Which specialties have the best lifestyle, while having high income potential?

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I agree with Psych & Derm. Also EM? Although it does have the "jack of all trades" attribute.
 
I'm not going to read all of that post, but just going off the title:

Derm
Psych
Rad-onc
Uro

It's not all about what field, but moreso how you set up your practice. The first three actually have tolerable residencies as well.

You can make a killing in psych if you are a good business person and set up a cash only business tailoring to rich housewives. Likewise you can make a pittance if you are doing medicaid child psych cases all day.

If you're unscrupulous you can make a lot in any field. Rad-oncs would make millions seeing how many prostate seed implants they could do in a day. Same with GI docs and scopes, same with urologists and vasectomies (ever see the billboards in florida and socal - one thousand bucks a pop in cash). Psychs can charge 300/hr cash in the right markets. Even family doctors can pull good money if that's their goal. It all depends on how unethical you are willing to be and are either willing to turn down patients in need for cash paying cosmetic customers or willing to milk medicare until you get busted. Happens all the time.

And it irritates me to no end that these are the people that are going to match in front of me.
 
xroc said:
I agree with Psych & Derm. Also EM? Although it does have the "jack of all trades" attribute.
Click to expand...

EM you are someone else's employee and you have to take what they pay you.

Psych, derm, uro, ent, plastics, GI, family med, the world is yours to exploit and charge people $2000 for a 30 minute procedure if you can find people or third parties sucker enough.

Oh, lets not forget the biggest of them all: orthodontics and oral surgery and their $5000 per child tax on the upper middle class. These guys have the biggest houses of anybody where I'm from. 3 days a week of work is about right. Has anybody ever heard a single story of an orthodontist telling a mom "your child will probably be fine without braces - I don't think it's worth it"? Ever?
 
Also consider Physical medicine and rehabilitation or PM&R for short. Not as well known as the other specialties but is slowly getting more competitive.

Definitely has the option of having a good lifestyle and if you go into interventional spine or pain management you will get a good salary as well.
 
FutureDoctorJ17 said:
I'm sorry in advance for the very long post. If you don't want to bother reading the entire text, I put my actual question below in bold print so you can just look at it. I know other people have asked about this, but many such threads are several years old and I'm not sure how applicable they will be for myself when I go into residency. I also wanted to make it clear that this question is not coming from a sense of "laziness," like some of the other similar threads, but from an increased awareness of the importance of family.

First, a little bit about myself. I am a MD/PhD student currently in the latter half of my PhD training. I would describe myself as a very hard worker - basically one of those "gunners." When I was in 1st & 2nd years of MD training, I studied ~14 hours/day, 6 - 7 days a week. I managed to be the top student in my med school class of 250 students, and got >260 score on Step 1. Back then I was thinking I would go into one of the extremely "hardcore" specialties such as Neurosurgery or Orthopedic Surgery, so I worked very hard to be a competitive student. This was a very douchey-thing to do in retrospect, but I often told my then-fiancee (now wife) that work will always be the #1 priority for me, ahead of family. I told her I wanted to be one of the best doctors in my field and that nothing would get in the way of my achieving that. She would often tell me that she doesn't care about the prestige or money associated with my future specialty; what she cares about is that we have a good family life together, that we get to travel while we are young, and that there's no point in me making a lot of money if we are too old before we get to spend it. I used to arrogantly brush her arguments aside.

Well, my wife and I have been together for 6 years now, married almost 2 years. And now that we live together, and have an adorable dog together, and most likely will have a child in the next few years, I have come around to thinking that there is something to be said for "family" and "lifestyle" after all - that it is not all about gunning to be the best doctor in the field at all costs. I would say I have become a lot more laid back in my personality in the last few years. Although I still have the passion within me to become the best doctor I can possibly be, my primary objective now is to make my wife (and future kids) happy by being able to spend time with her as much as possible. I feel terrible that in the six years of our relationship we've never had the time or money to go on an extended overseas trip, which she has been dearly wanting to do (we haven't even gone on a honeymoon). When I was a 2nd year med student, I basically lived in the school library. My wife had to bring lunch and dinner over to eat and hang out with me because I was otherwise too busy to spend any time with her.

In the near future, I will finish up my PhD training and go back to finish up 3rd & 4th years of medical school. I will have to decide which specialty to go into. Now, I'm probably still going to do rotations in Neurosurgery and Orthopedics. If I end up falling hopelessly in love with one of them, then so bit it - you gotta do what you love to do. But I do want to keep myself open to other specialties, and take rotations in specialties that are considered to have good balance of work, income, and family life. And if I end up really liking one of the latter specialties, that allows me to get both fulfillment and high income without necessarily sacrificing ungodly number of hours, it would be awesome.

So my straightforward question is: Which are the best specialties to go into, in terms of having both the potential for high income for those who work hard, and at the same time having good hours that are conductive to a happy family life? Basically, a specialty in which the minimal requirement is not much in terms of hours/week, but there is obviously potential for high income for those who elect to work extra hours or work really hard.

Some points that specifically apply to me:
1) I know I stated that I'm interested in Neurosurgery and Ortho, but please don't limit your suggestions to just surgical specialties. In fact, 2 things kind of discourage me from going into surgery. First, since I am in an MD/PhD training program, I will be close to 32 years old by the time I graduate med school. I really don't know if I would be willing to spend another 6 - 10 years in residency training before I can start making good money and enjoying more hours to spend time with my family. Second, a lot of surgical residents I've interacted with flat out told me they don't think I would end up going into surgery. When I asked them why, they simply said "Because you don't have an a**hole enough personality." I personally know a lot of surgeons who are very nice and not at all narcissistic, but I guess that's something to consider if those residents felt so strongly about it. Either way, specialties with shorter residencies are something I should really consider. I don't want to be making $50,000 a year in my late-30's, AND on top of that be too busy to spend time with my family.

2) I don't mind you suggesting specialties that are really competitive to get into. As I said I was top of my class for the first half of med school, scored >260 on Step 1, am going to finish my PhD with several quality first-author publications, and will be working really hard to be among the top students when I go back to finish up med school. I don't mind working really hard for the next few years in return for good payoff down the line. I already told my wife that I'll basically be MIA for all of 3rd year med school, and she's fine with it as long as I have time for her in residency and beyond. I've heard that Dermatology, ENT, and Plastic Surgery are very hard to get into, but are all pretty nice in terms of both income and hours?

3) Just because I'm a MD/PhD student doesn't necessarily mean that I will definitely want to go into academia and do research. I'm not opposed to it, but I want to be a good clinician first and foremost.

4) I do think I'm more attracted to being a specialist in something as opposed to a "jack of all trades, master of none." As such, I don't know if something like family medicine would be a good fit for me even though the 3-year residency is very attractive to someone in my position. Family physicians also don't make as much as other specialties from what I hear.

Thank you for your advice!
Click to expand...

Orthodontics. :laugh:
 
Hard for me to swallow the fact that you went through with the MD/PhD without a targeted career goal in mind..... most of us already know what field we will be going into. I think you chose pretty poorly by doing the MD/PhD after reading your post. Wasted a spot for someone who could truly be committed to an academic career and a field, which is pretty rare these days. I don't know why you did the PhD but it was a huge waste of your time since your heart was not set in using those skills and knowledge you have gained from it.

To answer your question Derm, Uro, Rads, Anesthesia, ENT, and maybe Ophthalmology.
 
Lots of IM subspecialties can satisfy that requirement, but it's a long road.
 
FutureDoctorJ17 said:
I'm sorry in advance for the very long post. If you don't want to bother reading the entire text, I put my actual question below in bold print so you can just look at it. I know other people have asked about this, but many such threads are several years old and I'm not sure how applicable they will be for myself when I go into residency. I also wanted to make it clear that this question is not coming from a sense of "laziness," like some of the other similar threads, but from an increased awareness of the importance of family.

First, a little bit about myself. I am a MD/PhD student currently in the latter half of my PhD training. I would describe myself as a very hard worker - basically one of those "gunners." When I was in 1st & 2nd years of MD training, I studied ~14 hours/day, 6 - 7 days a week. I managed to be the top student in my med school class of 250 students, and got >260 score on Step 1. Back then I was thinking I would go into one of the extremely "hardcore" specialties such as Neurosurgery or Orthopedic Surgery, so I worked very hard to be a competitive student. This was a very douchey-thing to do in retrospect, but I often told my then-fiancee (now wife) that work will always be the #1 priority for me, ahead of family. I told her I wanted to be one of the best doctors in my field and that nothing would get in the way of my achieving that. She would often tell me that she doesn't care about the prestige or money associated with my future specialty; what she cares about is that we have a good family life together, that we get to travel while we are young, and that there's no point in me making a lot of money if we are too old before we get to spend it. I used to arrogantly brush her arguments aside.

Well, my wife and I have been together for 6 years now, married almost 2 years. And now that we live together, and have an adorable dog together, and most likely will have a child in the next few years, I have come around to thinking that there is something to be said for "family" and "lifestyle" after all - that it is not all about gunning to be the best doctor in the field at all costs. I would say I have become a lot more laid back in my personality in the last few years. Although I still have the passion within me to become the best doctor I can possibly be, my primary objective now is to make my wife (and future kids) happy by being able to spend time with her as much as possible. I feel terrible that in the six years of our relationship we've never had the time or money to go on an extended overseas trip, which she has been dearly wanting to do (we haven't even gone on a honeymoon). When I was a 2nd year med student, I basically lived in the school library. My wife had to bring lunch and dinner over to eat and hang out with me because I was otherwise too busy to spend any time with her.

In the near future, I will finish up my PhD training and go back to finish up 3rd & 4th years of medical school. I will have to decide which specialty to go into. Now, I'm probably still going to do rotations in Neurosurgery and Orthopedics. If I end up falling hopelessly in love with one of them, then so bit it - you gotta do what you love to do. But I do want to keep myself open to other specialties, and take rotations in specialties that are considered to have good balance of work, income, and family life. And if I end up really liking one of the latter specialties, that allows me to get both fulfillment and high income without necessarily sacrificing ungodly number of hours, it would be awesome.

So my straightforward question is: Which are the best specialties to go into, in terms of having both the potential for high income for those who work hard, and at the same time having good hours that are conductive to a happy family life? Basically, a specialty in which the minimal requirement is not much in terms of hours/week, but there is obviously potential for high income for those who elect to work extra hours or work really hard.

Some points that specifically apply to me:
1) I know I stated that I'm interested in Neurosurgery and Ortho, but please don't limit your suggestions to just surgical specialties. In fact, 2 things kind of discourage me from going into surgery. First, since I am in an MD/PhD training program, I will be close to 32 years old by the time I graduate med school. I really don't know if I would be willing to spend another 6 - 10 years in residency training before I can start making good money and enjoying more hours to spend time with my family. Second, a lot of surgical residents I've interacted with flat out told me they don't think I would end up going into surgery. When I asked them why, they simply said "Because you don't have an a**hole enough personality." I personally know a lot of surgeons who are very nice and not at all narcissistic, but I guess that's something to consider if those residents felt so strongly about it. Either way, specialties with shorter residencies are something I should really consider. I don't want to be making $50,000 a year in my late-30's, AND on top of that be too busy to spend time with my family.

2) I don't mind you suggesting specialties that are really competitive to get into. As I said I was top of my class for the first half of med school, scored >260 on Step 1, am going to finish my PhD with several quality first-author publications, and will be working really hard to be among the top students when I go back to finish up med school. I don't mind working really hard for the next few years in return for good payoff down the line. I already told my wife that I'll basically be MIA for all of 3rd year med school, and she's fine with it as long as I have time for her in residency and beyond. I've heard that Dermatology, ENT, and Plastic Surgery are very hard to get into, but are all pretty nice in terms of both income and hours?

3) Just because I'm a MD/PhD student doesn't necessarily mean that I will definitely want to go into academia and do research. I'm not opposed to it, but I want to be a good clinician first and foremost.

4) I do think I'm more attracted to being a specialist in something as opposed to a "jack of all trades, master of none." As such, I don't know if something like family medicine would be a good fit for me even though the 3-year residency is very attractive to someone in my position. Family physicians also don't make as much as other specialties from what I hear.

Thank you for your advice!
Click to expand...


Yeah, I didn't read any of that...

Sounds like a winner of a thread though
 
Nursing


I partly joke but it's kind of true - they get paid hourly and are only required to work 40 hours via 12 hour shifts. They work more and they get 1 1/2 pay. Work outside of your hospital network and you can make 2x's for part-time. That and 3 12 hour workdays with 4 days off = really nice schedule.


So, drop out and go into nursing. I only say this because this is the most-asked question on SDN that you could google it and get your answer. There are a million graphs showing income to hourly ratios.

Or become a prostitute.
 
Anesthesiology. I once saw a video of this guy who is doing his anesthesiology residency in Stanford, CA. It look pretty laid-back he would enter in the morning and be home by 5.
After that you can always join a private practice or something.


Here's the vid.
http://www.youtube.com/watch?v=20YzbPVIzmE
 
The Buff OP said:
Anesthesiology. I once saw a video of this guy who is doing his anesthesiology residency in Stanford, CA. It look pretty laid-back he would enter in the morning and be home by 5.
After that you can always join a private practice or something.


Here's the vid.
http://www.youtube.com/watch?v=20YzbPVIzmE
Click to expand...

haha, maybe if you were finishing residency 20 years ago.
 
happygilmore said:
haha, maybe if you were finishing residency 20 years ago.
Click to expand...
Maybe. I think it depends on your residency. Survivor D.O. (he is a GS resident) even said general surgery is becoming family/lifestyle friendly.
 
The Buff OP said:
Maybe. I think it depends on your residency. Survivor D.O. (he is a GS resident) even said general surgery is becoming family/lifestyle friendly.
Click to expand...

Lol. So anesthesia is a future money maker and general surgery is lifestyle friendly? Just because one resident says a specialty is lifestyle friendly doesn't make it so - compared to what? Derm? Ophtho? Psych? EM? Radiology?

Go read the anesthesia forum for their 10 year outlook. Anesthesia without fellowship (bread and butter cases) is going to be a pretty slim market soon.
 
Gun for derm, optho, or rad onc.

I saw people suggest radiology and urology. Radiology will be six post graduate years and the lifestyle, while not terrible, is not nearly as good as the above fields.

Urology is fairly long too, 5 post grad years, plus the residency can be fairly brutal.
 
Last edited:
The Buff OP said:
Maybe. I think it depends on your residency. Survivor D.O. (he is a GS resident) even said general surgery is becoming family/lifestyle friendly.
Click to expand...

Lol....tell that to my buddy who was taking q2 call in the STICU while his wife was 9 months pregnant. He was lucky enough to see the birth because it happened at the same hospital that he was constantly working at. If you think GS is family friendly, I'd think again...
 
The Buff OP said:
Maybe. I think it depends on your residency. Survivor D.O. (he is a GS resident) even said general surgery is becoming family/lifestyle friendly.
Click to expand...

What Survivor DO is experiencing is referred to as "Stockholm Syndrome."
 
GS is *more* family/lifestyle friendly than it used to be.

However, there is no way that the residency, even in its current form, would be what the OP is looking for. While no one knows what the future holds, and a hospital employed position is more family/lifestyle friendly than private practice, it would not be on the short (or even long) list that the OP is looking for.

Anesthesia? No. Anything that requires in house call and urgent cases is not considered family/lifestyle friendly.

IMHO, those that listed Derm and Rad Onc are probably most lifestyle and wallet friendly. Although any specialty in which you have a relatively easy residency and can charge cash for patient visits, should qualify.
 
Winged Scapula said:
GS is *more* family/lifestyle friendly than it used to be.

However, there is no way that the residency, even in its current form, would be what the OP is looking for. While no one knows what the future holds, and a hospital employed position is more family/lifestyle friendly than private practice, it would not be on the short (or even long) list that the OP is looking for.

Anesthesia? No. Anything that requires in house call and urgent cases is not considered family/lifestyle friendly.

IMHO, those that listed Derm and Rad Onc are probably most lifestyle and wallet friendly. Although any specialty in which you have a relatively easy residency and can charge cash for patient visits, should qualify.
Click to expand...

Healthcare economics 101.
 
Stellar Clouds said:
Lol....tell that to my buddy who was taking q2 call in the STICU while his wife was 9 months pregnant. He was lucky enough to see the birth because it happened at the same hospital that he was constantly working at. If you think GS is family friendly, I'd think again...
Click to expand...

Wow! That's insane.

happygilmore said:
Lol. So anesthesia is a future money maker and general surgery is lifestyle friendly? Just because one resident says a specialty is lifestyle friendly doesn't make it so - compared to what? Derm? Ophtho? Psych? EM? Radiology?

Go read the anesthesia forum for their 10 year outlook. Anesthesia without fellowship (bread and butter cases) is going to be a pretty slim market soon.
Click to expand...
Hey! I never said I agree or believe on the things Survivor D.O. said. **** I know surgery residencies are not a joke. I have heard that before, about what you said about anesthesia.
 
Last edited:
Kaustikos said:
Nursing


I partly joke but it's kind of true - they get paid hourly and are only required to work 40 hours via 12 hour shifts. They work more and they get 1 1/2 pay. Work outside of your hospital network and you can make 2x's for part-time. That and 3 12 hour workdays with 4 days off = really nice schedule.


So, drop out and go into nursing. I only say this because this is the most-asked question on SDN that you could google it and get your answer. There are a million graphs showing income to hourly ratios.

Or become a prostitute.
Click to expand...

I'm a nurse working 72 hours this week and next week. Overtime puts me at a higher tax bracket, and after increased withholdings, I get about 3 hours of the 12 I work. Not worth it.

Nursing is extremely task oriented, and can wear one out. Not worth it.

Many units are unnecessarily understaffed. Not worth it.
 
FutureDoctorJ17 said:
I'm sorry in advance for the very long post. If you don't want to bother reading the entire text, I put my actual question below in bold print so you can just look at it. I know other people have asked about this, but many such threads are several years old and I'm not sure how applicable they will be for myself when I go into residency. I also wanted to make it clear that this question is not coming from a sense of "laziness," like some of the other similar threads, but from an increased awareness of the importance of family.

First, a little bit about myself. I am a MD/PhD student currently in the latter half of my PhD training. I would describe myself as a very hard worker - basically one of those "gunners." When I was in 1st & 2nd years of MD training, I studied ~14 hours/day, 6 - 7 days a week. I managed to be the top student in my med school class of 250 students, and got >260 score on Step 1. Back then I was thinking I would go into one of the extremely "hardcore" specialties such as Neurosurgery or Orthopedic Surgery, so I worked very hard to be a competitive student. This was a very douchey-thing to do in retrospect, but I often told my then-fiancee (now wife) that work will always be the #1 priority for me, ahead of family. I told her I wanted to be one of the best doctors in my field and that nothing would get in the way of my achieving that. She would often tell me that she doesn't care about the prestige or money associated with my future specialty; what she cares about is that we have a good family life together, that we get to travel while we are young, and that there's no point in me making a lot of money if we are too old before we get to spend it. I used to arrogantly brush her arguments aside.

Well, my wife and I have been together for 6 years now, married almost 2 years. And now that we live together, and have an adorable dog together, and most likely will have a child in the next few years, I have come around to thinking that there is something to be said for "family" and "lifestyle" after all - that it is not all about gunning to be the best doctor in the field at all costs. I would say I have become a lot more laid back in my personality in the last few years. Although I still have the passion within me to become the best doctor I can possibly be, my primary objective now is to make my wife (and future kids) happy by being able to spend time with her as much as possible. I feel terrible that in the six years of our relationship we've never had the time or money to go on an extended overseas trip, which she has been dearly wanting to do (we haven't even gone on a honeymoon). When I was a 2nd year med student, I basically lived in the school library. My wife had to bring lunch and dinner over to eat and hang out with me because I was otherwise too busy to spend any time with her.

In the near future, I will finish up my PhD training and go back to finish up 3rd & 4th years of medical school. I will have to decide which specialty to go into. Now, I'm probably still going to do rotations in Neurosurgery and Orthopedics. If I end up falling hopelessly in love with one of them, then so bit it - you gotta do what you love to do. But I do want to keep myself open to other specialties, and take rotations in specialties that are considered to have good balance of work, income, and family life. And if I end up really liking one of the latter specialties, that allows me to get both fulfillment and high income without necessarily sacrificing ungodly number of hours, it would be awesome.

So my straightforward question is: Which are the best specialties to go into, in terms of having both the potential for high income for those who work hard, and at the same time having good hours that are conductive to a happy family life? Basically, a specialty in which the minimal requirement is not much in terms of hours/week, but there is obviously potential for high income for those who elect to work extra hours or work really hard.

Some points that specifically apply to me:
1) I know I stated that I'm interested in Neurosurgery and Ortho, but please don't limit your suggestions to just surgical specialties. In fact, 2 things kind of discourage me from going into surgery. First, since I am in an MD/PhD training program, I will be close to 32 years old by the time I graduate med school. I really don't know if I would be willing to spend another 6 - 10 years in residency training before I can start making good money and enjoying more hours to spend time with my family. Second, a lot of surgical residents I've interacted with flat out told me they don't think I would end up going into surgery. When I asked them why, they simply said "Because you don't have an a**hole enough personality." I personally know a lot of surgeons who are very nice and not at all narcissistic, but I guess that's something to consider if those residents felt so strongly about it. Either way, specialties with shorter residencies are something I should really consider. I don't want to be making $50,000 a year in my late-30's, AND on top of that be too busy to spend time with my family.

2) I don't mind you suggesting specialties that are really competitive to get into. As I said I was top of my class for the first half of med school, scored >260 on Step 1, am going to finish my PhD with several quality first-author publications, and will be working really hard to be among the top students when I go back to finish up med school. I don't mind working really hard for the next few years in return for good payoff down the line. I already told my wife that I'll basically be MIA for all of 3rd year med school, and she's fine with it as long as I have time for her in residency and beyond. I've heard that Dermatology, ENT, and Plastic Surgery are very hard to get into, but are all pretty nice in terms of both income and hours?

3) Just because I'm a MD/PhD student doesn't necessarily mean that I will definitely want to go into academia and do research. I'm not opposed to it, but I want to be a good clinician first and foremost.

4) I do think I'm more attracted to being a specialist in something as opposed to a "jack of all trades, master of none." As such, I don't know if something like family medicine would be a good fit for me even though the 3-year residency is very attractive to someone in my position. Family physicians also don't make as much as other specialties from what I hear.

Thank you for your advice!
Click to expand...

In all seriousness,

Given your (insane) board scores and your gen'l desires, I would recommend the following:

PMR + Pain fellowship
Anesthesia + Pain fellowship
Derm
IM + GI
IM + Allergy
Psych

g'luck
:luck:
 
Why no mention of critical care? 12 hour days for 7 days a week are long, but wouldn't you enjoy not working 26 weeks a year on a 7 on/7 off schedule? Would still give you more time with your family than anything else listed here. Especially if you have young children...you're with them literally all day (well, half a year, but this is versus being gone all day, every day).
 
fancymylotus said:
👍

$$$$$/relatively low-stress/awesome lifestyle.


open a few offices, hire a bunch of minions...i mean..associates..to work for you. chillax. the end.
Click to expand...

until you eat your gun because you have to look down nasty mouths all day.
 
AlmostAnMD said:
Why no mention of critical care? 12 hour days for 7 days a week are long, but wouldn't you enjoy not working 26 weeks a year on a 7 on/7 off schedule? Would still give you more time with your family than anything else listed here. Especially if you have young children...you're with them literally all day (well, half a year, but this is versus being gone all day, every day).
Click to expand...

critical care is one of those things that always sounds good in theory, but people who do it always burn out and don't recommend it for lifestyle

dentistry is better than any gig in medicine if you can do it

too much psych being mentioned in this thread ... looks like people are finally starting to catch on
 
CRNA. $200k salary, 3 years of training. Easiest route to most cash. No stress, someone else burdens the responsibility, many, many, no call jobs.
 
acceptmeplease said:
I'm a nurse working 72 hours this week and next week. Overtime puts me at a higher tax bracket, and after increased withholdings, I get about 3 hours of the 12 I work. Not worth it.

Nursing is extremely task oriented, and can wear one out. Not worth it.

Many units are unnecessarily understaffed. Not worth it.
Click to expand...

That isn't how tax brackets work.
 
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