Pay goes in cycles. It is utterly stupid to go into Anesthesiology or Radiology for money.
Read the Anesthesiology forum and read about the threat of CRNAs. The fact is that 1/3 of the states do not require a CRNA to be overseen by an Anesthesiologist in 2010 with close to all 50 states in the next 5 years. Ask any Gas attending about this.
Sure Anesthesiology will continue to succceed but the number of jobs will be sliced by a large amount because there are a fixed number of jobs and a greater concentration will go to CRNAs. Gas men will be more supervisory with much less number of jobs to be in the OR.
As for Radiology, the biggest expenditure in healthcare is due to imaging costs. Since defensive medicine will not be policed. More physicians order unnecessary CT and MRI studies. What this means is that politicians cut radiology reimbursements. Go to google and type reimbursement cuts in radiology for 2009 and 2010 up to 40%.
Let's face it. In the 80's and early 90's the kings of the salary parade were Surgeons and Pathologists. People in Radiology and Anesthesiology could not find jobs at that time.
In the late 90's and early 2000's Radiology and Anesthesiology peaked with high salaries. Now reimbursement and competition will bring them back to the pack with Surgery in salary with increase number of work hours. Radiologists average 57 hours a week by the way.
The key is to figure out future trends and try to catch a specialty before it hits big. My money is on Neurology and Oncology to replace Radiology and Anesthesiology at the top echelon of the salary rung. The reason is that these two specialties are at the beginning of their cycle. Brain MRIs and Brain CTS will be read by all Neurologists in the near future. MRI fellowships are sprouting out for Neurology fellows everywhere. Plus, interventional neurology is at the beginning of the cycle where interventional cardiology existed in the early 80's. As for oncology, new cancer drugs, new radiation treatments will increase revenue as molecular target drugs come out to market.
Think about all of the AOA students in the 80's and 90's that matched into Sugery and Pathology in the 80's that hate their career. Same thing will happen to Rads and Gas.
Choosing a specialty based on high income is the dumbest thing you can do because politicians target the top specialties.
If you still want to catch a specialty on the rise. Neurology and Oncology have the brightest future for the next 20 years.
They are like GOOGLE IPO stock on the first day of trading. Buying Rads and Gas now is like buying MSFT stock right now (i.e. it is too late for appreciation but it has high PR).
If I was a 1st year medical student and I wanted to chase money and lifestyle. I would target Rad Onc, Heme Onc, and Neurology.
Radiology and Anesthesiology have passed their golden age.
