Which Specialty?

[Winged Scapula]

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Do not mistake the hours you are in the office with the hours you work.

Any office based practice has several hours of paperwork a week that can be added on to that "8-5" quote. Most nights when I am on SDN, its for a break from doing patient charts in my lifestyle specialty. 😉

In terms of hours per week, EM wins hands down. Again, do not count on being able to work in EDs with only FM training. As noted above, that's old skool and rapidly fading as an option.

In terms of stress, EM is probably worse than FM and IM as the "burn out rate" is reportedly higher.

General Surgery has never been, and never will be, a lifestyle specialty. The residency may be longer than 5 years by the time you get there, and many many programs are over 80 hrs per week (remember thats an average). If lifestyle is a consideration for you, you HAVE to do a lifestyle specialty after general surgery which increases the length of your training.

IMHO, the easiest lifestyle is the one you enjoy the most. I worked less hours a week in my former job and when on IM as a student, but those days crawled by. So easy is relative.

 

[mercaptovizadeh]

I'll be honest - I have no idea what 90% of that means.

The FM residency doesn't sound too bad. I read (on this board) that it's 3yr and averages 60hr a week. Maybe it stinks at times, but when compared to a 5yr, 80hr week surgical residency its looks like gold.

The FM FAQs also hinted that if you did outpatient only FM it was very 8-5 and no call. And if you wanted you could throw in a few shifts on fast-track ER.

Here's something - I'm getting conflicting ideas/opinions (which I expected) about which one (FM, IM (hospitalist), or EM) makes for the easiest lifestyle.

FM is also such a broad specialty that it is really almost entirely primary care. You will find it hard to be an FM hospitalist or work in the ED. You just don't know enough internal medicine to be dealing with inpatients with complex issues, nor are your skills in dealing with a critical and rapidly-advancing situation anywhere near what an EM doc will have. There's a reason that only IM or peds can do their respective subspecialties (with the exception of CC, which GS, anesthesia, and EM can also do). FM can't do these subspecialties.

Just make sure you really really want to do primary care. Because if you suddenly start getting interested in scoping or cathing, you can't do it from FM.

If you want easiest lifestyle, do derm or rads or PMR.

 

[Khaos05]

I also have a feeling that my hospital (and probably my state in general) are very lax with FMs being in EM and IM. That doctor told you about just started as a hospitalist about a month ago. She graduated in 2006 and has already worked in 2 hospitals (also in AR) as an ER doc. That's not long ago.

I just want something that's exciting, has somewhat predictable hours, and has minimal call (some is fine, but i don't want to be called out every night, all night).

The hospitalists at my hospital have a pretty easy schedule. 1 week nights (7p-6a), 1 week off, 1 week day1 (6a-1p), 1 week off, 1 week day2 (1p-7p), repeat.

Don't know how the ER docs work at my hospital - maybe the same as most others?

FM docs I know - don't have a clue. Probably varies so much it's not even worth saying a "general" trend.

 

[mercaptovizadeh]

I also have a feeling that my hospital (and probably my state in general) are very lax with FMs being in EM and IM. That doctor told you about just started as a hospitalist about a month ago. She graduated in 2006 and has already worked in 2 hospitals (also in AR) as an ER doc. That's not long ago.

I just want something that's exciting, has somewhat predictable hours, and has minimal call (some is fine, but i don't want to be called out every night, all night).

Exciting is subjective.

Predictable hours only in a specialty with practically no emergencies, such as derm or PMR or rad onc or something like that, or shifts, such as hospitalist or ER.

Shifts will give you minimal call. I'm guessing rad onc, PMR, and derm have pretty light call.

General surgery or an intense subspecialty like cards or CC does not sound right for you at all.

 

[chartero]

Just make sure you really really want to do primary care. Because if you suddenly start getting interested in scoping or cathing, you can't do it from FM.

FPs and general internists absolutely can and do scope, especially in rural and underserved practices; opportunities depend on practice settings, but this as it is in anything. Organizations: The American Association for Primary Care Endoscopy is focused on GI endoscopy; the founding president is a former president of the AAFP and the AAFP Foundation. For colposcopy, the American Society for Colposcopy and Cervical Pathology offers membership and training to physicians across specialty with training in colposcopy, and they seem to have healthy representation from FM.

 

[Khaos05]

Exciting is subjective.

Predictable hours only in a specialty with practically no emergencies, such as derm or PMR or rad onc or something like that, or shifts, such as hospitalist or ER.

Shifts will give you minimal call. I'm guessing rad onc, PMR, and derm have pretty light call.

General surgery or an intense subspecialty like cards or CC does not sound right for you at all.

I very much appreciate the advice. I know i've still 2-3 yrs out of med school alone, but it helps calm my "nerves"

I'm just trying to find a way to achieve my dream of practicing medicine and enjoying it while being able to enjoy my wife and kids (future).

Soooo I'm thinking EM/IM(hospitalist)? 🙂

 

[Pinkertinkle]

I very much appreciate the advice. I know i've still 2-3 yrs out of med school alone, but it helps calm my "nerves"

Have u talked to anyone about your anxiety?

 

[Khaos05]

Have u talked to anyone about your anxiety?

joke? Hard to tell via text.

If not, I meant that more as the fact that I can just put my head down and go for it. Kind of gives me a sense of direction and a goal to get to👍

 

[Rendar5]

not sure it really is. you're spending a lot of time making a decision now that does not need to be made for 5-6 more years. It's like someone in 6th grade trying to figure out what college they want to apply to. One step at a time 🙂 Whatever you want out of life at this point is going to be possible and in 3 years you'll start having access to more of the information that you need to make this decision. It's ok to go into school with an eye towards something, but it's hard for you to really judge just what it is that you love about something until you're closer to it. I knew I wanted EM before starting med school, but I did have an open mind, and I didn't figure out just what it was that I liked about it until a couple years in.

 

[Khaos05]

well, I'm actually a very laid back person. I just wanted to ask a few questions and gain a little knowledge about different ones. Do I have to make a decision now? No. Should I? Probably not. Can I? Not at all.

I just want to have a clear heads up. I've definitely narrowed it down to 3-4 ones I'm really interested in, but I do plan on keeping an open mind during clerkships.

Thanks a ton for the advice everyone!