To fellowship or not to fellowship...and in what?

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SleepIsGood

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I'm in another specialty so this question isnt for me. I've been in the process of helping a PGY2 IM resident come to a decision and that's why I figured I could post here.

Here it is.

What is more financially rewarding?

To practice med/peds as a general doc doing ambulatory with some hospitalist hours thrown in perhaps. I think gen med docs will always be in demand since they are the 'gatekeepers' and everyone needs them in order to get to a specialist. They will be hounded after by specialists since people are always seeking referrals from them

Or is it more rewarding to go into a specialty? The highest paid ones I think are Cards and GI. What I hear about Cards is that the lifestyle isnt that hot. GI I dont know too much about. But what else is a financially rewarding field? Rheum? Allergy?

The person I am discussing this with loves pretty much everything and isnt set on just one thing yet. Yes, the obvious answer would then be do gen med...but is that as financially rewarding? She's got lots of loans etc to pay back.

What are people's thoughts? Her board scores are solid (>98%) on all the Steps, she's a US grad,etc.

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