specialties with poor job prospects

[jarafernando]

Some of the specialties are so useless inspite of gruelling time spend. These residencies and fellowships are not worth a dime. i you spend that time doing nursing (yes , ) its more worth it

nuclear medicine
Medical toxicology (useless and waste ! future Em residents please do Critical care or EMS )
Genetics , unless you are a IM resident with another fellowship
Occ Medicine
Pediatric Rheumatology - only 1 peds rheumatology needed in a state
Peds Pulmonology - Poor referaal base , peds PCP will take care of asthma, no procedures...bronchoscopy fell out of favor!
Addiction Medicine - there is overcrowding of addiction medicine docs !

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[jarafernando]

Nurse practitioner in Psych salary - 160k
Peds Salary 135k (for MD, not APN) !

this is in NY

 

[Oso]

Can’t speak to a lot of these, but as someone in pediatrics…

1. Genetics/metabolism: important and will only become more important as we develop better genetic testing/continue to send tests on more patients as they become cheaper

2. Peds rheumatology: important and there’s a shortage of rheumatologists

3. Peds pulm: important, they treat difficult asthma cases plus who else is going to follow patients with CF, chronic trach/vent, etc? Also bronchs did not “fall out of favor”

You don’t seem to actually know what you’re talking about.

 

[guytakingboards]

Radiologist here.

Nuclear medicine on its own, yes it's pretty tough to get a job. Radiology with Nuclear medicine training? Not nearly as bad. If fact, I'd argue that it's importance has only increased over the last 20 years with the massive increase in PET/CT and may further exponentially increase in the next 10-20 years as theranostics become more commonplace. My group is building out a theranostics program and we estimate that service line could be worth millions of dollars per year potentially. So getting a good nuc med trained rad who can oversee that program could be a huge boon. Re: job availability, it's not an amazing job market but I've definitely seen a goodly number of openings in both the private and academic realms in the last few years. My group has brought in 2 in the last 2 years.

I concur, you don't actually seem to know what you're talking about.

 

[EthylMethylMan]

Not to beat a dead horse, but EM has some pretty rough problems that are bubbling up to the surface now. Lots of sub-par residency programs opening up and flooding the market with grads, lots of mid-level encroachment, same old burnout. I don't have perspective too much on other fields, but I'd say people wanting to do EM right now should check out anesthesia, critical care, or general surgery/surgical subs.

 

[dr.z]

Can’t speak to a lot of these, but as someone in pediatrics…

1. Genetics/metabolism: important and will only become more important as we develop better genetic testing/continue to send tests on more patients as they become cheaper

Sure, salary isn’t great in genetics but the demand is very high. There are plenty of jobs out there. I’ve even seen and been contacted about doing locums in genetics.

 

[Franzd'Epinay]

OP is utterly clueless. It's hard to believe this is someone in medicine.

 

[mvenus929]

Just to throw it out there, I am eternally grateful to the medical toxicologists out there. They help run poison control centers, which all sorts of people rely on. We may not need huge numbers of them, but it's sure nice having one to call when you need them.

 

[jarafernando]

My peds pulmonology freind doing hospitalisy work ans when he asked whether he can see asthma consults rhe chair said no ans apparently gen peds is capable ...he thinks he wasted 3 valuable years in doing peds pulm . It should be 1 year fellowship. In his hospital thenCF is run by adult pulm and peds GI

My peds rheumatologist freind had to move to somewhere in south to find one job after he was rejected by 20 places

 

[jarafernando]

Just to throw it out there, I am eternally grateful to the medical toxicologists out there. They help run poison control centers, which all sorts of people rely on. We may not need huge numbers of them, but it's sure nice having one to call when you need them.

It's good but the poison specialist take care of initial calls. I heard that the toxicologist who are on call to back up the poison specialist they are paid 50 dollars as a stipend for 24 hrs..he said he takes 4 days...so gets 200 bucks per month ..coffee money ! 200 bucks for 2 yr fellowship!

 

[hallowmann]

It's good but the poison specialist take care of initial calls. I heard that the toxicologist who are on call to back up the poison specialist they are paid 50 dollars as a stipend for 24 hrs..he said he takes 4 days...so gets 200 bucks per month ..coffee money ! 200 bucks for 2 yr fellowship!

Everyone doing this is doing it in addition to their day job, and if they're doing it for $50/day they are doing it out of the goodness of their hearts or for other fringe benefits (e.g. faculty appointment, retirement benefits, UpToDate access, CME, etc.).

I will add, there is a shocking amount of money and demand in Addiction Medicine all over the place right now. Grants literally being thrown around everywhere to expand services both in the midwest and the coasts. The work is easier than most primary specialties because it is very focused, does not currently require fellowship, but even if it did its only a year and is pretty laid back 8-5 M-F clinic work, and again the majority doing it are doing it in addition to their primary specialty. I suspect you are misinformed based on the original post.

 

[rokshana]

My peds pulmonology freind doing hospitalisy work ans when he asked whether he can see asthma consults rhe chair said no ans apparently gen peds is capable ...he thinks he wasted 3 valuable years in doing peds pulm . It should be 1 year fellowship. In his hospital thenCF is run by adult pulm and peds GI

My peds rheumatologist freind had to move to somewhere in south to find one job after he was rejected by 20 places

Being rejected from 20 places sounds like more of a him problem…

 

[J ROD]

sounds like a n=1 based post.

 

[Oso]

My peds pulmonology freind doing hospitalisy work ans when he asked whether he can see asthma consults rhe chair said no ans apparently gen peds is capable ...he thinks he wasted 3 valuable years in doing peds pulm . It should be 1 year fellowship. In his hospital thenCF is run by adult pulm and peds GI

My peds rheumatologist freind had to move to somewhere in south to find one job after he was rejected by 20 places

Sounds like your friends are the exception to the rule.

I recommend obtaining more information before writing such biased posts attempting to dissuade others from specific careers.

 

[jarafernando]

Speak the truth...so folks won't get into wrong specialty. Love what you do ...but there should be opportunity to do love what you do. Many doctors are burnt because of this ans is at the mercy of administrators such as social workers and nurses....I post these to help prospective folks to carefully weigh in their options. Think hard whether you want to be bounced around by a social worker administrator

My brother in law is a gem of a person ans he regrets taking peds fellowship of rheum. Now he is working as a gen peds 135k salary! While my neighbor NP gets 160k thereabouts.

 

[jarafernando]

I see tbis in my family folks.. the discrepancy between the specialties.. My peds pulmonology freind is also not happy. His boss is a nurse turned administrator in a multispecialty group

These fellowships should be 1 year maximum or scrapped off.

I know nucu and neurology

 

[jarafernando]

I know nicu , neurology , are the safest in peds...

 

[jarafernando]

Addiction medicine is good for now..but you will get multiple calls for scripts lost you are dealing with a pt population with mortality risk of 10 to 20 times compared to gen population. I know many doctors in addiction winding up because of the potential lawsuits when pt overdoses and it will weigh heavily on your confidence ans morale.....the pay is like primary care. Yes ita 9 to 5 if you are in a clinic but it is the follow up and aftermath that will get you.

The hiapitalist who takes care of addicted patients..gives you consult left and right ..they want to minimize their risk...!

But somebody has to do the work! But these are the stuff I am hearing from my freinds in the field

 

[jarafernando]

Gen peds much better if you open your own office

 

[jarafernando]

Regarding the addiction medicine, many psychiatrists with addiction psychiatry board dont want to addictions because of rhe reasons I enumerated. I know at least 3 addiction psychiatry certification opted out of addictions . They say its too much stress!!

 

[RangerBob]

Regarding the addiction medicine, many psychiatrists with addiction psychiatry board dont want to addictions because of rhe reasons I enumerated. I know at least 3 addiction psychiatry certification opted out of addictions . They say its too much stress!!

This is true of almost every specialty. It's part of life--to find out the path we took wasn't the right one. We should do our best in med school to get an accurate assessment of whether our specialty choice (or even choice of medicine) is the right one, but it's not a failure to go one way and decide later on that it wasn't right. Just a minor fork in the road.

Life is full of risk. It' the primary risk factor for death.

In my experience, the people who "go with the flow" and aren't super neurotic about all the little things (paperwork, NP competition, minor salary differences/changes, overbearing OR nurses, whatever) are the ones who are the happiest in medicine--or any job. Literally every job has stuff to complain about. My brother travels the world on scientific cruises, but he still drowns in paperwork in an office much of the time (it's still a cool job though!). I doubt the Kardashians/other influences are super thrilled their entire lives are almost 100% public. I'm sure they're happy with the fame/fortune part, but people like them or Kevin Costner/Bruce Willis can hardly attend their kid's or grandkid's soccer games in peace. My pastor was at a game with Costner and decided to sit next to him and Costner was grateful that my pastor didn't bring up the fame/fortune/acting stuff once. They just talked about their kids/grandkids.

The primary determinants of happiness for the bulk of humanity is our connection to other humans--namely friends/family. I'd wager more Americans would be happier if we were "that kid" who stayed in our hometown after high school, kept all our childhood friends, got married early/had a bigger family, and worked at whatever job was around town that were were "happy enough" with.

 

[rokshana]

Speak the truth...so folks won't get into wrong specialty. Love what you do ...but there should be opportunity to do love what you do. Many doctors are burnt because of this ans is at the mercy of administrators such as social workers and nurses....I post these to help prospective folks to carefully weigh in their options. Think hard whether you want to be bounced around by a social worker administrator

My brother in law is a gem of a person ans he regrets taking peds fellowship of rheum. Now he is working as a gen peds 135k salary! While my neighbor NP gets 160k thereabouts.

You are probably a little biased since it’s a family member struggling… there are plenty of people that are good people…doesn’t mean they make the better doctor for a job.

And you certainly can not be an expert on so many specialties that you have the ability to comment on the perspective of each specialty… and members of these specialties have made comments about the inaccuracies you present…best to probably not continue to double down… you are losing any possible credibility.

 

[UTsksk]

Sure, salary isn’t great in genetics but the demand is very high. There are plenty of jobs out there. I’ve even seen and been contacted about doing locums in genetics.

I agree the demand is there. I’m at an academic center with basically every specialty program, but genetics. So many kids get referred 5 hours away for a geneticist or end up seeing one virtually.

 

[Kokonaut]

Speak the truth...so folks won't get into wrong specialty. Love what you do ...but there should be opportunity to do love what you do. Many doctors are burnt because of this ans is at the mercy of administrators such as social workers and nurses....I post these to help prospective folks to carefully weigh in their options. Think hard whether you want to be bounced around by a social worker administrator

My brother in law is a gem of a person ans he regrets taking peds fellowship of rheum. Now he is working as a gen peds 135k salary! While my neighbor NP gets 160k thereabouts.

Speaking as a social worker who has worked in hospitals, I have rarely if ever seen social worker admins and the whip gets cracked at us just the same. That aside, I think multiple disciplines would gripe about admins (aside from admins?).

 

[Taddy Mason]

Addiction medicine is good for now..but you will get multiple calls for scripts lost you are dealing with a pt population with mortality risk of 10 to 20 times compared to gen population. I know many doctors in addiction winding up because of the potential lawsuits when pt overdoses and it will weigh heavily on your confidence ans morale.....the pay is like primary care. Yes ita 9 to 5 if you are in a clinic but it is the follow up and aftermath that will get you.

The hiapitalist who takes care of addicted patients..gives you consult left and right ..they want to minimize their risk...!

But somebody has to do the work! But these are the stuff I am hearing from my freinds in the field

You clearly have no idea what addiction med/psych entails. Regarding the mortality, this is a prime example of the need for this specialty - which also per your previous post is not saturated. Yes, more people are pursuing fellowship but many do so with the intent of being able to better serve patients with substance use disorders within their primary specialty. Regarding the comment about consults from hospitalists, there’s a reason why inpatient addiction consult services are a growing area within this field and it’s not purely (or even remotely) related to minimizing liability. Also, the liability from a patient overdosing is no different for addiction med/psych than it is for any other specialty. No idea what to make of the lost script comment….

Regarding the addiction medicine, many psychiatrists with addiction psychiatry board dont want to addictions because of rhe reasons I enumerated. I know at least 3 addiction psychiatry certification opted out of addictions . They say its too much stress!!

Yeah, and that’s exactly how I feel about CAP. Different strokes for different folks.

 

[PTPoeny]

My impression is that peds rheum is in very high demand. My hospital had been trying to hire one for two years in the Midwest and everyone we interview has a dozen offers.

Was the person you know who had difficulty trying to stay in a very specific geographic location?

 

[DeadCactus]

Do you have any direct experience with any of these specialties? What an odd combination of ignorance and arrogance to come to a trainee forum and post an unprovoked, uninformed commentary on specialties you fundamentally don't seem to have any understanding of.

 

[gutonc]

I think we can just close this.