specialty choice thread: IM vs rads

[owenwilsonwoah]

So after having done both rotations and reading countless threads regarding both fields, I am at an impass.

Everywhere I look on sdn/reddit, people say anyone who chooses IM over rads is crazy due to better pay, lifestyle in rads.

However, I am still drawn to IM with the goal of doing PCP outpatient or a chill fellowship like rheum,endo or allergy.

I enjoy clinic with patients and enjoyed my IM rotation. However, as an M3 I am concerned that I didnt have full exposure to the cons of IM which are stated often here, so my perception may be skewed.

On my rads rotation, I thought the subject matter was fascinating and very interesting. However, after seeing the radiologists in the dark rooms all day, it was fairly deppresssing. My concern was that I would get burn out due to lack of patient interaction and no quantifiable effect of my work. It almost felt like doing a desk job which is at odds with why I was drawn to medicine.

My overall goal is to work reasonable hrs as an attending ( 3-4 days a week with minimal call) and I dont mind taking a paycut to achieve this. This seems more feasible in IM ( or fellowship) compared to rads ( rads seems more call heavy, but with much more vacation).

Part of me feels as if I am making the wrong choice if I choose IM over rads due to higher pay and interesting subject matter.

Given my goals, interests, which should I choose? Apologies if I misrepresented either specialty, just going off my experiences and what i've read online

Would love any input

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[libertyyne]

Do you need patient interaction?

I think you can probably land a gig in radiology with flexibility to work as much as you say you want to work, and radiology call is different compared to IM call. Maybe some of the radiology attendings can clarify that peace.

 

[appalachian_man]

If you are in a position to pursue academic IM it sounds like that would be your best bet. If you're worried about getting burned out by not seeing patients, I don't think rads is for you lol. Academic IM jobs can be very cushy, especially if you do mainly outpatient. Easily can find somewhere doing 3-4 clinical days a week with some teaching/admin stuff thrown in. And you only have to do 3 years of residency.

Wouldn't say you'd see many quantifiable effects of your work in clinic either, but that's just my personal bias

 

[owenwilsonwoah]

Do you need patient interaction?

I think you can probably land a gig in radiology with flexibility to work as much as you say you want to work, and radiology call is different compared to IM call. Maybe some of the radiology attendings can clarify that peace.

I think patient interaction is definitely appreciated, I don't know if its necessary. I feel as though going to work in a dark room for your career would lead to a sense of loneliness or lack of community. Perhaps this is a foolish fear since im only an m3. but its something that lurks in my mind. I am happy in an outpatient clinic talking to folks

And yea, rads call is brutal from what ive seen and read. A fear I have is that the rads job market tightens when I graduate and the flexible gigs are not availble. I would much rather be in IM doing less hours for less pay than working more in rads in that case.

 

[owenwilsonwoah]

If you are in a position to pursue academic IM it sounds like that would be your best bet. If you're worried about getting burned out by not seeing patients, I don't think rads is for you lol. Academic IM jobs can be very cushy, especially if you do mainly outpatient. Easily can find somewhere doing 3-4 clinical days a week with some teaching/admin stuff thrown in. And you only have to do 3 years of residency.

Wouldn't say you'd see many quantifiable effects of your work in clinic either, but that's just my personal bias

How do i determine if in a positition to pursue academic IM? that does indeed sound nice

I got to an unranked state school. My stats are 250+ step 1, honors in surg, IM; aoa unlikely

 

[libertyyne]

I think patient interaction is definitely appreciated, I don't know if its necessary. I feel as though going to work in a dark room for your career would lead to a sense of loneliness or lack of community. Perhaps this is a foolish fear since im only an m3. but its something that lurks in my mind. I am happy in an outpatient clinic talking to folks

And yea, rads call is brutal from what ive seen and read. A fear I have is that the rads job market tightens when I graduate and the flexible gigs are not availble. I would much rather be in IM doing less hours for less pay than working more in rads in that case.

Rads call is just another rads shift on the weekends or extension of a day shift till 9pm or something like that.

I realy think you need to speak to a mentor in radiology and someone in IM to get a better perspective.

 

[owenwilsonwoah]

Rads call is just another rads shift on the weekends or extension of a day shift till 9pm or something like that.

I realy think you need to speak to a mentor in radiology and someone in IM to get a better perspective.

haha, i have a doc from each specialty who are mentors (each who speak negatively of the other field), but i am still undecided. perhaps im just frightened in picking rads since its 6 yrs of training + as medstudents we cant appreciate rads whereas IM is familiar

 

[appalachian_man]

How do i determine if in a positition to pursue academic IM? that does indeed sound nice

I got to an unranked state school. My stats are 250+ step 1, honors in surg, IM; aoa unlikely

You're good fam. USMD with 250+ step 1 should have no problem.

I'm doing rads and thought I wanted to do either IM/FM/EM for almost all of med school so I empathize with your dilemma. Hope you find what you're looking for!

 

[Ho0v-man]

Yeah dude you’re almost definitely not the rads type if you need pt interaction to avoid burnout. Overnight call alone is 10-12 hours of churn n burn reads with no patient contact at some places. If it’s just the money in rads that appeals to you over IM that really doesn’t make sense. You can stop at 3 years of training in IM. You’ll make less, but also train half as long. If you decide you want more money, there’s plenty of lucrative fellowships that put you close to the same earning potential for the same total training time but again have the patient contact you desire. Seems like a no-brainer.

 

[throwaway1000000]

So after having done both rotations and reading countless threads regarding both fields, I am at an impass.

Everywhere I look on sdn/reddit, people say anyone who chooses IM over rads is crazy due to better pay, lifestyle in rads.

However, I am still drawn to IM with the goal of doing PCP outpatient or a chill fellowship like rheum,endo or allergy.

I enjoy clinic with patients and enjoyed my IM rotation. However, as an M3 I am concerned that I didnt have full exposure to the cons of IM which are stated often here, so my perception may be skewed.

On my rads rotation, I thought the subject matter was fascinating and very interesting. However, after seeing the radiologists in the dark rooms all day, it was fairly deppresssing. My concern was that I would get burn out due to lack of patient interaction and no quantifiable effect of my work. It almost felt like doing a desk job which is at odds with why I was drawn to medicine.

My overall goal is to work reasonable hrs as an attending ( 3-4 days a week with minimal call) and I dont mind taking a paycut to achieve this. This seems more feasible in IM ( or fellowship) compared to rads ( rads seems more call heavy, but with much more vacation).

Part of me feels as if I am making the wrong choice if I choose IM over rads due to higher pay and interesting subject matter.

Given my goals, interests, which should I choose? Apologies if I misrepresented either specialty, just going off my experiences and what i've read online

Would love any input

I don't think you are crazy for choosing IM over rads. If you look at top 30 programs IM candidates, they will probably be more competitive than an average radiology candidate. I would argue all these competitive candidates are not crazy for choosing IM over radiology where they would have matched.
If pay is your issue, do IM and GI/Cards/Hem-Onc/Pulm-Crit. In GI and Cards, you will probably be making more than a radiologist. In Hem-Onc and Pulm-Crit, you will probably be making similar/little lower depending on your work settings, etc.
I would not choose rads over IM if pay and lifestyle are the only things you care about because you can get that in IM too.
I felt the same on my rads rotation-bored out of my mind. Came to medicine to treat high-acuity, critically ill patients.
Unless IM had no fellowships, then maybe I would have sacrificed my passion for rads. But given IM fellowships do have exponential potential for pay (procedural cards and GI) or lifestyle (endocrine, rheum, etc), I chose to pursue what I was passionate instead.
I think the combo of pay and lifestyle is tough in IM (maybe GI) so that's something you have to look at. Rads does give you pay and lifestyle, but not going to sacrifice my passion for that combo.

 

[zero0]

haha, i have a doc from each specialty who are mentors (each who speak negatively of the other field), but i am still undecided. perhaps im just frightened in picking rads since its 6 yrs of training + as medstudents we cant appreciate rads whereas IM is familiar

Doesn't seem like rads is for you if you like clinic. You'll get some interaction with patients when you go do procedures but that's about it. Fwiw though you don't really need a fellowship in rads anymore. Now that the job market is hot again you can land a nice private practice gig straight out of residency if you're geographically flexible. I'd go for rheum or AI if you want a clinic based lifestyle specialty out of IM. Otherwise, if you just wanna do clinic after 3 years do FM. No reason to subject yourself to a brutal IM residency.

If you do decide to go rads though be aware there are subspecialties that are clinic based with significant patient interaction like mammo and IR.

 

[radsisrad]

By the time you're done with your PGY-1 year, you'll probably be sick of patient interaction and longing for a well-paying desk job that allows you to sip coffee and look at pictures all day. Oh, with 10 weeks of vacation a year, to boot. Oh, and for 600k/year.

Rads is the easiest money I can imagine. Though, to be honest, I've never understood why anyone would want to spend one's life palpating livers, examining ulcers, and auscultating hearts.

 

[throwaway1000000]

By the time you're done with your PGY-1 year, you'll probably be sick of patient interaction and longing for a well-paying desk job that allows you to sip coffee and look at pictures all day. Oh, with 10 weeks of vacation a year, to boot. Oh, and for 600k/year.

Rads is the easiest money I can imagine. Though, to be honest, I've never understood why anyone would want to spend one's life palpating livers, examining ulcers, and auscultating hearts.

Basically the mindset you need to have to enjoy rads!

 

[Equality]

You can do interventional radiology. Get pt care + sitting down to look at images. And $$.

 

[efle]

Do you see medicine as a job or a calling? Boom, you've got your answer.

 

[owenwilsonwoah]

Do you see medicine as a job or a calling? Boom, you've got your answer.

its a job. realistically, im pretty lazy. so I'm more drawn to fields with reasonable work schedules with solid compensation. Rads seems to almost fit this bill, however the social isolation and uncertainty about autonomy of picking one's own hours have me reserved. Whereas, if I do rheum/AI/hemeonc, the pay is solid with controllable low hrs.

and i already did a derm elective, and hated it fyi

 

[Splenda88]

IM.... 250-300k plus patient interaction. The same patients even if you are a hospitalist.
Rad.. 400-500k and no patient interaction


The choice could not be any easier.

Med students underestimate how bad patient interaction can be...Most patients are children. Many don't listen and some don't care.

This is coming from an IM PGY2... After a few years, most careers become job. At least radiology will be a heck of a good paying job.

 

[throwaway1000000]

IM.... 250-300k plus patient interaction. The same patients even if you are a hospitalist.
Rad.. 400-500k and no patient interaction


The choice could not be any easier.

Med students underestimate how bad patient interaction can be...Most patients are children. Many don't listen and some don't care.

This is coming from an IM PGY2... After a few years, most careers become job. At least radiology will be a heck of a good paying job.

I would agree with you if IM didn't have any fellowships
If money is a priority, you can make money and practice what you like (example cardiology or GI)
If lifestyle is a priority, you can have a relaxed lifestyle and practice what you like (rheum, endo, primary care)
Slightly tricky to make both big bucks and have a good lifestyle but can be done in GI if you want to scope all day.
When there is an opportunity to make money, have a good lifestyle and practice what you like, I would go that route than doing something that I hate just for the money.
If you like rads OP, by all means do it. But if you don't like it, know there are other pathways to make money and have a lifestyle.
Also downside to IM like was mentioned is that it is definitely a tougher residency compared to radiology-so keep that in mind if not working hard is a priority for you.

 

[efle]

its a job. realistically, im pretty lazy. so I'm more drawn to fields with reasonable work schedules with solid compensation. Rads seems to almost fit this bill, however the social isolation and uncertainty about autonomy of picking one's own hours have me reserved. Whereas, if I do rheum/AI/hemeonc, the pay is solid with controllable low hrs.

and i already did a derm elective, and hated it fyi

Same boat man. Did rotations in eyeballs and skin both, found the daily grind of overbooked clinics to be intolerable. I also have come to view medicine as a job and so for me it's Rads >> IM. If you know you want a insanely well-paying job with tons of vacation and ability to be your own boss/partner of a group private practice, won't be that hard to get over the lack of patient ownership or patient contact.

 

[Splenda88]

I would agree with you if IM didn't have any fellowships
If money is a priority, you can make money and practice what you like (example cardiology or GI)
If lifestyle is a priority, you can have a relaxed lifestyle and practice what you like (rheum, endo, primary care)
Slightly tricky to make both big bucks and have a good lifestyle but can be done in GI if you want to scope all day.
When there is an opportunity to make money, have a good lifestyle and practice what you like, I would go that route than doing something that I hate just for the money.
If you like rads OP, by all means do it. But if you don't like it, know there are other pathways to make money and have a lifestyle.
Also downside to IM like was mentioned is that it is definitely a tougher residency compared to radiology-so keep that in mind if not working hard is a priority for you.

If only getting a GI/Card spot was a guarantee... You still have to well in residency, do some research and play the game so to speak...

 

[radsisrad]

its a job. realistically, im pretty lazy. so I'm more drawn to fields with reasonable work schedules with solid compensation. Rads seems to almost fit this bill, however the social isolation and uncertainty about autonomy of picking one's own hours have me reserved. Whereas, if I do rheum/AI/hemeonc, the pay is solid with controllable low hrs.

and i already did a derm elective, and hated it fyi

What do you consider "solid" pay?

Rheum: whining about sore joints
AI: enticingly boring and easy, but VERY tight market
H/O: too much facial contortion to express sympathy and sadness. You will need a facelift by 45

Filter out the humor from the seriousness.

BTW, the biggest mistake I made as a med student was not pursuing derm based on the fact that I, too, found the rotation boring. It is, but derm is a business. Looking back, the attending I shadowed would walk into a room and basically start the exam immediately as the patient talked, then cut in after one minute, state the diagnosis and treatment matter-of-factly, "ask" (but not really) the patient whether (s)he had any questions, then walk out the door and tell the scribe what to write.

If you can swing derm, do derm. Secret: 97%of people in the field know just as well as you do that it's boring. They've just figured out the game of life earlier than most other med students.

 

[Lawpy]

IM.... 250-300k plus patient interaction. The same patients even if you are a hospitalist.
Rad.. 400-500k and no patient interaction


The choice could not be any easier.

Med students underestimate how bad patient interaction can be...Most patients are children. Many don't listen and some don't care.

This is coming from an IM PGY2... After a few years, most careers become job. At least radiology will be a heck of a good paying job.

wait i'm curious why rads pays so well because it feels like an underappreciated specialty on SDN (not that SDN means anything but still)

 

[throwaway1000000]

If only getting getting a GI/Card spot was a guarantee... You still have to well in residency, do some research and play the game so to speak...

Yup...this is valid reason for sure. If your goal is to just coast in residency, not compete with anyone, then rads is better suited for you.

 

[throwaway1000000]

wait i'm curious why rads pays so well because it feels like an underappreciated specialty on SDN (not that SDN means anything but still)

Surprises me too. But probably just how reimbursement works. Imaging studies are very well reimbursed and you can pump out a lot in a day.
I mean path is very similar type of work and field but they get screwed in terms of pay.

 

[efle]

^ Also cardiology is not lifestyle oriented at all and GI if you want big bucks is essentially stuffing cameras up butts and down throats as fast as you safely can. Mind numbing amounts of normal colon walls to look at. Maybe, if you're lucky, something to biopsy! How exciting...

The true lifestyle options like private practice allergy generally pay way less than lucrative ROAD setups. MGMA has allergy private median at 300k while rads is 500-600k. Not a tough choice imho unless you are really married to the idea of being a "real doctor" in the traditional sense

 

[Splenda88]

The true lifestyle options like private practice allergy generally pay way less than lucrative ROAD setups. MGMA has allergy private median at 300k while rads is 500-600k. Not a tough choice imho unless you are really married to the idea of being a "real doctor" in the traditional sense

Radiologists are more real doctors than IM since they are the ones who make the final dx most of the time. The only thing is that they are not walking around the hospital displaying their ego...

 

[throwaway1000000]

^ Also cardiology is not lifestyle oriented at all and GI if you want big bucks is essentially stuffing cameras up butts and down throats as fast as you safely can. Mind numbing amounts of normal colon walls to look at. Maybe, if you're lucky, something to biopsy! How exciting...

The true lifestyle options like private practice allergy generally pay way less than lucrative ROAD setups. MGMA has allergy private median at 300k while rads is 500-600k. Not a tough choice imho unless you are really married to the idea of being a "real doctor" in the traditional sense

I mean the same thing can be said for many fields.
If money is the only thing that matters, you have to be scoping all day in GI
But GI in itself has a lot of variety: hepatology, IBD, advanced endoscopy, functional disorders

 

[radsisrad]

wait i'm curious why rads pays so well because it feels like an underappreciated specialty on SDN (not that SDN means anything but still)

Who underappreciates it?

It pays well because it's necessary and because physical exams are of extremely limited use except in dermatologic dz.

 

[efle]

wait i'm curious why rads pays so well because it feels like an underappreciated specialty on SDN (not that SDN means anything but still)

It's a sleeper for sure. I've asked around several times in Rads forums why it isn't more popular and competitive. Consensus seems to be

1) it's a relatively big field with ~1000 seats per year, compare that to similarly paid specialties that are only a few hundred spots.
2) There's relatively little exposure. Everyone at least dips a toe into surgery and medicine. Very few rotate in rads.
3) Many people go to med school envisioning themselves in a white coat counseling or treating patients. Big change to redirect into sitting in the dark looking at images.

 

[FindersFee5]

its a job. realistically, im pretty lazy. so I'm more drawn to fields with reasonable work schedules with solid compensation. Rads seems to almost fit this bill, however the social isolation and uncertainty about autonomy of picking one's own hours have me reserved. Whereas, if I do rheum/AI/hemeonc, the pay is solid with controllable low hrs.

and i already did a derm elective, and hated it fyi

Social isolation is a very different worry to have than lack of patient interaction. If it's truly lack of patient interaction you're worried about, than rads probably isn't for you. But there is no way rads is socially isolated: in most of the reading rooms I've been in, people will be constantly consulting each other. And primary teams LOVE radiologists who communicate with them; in neurology, the neuroradiologists who were willing to call up the primary team about weird findings or thoughts were like gold. So you can have quite a bit of social interaction.

 

[aSagacious]

I'm too lazy to read the whole thread, so somebody may have already mentioned this... but you should consider breast imaging. Usually no call (depends on the group). Lots of patient interaction. Better compensation than IM.

 

[Dr. Death]

Radiologists are more real doctors than IM since they are the ones who make the final dx most of the time. The only thing is that they are not walking around the hospital displaying their ego...

Is "correlate with clinical picture" a final Dx?

 

[throwaway1000000]

Radiologists are more real doctors than IM since they are the ones who make the final dx most of the time. The only thing is that they are not walking around the hospital displaying their ego...

Depends on your perspective.
I see radiology interpretation as a tool to make a diagnosis and come up with treatment plan just like I would see pathology specimen interpretation.
So that doesn't personally excite me at all.
But if you hold a perspective that radiologists are the ones making the final diagnosis, then you know radiology is for you
(I know you're an IM doc but for OP)

 

[Splenda88]

Depends on your perspective.
I see radiology interpretation as a tool to make a diagnosis and come up with treatment plan just like I would see pathology specimen interpretation.
So that doesn't personally excite me at all.
But if you hold a perspective that radiologists are the ones making the final diagnosis, then you know radiology is for you
(I know you're an IM doc but for OP)

Agree... I should have phrased that better. My point was they are as much as diagnosticians as IM docs.

 

[libertyyne]

Maybe consider the worst aspects of each specialty ?
IM
Getting dumped on from ER and other services .
Dealing with social issues for dispo.
Trending lab values and claiming they have an impact on outcomes even when they are within the margin of error for the lab.
Being a generalist and not the expert on many pathologies.
lower end of the pay spectrum.


DR
Dark room
Grinding images
Reading unnecessary tests , or wrong tests for the question.
No gratefulness from patients.
liability

 

[CyrusHabs7695]

if only there were integrated IM residencies (IM-Cards/GI) etc.....

 

[owenwilsonwoah]

I'm too lazy to read the whole thread, so somebody may have already mentioned this... but you should consider breast imaging. Usually no call (depends on the group). Lots of patient interaction. Better compensation than IM.

any cons to mammo gigs? I looked into it and sounds like it would be perfect for me

Same boat man. Did rotations in eyeballs and skin both, found the daily grind of overbooked clinics to be intolerable. I also have come to view medicine as a job and so for me it's Rads >> IM. If you know you want a insanely well-paying job with tons of vacation and ability to be your own boss/partner of a group private practice, won't be that hard to get over the lack of patient ownership or patient contact.

lol sounds like we have similar mindsets. have you personally noted any downsides to rads? this thread is definitely making me reconsider my choices.

Social isolation is a very different worry to have than lack of patient interaction. If it's truly lack of patient interaction you're worried about, than rads probably isn't for you. But there is no way rads is socially isolated: in most of the reading rooms I've been in, people will be constantly consulting each other. And primary teams LOVE radiologists who communicate with them; in neurology, the neuroradiologists who were willing to call up the primary team about weird findings or thoughts were like gold. So you can have quite a bit of social interaction.

you hit the nail on the head. perhaps i am a little "soft" but I feel like having a social group at work is important and helps stave off burnout and overall negative thoughts. My concern with rads is that it would be too much like a stressful desk job. But given what you are describing that sounds pretty good. The rads I rotated with also talked with docs a lot during their shifts.

 

[aSagacious]

any cons to mammo gigs? I looked into it and sounds like it would be perfect for me

Some argue that it would be monotonous focusing on one question all day every day (cancer or not). That was more true a couple decades ago when there was just film mammo. Now with tomo, US, MRI, and biopsies the variety is decent. You could also elect to split your time doing half mammo and half general radiology for even more variety, though the risk would be you'd likely get thrown into the call pool.

 

[slowthai]

any cons to mammo gigs? I looked into it and sounds like it would be perfect for me

Downsides are:
1. Cancer
2. Cancer
3. Litigation
4. Emotionally draining
5. Cancer

 

[slowthai]

if only there were integrated IM residencies (IM-Cards/GI) etc.....

I have always found this topic very interesting. Some argue that an IM residency is an absolute must for practicing safely as a subspecialist. Interestingly enough, that is not the case for several surgical subs: ortho, nsx, ENT, and plastics (though some programs admittedly have more rotations in GS than others).

 

[Splenda88]

I have always found this topic very interesting. Some argue that an IM residency is an absolute must for practicing safely as a subspecialist. Interestingly enough, that is not the case for several surgical subs: ortho, nsx, ENT, and plastics (though some programs admittedly have more rotations in GS than others).

Maybe a 2(IM)+3 would not make a huge difference... Who knows!

By the way, GI was only a 2-yr fellowship up until the 80s... Neurology was an IM subspecialty up until the 70s

 

[slowthai]

Maybe a 2(IM)+3 would not make a huge difference... Who knows!

It would be so interesting to see how integrated GI/cards would fare in competitiveness compared to the surgical subs.

 

[libertyyne]

It would be so interesting to see how integrated GI/cards would fare in competitiveness compared to the surgical subs.

Althought not the same thing, this is the closest.

 

[DOFOSHO]

So after having done both rotations and reading countless threads regarding both fields, I am at an impass.

Everywhere I look on sdn/reddit, people say anyone who chooses IM over rads is crazy due to better pay, lifestyle in rads.

However, I am still drawn to IM with the goal of doing PCP outpatient or a chill fellowship like rheum,endo or allergy.

I enjoy clinic with patients and enjoyed my IM rotation. However, as an M3 I am concerned that I didnt have full exposure to the cons of IM which are stated often here, so my perception may be skewed.

On my rads rotation, I thought the subject matter was fascinating and very interesting. However, after seeing the radiologists in the dark rooms all day, it was fairly deppresssing. My concern was that I would get burn out due to lack of patient interaction and no quantifiable effect of my work. It almost felt like doing a desk job which is at odds with why I was drawn to medicine.

My overall goal is to work reasonable hrs as an attending ( 3-4 days a week with minimal call) and I dont mind taking a paycut to achieve this. This seems more feasible in IM ( or fellowship) compared to rads ( rads seems more call heavy, but with much more vacation).

Part of me feels as if I am making the wrong choice if I choose IM over rads due to higher pay and interesting subject matter.

Given my goals, interests, which should I choose? Apologies if I misrepresented either specialty, just going off my experiences and what i've read online

Would love any input

in radiology you will be far more intimately involved in patient care than you can imagine. you just won't see the patient face to face. its a big difference actually navigating through cases than it is to sit and watch someone; its like playing a video game rather than sitting there watching someone play.

 

[zero0]

What do you consider "solid" pay?

Rheum: whining about sore joints
AI: enticingly boring and easy, but VERY tight market
H/O: too much facial contortion to express sympathy and sadness. You will need a facelift by 45

Filter out the humor from the seriousness.

BTW, the biggest mistake I made as a med student was not pursuing derm based on the fact that I, too, found the rotation boring. It is, but derm is a business. Looking back, the attending I shadowed would walk into a room and basically start the exam immediately as the patient talked, then cut in after one minute, state the diagnosis and treatment matter-of-factly, "ask" (but not really) the patient whether (s)he had any questions, then walk out the door and tell the scribe what to write.

If you can swing derm, do derm. Secret: 97%of people in the field know just as well as you do that it's boring. They've just figured out the game of life earlier than most other med students.

Pretty enlightened stuff right here. Odds are 10 years into being an attending you won't really be interested in much of anything you do. That's when you'll just want a better lifestyle and more time with people who matter to you. Makes me think twice about pursing an ESIR->IR track. Even though I think it's cool now, I'll probably just want the lifestyle of DR later on and wish I could switch back.

 

[efle]

Pretty enlightened stuff right here. Odds are 10 years into being an attending you won't really be interested in much of anything you do. That's when you'll just want a better lifestyle and more time with people who matter to you. Makes me think twice about pursing an ESIR->IR track. Even though I think it's cool now, I'll probably just want the lifestyle of DR later on and wish I could switch back.

That does seem like the reason integrated IR is highly competitive while fellowship DR-->IR isnt: a senior rads resident is a lot less likely to be enamored with the proceduralist lifestyle, compared to an MS3.

 

[efle]

Althought not the same thing, this is the closest.
View attachment 302548

Match rates are similar too IIRC, 80s to low 90s for GI/Cards/Hemeonc

 

[Dro133]

Pretty enlightened stuff right here. Odds are 10 years into being an attending you won't really be interested in much of anything you do. That's when you'll just want a better lifestyle and more time with people who matter to you. Makes me think twice about pursing an ESIR->IR track. Even though I think it's cool now, I'll probably just want the lifestyle of DR later on and wish I could switch back.

Is...is this true? Are people in non-medical fields who are 10 years into their careers just like, "ah f*ck it, my job is boring as $hit but at least I make good money"? I have a brother in tech who's mindset is this tbh, but I always thought he was an anomaly.

I mean, I see the appeal, but also seems like a bleak way to spend 50 hours/week. I guess if you're part time and have other hobbies then it wouldn't be as bad. But is that really what a career is supposed to be like?

 

[CherryRedDracul]

By the time you're done with your PGY-1 year, you'll probably be sick of patient interaction and longing for a well-paying desk job that allows you to sip coffee and look at pictures all day. Oh, with 10 weeks of vacation a year, to boot. Oh, and for 600k/year.

Rads is the easiest money I can imagine. Though, to be honest, I've never understood why anyone would want to spend one's life palpating livers, examining ulcers, and auscultating hearts.

I like that stuff. I actually like the really nerdy stuff in internal medicine. I will talk someone's head off about mixed acid-base disorders, strong ion difference, Frank-Starling curves, how to properly auscultate the heart or how to work up hypophosphatemia.

But I hate doing the IM busywork of charting, which I am now living through as a redeployed COVID doc. Can't wait to be back in radiology.

 

[JibsGuy52]

Wow. This thread hits hard. Considering radiology vs IM as well. Due to COVID haven’t had a chance to do a radiology rotation but on IM rotation I loved looking at pictures and made me consider the field.

I still have no idea what I want and I’m about to end MS3. Thought it was cards but I saw the lifestyle. Loved my cardio electives albeit.

another thing is I’m probably not a competitive candidate for DR. 233 step 1, canadian citizen attending USDO.

so many questions .....