Rheumatology vs Endocrinology?

[loganciclovir]

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Hey there! I am a PGY-2 IM resident who, after being incredibly indecisive about what I want to do with my life for the past 18 months, has decided that I want to pursue fellowship in either endocrinology for rheum. I like the subject matter of both fields but I am having a hard time deciding between each. I value work life balance a lot but also want to feel intellectually stimulated. Anyone have any insight into the reality of these specialties that might help me narrow down? I am leaning towards endocrinology, but I fear that may also be because of more exposure to that field compared to rheum.

Also, as a separate question, could anyone who has applied to either or knows about the application process help me gauge which tier of programs I should target for whichever specialty I pick? I am a USMD. No in-house fellowship for either. 270+ step 2 and 260+ step 3. Research is a weak point for my app as I just have a couple posters and a case report that is pending publication.

 

[bronx43]

Neither. Primary care is honestly better than both. But if you HAD to pick one, endo has better supply/demand dynamics in a major metro.

I'm rheum.

 

[Prehealth1011]

I hated both patient population as a resident and vowed never to deal with them after graduation. It’s young females with vague joint pains vs non-compliant primary care patients. I would consider Allergy if that interests you.

 

[loganciclovir]

I hated both patient population as a resident and vowed never to deal with them after graduation. It’s young females with vague joint pains vs non-compliant primary care patients. I would consider Allergy if that interests you.

I will look into allergy/immunology as well! Unfortunately we get hardly any experience in that unless we actively seek it in the first couple of years, which might be tight timing wise.

 

[Prehealth1011]

I will look into allergy/immunology as well! Unfortunately we get hardly any experience in that unless we actively seek it in the first couple of years, which might be tight timing wise.

I wouldn’t rush into choosing something you’ll be doing for the rest of your career.

 

[bronx43]

I hated both patient population as a resident and vowed never to deal with them after graduation. It’s young females with vague joint pains vs non-compliant primary care patients. I would consider Allergy if that interests you.

Allergy is better day to day than rheum/endo but the market is horrendous.

You can pretty much close your eyes, pick a location on the map and land an endo gig, where the employer is falling over backwards to recruit you.

Allergy is “I have a contact in X city where I hear there’s possibly a job opening.”

 

[PugsAndHugs]

I am a new endo attending that thought they wanted to do rheum at first. My advice is DO ROTATIONS/ELECTIVES IN BOTH. They are SO different. Endocrine is a very objective field (labs/data) and you rarely have to deal with pain of any kind while Rheum’s main chief complaint is pain and is very focused on physical exam, which can be subjective. I knew first week of Rheum elective there was no way I could deal with this. I would say definitely sicker patients as well in the inpatient setting.

PM me if you have any questions. Do the electives ASAP. Message your program director and tell them you need to figure out so try to change your schedule around to make it work. If you need to do a PCP vs hospitalist year for more time that is also reasonable. You can also do an Obesity medicine fellowship year as well if you need something to do in that year.

 

[dozitgetchahi]

Hey there! I am a PGY-2 IM resident who, after being incredibly indecisive about what I want to do with my life for the past 18 months, has decided that I want to pursue fellowship in either endocrinology for rheum. I like the subject matter of both fields but I am having a hard time deciding between each. I value work life balance a lot but also want to feel intellectually stimulated. Anyone have any insight into the reality of these specialties that might help me narrow down? I am leaning towards endocrinology, but I fear that may also be because of more exposure to that field compared to rheum.

Also, as a separate question, could anyone who has applied to either or knows about the application process help me gauge which tier of programs I should target for whichever specialty I pick? I am a USMD. No in-house fellowship for either. 270+ step 2 and 260+ step 3. Research is a weak point for my app as I just have a couple posters and a case report that is pending publication.

I’m a happy rheumatologist.

Rheum is great. Don’t listen to the doom and gloom you hear on this board about it.

I’d choose rheum over PCP every day of the week, and twice on Sunday.

Rheum job market is red hot too.

 

[NRAI2001]

PCPs can do about 90% each field does... and most Fm docs have similar if not better pay and hours.

 

[dozitgetchahi]

PCPs can do about 90% each field does... and most Fm docs have similar if not better pay and hours.

If you seriously think this, then you have no idea what we do in either rheumatology or endocrinology.

90% of what I do on a daily basis as a rheumatologist are things no PCP has any business doing. (Unless you think all we do is fibro and OA, in which case I’ve nothing to say to you - neither of those are actually rheumatologic issues, and are only a very small portion of what I do.)

I work 4.5 days a week, no call, no hospital rounding - and I made about $850k in a PP. How many PCPs are doing that?

 

[NRAI2001]

If you seriously think this, then you have no idea what we do in either rheumatology or endocrinology.

90% of what I do on a daily basis as a rheumatologist are things no PCP has any business doing. (Unless you think all we do is fibro and OA, in which case I’ve nothing to say to you - neither of those are actually rheumatologic issues, and are only a very small portion of what I do.)

I work 4.5 days a week, no call, no hospital rounding - and I made about $850k in a PP. How many PCPs are doing that?

Do you own your own clinic? Do you do infusions? I have heard infusions are lucrative for rheum. Most IM docs I know went into Endo and Rheum bc they wanted better hours. If they re working a job without ownership they are basically working and making FM hours and pay.

There are many FM docs with PP or UCs making that much or more when they own the clinic.

Its not a competition but I was making $700-800k working 5 days a week at my last job but it was very busy and I quit after 7 years of being there. I now make $500k a year working 5 days a week with 1/4 the workload. I was someone who was interested in both IM and FM initially. I appreciate IM but doing IM bc "I maybe want to be a cardiologist or GI doc possibly one day" is a dumb reason to do IM and was the reason many medical students chose IM over FM. Most end up doing general IM, hospitalist or go into IM subspecialties that basically mimic FM 90% of the time bc they want easier hours and clinic life.