What specialties were competitive in the past?

[RJGOP]

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That's actually a good point.

 

[DermViser]

Radiology.

Ah, I think I know who you're talking about: http://www.uth.tmc.edu/radiology/radiology-match-guide/

 

[colbgw02]

Ah, I think I know who you're talking about: http://www.uth.tmc.edu/radiology/radiology-match-guide/

Not her specifically. I just tired of 40+ year old attendings reminding me that it was 'very competitive' to get in. They had a way of saying it that implied you weren't good enough. The whole time, I'm thinking, 'dude, you're not good enough nowadays either.'

 

[DermViser]

Not her specifically. I just tired of 40+ year old attendings reminding me that it was 'very competitive' to get in. They had a way of saying it that implied you weren't good enough. The whole time, I'm thinking, 'dude, you're not good enough nowadays either.'

Yup, they'll never talk about that. There was another Radiology PD who was too big for her britches: http://www.studentdoctor.net/2010/10/the-successful-match-getting-into-radiology/

 

[Arkangeloid]

Ah, I think I know who you're talking about: http://www.uth.tmc.edu/radiology/radiology-match-guide/

We'll see how much they brag about competitiveness when Medicare cuts their reimbursement to shreds.

 

[PL198]

Not her specifically. I just tired of 40+ year old attendings reminding me that it was 'very competitive' to get in. They had a way of saying it that implied you weren't good enough. The whole time, I'm thinking, 'dude, you're not good enough nowadays either.'

Interesting, plus I want to go into rads so <3. I imagine that would be very frustrating and I'd say the reason they make statements like that is because they know they wouldn't be competitive if the positions were reversed.

We'll see how much they brag about competitiveness when Medicare cuts their reimbursement to shreds.

Obviously I wouldn't want less money, but I'd be more than happy to make what a FM doc makes while doing rads.

 

[DermViser]

We'll see how much they brag about competitiveness when Medicare cuts their reimbursement to shreds.

That's what I thought was hilarious. When you brag about how competitive your specialty is in comparison to other fields and that those applying now are never good enough, then don't be surprised when other specialties laugh at your specialty for getting its reimbursement cut.

 

[DermViser]

Obviously I wouldn't want less money, but I'd be more than happy to make what a FM doc makes while doing rads.

Not with Rads turning into a 24/7 service.

 

[PL198]

Not with Rads turning into a 24/7 service.

Fine by me, hell I either sit in my basement at home or do work, so there's nearly no distinction for me. lololol but really

 

[DermViser]

Interesting, plus I want to go into rads so <3. I imagine that would be very frustrating and I'd say the reason they make statements like that is because they know they wouldn't be competitive if the positions were reversed.

Esp. bc she wasn't doing anything for a year and a half before slipping into a Rads spot.
http://www.uth.tmc.edu/radiology/faculty/sandra-a-a-oldham/index.html

 

[colbgw02]

Interesting, plus I want to go into rads so <3. I imagine that would be very frustrating and I'd say the reason they make statements like that is because they know they wouldn't be competitive if the positions were reversed.

I wouldn't even give them enough credit to have the introspection to recognize this. I just think people, in general, and those running GME programs, in particular, just think they're hot ish regardless.

 

[DermViser]

Fine by me, hell I either sit in my basement at home or do work, so there's nearly no distinction for me. lololol but really

I'm talking about on-site Rads or you work for a Teleradiology company where you have a huge volume.

 

[DermViser]

I wouldn't even give them enough credit to have the introspection to recognize this. I just think people, in general, and those running GME programs, in particular, just think they're hot ish regardless.

I agree. The level of instrospection is lacking. It only hits them (maybe) when candidates of lesser and lesser caliber are he norm applying to their program.

 

[colbgw02]

Obviously I wouldn't want less money, but I'd be more than happy to make what a FM doc makes while doing rads.

CMS reimbursement rates have precisely nothing to do with prestige. It's all about who is the biggest target, and medical imaging has certainly fit that bill of late.

Kudos to you for your attitude vis-a-vis radiology. I believe our specialty has been hurt by people who entered it for the wrong reasons. Combine that with the sea change in how medical images is utilized in the last two decades, and it's easy to see why so many radiologists resemble chicken little.

 

[PL198]

I'm talking about on-site Rads or you work for a Teleradiology company where you have a huge volume.

Honestly if radiology became worse than FM in terms of PITA, crappy compensation and etc I'd still want to do it. I'm not big on the whole concept of sacrificing tons of financial benefit for one's interest level typically, but I'm like schoolgirl in love. I feel like these projected derivatives for the job markets are always overstated, both positively and negatively, so I'm not worried.

 

[PL198]

CMS reimbursement rates have precisely nothing to do with prestige. It's all about who is the biggest target, and medical imaging has certainly fit that bill of late.

Kudos to you for your attitude vis-a-vis radiology. I believe our specialty has been hurt by people who entered it for the wrong reasons. Combine that with the sea change in how medical images is utilized in the last two decades, and it's easy to see why so many radiologists resemble chicken little.

Yeah, I was just saying I look at it as so interesting, that I would do it for X salary and the difference between the avg now and that is just a cherry on top IMO.

 

[DermViser]

Kudos to you for your attitude vis-a-vis radiology. I believe our specialty has been hurt by people who entered it for the wrong reasons. Combine that with the sea change in how medical images is utilized in the last two decades, and it's easy to see why so many radiologists resemble chicken little.

While I agree, the people who I know liked Rads, liked it for it's visual nature. It's quite ridiculous that Radiology has become as long as a Surgery residency + fellowship just to get an attending job, due to the specialty becoming commoditized.

 

[DermViser]

Yeah, I was just saying I look at it as so interesting, that I would do it for X salary and the difference between the avg now and that is just a cherry on top IMO.

I can almost guarantee you wouldn't do Radiology for the salary of an FM doctor (who finishes in 3 years) vs. 5 years + 1-2 yr. fellowship of Radiology residency, unless you're independently wealthy.

 

[PL198]

I can almost guarantee you wouldn't do Radiology for the salary of an FM doctor (who finishes in 3 years) vs. 5 years + 1-2 yr. fellowship of Radiology residency, unless you're independently wealthy.

Well the cynic in me says that you're right, but another part of me says I'd blow my brains out in FM so it would be a tough decision.

 

[colbgw02]

While I agree, the people who I know liked Rads, liked it for it's visual nature. It's quite ridiculous that Radiology has become as long as a Surgery residency + fellowship just to get an attending job, due to the specialty becoming commoditized.

Length of training in radiology has nothing to do with commoditization. The 4-year training pathway preceded the latter, and recent advancements make longer training more important. All while the trend toward commoditization has slowed.

 

[DermViser]

Well the cynic in me says that you're right, but another part of me says I'd blow my brains out in FM so it would be a tough decision.

True. If you don't like the mundane of problems, that usually encompasses FM (assuming you don't do OB-Gyn services), then no amount of salary will change your mind. Unless maybe if you did concierge, where you have enough time to actually spend time with your patients and make a difference in their lives.

 

[DermViser]

Length of training in radiology has nothing to do with commoditization. The 4-year training pathway preceded the latter, and recent advancements make longer training more important. All while the trend toward commoditization has slowed.

No, I'm saying the reason that Radiology is having problems now are BECAUSE of it's commoditization and ability to be done off-site (Telerads). Now, with jobs essentially not coming as easily, a fellowship has essentially become a de facto requirement, rather than an option.

 

[KanyeWes]

Honestly if radiology became worse than FM in terms of PITA, crappy compensation and etc I'd still want to do it. I'm not big on the whole concept of sacrificing tons of financial benefit for one's interest level typically, but I'm like schoolgirl in love. I feel like these projected derivatives for the job markets are always overstated, both positively and negatively, so I'm not worried.

How you feel about rads is how I feel about derm. ;( I'm just so disappointed that so disappointed that the hyper competition squeezed me out.

 

[DermViser]

How you feel about rads is how I feel about derm. ;( I'm just so disappointed that so disappointed that the hyper competition squeezed me out.

You haven't even started med school yet.

 

[PL198]

How you feel about rads is how I feel about derm. ;( I'm just so disappointed that so disappointed that the hyper competition squeezed me out.

lol just tear **** up and get a spot man. (inb4 I end up matching FM Montana)

 

[neusu]

When did neurosurgery become its own residency, and not a fellowship after general surgery?

Neurosurgery never was a fellowship after general surgery. It started as general surgeons interested in the central nervous system. Formal training as a resident in neurosurgery began in the 1910s-20s. The Society of Neurological Surgeons (or the senior society) began in 1920. The precursor to the AANS (The Harvey Cushing Society) was created in 1931. The American Board of Neurological Surgery has been around since 1940.

 

[Arkangeloid]

Well the cynic in me says that you're right, but another part of me says I'd blow my brains out in FM so it would be a tough decision.

FM seems fine to me. But I've slept through too many rads rounds to be interested in such a specialty.

 

[colbgw02]

No, I'm saying the reason that Radiology is having problems now are BECAUSE of it's commoditization and ability to be done off-site (Telerads). Now, with jobs essentially not coming as easily, a fellowship has essentially become a de facto requirement, rather than an option.

I see. Well, with respect to the job market, teleradiology and commoditization are really only part of the story. A substantial part, but only a part - and a part that I think has reached an equilibrium. Regarding fellowships, in my opinion, the movement toward subspecialization is primarily a function of the natural progression of the field. The two phenomena are most definitely related, but they're independent trends, IMO.

 

[DermViser]

FM seems fine to me. But I've slept through too many rads rounds to be interested in such a specialty.

I would have pegged Rads as perfect for you and you have yet to really experience FM.

 

[colbgw02]

Do. Not. Want.

 

[Arkangeloid]

I would have pegged Rads as perfect for you and you have yet to really experience FM.

I mean, the visual nature of it is pretty cool, but there's so much Anatomy involved that it's a turnoff.

 

[BobbyB]

FM seems fine to me. But I've slept through too many rads rounds to be interested in such a specialty.

if you ever go into IM/FM/psych, you are going to get depressed seeing those patients

 

[DermViser]

I mean, the visual nature of it is pretty cool, but there's so much Anatomy involved that it's a turnoff.

While yes, but it's not gross anatomy all over again, it's clinically relevant. You're not looking at X-rays of every minutiae structure.

 

[DermViser]

if you ever go into IM/FM/psych, you are going to get depressed seeing those patients

Why?

 

[BurghStudent]

Neurosurgery never was a fellowship after general surgery. It started as general surgeons interested in the central nervous system. Formal training as a resident in neurosurgery began in the 1910s-20s. The Society of Neurological Surgeons (or the senior society) began in 1920. The precursor to the AANS (The Harvey Cushing Society) was created in 1931. The American Board of Neurological Surgery has been around since 1940.

I love history.

 

[DermWiser]

Only the smartest people go into dermatology. It is the most intellectual field of medicine.

 

[evilbooyaa]

Only the smartest people go into dermatology. It is the most intellectual field of medicine.

Really.... a parody account of @DermViser ?

Oh, boy.

@Winged Scapula, can you do an IP check on this? I'm relatively confident it's against the TOS.

 

[Smurfette]

Really.... a parody account of @DermViser ?

Oh, boy.

@Winged Scapula, can you do an IP check on this? I'm relatively confident it's against the TOS.

In the future, you can just hit "report" to have it flagged for moderator staff to investigate. 🙂 This way multiple mods have the ability to review the post if someone else is busy.

 

[DermViser]

Really.... a parody account of @DermViser ?

Oh, boy.

@Winged Scapula, can you do an IP check on this? I'm relatively confident it's against the TOS.

It's funny bc his parody of me is nothing like what I actually say. I have never said that Derms are the smartest of anyone else. At first I thought it was rocketbooster reincarnated.

 

[RJGOP]

It's funny bc his parody of me is nothing like what I actually say. I have never said that Derms are the smartest of anyone else. At first I thought it was rocketbooster reincarnated.

It really makes me wonder who it is.

 

[maxxor]

Length of training in radiology has nothing to do with commoditization. The 4-year training pathway preceded the latter, and recent advancements make longer training more important. All while the trend toward commoditization has slowed.

Wasn't Radiology a 3 year residency without a required internship in the 80s?

 

[Kahreek]

Peds used to be more popular, didnt it?

 

[maxxor]

Yeah TBH I feel like the residency hardship of the 70s and 80s is overstated. It has to be. I don't think people's temperaments are dynamic enough as a population to actually tolerate the things I hear about residency back then. I'm sure it was hard, but if residency was actually 100 hrs/week or whatever like we all hear, then it would have been more an issue back then.

From attendings who are a bit more introspective, they reflect that hours in residency were spent differently. There was just more down-time in the hospital. You couldn't leave when you were on call, but it's not like you had 80-bajillion clinical documentation related things to do for each patient either. We also had a lower acuity of care in general. People would be admitted for inguinal hernia repairs for multiple days or even for elective cholecystectomy. So with all these relatively healthy people representing the average list, things were more straightforward.

 

[PL198]

From attendings who are a bit more introspective, they reflect that hours in residency were spent differently. There was just more down-time in the hospital. You couldn't leave when you were on call, but it's not like you had 80-bajillion clinical documentation related things to do for each patient either. We also had a lower acuity of care in general. People would be admitted for inguinal hernia repairs for multiple days or even for elective cholecystectomy. So with all these relatively healthy people representing the average list, things were more straightforward.

See I buy this. There's just no way the whole " In my day, we worked 120 hours/week and ran room to room" group is telling the truth, and just pulling the typical " walking to school uphill both ways" routine that you typically see in older people.

 

[colbgw02]

Wasn't Radiology a 3 year residency without a required internship in the 80s?

I honestly don't know when those changes came about, but it very well could have been in the 80s.

 

[maxxor]

I honestly don't know when those changes came about, but it very well could have been in the 80s.

Google came to the rescue:

By the early 1970s, diagnostic and therapeutic radiology were separate departments in most American medical schools. The duration of training in diagnostic radiology was 3 years and then extended to 4 years in 1982. Technology in diagnostic imaging was developing rapidly. Computed tomography, ultrasound, nuclear medicine, and digital subtraction angiography led the advances and prepared the way for MRI in the mid-1980s. Between 1972 and 1986, Diagnostic Radiology continued to grow and many future leaders of American radiology were trained in the department.

http://medicine.yale.edu/diagnosticradiology/about/history/index.aspx

 

[PL198]

Google came to the rescue:


http://medicine.yale.edu/diagnosticradiology/about/history/index.aspx

oh my lord 3 years and no intern, that would be the ****. I'd trade my nuts for that opportunity. semi-srs.

 

[DermViser]

From attendings who are a bit more introspective, they reflect that hours in residency were spent differently. There was just more down-time in the hospital. You couldn't leave when you were on call, but it's not like you had 80-bajillion clinical documentation related things to do for each patient either. We also had a lower acuity of care in general. People would be admitted for inguinal hernia repairs for multiple days or even for elective cholecystectomy. So with all these relatively healthy people representing the average list, things were more straightforward.

Yes, for example, back then, people were in the ICU for malignant hypertension, and that was their only problem. People were MUCH less sicker back then unlike now where it is just plain ridiculous.

 

[maxxor]

So, even more research.

In 1971 the ABR eliminated the requirement for internship. For 26 years they did not require internship until 1997.

http://www.ncbi.nlm.nih.gov/pubmed/18692762

 

[DermViser]

oh my lord 3 years and no intern, that would be the ****. I'd trade my nuts for that opportunity. semi-srs.

Now that fellowship has become a defacto requirement, it should be a 3 years residency. A prelim year is pretty much useless as it's always been. Maybe it might help for Interventional, idk.