ROAD specialties not as appealing anymore?

[dantt]

That's very oddly specific of your school to apparently brow beat you with something like this. Touton giant cells are extremely low yield (even for preclinical medical students). They don't even appear in my medical school's Histology text.

My impression was the only people who learn about touton giant cells are derm, ophth, and path. The only ones who really need to know it are path (or the derm and ophth who do path).

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[Brain Bucket]

That's very oddly specific of your school to apparently brow beat you with something like this. Touton giant cells are extremely low yield (even for preclinical medical students). They don't even appear in my medical school's Histology text.

You consider this browbeating?

BAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA.

You don't know the half of it.

They're going to drive me mad by next month.

 

[username456789]

My impression was the only people who learn about touton giant cells are derm, ophth, and path. The only ones who really need to know it are path (or the derm and ophth who do path).

That's pretty much correct. They sometimes show up with simple fat necrosis, but touton giant cells specifically are not something I imagine most medical schools waste time on, let alone repeatedly test their students on.

Then again, medical school seems to cherry pick some odd things to focus on at times.

 

[DermViser]

Calm down. I never said that you can breeze right into optho with a 220. I simply said it was possible whereas it's highly unlikely in derm or PRS. Also keep in mind that dozens of people apply in every competitive specialty with 210-230 step 1 scores every year. Why don't you ever hear about these numbers on the trail? Because people are usually smart enough not to go around talking about their subpar board scores.

Only on SDN, where someone who knew someone's boyfriend's friend's cousin, who matched with that score (without any context of OTHER things they did), the exception is given more credence than the rule.

 

[DermViser]

If it's not in first aid then I don't know it.

Well at least not for something as RIDICULOUSLY low yield as Histology.

 

[LackofFreedom]

First, I'd like to say that SDN's security measures are a joke and are easily circumvented.
Secondly, banning me, Shnurek/RadixLuminogen will only be a disservice to SDN in the long run.

Here's why:
It violates one of the fundamental core premises of free and open debate. I was not being discriminatory or insulting. I was merely posting facts and opinions about my perspective in the healthcare field.
It will cause others to censor what they say in the future because they will have to think twice to themselves, "O wait, maybe I shouldn't share my real opinion because I might get banned."

People like you that censor free speech are exactly the problem with America as a country. Your media is blasting you with propaganda while you are probably ignorant enough not to look for other sources of news to help form your opinion. Narrow minded individuals like yourselves only cause censorship, lack of free speech and innovative thinking and contribute to the decline of free and open debate that contributes to the decline of major websites such as this one.

Edward Snowden was banned from the U.S. government because he spoke the truth. Now I am not comparing myself to him but just trying to show you an example in another setting. Ever heard the saying, "Truth is treason in an empire of lies."?

The U.S. Government has now basically monopolized itself in handing out and reaping the profits from almost every one of you that takes out student loans. Around 90% of you will be financial slaves to the federal government for the next years to decades. "But shnurek, they gave us the opportunity to educate ourselves!" I hope you do realize that easily accessible student loans are the main reason behind high tuition increases and a creation of an educational bubble. http://www.nejm.org/doi/full/10.1056/NEJMp1310778

Anyways, that is all I had to say. I hope you continue with your semi-useless semi-self-censored chatter and ban everyone that says anything useful and of substance. And just know that I can get on SDN any time I want even though you banned me but I also don't want to contribute to a website that bans individuals for their differing opinions starting now.

 

[dr zaius]

First, I'd like to say that SDN's security measures are a joke and are easily circumvented.
Secondly, banning me, Shnurek/RadixLuminogen will only be a disservice to SDN in the long run.

Here's why:
It violates one of the fundamental core premises of free and open debate. I was not being discriminatory or insulting. I was merely posting facts and opinions about my perspective in the healthcare field.
It will cause others to censor what they say in the future because they will have to think twice to themselves, "O wait, maybe I shouldn't share my real opinion because I might get banned."

People like you that censor free speech are exactly the problem with America as a country. Your media is blasting you with propaganda while you are probably ignorant enough not to look for other sources of news to help form your opinion. Narrow minded individuals like yourselves only cause censorship, lack of free speech and innovative thinking and contribute to the decline of free and open debate that contributes to the decline of major websites such as this one.

Edward Snowden was banned from the U.S. government because he spoke the truth. Now I am not comparing myself to him but just trying to show you an example in another setting. Ever heard the saying, "Truth is treason in an empire of lies."?

The U.S. Government has now basically monopolized itself in handing out and reaping the profits from almost every one of you that takes out student loans. Around 90% of you will be financial slaves to the federal government for the next years to decades. "But shnurek, they gave us the opportunity to educate ourselves!" I hope you do realize that easily accessible student loans are the main reason behind high tuition increases and a creation of an educational bubble. http://www.nejm.org/doi/full/10.1056/NEJMp1310778

Anyways, that is all I had to say. I hope you continue with your semi-useless semi-self-censored chatter and ban everyone that says anything useful and of substance. And just know that I can get on SDN any time I want even though you banned me but I also don't want to contribute to a website that bans individuals for their differing opinions starting now.

Roll tide!

 

[evilbooyaa]

First, I'd like to say that SDN's security measures are a joke and are easily circumvented.
Secondly, banning me, Shnurek/RadixLuminogen will only be a disservice to SDN in the long run.

Here's why:
It violates one of the fundamental core premises of free and open debate. I was not being discriminatory or insulting. I was merely posting facts and opinions about my perspective in the healthcare field.
It will cause others to censor what they say in the future because they will have to think twice to themselves, "O wait, maybe I shouldn't share my real opinion because I might get banned."

People like you that censor free speech are exactly the problem with America as a country. Your media is blasting you with propaganda while you are probably ignorant enough not to look for other sources of news to help form your opinion. Narrow minded individuals like yourselves only cause censorship, lack of free speech and innovative thinking and contribute to the decline of free and open debate that contributes to the decline of major websites such as this one.

Edward Snowden was banned from the U.S. government because he spoke the truth. Now I am not comparing myself to him but just trying to show you an example in another setting. Ever heard the saying, "Truth is treason in an empire of lies."?

The U.S. Government has now basically monopolized itself in handing out and reaping the profits from almost every one of you that takes out student loans. Around 90% of you will be financial slaves to the federal government for the next years to decades. "But shnurek, they gave us the opportunity to educate ourselves!" I hope you do realize that easily accessible student loans are the main reason behind high tuition increases and a creation of an educational bubble. http://www.nejm.org/doi/full/10.1056/NEJMp1310778

Anyways, that is all I had to say. I hope you continue with your semi-useless semi-self-censored chatter and ban everyone that says anything useful and of substance. And just know that I can get on SDN any time I want even though you banned me but I also don't want to contribute to a website that bans individuals for their differing opinions starting now.

Lol.

@ Bolded - "And nothing of value was lost."

 

[xenotype]

Its amazing how far and how fast a thread in SDN can get derailed. Anyways,

From 2010 MGMA:

75% general optho: 456k
75% corneal optho: 542k
75% retinal optho: 772k
75% peds optho: 354k

Clearly the article did not specify "retina" even thought that is the data it is using. However, 456k is nothing to scoff at, and I certainly wouldn't call it "far from the average optho's reality."

When somebody comes along and says that the MGMA averages are sky high and nobody makes that much, well, you have to remember that this is an internet forum and a single voice can reach millions. Also, 50% of physicians are going to see that data and be pissed because they are making less than average. Of course those in the bottom half are going to take issue with it. Nobody likes to believe they are making less than their peers. Tough, but somebody's got to be at the bottom. 25%tile general optho is 250k. 75% of opthos are making more than that.

The medscape numbers are considered much more representative of reality than MGMA. Medscape 2013 average for optho is $276k. Sure, almost everyone can hit the 75% for their specialty, if they work longer hours. The people at the top of the income scale are hustling. Averages are the only reasonable apples-to-apples comparison between different specialties because they can be matched with average hours per week worked in similar lifestyle surveys. Your original post was very disingenuous to use one of the most well reimbursed (and hardest working) subspecialties of optho as representative of the whole field. People making plenty of money in medicine A) live somewhere other people don't want to live and/or B) work longer hours than others. A good billing setup in a partnership can do a lot, but rapidly changing insurance markets are making this less of a factor.

 

[rocketbooster]

Its amazing how far and how fast a thread in SDN can get derailed. Anyways,



The medscape numbers are considered much more representative of reality than MGMA. Medscape 2013 average for optho is $276k. Sure, almost everyone can hit the 75% for their specialty, if they work longer hours. The people at the top of the income scale are hustling. Averages are the only reasonable apples-to-apples comparison between different specialties because they can be matched with average hours per week worked in similar lifestyle surveys. Your original post was very disingenuous to use one of the most well reimbursed (and hardest working) subspecialties of optho as representative of the whole field. People making plenty of money in medicine A) live somewhere other people don't want to live and/or B) work longer hours than others. A good billing setup in a partnership can do a lot, but rapidly changing insurance markets are making this less of a factor.

Nope. Medscape is known to be much worse and inaccurate compared to MGMA. I have actually never heard of

Its amazing how far and how fast a thread in SDN can get derailed. Anyways,



The medscape numbers are considered much more representative of reality than MGMA. Medscape 2013 average for optho is $276k. Sure, almost everyone can hit the 75% for their specialty, if they work longer hours. The people at the top of the income scale are hustling. Averages are the only reasonable apples-to-apples comparison between different specialties because they can be matched with average hours per week worked in similar lifestyle surveys. Your original post was very disingenuous to use one of the most well reimbursed (and hardest working) subspecialties of optho as representative of the whole field. People making plenty of money in medicine A) live somewhere other people don't want to live and/or B) work longer hours than others. A good billing setup in a partnership can do a lot, but rapidly changing insurance markets are making this less of a factor.

No med scape are known to be the most inaccurate of all the surveys. Mgma is considered the most accurate but it's still def inflated. These surveys have like a 25% response rate.

Also it's ignorant to think everyone wants to live in a big coastal city.

 

[PrideNeverDie]

maybe the PROP thing is catching on

all PM&R spots were filled this match

 

[evilbooyaa]

maybe the PROP thing is catching on

all PM&R spots were filled this match

All aboard the bandwagon!

 

[PrideNeverDie]

All aboard the bandwagon!

all 104 spots! haha

i wonder how many people pick their specialty just because it is trending

 

[Temperature101]

Wow! There are always all these doom and gloom threads in the med student forum... After reading most of these posts, it does not seem to be that bad gunning for FM after all. I guess that I am someone with really low expectation....

 

[Siggy]

First, I'd like to say that SDN's security measures are a joke and are easily circumvented.
Secondly, banning me, Shnurek/RadixLuminogen will only be a disservice to SDN in the long run.

 

[malaika]

I have some serious questions:

Are there alot of female urologists? Would you trust your peens in the hands of a female? Let her stick her finger up your a$$?

 

[username456789]

I have some serious questions:

Are there alot of female urologists? Would you trust your peens in the hands of a female? Let her stick her finger up yours?

I wouldn't let anyone stick their finger up my penis.

 

[malaika]

I wouldn't let anyone stick their finger up my penis.

I meant up ur a--. Would u?

 

[colbgw02]

I have some serious questions:

Are there alot of female urologists? Would you trust your peens in the hands of a female? Let her stick her finger up your a$$?

As to the last question, you are more comfortable with a dude's fingers up your bunghole? NTTAWWT.

 

[mcloaf]

As to the last question, you are more comfortable with a dude's fingers up your bunghole? NTTAWWT.

 

[Temperature101]

From 2010 MGMA:

75% general optho: 456k
75% corneal optho: 542k
75% retinal optho: 772k
75% peds optho: 354k

Clearly the article did not specify "retina" even thought that is the data it is using. However, 456k is nothing to scoff at, and I certainly wouldn't call it "far from the average optho's reality."

When somebody comes along and says that the MGMA averages are sky high and nobody makes that much, well, you have to remember that this is an internet forum and a single voice can reach millions. Also, 50% of physicians are going to see that data and be pissed because they are making less than average. Of course those in the bottom half are going to take issue with it. Nobody likes to believe they are making less than their peers. Tough, but somebody's got to be at the bottom. 25%tile general optho is 250k. 75% of opthos are making more than that.

75% retinal ophthalmology: 772k? Is this freaking real?

 

[DermViser]

The Emmanuels are certifiably evil scumbags.

The high prices are charged to 3rd party payers because

a.) people receiving the services do not bear the cost of said service directly. In other words, they charge it because they can get away with it.
b.) they need remuneration from someone for the large percentage of people who overuse the expensive parts of the system (I.e. the ER) at absolutely no cost.

Yeah, but that makes sense. It's much easier to just demonize and browbeat MD Anderson Cancer Center instead: http://www.nytimes.com/2014/03/06/opinion/in-health-care-choice-is-overrated.html

 

[rocketbooster]

75% retinal ophthalmology: 772k? Is this freaking real?

Yes it is probably pretty accurate. All the retina guys I know make at least 600k.

The other numbers are also probably accurate for the top 75th percentile, but the cornea number is misleading. For cornea, you do a fellowship in cornea/refactive. Cornea is more like a hobby in that it doesn't make much more, but refractive covers LASIK and PRK and those docs make bank if they have a big practice setup. There are probably several refractive surgeons who are pulling those numbers up since there tend to be a few who dominate that market and it's very saturated.

 

[malaika]

As to the last question, you are more comfortable with a dude's fingers up your bunghole? NTTAWWT.

So from your question I take it that you prefer a dude's fingers up yours right?

 

[IlDestriero]

I meant up ur a--. Would u?

I think there are lots of folks that would like that...
I couldn't care less if my urologist was a woman. Let's do this thing and get on with our lives.

 

[malaika]

I think there are lots of folks that would like that...
I couldn't care less if my urologist was a woman. Let's do this thing and get on with our lives.

Urologist/GYN - such an invasive field in this profession.

I'd never let a male GYN touch me. Just not comfortable with that. So I was wondering if it's same thing with men. Not wanting to have a female urologist

 

[colbgw02]

So from your question I take it that you prefer a dude's fingers up yours right?

No, but you can infer that, in a medical setting, I don't care the sex of the person who is doing my prostate exam. It's not a sexual encounter, no matter how much it might mimic one for some people.

 

[Brain Bucket]

People need to stop confusing the horns for 'call me'.

 

[mcloaf]

People need to stop confusing the horns for 'call me'.

Agree, t'was just the most suggestive GIF that came up when I searched.

 

[Dave89]

75% retinal ophthalmology: 772k? Is this freaking real?

Have to remember that ophtho has a good deal of overhead (expensive equipment, techs, etc.).

 

[anbuitachi]

Its amazing how far and how fast a thread in SDN can get derailed. Anyways,



The medscape numbers are considered much more representative of reality than MGMA. Medscape 2013 average for optho is $276k. Sure, almost everyone can hit the 75% for their specialty, if they work longer hours. The people at the top of the income scale are hustling. Averages are the only reasonable apples-to-apples comparison between different specialties because they can be matched with average hours per week worked in similar lifestyle surveys. Your original post was very disingenuous to use one of the most well reimbursed (and hardest working) subspecialties of optho as representative of the whole field. People making plenty of money in medicine A) live somewhere other people don't want to live and/or B) work longer hours than others. A good billing setup in a partnership can do a lot, but rapidly changing insurance markets are making this less of a factor.

MGMA 2010 is outdated. THeir new ones show much lower salaries for certain specialties.

 

[IlDestriero]

Mgma does not include overhead.
You can deny the validity of mgma all you want, but it is still representative of private practice. There's money to be made in medicine for people that want to work. Even in some academic jobs. Find one that values recruiting and retaining talent and rewards hard work with cold hard cash.

 

[Dave89]

Mgma does not include overhead.
You can deny the validity of mgma all you want, but it is still representative of private practice. There's money to be made in medicine for people that want to work. Even in some academic jobs. Find one that values recruiting and retaining talent and rewards hard work with cold hard cash.

Just for clarification - are you saying that it adjusts for overhead? I always thought it was just plain old gross income.

 

[IlDestriero]

From MGMA-

What is included in total compensation?

Total compensation is defined as the direct compensation amount individually reported on a W2, 1099 or K1 tax form, plus all voluntary salary reductions [401(k), 403(b), section 125 tax savings plan contributions].
Total compensation includes:
Salary
Bonus
Incentive payments
Research stipends
Honoraria and distribution of profits

Total compensation does not include:
Expense reimbursements
Fringe benefits paid by the practice (retirement plan, life and health insurance, automobile allowances)
Any employer contributions to a 401(k), 403(b) or Keogh plan.

They also collect data on total operational costs which includes things like staffing and equipment.

Where mgma data gets confusing is when you are comparing w2 and 1099 compensation. W2 jobs, like mine, can offer a significant amount of fringe benefits. They are not included in the compensation data. These benefits are valuable, in my case they are worth over $80,000 a year.

They also offer an academic compensation data set . But we do not use it so I can tell you if the data included is any good.

 

[notbobtrustme]

I wouldn't let anyone stick their finger up my penis.

dont knock it till you try it

 

[anbuitachi]

From MGMA-

What is included in total compensation?

Total compensation is defined as the direct compensation amount individually reported on a W2, 1099 or K1 tax form, plus all voluntary salary reductions [401(k), 403(b), section 125 tax savings plan contributions].
Total compensation includes:
Salary
Bonus
Incentive payments
Research stipends
Honoraria and distribution of profits

Total compensation does not include:
Expense reimbursements
Fringe benefits paid by the practice (retirement plan, life and health insurance, automobile allowances)
Any employer contributions to a 401(k), 403(b) or Keogh plan.

They also collect data on total operational costs which includes things like staffing and equipment.

Where mgma data gets confusing is when you are comparing w2 and 1099 compensation. W2 jobs, like mine, can offer a significant amount of fringe benefits. They are not included in the compensation data. These benefits are valuable, in my case they are worth over $80,000 a year.

They also offer an academic compensation data set . But we do not use it so I can tell you if the data included is any good.

What type of benefits are worth 80000 a year??

 

[notbobtrustme]

What type of benefits are worth 80000 a year??

personal butt toucher

 

[DermViser]

I meant up ur a--. Would u?

Do you talk to your mother with that mouth?

 

[scarletgirl777]

I have some serious questions:

Are there alot of female urologists? Would you trust your peens in the hands of a female? Let her stick her finger up your a$$?

There are not a lot of female urologists, which is a shame because there are a lot of female patients with urologic complaints, kidney problems, etc.

A lot of times when a doctor needs to stick a finger up yours it's an urgent to semi-urgent situation. Come to think about this every patient I've ever done this to was a man and pretty much I told them what was going to happen rather than asking what they felt about it.

 

[IlDestriero]

What type of benefits are worth 80000 a year??

Rolls Royce family health insurance, etc. Malpractice, retirement, expense acct, supplemental annuity, other fringe benefits, etc. All those things excluded from the calculations above. It will be a lot more when the kids get the tuition benefit.

 

[tco]

personal butt toucher

Wait... They touch mine or I touch theirs? I'm game for one of the two.

Sent from my SCH-I535 using Tapatalk

 

[malaika]

Do you talk to your mother with that mouth?

But I talk to your father with it

personal butt toucher

There are not a lot of female urologists, which is a shame because there are a lot of female patients with urologic complaints, kidney problems, etc.

A lot of times when a doctor needs to stick a finger up yours it's an urgent to semi-urgent situation. Come to think about this every patient I've ever done this to was a man and pretty much I told them what was going to happen rather than asking what they felt about it.

Interesting! I'll walk around today counting the men I suspect may have had a finger up theirs

 

[sazerac]

Looks like the word is out on the ROAD -> PROP transition. PM&R had exactly zero unfilled positions in this year's match, while the anesthesiology unfilled match positions grow year after year.

 

[auburnO5]

Looks like the word is out on the ROAD -> PROP transition. PM&R had exactly zero unfilled positions in this year's match, while the anesthesiology unfilled match positions grow year after year.

Which makes anesthesia even more appealing, in my opinion.

Can't be playing checkers when others are playing chess. You gotta think about the long game.

 

[punkedoutriffs]

Which makes anesthesia even more appealing, in my opinion.

Can't be playing checkers when others are playing chess. You gotta think about the long game.

By that logic, you should apply to law school.

 

[DocVapor]

Looks like the word is out on the ROAD -> PROP transition. PM&R had exactly zero unfilled positions in this year's match, while the anesthesiology unfilled match positions grow year after year.

Not sure your analysis is entirely complete. It's probably premature say that PM&R is replacing Anesthesiology. It's easy to have no unfilled positions when there are hardly any available to begin with.

2013 NRMP Match Statistics (available here on page 4):
Anesthesiology:
Programs: PGY1: 147 PGY2: 86
Positions: PGY1: 1,073 PGY2: 580
Unfilled Programs: PGY1: 19 PGY2: 9

Physical Medicine and Rehab:
Programs: PGY1 :36 PGY2: 61
Positions: PGY1: 103 PGY2: 294
Unfilled Programs: PGY1: 0 PGY2: 1

Further down on page 7 you'll see that 118 PGY1 and PGY2 spots were filled by Osteopathic graduates, while only 175 PGY1 and PGY2 Anesthesiology spots were filled by Osteopathic grads. It doesn't seem like allopathic students are giving up Anesthesiology and flocking to PM&R just yet.

2013 AOA Match Statistics (available here):
Anesthesiology:
Programs: 13
Positions: 32
Unfilled Positions: 2

Physical Medicine and Rehab:
Programs: 4
Positions: 14
Unfilled Programs: 1

 

[auburnO5]

By that logic, you should apply to dental school.

Agreed.

 

[username456789]

Looks like the word is out on the ROAD -> PROP transition. PM&R had exactly zero unfilled positions in this year's match, while the anesthesiology unfilled match positions grow year after year.

No, DERP is where it's at.

Derm, ENT, Rad Onc, Path/PM&R

 

[IlDestriero]

Derm is lethally boring, maybe MOHS?
Every ENT I know works Hard. Pass.
Rad onc is brutal. All cancer patients? Hell NO!
Path? Dead already and the ship is sinking. Their time is over. Also boring.
PM&R? Seriously? Do you know what they do every day?

 

[username456789]

Derm is lethally boring, maybe MOHS?

Your specialty is predicated upon your patients staying asleep long enough for you to finish this week's NYT crossword and get caught up on Marmaduke's latest antics.