Clinic Im Specialties Vs. Fm

[TechToMD]

Trying to decide between doing a clinic IM specialty vs. clinic FM.

 

1) What IM specialties have a good lifestyle? I can think of rheum, endo, and allergy clinics but is there anything else? What would work hours be like?

 

2) How competitive is the job market like for something like rheum, endo or allergy? Can I get a job almost anywhere? Is it hard to get a job in a clinic inside the hospital? I would prefer to do that because the infrastructure is already taken care of and I wouldn't have to invest up front for starting up a private clinic.

 

3) What's the difference in pay like between the clinic IM specialties compared to FM? I've heard that Rheum and FM make almost the same amount if both are working 40 hours/week? Would FM come out ahead then, since the training only takes 2 years vs. 5 years?

 

If anyone has any insight or is in an FM or IM program, I would appreciate any advice. I have to decide relatively soon because I'm in a 3 year program and would like to start thinking about planning summer electives and research.

 

Thanks so much!

 

LC

 

[#YOLO]

do fm..profit

[Edict]

I think respirology is another clinic based specialty. Job market kind of varies, I heard a few years ago rheum became the hottest thing because there were jobs and great pay and i'm not sure if that is still a thing anymore. GIM right now is probably one of the more competitive specialties and that likely has something to do with the job market right now. 

 

Best decision is to just do what you like, the job market can vary. If you really want 100% job security then family is probably your best bet. 

[TechToMD]

Thanks for the replies so far. I didn't realize resp was also clinic based, just assumed it was similar to cardiology.

 

If I choose to do something like rheum, endo, or allergy, can I still practice GIM in a community centre if it's not in a popular area like Toronto? Or do I need the 4 or 5 year GIM?

[Rorzo]

Pretty much any IM specialty CAN be lifestyle, but it's a matter of how much income you'd be sacrificing. Cardio for example - there are people with outpatient a-fib clinics, but you can bet that the guys in the cath lab at 3am are making more money. As staff if you're not affiliated with a hospital, you can set your own work hours, you don't have to worry about what is typical.

 

You can open up a private clinic pretty much anywhere for most IM specialties and just let the local Family doctors know and you'll  get a practice pretty quickly. Jobs in hospital clinics are mostly academic positions, so harder to get, but not impossible. Community hospitals would be another story I'm not familiar with.

 

Pay is staff dependent again. Some FM work 2 days a week and make less than 100k, others run the ER, have a dozen inpatients, and do OB on top of their clinic and clear 400k. With rheum I've been with preceptors who left at 3 to pick up their kids and made similar to what you'd expect FM doing that to make, and I've seen practices with long hours focused on getting through patients billing $3500 a day. If you don't want to go rural I'd say on average the IM specialties pay more, but that average takes in to account individual priorities that may not apply to you - the nature of the job is going to matter so much more than whatever the difference in income would be that it's be best to just do what you want.

 

On CTU in an academic center our attendings were 50/50 GIM vs subspecialists like rheum/endo/nephro, I'm sure you'd be able to practice GIM in a community center if that's what you want to do. Of note though, some excellent physicians are unable to get jobs in academic centers with the 4 year GIM, if your goal is something like that I'd aim for the 5 year.

 

[LittleDaisy]

If one becomes an academic endo or rheumato, would it still be possible to do CTUs in GIM ?

I saw many subspecialists doing CTUS in Toronto, I don't know if it is common practice across the country? 

I wonder with the two year fellowship in GIM, if the academic General Internists staff would take more place in teaching CTUs, and take over the subspecialists in CTUS ?

It's a long road, but If I manage to get an academic position as an IM sub-specialist, I would love to teach CTUs once awhile, just love teaching medical students