What are the top 5 specialties in terms of projected shortage

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postbacpremed87

postbacpremed87

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Outside of family medicine and internal medicine....
1-5?
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I would say neurology and general surgery (true general surgeons not sub-specialists) will suffer severe shortage in the foreseeable future. Neurology due to its low pay and general surgery due to specialization.

On the other hand, I think EM, GI, and Hospitalist (Inpatient IM) will become saturated.
 
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Do neurologists make considerably less than other specialties?
 
Carl Seitan said:
Do neurologists make considerably less than other specialties?
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Depends. Outpatient Neuro pays **** (180k to low 300K). Neurohospitalists and Neurocritical care pays much better (upper 200K to lower 200K). Still, with same amount of training and work, one could do EM/Anesthesiology/GI/Surgery and make much more.
 
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Ibn Alnafis MD said:
Depends. Outpatient Neuro pays **** (180k to low 200K). Neurohospitalists and Neurocritical care pays much better (upper 200K to lower 200K). Still, with same amount of training and work, one could do EM/Anesthesiology/GI/Surgery and make much more.
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This information I gathered from reading numerous threads in the Neurology forum.
 
In my personal opinion, based off the literature I'm reading, I feel EM will remain safe for a while.

ER remains profitable for a hospital--thus the demand will remaind.
 
I think this would be better addressed to residents and attendings. What do premeds know about projected shortages?
 
WillburCobb said:
Psych is a VERY under served area. Where I live (upper Midwest) there's a huge need for psychiatrists and they can easily start at 200-250k plus.


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Yeah. I know of only one psychiatrist and he/she is a D.O.
 
O Grady said:
Is the lifestyle just bad or what? Why is it so undersaturated?
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It's just the field itself (e.g., the patients you work with and the roadblocks you'll encounter in providing adequate resources for them). It definitely requires the right interest and personality to go into. Plus there's a misperception of it being a field with less prestige. I personally would consider going into psych (right now I'd say it's my second choice), but ironically the reasons I would go into it are also some of the reasons I wouldn't go into it.


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I think there's a fair amount of unmet expectations in psych, too. I know some that expected full spectrum mental health from counseling, therapy, etc. to regular evaluations and prescribing. They're just like any other medical doctor: it's about diagnosing and treating medically. The therapy stuff is shifted to psychologists and counselors.
 
Psych probably will always be undersatured and underserved.
 
Ibn Alnafis MD said:
Depends. Outpatient Neuro pays **** (180k to low 200K). Neurohospitalists and Neurocritical care pays much better (upper 200K to lower 200K). Still, with same amount of training and work, one could do EM/Anesthesiology/GI/Surgery and make much more.
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Depends on the area. I've seen listings for new graduates starting art 250k in California. Places like Sacramento and LA.
 
Ibn Alnafis MD said:
I would say neurology and general surgery (true general surgeons not sub-specialists) will suffer severe shortage in the foreseeable future. Neurology due to its low pay and general surgery due to specialization.

On the other hand, I think EM, GI, and Hospitalist (Inpatient IM) will become saturated.
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EM won't be saturated for a long time....considering the majority of EDs are covered by FP/IM docs I would be more concerned if I was in one of those specialities using it as a back door into EM. (I foresee this being safe for them for quite a while as well.)
 
Ibn Alnafis MD said:
Depends. Outpatient Neuro pays **** (180k to low 200K). Neurohospitalists and Neurocritical care pays much better (upper 200K to lower 200K). Still, with same amount of training and work, one could do EM/Anesthesiology/GI/Surgery and make much more.
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****, I make more than that in FP - easy
 
Makati2008 said:
EM won't be saturated for a long time....considering the majority of EDs are covered by FP/IM docs I would be more concerned if I was in one of those specialities using it as a back door into EM. (I foresee this being safe for them for quite a while as well.)
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I hope you are right. But pumping 2000 new EM docs every year, combined with the increasing utilization of ER PA's and NP's, will saturate the market very soon. This isn't going to happen overnight, but by the time I'm out of residency (7-8 years), the job market will have begun to tighten up a little.
 
AlbinoHawk DO said:
Depends on the area. I've seen listings for new graduates starting art 250k in California. Places like Sacramento and LA.
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According to what I have been reading, this type of income is only possible for a neurologist who relies heavily on inpatient work. Unless you are a headache or a sleep specialist, making 250K doing only outpatient neurology is very hard.
 
Ibn Alnafis MD said:
According to what I have been reading, this type of income is only possible for a neurologist who relies heavily on inpatient work. Unless you are a headache or a sleep specialist, making 250K doing only outpatient neurology is very hard.
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The 2010 MGMA salary survey says the average neurologist salary is $268k/year.
 
O Grady said:
Is the lifestyle just bad or what? Why is it so undersaturated?
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It is a field in which your patients might very well never get better no matter what you do. Their problems often have no clear solution, and a lot of the time you're just shooting in the dark, trying med after med, hoping to get the right one. Reimbursement for non-pharmaceutical psychiatric services is poor, so your actual time is often not compensated particularly well. Also, you frequently deal with severely mentally disturbed people, which really, really isn't for everyone.

Sitting with psych patients as a tech in the ED made for literally some of the worst days of my working life, and I've worked some bad places and jobs over the years. It's not that I don't feel terrible for these people, but I just can't handle crazy, it doesn't compute in my brain and frustrates the hell out of me. You can only have a guy insist "the walls are angry and want to hurt you" so many times before it starts to drive you a little crazy along with him. I can't imagine dealing with that all that time- it really takes a special person with a lot of patience and understanding.
 
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Psych really requires a sense of humility and finding the true humor, absurdity, and unfortune that is reality.

Edit: also psych is something that's hard to look at in a very objective lens.


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WillburCobb said:
Psych really requires a sense of humility and finding the true humor, absurdity, and unfortune that is reality.

Edit: also psych is something that's hard to look at in a very objective lens.


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That's why it can be the most interesting specialty in my opinion.
 
serenade said:
That's why it can be the most interesting specialty in my opinion.
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Exactly! One of the most interesting and also one of the most difficult.


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From what I've gathered, true general surgeons are projected to be in a shortage.
 
What is the average salary for EM? I saw someone posted some 'EM job postings' in the allo forum and almost all offering $200/hr... Is that the norm? That is like 400k/year on a 40hrs/week average... This seems to be too high for EM docs... Thought they made 250k-300k/year.
 
Temperature101 said:
What is the average salary for EM? I saw someone posted some 'EM job postings' in the allo forum and almost all offering $200/hr... Is that the norm? That is like 400k/year on a 40hrs/week average... This seems to be too high for EM docs... Thought they made 250k-300k/year.
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I remember reading a report mentioning that the average hourly pay for EM physicians was $175, so 200/hr in rural regions wouldn't be far from reality. That said, very few EM docs work more than 36 hours per week. Most work on average 32 hours per week.
 
Ibn Alnafis MD said:
I remember reading a report mentioning that the average hourly pay for EM physicians was $175, so 200/hr in rural regions wouldn't be far from reality. That said, very few EM docs work more than 36 hours per week. Most work on average 32 hours per week.
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EM has become my #2 now after FM.
 
O Grady said:
Is the lifestyle just bad or what? Why is it so undersaturated?
Click to expand...
Something that stuck with me was when I was shadowing as a premed, I ran into a 3rd year who had just finished his psych rotation. I asked if he was interested in it and he said no, so I asked him why. He responded with, "The patients tell me that they want to kill me, and I believe them which makes it terrifying."
 
Ibn Alnafis MD said:
I remember reading a report mentioning that the average hourly pay for EM physicians was $175, so 200/hr in rural regions wouldn't be far from reality. That said, very few EM docs work more than 36 hours per week. Most work on average 32 hours per week.
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That few? I was led to believe they worked ~50 hr/wk?
 
Carl Seitan said:
That few? I was led to believe they worked ~50 hr/wk?
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Birdstike, an EM attending on this site always refers to the "1.5x" rule. Basically, each hour worked in the ER is equivalent to working 1.5 hours doing anything else. That's because EM docs have very little down time and experience a high level of fluctuations in their work schedule. In theory, one could say "I will work 60 hours a week for 5 years after residency making 600k/year. I will do that for five years, payoff my debt and mortgage then retire." I, for one, thought like that. However, from reading the EM subforum I realized that the burnout rate in the field is quite apparent. Those seasoned docs recommend that you work as little hours as possible so you could avoid being burnout prematurely.
 
Temperature101 said:
What is the average salary for EM? I saw someone posted some 'EM job postings' in the allo forum and almost all offering $200/hr... Is that the norm? That is like 400k/year on a 40hrs/week average... This seems to be too high for EM docs... Thought they made 250k-300k/year.
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Go lurk in the EM forums. They talk about high salaries all the time. That 400k/ 40 hr a week thing is no joke in certain places.
 
Ibn Alnafis MD said:
Birdstike, an EM attending on this site always refers to the "1.5x" rule. Basically, each hour worked in the ER is equivalent to working 1.5 hours doing anything else. That's because EM docs have very little down time and experience a high level of fluctuations in their work schedule. In theory, one could say "I will work 60 hours a week for 5 years after residency making 600k/year. I will do that for five years, payoff my debt and mortgage then retire." I, for one, thought like that. However, from reading the EM subforum I realized that the burnout rate in the field is quite apparent. Those seasoned docs recommend that you work as little hours as possible so you could avoid being burnout prematurely.
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As a PA that did EM(and now hoping to match EM as a Physician) I totally agree with you. Pushing much above 40hrs leads to mistakes and definitely burn out.
 
FrkyBgStok said:
Something that stuck with me was when I was shadowing as a premed, I ran into a 3rd year who had just finished his psych rotation. I asked if he was interested in it and he said no, so I asked him why. He responded with, "The patients tell me that they want to kill me, and I believe them which makes it terrifying."
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Well that's depressing
 
Something that stuck with me was when I was shadowing as a premed, I ran into a 3rd year who had just finished his psych rotation. I asked if he was interested in it and he said no, so I asked him why. He responded with, "The patients tell me that they want to kill me, and I believe them which makes it terrifying."
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Hahahaha! The things psych patients say are priceless which is one of the best things about the field. One of my favorites was after putting a 9 year old in seclusion he yelled, "I'll ram my ****ing cock down your throat until you bleed to death!" One of the psychiatrists happened to be walking by when the patient said this just laughed, held up is thumb and index finger, and said, "Don't worry I'm sure it's only this big."
 
WillburCobb said:
Hahahaha! The things psych patients say are priceless which is one of the best things about the field. One of my favorites was after putting a 9 year old in seclusion he yelled, "I'll ram my ******* cock down your throat until you bleed to death!" One of the psychiatrists happened to be walking by when the patient said this just laughed, held up is thumb and index finger, and said, "Don't worry I'm sure it's only this big."
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And if you're not into that scene you could always be an outpatient psychiatrist who mostly just med management and some therapy. Not to mention you can always subspecialize in cool stuff like addiction psych or neuropsych or etc.
 
medickdb said:
Interesting addition to the discussion:
http://www.cbsnews.com/news/1-million-mistake-becoming-a-doctor/
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It's all rubbish. Even if, between the opportunity cost and medical school tuition, you are a million dollars in the hole, your lifetime earning as a doctor make up for it. Heck, the job security alone is worth it.

Medical school debt is outrages, no doubt about it. However, people keep dismissing the countless of opportunities you will have to payback the debt and still lead a comfortable life. Government repayment plans (IBR/PAYE/PSLF), working in rural areas, joining the military, and continuing to live like a resident (living frugally and working insane hours) for few years past residency are all viable options to put down the enormous debt.

Personally, I think PAYE is the way to go. Pay 10% of your income every year for 20 years after medical school and save another 5% on the side to take care of the massive tax on the forgiven amount.
 
Ibn Alnafis MD said:
It's all rubbish. Even if, between the opportunity cost and medical school tuition, you are a million dollars in the hole, your lifetime earning as a doctor make up for it. Heck, the job security alone is worth it.

Medical school debt is outrages, no doubt about it. However, people keep dismissing the countless of opportunities you will have to payback the debt and still lead a comfortable life. Government repayment plans (IBR/PAYE/PSLF), working in rural areas, joining the military, and continuing to live like a resident (living frugally and working insane hours) for few years past residency are all viable options to put down the enormous debt.

Personally, I think PAYE is the way to go. Pay 10% of your income every year for 20 years after medical school and save another 5% on the side to take care of the massive tax on the forgiven amount.
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But, I think it's also trying to make the point that many who go through medical education didn't realize what it would entail, and they later regret it. It's not something that you can really get out of once you start paying tuition unless you want to leave with a mountain of debt with no easy way to pay it off.

Medical school in a lot of other countries is much cheaper, starts after high school, and lasts for six to seven years. Those who decide not to continue after a year or two are not at as much of a loss.

A lot of medical students here in the US don't realize that medicine is not for them until their 3rd year clinical rotations. There's really no going back at that point though, so they finish and work a job they don't necessarily want to do.
 
Def psych. Especially child and adolescent.
 
Here is my two cents...
1. FM (there will always be less family docs than the world needs and the ACA expansion of coverage)
2. Geriatrics (the aging population is growing in number w/ the Baby boomers and advances in technology will extend this shortage)
3. Psych (mental health is a HUGE need and will always be that way. It will always have less than enough due to the polarizing nature of the field- not everyone is fit for it and intense nature of it)
The other ones may be more controversial but as I see it
4. Infectious Disease (low paying subspecialty with a 2 year minimum fellowship; high need as antibiotic resistance grows and new methods for tx of serious and newly emerging conditions occurs faster than new pharm)
5. Palliative Care (grossly under-utilized or known subspecialty of chronic and terminal disease management whose role I foresee will expand particularly in untreatable LBP and other conditions and the growing awareness from hospitals and insurers that those who have a Palliative care specialist treating them end up having lower medical expenses)
 
wjs010 said:
Go lurk in the EM forums. They talk about high salaries all the time. That 400k/ 40 hr a week thing is no joke in certain places.
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Everyone talks about the top 5% like it's the average. Sure you can make 400k, but in most cases you either have to be in BFE or work well above average hours (average for EM, I mean). 250k-350 is probably a better number to use, and certainly nothing I would turn my nose up to.
 
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