialty hands down. Add the small # of residencies and you have a golden ticket - reason why derm is so competitive. Again Rads is awsome, but let's not kid ourselves about the realities of derm. I would personally encourage anyone who is able to go into derm to do so. I have yet to find an unhappy derm, and they are consistently ranking as #1 in terms of satisfaction.
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While maybe well intentioned, this post is also misleading. The new cosmetic derm runs into the same problem that the new plastic surgeon does: competition at the hot spots (e.g. metro areas). You can start your own cosmetic derm center in 6 months, sure, but your competition is spas, plastics for body dysmorphs, and crap like that, not to mention every other doctor who can buy a laser (e.g. some interventional rads) or push cream and inject botox (everyone with a mind to, including family practice). I'm not sure what your goals are in making derm look so rosy, but "not uncommon to see million dollar practices where it's cold hard cash, 4 day work week 8-5 exclusively" is baloney for a new derm grad wandering out of residency with no connections (source: my derm relative). The idea that there's a dearth of derms who want to be actual doctors is accurate (source: my derm relative), which does create opportunity for people who want the harder doctor work of treating cancer and psoriasis instead of slathering goop on wrinkles.
Seriously comparing rads and derm: salary, type of work, whatever, is for a very naïve medical student. The fields are completely different. If a med student thinks in terms of ROAD, he or she needs to quit accepting misleading acronyms, try harder to look at what the fields actually do, and then be honest with him or herself.
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There is a very big misconception that cosmetic derm makes a huge amount of money. Similar to what people think about plastic surgery.
There are a few Plastic surgeons and Dermatologists in Manhattan or Beverly Hills who make a killing by doing cosmetics. You can say the same for Bankers or IT people.
Outside a few places, cosmetics market either doesn't exist or there is a huge competition with Family doctors, NPs, Local Spas, Surgeons and ... Almost everyone who can hold a needle is doing cosmetics. And an average individual in a middle class (and not Kim Kardashian) chooses the least price. Most of cosmetics effect is reversible and people just give it a try if their friend or neighbor had a good result. FYI, a family doctor in my area has one of the busiest cosmetics practice because he charges peanuts for each Botox injection.
People's opinion about physician's salaries is very inaccurate at best. Even there are always huge misconceptions among physicians about other physicians salaries. I know a few physicians who think that I work 4 days a week from 9-4 and make more than a million. When I tell my friends in some non hospital based fields that I take call, they barely believe me.
There are a few Plastic surgeons and Dermatologists in Manhattan or Beverly Hills who make a killing by doing cosmetics. You can say the same for Bankers or IT people.
Outside a few places, cosmetics market either doesn't exist or there is a huge competition with Family doctors, NPs, Local Spas, Surgeons and ... Almost everyone who can hold a needle is doing cosmetics. And an average individual in a middle class (and not Kim Kardashian) chooses the least price. Most of cosmetics effect is reversible and people just give it a try if their friend or neighbor had a good result. FYI, a family doctor in my area has one of the busiest cosmetics practice because he charges peanuts for each Botox injection.
People's opinion about physician's salaries is very inaccurate at best. Even there are always huge misconceptions among physicians about other physicians salaries. I know a few physicians who think that I work 4 days a week from 9-4 and make more than a million. When I tell my friends in some non hospital based fields that I take call, they barely believe me.
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what's it like to do cosmetic IR? http://cvsnyc.com/about/
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I bet they don't even know what "call" for you means, if they are anything like the people I know!
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This is highly inaccurate. Cosmetic dermatologists are making enormous amounts of money. If you don't believe that, go to see the practices being sold and see how much they are netting - not grossing, but netting. Ask an avg dermatologist who does solely cosmetics and someone who does some cosmetic and some medical and you will see that the cosmetic derms are making enormous amounts of money. Also realize that the avg dermatologist works 4 days a week, and doesn't take call - it's outpt. My own dermatologist and his entire group who works in one of the most desirable cities in the nation works 4 days a week, from 9-5:30pm, no call, entirely cash based. His group and countless others in the city are making tremendous amounts of $. For a 100% non-cosmetic derm, the wait here is about 3 months for new patients. Again this is not podunk USA, it's one of the most desirable cities in the nation. Derm is absolutely rosy. If you don't think that I'm very sorry. The fact that derm is so competitive is not just because everyone loves skin so much but because you can make so much $.
Even with competition, dermatologists and cosmetic ones at that, do extremely well.
Not sure why you think this is offensive to you somehow. It's just the way it is.
No one is saying Rads is not a great field, but it is certainly not Derm.
I agree this thread is filled with stereotypes and inaccuracies mainly from people not in dermatology. Let me give you an opinion from an attending dermatologist.
1. You can make a ton of money doing cosmetics but its not easy getting established and there is a ton of competition in most markets. You have to like doing it too. The average derm probably does 10% cosmetic, 90% medical. Your malpractice will also go up a lot if you do a ton of cosmetic stuff.
2. Income - agree probably about equal between the two fields on average. Upside may be more for derm but not sure (older radiologists practice owners probably do similarly).
3. I agree lifestyle is probably better in derm overall.
4. Job market in derm is way better but it's not "wide open" as you claim. Large cities are sometimes saturated and you can get a job but it may be crappy (ie partners taking advantage over you). Mohs and dermpath subspecialites are very tight - probably similar to rads market as I understand.
5. Interest and "intellectual stimulation." This is not a objective measure although I do feel that overall a stereotype of derm seen by outside fields is "boring" although most people saying this have no real idea what we do. As you are well aware, shadowing or doing a month rotation gives one very little insight. I found radiology "boring" in my one month rotation but realize that's because I had no idea what I was looking at. General Derm is a great blend of minor surgeries /procedures interspersed with skin cancer, hundreds of different inflammatory conditions in your ddx, pathology and of course maintaining a long term relationship with patients from babies to geriatric population. I would say that if you enjoy acute emergency or critical care obviously derm is not the field for you. Each to his own though.
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So you agree that you can make a ton of money doing cosmetics. Exactly. And like with anything, it takes time to establish any type of practice. I never discussed the "time." But I'd think you'd be kidding yourself if you said that a great deal of people going into dermatology don't do so mostly because of cosmetics. This is even per most of the dermatologists I rotated with. Like I said, mostof my classmates who went into derm - all of them went into cosmetics except 1 who happened to have a PhD and liked research.
Income - have you seen starting Radiology salaries recently? It is not a surprise that there are countless threads about people complaining about the low starting Rads salaries and how much Rads has gone downhill in terms of reimbursement. Look at avg job postings as well. You cannot compare the starting Derm vs Rads salaries. Sure mega partners may be making a killing, but that's the past not the present or reality. Like most people on here say, the days of Rads making 500k are in the past. Nothing wrong with that, no one needs that kind of $ to be happy, but reality is reality. Quick look at the derm forum and you'll see plenty of finishing residents/new attendings talking about how you can make a good 450k running a steady practice in less than 1 yr. These are your colleagues talking btw.
Lifestyle hands down Derm like you said and agreed. No call, you won't be up reading countless studies, no emergencies, etc. Sure rare weekend consult that may or may not need to be seen. But other than that it's rare for derms to work past regular business hours.
Market- large cities are always saturated in every specialty, but in every city even desirable ones you will find a job, and likely a decent one. Here in Austin, one of the most desirable cities in the country, there are HUNDREDS of derm jobs, with salaries that make your eyes hurt. Try doing that in Rads. Last time I checked, there were less than 20 jobs in Rads here.
Interest and intellectual stimulation is entirely dependent on a person's interest, so it's a moot point.
I think both specialties are important and needed, but unfortunately Rads is going and has been going through a rough patch. And as someone who recently left the field I think I have a pretty healthy perspective of what's been happening in the field.
Income - have you seen starting Radiology salaries recently? It is not a surprise that there are countless threads about people complaining about the low starting Rads salaries and how much Rads has gone downhill in terms of reimbursement. Look at avg job postings as well. You cannot compare the starting Derm vs Rads salaries. Sure mega partners may be making a killing, but that's the past not the present or reality. Like most people on here say, the days of Rads making 500k are in the past. Nothing wrong with that, no one needs that kind of $ to be happy, but reality is reality. Quick look at the derm forum and you'll see plenty of finishing residents/new attendings talking about how you can make a good 450k running a steady practice in less than 1 yr. These are your colleagues talking btw.
Lifestyle hands down Derm like you said and agreed. No call, you won't be up reading countless studies, no emergencies, etc. Sure rare weekend consult that may or may not need to be seen. But other than that it's rare for derms to work past regular business hours.
Market- large cities are always saturated in every specialty, but in every city even desirable ones you will find a job, and likely a decent one. Here in Austin, one of the most desirable cities in the country, there are HUNDREDS of derm jobs, with salaries that make your eyes hurt. Try doing that in Rads. Last time I checked, there were less than 20 jobs in Rads here.
Interest and intellectual stimulation is entirely dependent on a person's interest, so it's a moot point.
I think both specialties are important and needed, but unfortunately Rads is going and has been going through a rough patch. And as someone who recently left the field I think I have a pretty healthy perspective of what's been happening in the field.
Since I'm not in radiology and you are, I will defer to you on how salaries and the job market is in comparison to derm. I fully acknowledge that we have a very good market for genderm compared to (most) specialties. Mohs and dermpath are significantly different as I said.
However, I really think you don't understand the cosmetics market. There are a limited number of patients that are willing to pay $350 cash for 5 minites of botox, $1000 for filler or $4000 for laser resurfacing. I'm telling you from experience that less than 1 in 50 dermatologists are doing more then 50% cosmetics in their practices- the usual mix is 90/10% or less. Most would do more if they could because its easy money but competition prevents that.
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Interesting posts!
I wanted to also add from what I've seen, Derm offices can also have PA's/Nurses see patients which could help with some of the charting/paperwork.
I don't see a PA or Nurse reading films anytime soon, well at least I hope not!
I wanted to also add from what I've seen, Derm offices can also have PA's/Nurses see patients which could help with some of the charting/paperwork.
I don't see a PA or Nurse reading films anytime soon, well at least I hope not!
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Well my friend you are in for a nasty surprise, because now there is a huge push for another catastrophic event - that of Radiology assistants! to do things like help with simple fluoro procedures, help in IR related things, and to some extent "read" prelim simple films. Get ready for catastrophe soon. It's sad that Rads has not learned from the disaster that CRNAs have created for Anesthesia.
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Oh man I am so rabidly anti rad assistants you have no idea. The concept makes no sense. Let's take a rad technologist who's entire training is in image acquisition and throw them into some weird version of PA school where they learn some limited subset of physiology and pathophysiology, and then have them interpret plain films, the hardest, most liability inducing studies in existence? And under our license?
For $8 a plain film?
Hell no.
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wait so this is actually happening? I've never heard of this before
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A few places have PAs shoot the fluoro studies. It's fraught with problems, but since fluoro is such a small part of a radiology group, some people can get away with it.
The few rad assistants I've seen are analogous to ultrasound techs. Sonographers are awesome, but they'll never replace a radiologist. US techs in some places used to put in prelims overnight, but the push for 24-7 attending coverage makes any rad assistant less useful.
There's also no need for rad assistants for plain films. ED PAs already give their "prelim" read. There's no need to duplicate one PA with another in terms of disposition. Any rad who would just sign off on what a theoretical rad PA prelimmed overnight is entering a liability trap, and cost savings would seem questionable.
The few rad assistants I've seen are analogous to ultrasound techs. Sonographers are awesome, but they'll never replace a radiologist. US techs in some places used to put in prelims overnight, but the push for 24-7 attending coverage makes any rad assistant less useful.
There's also no need for rad assistants for plain films. ED PAs already give their "prelim" read. There's no need to duplicate one PA with another in terms of disposition. Any rad who would just sign off on what a theoretical rad PA prelimmed overnight is entering a liability trap, and cost savings would seem questionable.
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Hyperbole much?
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Oh man, PAs or NP's writing "imaging independently evaluated by this author" make me giggle. I just assume they opened, paused, and thought "yup, those are some lungs".
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I just assume it's some billing requirement.
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IR not withstanding, you want to sit in front of a computer all day?
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IR is not the only sub specialty in radiology that does procedures
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Hell yes.
What is the alternative?
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Just in comparison to derm.
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What specialties in medicine do not sit in front of a computer all day now that we are in the era of EMR?
Might as well focus 100% on the computer rather than have patients bitch about us not paying attention to them.
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deleted564680
Maxxor nails this x100. ALL physicians are in front of a computer most of the day and it's going to get worse as the government/insurance companies/etc. keeping adding more and more "check-boxes."
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Ah, man. This is my parade you're raining on.
No.
If you don't do radiology (=sitting in front of a computer all day), what is the alternative? Doing rectal exams or looking at moles the whole day?
Patient contact is way way overrated. There is an inferiority complex in some people that they want to go around the hospital and be called "doc" or "surgeon".
I do 30-40% procedures including spine pain/injections, kypho/vertebro, all sorts of biopsies, lines, tubes, drains, catheters, ports and .... I am pretty sure that 10 years from now if I can choose my type of work, I will choose to be in my peaceful corner sitting in front of the computer solving problems. This moves me more than doing my 10000th biopsy.
This is beyond the understanding of a fresh medical student who gets super excited by his new white coat and gets intrigued by long useless medicine rounds.
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Fair enough.... But now I wanna know how you really feel.
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In between when you have to, you know, see patients in the office and hospital.
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Charting takes as long as seeing the patient with every mega corporate EMR I have ever seen. Only a few home grown ones are actually fast.
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F/Us can be easy once you've got one good note in the system.
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There are standing tables.
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You really need a treadmill table
http://www.businessinsider.com/the-truth-about-working-on-a-treadmill-desk-2013-11
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old news, worked in pp with RA's, they did flouro and procedures, actually did them pretty well,
Radiology has a lot of challenges, RA's is not one of them. Worked with them in PP a few years ago on the east coast, they were awesome in performing fluoro and light IR. They could interpret straight out negative flouro but throw in a "slight" twist (eg. not so subtle anastomotic leak and they were off). Not even close to interpreting radiographs, "simple" films are occasionally anything but. Forget about CT/US. MR? C'mon man!
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absolutely hate 'em
rads just has so much less hassle. like being a surgeon is more high and lows ( with a lot more lows than highs IMO) vs rads which is just a consistent in the middle
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wouldn't so quick to brush it off just because you don't think their skill level wasn't that great for more complex stuff. doesn't really matter if they can publish some BS studies showing decent outcomes and end up with extended scopes
