Which specialties require the most years of school?

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Jstone123

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I heard some specialties like cardiac electrophysiology require 8 years after medical school until you are a practicing physician. Which other specialties require such long residencies/fellowships? This means you won't be practicing on your own until you're 34 assuming you got into medical school after undergrad!
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Residencies typically range from 3 years (EM, Peds, IM, FP) to 5 or 6 years (surgical specialties). Fellowships range anywhere from 1 to 3 years, and I'm not sure if they are usually longer than that. I know the specialty tracks I'm most interested in are 6 or 7 years (6 for peds-neonatology, 3 years each and 7 for REI or MFM, 4 years Ob/Gyn residency then 3 year fellowship).
 
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people who do congenital heart defect repair on little kids have really long training, and a fair amount of them have PhDs too.
 
Probably not the longest, but how about MD/PhD + neurosurgery residency + spinal surgery fellowship 😱
 
Excluding fellowships, neurosurgery and plastic surgery are the longest.
 
Surgical specialties tend to have the longest residency programs. In fact, cardiothoracic surgery and neurosurgery take about 7-8 years to complete.

You wouldn't want a newbie operating on your brain or heart now would you?
 
And just outta curiosity, around how much would a resident in a long, but difficult, residency be paid (specifically neuro and cardio)...
Let's face it, we will have to live our life AND pay down loans in these 8 or so years too. You can break 6 figures in residency programs for these specialties, no?
 
No. Residents typically earn around $50K a year right now (depends on where you live, but around Philly, this seems to be the case). Fellows only earn slightly more, but you are not pulling down an attending's salary until you are, well, an attending.
 
Doodl3s said:
And just outta curiosity, around how much would a resident in a long, but difficult, residency be paid (specifically neuro and cardio)...
Let's face it, we will have to live our life AND pay down loans in these 8 or so years too. You can break 6 figures in residency programs for these specialties, no?
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Haha, no
 
Residents get paid around minimum wage. Annual salary is around ~45K with slight variation depending upon the state you're in. If you want to make more, you can moonlight, but that is only permitted by some programs.
 
I hadn't realized how low the salary is. I mean, it's not low, let's not get greedy. But with all the loans, and YEARs of hard work for these more intense programs, I feel something more around 70-80k is deserved during the later years at least....
 
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Doodl3s said:
I hadn't realized how low the salary is. I mean, it's not low, let's not get greedy. But with all the loans, and YEARs of hard work for these more intense programs, I feel something more around 70-80k is deserved during the later years at least....
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Don't we all? It's not the case.
 
Loans form undergrad + med school loans + 80 hour weeks = not grays anatomy
 
heh... don't worry, I don't have any delusions about being a doctor and am aware that Diagnostic medicine is NOT a specialty lol 😛

I'm a person big on getting what you deserve. Any person putting such RIDICULOUS amounts of work, or should i say a ridiculous amount of their LIFE deserves more than 50k a year during 7 years of slaving in some of the hardest programs, with a crapton of debt already there.

Granted, I'm still interested in these programs so i guess it tells me I'm not in it for the money otherwise I'd join my business buddies who some of which will already be making 6-figures straight out of undergrad in places like goldman...

aw well, I'm really banking that the reward of seeing someone's face after I physically "fix" them through surgery and medicine, and have them have a better quality of life thanks to me is worth the years of work 🙂... i'm sure it will be! it MUST! lol
 
There is no bump in pay for fellowships. A first year neonatology fellow or first year cardiology fellow will earn the exact same as a 4th year general surgery resident at the same sponsoring institution.

At most places, yearly increases in salary are automatic, so by the time you get to the 4th or 5th year, you're making closer to $54-56k, depending on where you started. However, depending on where you did residency and where you do fellowship, it's entirely possible to take a significant pay cut, though it'll probably be made up in the difference of cost of living (though it may not feel like it).

The one difference that may enhance fellows' salary - particularly those coming out of IM and Peds - is moonlighting. Once you're licensed, you may be able to find locations (acute care/doc in a box), that will pay you well for taking care of coughs/colds/ear aches and gastro cases. Of course, whether your fellowship allows moonlighting either by policy or in the amount of free time you have (critical care fellows may have difficulty in finding enough time) is a very different discussion. Also, it's a little tough to find moonlighting opportunities for surgeons...
 
BigRedBeta said:
There is no bump in pay for fellowships. A first year neonatology fellow or first year cardiology fellow will earn the exact same as a 4th year general surgery resident at the same sponsoring institution.

At most places, yearly increases in salary are automatic, so by the time you get to the 4th or 5th year, you're making closer to $54-56k, depending on where you started. However, depending on where you did residency and where you do fellowship, it's entirely possible to take a significant pay cut, though it'll probably be made up in the difference of cost of living (though it may not feel like it).

The one difference that may enhance fellows' salary - particularly those coming out of IM and Peds - is moonlighting. Once you're licensed, you may be able to find locations (acute care/doc in a box), that will pay you well for taking care of coughs/colds/ear aches and gastro cases. Of course, whether your fellowship allows moonlighting either by policy or in the amount of free time you have (critical care fellows may have difficulty in finding enough time) is a very different discussion. Also, it's a little tough to find moonlighting opportunities for surgeons...
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That's what I meant by fellows earning slightly more than residents. I wasn't very clear. I've looked at some of the teaching hospitals around here just out of curiosity since I expect I will stay in this area for my residency and possible fellowship. It looks like there's about a $1-2K increase in pay every year.

Now I'm curious. How likely is it to find moonlighting positions as an Ob/Gyn subspecialty fellow?
 
Doodl3s said:
And just outta curiosity, around how much would a resident in a long, but difficult, residency be paid (specifically neuro and cardio)...
Let's face it, we will have to live our life AND pay down loans in these 8 or so years too. You can break 6 figures in residency programs for these specialties, no?
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if you are a resident for the military, you earn around $70,000 a year
 
I'll be moonlighting during a derm residency. Pay my loans off before I'm even done.
 
Geekchick921 said:
Now I'm curious. How likely is it to find moonlighting positions as an Ob/Gyn subspecialty fellow?
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I think it depends on how many community hospitals you have around you... don't do a residency in podunkville I guess.

muhali3 said:
I'll be moonlighting during a derm residency. Pay my loans off before I'm even done.
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sure you will dude.
 
it's a joke guys...🙄.

but hypothetically, I don't see why it couldn't be done, assuming you minimized loans as much as possible during MS, matched into a program that allowed moonlighting, and moonlighted as much as possible. not really realistic though.
 
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muhali3 said:
I'll be moonlighting during a derm residency. Pay my loans off before I'm even done.
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Actually, the specialty that generally has the most moonlighting for residents is ER. It's of course dependent that your program allow external moonlighting to begin with, but most of the time, during the ER months after the first year are usually comprised of ~15 shifts a month (keep in mind ER residents will rotate through the various ICU's, the trauma service, possibly sedation or anesthesia). That leaves lots of time for travelling to podunk towns and covering nights in their ED.


As for the hours during fellowship question, it does depend on the field, but in general, when on service, you'll be covering more hours, but how that time is split up varies. For example if you're on a consult service (heme/onc, neuro, rheum, endocrine, ID) there will be more time on home call - so technically not working, but possibly getting woken up multiple times a night with calls. If you're in something like critical care, cardiology, something surgical, then the hours will be much more likely to be in-house and may closely resemble q4 call schedules. Given the new work hour limits going into place in July that really affect interns (which had the brunt of q4 call most places), it's likely that fellowship is going to become the busiest years of one's training without a doubt.

While one is on a research month (for example all the peds fellowships are 3 years, and of that, ~50% of the time is spent on research activities), cross coverage call will be very dependent on the program, the number of fellows they have, the number of rotating fellows (ie Peds ER fellows often spend several months in the PICU, Peds Critical Care fellows often rotate through Peds Cardiovascular ICU's if they're program has separate units), and the type of coverage needed.
 
Geekchick921 said:
Now I'm curious. How likely is it to find moonlighting positions as an Ob/Gyn subspecialty fellow?
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Depending on the program, some OB/gyn programs have their fellows continue to take call - basically acting as one more layer before the attending has to be woken up. At some places, for example, the MFM fellow will cover L&D and supervise the residents, and only call the attending if the **** REALLY hits the fan.
 
smq123 said:
Depending on the program, some OB/gyn programs have their fellows continue to take call - basically acting as one more layer before the attending has to be woken up. At some places, for example, the MFM fellow will cover L&D and supervise the residents, and only call the attending if the **** REALLY hits the fan.
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That makes total sense to me.

I wasn't really expecting this to be a possibility, but if it turns out it is, I might consider it (depends on a lot of factors). I was mostly just thinking out loud.
 
muhali3 said:
it's a joke guys...🙄.

but hypothetically, I don't see why it couldn't be done, assuming you minimized loans as much as possible during MS, matched into a program that allowed moonlighting, and moonlighted as much as possible. not really realistic though.
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Unless you are moonlighting as a "resident", being an extra-set of hands to help a teaching service/hospital - if you are moonlighting as a full-fledge physician, you are working as a physician with an unrestricted license - which mean you are fully exposed if you get sued (won't have the captain-of-the-ship doctrine to protect you which you usually have as a resident).

For moonlighting - who will provide the malpractice insurance? Will there be tail coverage or will you still be exposed even after you leave your moonlighting job? Will you be an employee or will you be an independent contractor - this will matter greatly when it comes to taxes (medicare and social security).

And you technically have to include the hours that you moonlight into the 80hrs/week ACGME requirement. Now your program director may look the other way, or not know about it, but if the RRC during a site visit finds out, then your program gets in trouble. In addition, if you are not performing up to expectation as a resident (both clinical, scholarly, as well as on inservice exams), moonlighting activities can be used against you (program director gives you an ultimatum - stop moonlighting and focus on your residency or be dismissed from the program)

Otherwise, it's a great way to make money
 
Jstone123 said:
I heard some specialties like cardiac electrophysiology require 8 years after medical school until you are a practicing physician. Which other specialties require such long residencies/fellowships? This means you won't be practicing on your own until you're 34 assuming you got into medical school after undergrad!
Click to expand...
CT surgery requires 8 yrs of training. 5 yrs of General surgery residency, then 2-4 yrs of CT fellowship
 
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