rheuma vs. endo

[europeanIMG]

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I am hesitating between rheuma and endo and would appreciate some advice from you guys.

I´d prefer to have mainly outpatients. I do not like "action" that much. Actually I was considering FM but felt it would be nicer to be a specialist and really master a relatively restricted part of medicine than to be a generalist.

I really like rheuma but sometimes think it would be too complicated. Not easy to differentiate between diseases that have so many similiarities etc. Endo seems easier... What do you think?

What is the future like for rheumatologists and endocrinologists? Easy or hard to find a job in a nice location?

 

[staup]

I would pick Endocrine.... Rheum is very interesting, but even the experts have trouble classifying what some Rheum patients actually have. To me though, the problem with Rheum is the patient base. They have pain pain pain, and they let you know it. It can be like running a pain clinic, constantly battling about meds with them. Many specialties have this problem, but Rheum patients can live a very long time with their diseases, and hence you are always battling giving them stronger meds verses the side effects. And if you actually give out narcotics (which many Rheum docs do not), they will never stop complaining to you. Endocrine has less of this problem. I would really consider whether you would like to deal with this when picking your specialty. It may be less of a concern if you stay in academics and super specialize in Rheum patients with less pain, say maybe sclerodema or vasculitis although they definitely have pain as well. I see it has the downfall of a very very interesting field. I must say, some of the patients and consults they get in the academic world are amazingly intriguing.

 

[europeanIMG]

Interesting points.

Do endocrinologists in the US mainly see outpatients or some inpatient service as well?

Are they ever on call for all kinds of IM patients? (In my country endo docs mainly see outpatients but have to be on call maybe once a week and then they have to handle all kinds of IM patients).

What is the job market like for rheuma and endo docs? WHat is the lifestyle like?

 

[futureres]

Interesting points.

Do endocrinologists in the US mainly see outpatients or some inpatient service as well?

Are they ever on call for all kinds of IM patients? (In my country endo docs mainly see outpatients but have to be on call maybe once a week and then they have to handle all kinds of IM patients).

What is the job market like for rheuma and endo docs? WHat is the lifestyle like?

If you are at an academic center you will get called for consults...are you looking for the easiest lifestyle/fellowship match?

Neither is that competitive (endo may be slightly more competitive than rheum). Rheum consults are more common than endo. "Call" for either is rare, and they deal with IM issues related to their specialty when they are called (rheum would be called more than endo, since real endo emergencies are typically handled by the in-house IM doc, i.e. for DKA).

Mostly outpatient visits for both, neither specialty earns incomes comparable to Cards/GI but more than primary care (both on the lower end of all subspecialties).

 

[europeanIMG]

I guess I am looking for an interesting career with not too much stress.

I love studying cardiology but I don´t think my personality is ideal for the specialty. I don´t like the hectic and stressful environment. Different ppl like different jobs. I know tons of people who would find it boring to only see outpatients and not having any emergencies, well not me.

As I told you I was considering FM. I thought that endo/rheum would combine the lifestyle/work environment of FM with being an expert in something. I especially liked rheuma but endo seems interesting too.

Money is not an important factor for me. I guess most American docs earn well, especially for us who don´t have those huge student debts you guys in the US sometimes have.

Finding a job is very important though, is it easy to find a job in a nice location (NYC, Boston e.g.) for rheuma and endo docs?