Switching to Rads

[keye]

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Currently I am an intern with an Ophtho spot at an excellent program. However, Im considering a switch to Rads -- has this ever happended before? Are there programs with spots outside the NRMP?

 

[goobernaculum]

very tough to get a spot outside of nrmp. if i remember correctly, there were very few spots left after the match. even with those unfilled spots, there's a strong likelihood that those spots filled after the scramble. also, isn't there some kind of contract we're bound to if we matched in a program?

that being said, there are some programs that get accredited to increase the size of their radiology programs AFTER the match occurred. for example, i know that UCSF added two more spots to their incoming (and future) radiology class after the 2007 match. if you matched at an "excellent" optho program, then you may qualify for a place like ucsf. but the biggest hurdle for you at this point is getting out of the contract you have with the optho program.

 

[-Goose-]

Currently I am an intern with an Ophtho spot at an excellent program. However, Im considering a switch to Rads -- has this ever happended before? Are there programs with spots outside the NRMP?

Why not do at least a year of ophtho? Thats a pretty coveted spot your giving up...

 

[keye]

You have a great point. I am going to try it out for a year becuase I know far more about Ophtho that about Rads. Just worreid about the abililty to switch after having done a year vs. being fresh out of intern year.

 

[f_w]

Stick with the eyeballs, a great field.

 

[-Goose-]

Ophtho blows for the following reasons:

• Pay is down to like 1/3 of what it was 5 years ago
• LASIK is old news
• You will be a clinic SLAVE for the rest of your life
• You have to see annoying patients

Now I'm sure somebody's gonna post how they have an uncle or cousin or whatever out there "making over a mill!" or something like that. Fine. I believe you. But trust me they are serious outliers. The average general eye guy makes as much as loser pediatricians.

The new acronym for the premier gigs is the RAD to happiness. (Don't you love how ironically that both starts with radiology and spells out radiology too? It's a sign people!)

OP: Get out while you can! Rads hands-down blows ophtho out of the water.

😴

 

[f_w]

Apache, your contributions start to turn into some kind of spam on this board. We all know you detest patients, just move on.

My wife is an ophthalmologist, incidentally for about the past 5 years. I don't know what body orifice you pull your 'facts' out of, but neither the experience of her practice nor anyone elses in the field matches your statements.

(yes medicare reimbursement for a cataract is about 1/3 of what it was 20 years ago. But then again, in the old days you couldn't do those in an ASC with 10-15 minute OP times and minimal turn-around.)

 

[OHMAN0125]

You have a great point. I am going to try it out for a year becuase I know far more about Ophtho that about Rads. Just worreid about the abililty to switch after having done a year vs. being fresh out of intern year.

Why are u deciding on Rads now? It's a very different field from the surgical specialties. If I were you, I'd just stay with Optho, granted there is a decrease in reimbursements and OD's trying to take over the eye, Optho is still one of the hardest matches. It sure is harder than rads,ortho,gas, uro, etc. Probably right below derm and plastics. And it is still hands-down one of the best lifestyle fields with great reimbursements.
Unless of course, you despise your field for some reason I can't imagine.

 

[Taurus]

There's a recent grad who is a frequent poster on the ophtho forum who reports making only $90k. Seems like many markets are saturated.

 

[goobernaculum]

90K? doubtful. either that person f*cked up real badly, s/he's working part time, or is hardly working at all.

 

[f_w]

As we are thinking about relocating down the line, I keep an eye on the ophtho job market. Yes, those 90 or 105k ophtho jobs exist, mostly in large metro areas along the coasts. They are certainly not the rule, and just like in any other specialty, the one with a smidge of business sense can still do well with the eyeballs 😀 It's not radiology or cardiology money, but then again, a 'busy call' means going in once on saturday morning and fielding maybe 10 phonecalls (in a week!).

 

[OHMAN0125]

As we are thinking about relocating down the line, I keep an eye on the ophtho job market. Yes, those 90 or 105k ophtho jobs exist, mostly in large metro areas along the coasts. They are certainly not the rule, and just like in any other specialty, the one with a smidge of business sense can still do well with the eyeballs 😀 It's not radiology or cardiology money, but then again, a 'busy call' means going in once on saturday morning and fielding maybe 10 phonecalls (in a week!).

90-105k as an MD optho? We're not talking about a OD right? If that's the case...it better be that ur working only parttime....geez

 

[f_w]

Why do you people doubt me?

Because... never mind.

 

[f_w]

90-105k as an MD optho? We're not talking about a OD right? If that's the case...it better be that ur working only parttime....geez

Unfortunately, those jobs do exist. I know some people who have done those gigs. Often in places like NYC or LA. You don't know what people are willing to do in order to live in some places.
Most of those jobs are not based on long-term relationships. These practices are known, they usually go through a new associate every 2 years.

One thing in ophtho is that often the initial associate salaries are rather low. Ophtho is quite referral based and it takes a while to become established in a community (typically 3-4 years to reach a mature practice). Collections for a new associate in year 1&2 don't support generous salaries, once someone is surgically busy and fast, collections and incomes pick up (also, the more established you are, the more commercially insured patients will wander in your office and compensate for some of the lower reimbursing goverment work). In addition, the longer you are in practice, the more opportunities for related income (e.g. ownership in an ASC or optical shop) become available.

5 years in, your income will be comparable to fields like GS, GI or nephro (except that you don't spill bile or blood over your pradas, the night-time work is very limited and your patients usually don't die).

 

[keye]

Furthermore, general opthalmologists are the ones hit most by the cuts. The specialist such as Retina still make 500K to 700K per year.

 

[f_w]

Furthermore, general opthalmologists are the ones hit most by the cuts. The specialist such as Retina still make 500K to 700K per year.

Just like any other high-earning specialty, they are at risk of seing drastic cuts.

 

[keye]

so why doesnt your argument apply to Radiology as well?

 

[Taurus]

5 years in, your income will be comparable to fields like GS, GI or nephro (except that you don't spill bile or blood over your pradas

So in the time it takes for ophtho's to afford pradas, I'll be like 25% closer to being able to retire if I do rads. 😀

 

[f_w]

so why doesnt your argument apply to Radiology as well?

It does apply to radiology as well. Initial versions of he S-CHIP bill contained drastic cuts in radiology professional fees. The deficit reduction act of 06 mandated considerable cuts in technical fees for free-standing imaging centers. No specialty is safe, the higher your proportion on total health expenditures, the bigger a target your specialty is.

 

[f_w]

Why are you considering the switch in the first place ? Is it your decision that you want to practice radiology for the rest of your career or have you heard of 'untold riches of the west'.

 

[philly4343]

F_W

I am really interested in how you figured out what the governement cuts will be in the future..ie what you said about the S-Chip bill and 2006 deficit correction. Where are you getting your info?

I honestly believe that RADS will end up fighting for their lives at some point...only cause some of your work can be outsourced to India.


Also, IR seem to make BANK...but that cannot sustain itself...the powers that be will sniff this out and cut the money train in half at some point what do you think?

 

[f_w]

I am really interested in how you figured out what the governement cuts will be in the future..ie what you said about the S-Chip bill and 2006 deficit correction. Where are you getting your info?

Pro-fees where supposed to be divied up into 3-4 different 'pots' with the total amount of reimbursement in each pot capped. Imaging and path would have been together in one of those 'pots', primary care in another. With the increasing utilization of imaging accross the board but capped pro-fees, the amount per procedure would have decreased by 10% per year for the forseeable future.
It was eventually defeated (along with some other nonsense), but it shows where politicians are trying to go with this.

I honestly believe that RADS will end up fighting for their lives at some point...only cause some of your work can be outsourced to India.

dead horse, still being flogged.

Also, IR seem to make BANK...but that cannot sustain itself...the powers that be will sniff this out and cut the money train in half at some point what do you think?

Already have. IR took some substantial cuts 2-3 years ago. Right now, there are attempts afoot to eliminate component billing. If that comes through, IR will not be attractive anymore (for me personally, it is not attractive already. I have pretty much given up my IR practice as it is not worth the hassle).

 

[radrounds]

Rads is a great field but Optho also has its positives. Bottom line is to do what makes you happy--cliche but hey, chasing the $$ or the lifestyle isn't necessarily the only motivation one should strive for.

I personally think rads is a great field but I probably would have been just as happy in alot of other fields. To answer the original question--can one switch? People have already made excellent replies and posts. I just want to give another example re: a good friend of mine who switched from one of the top surgery programs in the country to go into one of the so called "top tier" rads residency programs last year. He got interviews everywhere. It can be done. Plus they ended up offering him a spot outside the match to save him another year.

So good luck to you! if you plan to switch. Rads is awesome!

 

[IntervRads]

Yes, I actually switched from Optho to Rads and am now completely happy. I had no problems getting interviews and, for the most part, programs were understanding of why I made the switch. Be fully prepared to address the question of why you changed specialties in detail when you interview.

 

[coco09]

intervrads and keye...

just wondering why you switched to rads? I'm a M3 student and deciding between ophtho and rads. thanks!

 

[discontinuebed]

Ophtho blows for the following reasons:

• Pay is down to like 1/3 of what it was 5 years ago

Err...may I ask why?

And isn't rads next on the list of significant pay cuts?

(If I come off as trying to sound arrogant or flippant, I'm not. I'm genuinely asking.)

Heck, if you're trying to flip through all the ROAD specialties, might as well end up on derm. You've got dropping salaries in ophtho, potential dropping salaries in rads, and the issue of possible CRNA competition in anesthesia.

 

[discontinuebed]

The wild card that's going to keep rads salaries high despite reimbursement cuts is ever-increasing demand in diagnostic imaging. IMHO this is the single most important factor that differentiates rads from all other fields in medicine and surgery. True derm isn't facing bureaucratic pay cuts, but people aren't getting more eczema either --> salaries stay the same. The #'s of CRNA's and the breadth of the things they're allowed to do are increasing (slowly) --> Gas salaries will drop somewhat over the long run. Neurosurg, ortho, urology... pretty much steady #'s of head, bone, and kidney path in the forseable future --> salaries stay the same (or drop if you consider inflation -- but that's another thread altogether). (Although penile implants are proving quite lucrative these days -- no joke) Cards's salaries would drop BIGTIME because they're losing their biggest money-maker -- the diagnostic cath -- but they are a shrewd enough bunch that they're successfully making the turf segue over to CCTA.

I'm not denying that rads is facing some potential salary-dropping factors in the market -- reiumbursement cuts, telerad, outsourcing -- but I believe increasing demand in diagnostic imaging is/will outpace them all --> salaries and perquisites remain at the very top of the medical specialties hill.

Hmm...solid argument.

Thanks for the info!

 

[Taurus]

working from home --> priceless

Even with cuts, rads will still be one of the highest paid specialties out there. Why? Nothing gets done without imaging these days. We just have to make sure we keep other specialties out. Outsourcing to other countries won't be as huge of a problem as people think. The true threat is from large groups such as academics from within this country trying to consolidate all available contracts.

And everyone is getting into the skin care business these days. http://www.nytimes.com/2008/01/13/business/13sleek.html?pagewanted=1&ref=business

No field is 100% perfect.

 

[f_w]

'Predatory academia' is imho less of a danger to the future of radiology as a specialty than large publicly traded commercial providers such VRC and Nighthawk.

In Australia, 3 large companies have consolidated the majority of the private imaging market. Radiologists are either lowly paid employees in the public hospital sector, or they slave away for the stockholders of the corporate providers. Because these companies have achieved market dominance, they can hire at their own conditions. With the amount of money raised by the IPOs of these US telerad companies, I see a danger of them going on australian style buying spree.