IM subspecialties

[DeeplySuperficial]

Hey everyone, confused pre-clerk here trying to narrow down my residency choices. I really like IM and some of its sub-specialties, specifically - GI, Endocrinology, Geriatrics, Hematology, ID and Nephro. Due to family reasons I need to stay in the Greater Toronto Area. Does anyone know what the job market is like for the stated sub-specialties in a hospital setting? Also are extra fellowships/masters needed for community hospital jobs in these sub-specialties?

I could really use people's advice. Thanks in advance.

[Bluberblubo]

As an IM resident my understanding is:

GI - really bad 

Endocrinology - Good if you set up your own office 

Geriatrics - Good if you set up your own office  

Hematology - somewhere in the middle

ID - somewhere in the middle

Nephro - absolute shit

I'll add GIM - Really fucking good

[Vivieeeeeee]

17 minutes ago, skyuppercutt said:

As an IM resident my understanding is:

GI - really bad 

Endocrinology - Good if you set up your own office 

Geriatrics - Good if you set up your own office  

Hematology - somewhere in the middle

ID - somewhere in the middle

Nephro - absolute shit

I'll add GIM - Really fucking good

Thank you! Any input on cardiology?

[Bluberblubo]

1 minute ago, Vivieeeeeee said:

Thank you! Any input on cardiology?

If you want to set up an outpatient office, for sure you'll be good. General cardiology you won't have trouble finding a job, especially in the community, but the volume is lower. 

If you want to do other stuff like caths or EP, the job market is a bit tighter at the moment. I think doing echos or cardiac imaging is still okay. Keep in mind that cardiology is a 3 year fellowship (6 years in total including the 3 years of IM that you do first). Also fellowships like cath, EP, cardiac imaging are an additional 2 years on top of that (cardiac imaging may also just be 1 additional year if you want to focus on echos, although I may be wrong about that. That's what the cardio fellow told me when I spoke to him about it when I was on call. 

As a side note, welcome to medical school at western! If you want to do some shadowing in internal, reach out to your IM mentorship group or something. I've had a couple of your upper year classmates do observerships with me and I may be your senior at some point during your training 

[Vivieeeeeee]

Just now, skyuppercutt said:

If you want to set up an outpatient office, for sure you'll be good. General cardiology you won't have trouble finding a job, especially in the community, but the volume is lower. 

If you want to do other stuff like caths or EP, the job market is a bit tighter at the moment. I think doing echos or cardiac imaging is still okay. Keep in mind that cardiology is a 3 year fellowship (6 years in total including the 3 years of IM that you do first). Also fellowships like cath, EP, cardiac imaging are an additional 2 years on top of that (cardiac imaging may also just be 1 additional year if you want to focus on echos, although I may be wrong about that. That's what the cardio fellow told me when I spoke to him about it when I was on call. 

As a side note, welcome to medical school at western! If you want to do some shadowing in internal, reach out to your IM mentorship group or something. I've had a couple of your upper year classmates do observerships with me and I may be your senior at some point during your training 

Aha thank you!! Will keep an eye out for IM interest group emails  

[DeeplySuperficial]

8 minutes ago, skyuppercutt said:

If you want to set up an outpatient office, for sure you'll be good. General cardiology you won't have trouble finding a job, especially in the community, but the volume is lower. 

If you want to do other stuff like caths or EP, the job market is a bit tighter at the moment. I think doing echos or cardiac imaging is still okay. Keep in mind that cardiology is a 3 year fellowship (6 years in total including the 3 years of IM that you do first). Also fellowships like cath, EP, cardiac imaging are an additional 2 years on top of that (cardiac imaging may also just be 1 additional year if you want to focus on echos, although I may be wrong about that. That's what the cardio fellow told me when I spoke to him about it when I was on call. 

As a side note, welcome to medical school at western! If you want to do some shadowing in internal, reach out to your IM mentorship group or something. I've had a couple of your upper year classmates do observerships with me and I may be your senior at some point during your training 

Thanks for your input @skyuppercutt.  Sorry if this seems like a stupid question. If a Cardiologist sets up an outpatient office practice or joins a outpatient group practice can he/she decide how many hours to work per week. I like cardiology as well but my understanding is that they work upwards of 60hrs/wk which is scary. 

[BernieMac]

On 9/16/2019 at 6:59 PM, DeeplySuperficial said:

Thanks for your input @skyuppercutt.  Sorry if this seems like a stupid question. If a Cardiologist sets up an outpatient office practice or joins a outpatient group practice can he/she decide how many hours to work per week. I like cardiology as well but my understanding is that they work upwards of 60hrs/wk which is scary. 

-

[JohnGrisham]

27 minutes ago, YesIcan55 said:

Cardiologists work more than 60hr a week lol, its also one of the hardest subspecialties life-wise and that is after 3 years of IM which on its own very tough....if you are even considering lifestyle don't think about cardiology..

Regional variation and depends on practice style. Two of the cardios ive worked with definitely dont do 60+ a week consistently, and are mid-career. 

[LittleDaisy]

2 hours ago, JohnGrisham said:

Regional variation and depends on practice style. Two of the cardios ive worked with definitely dont do 60+ a week consistently, and are mid-career. 

The cardiology residency is very tough and involves long hours. I know a few cardiology residents who do GIM locum night shifts on top of being the senior at CCU unit. You have to be highly motivated, okay to sacrifice your personal lives and extremely hard-working and able to multi-task, it takes a group of talented and extremely type A ++++ personality. 

The job market nowadays is saturated. To work in a community hospital, most of the cardio fellows are looking for at least 1-2 years of fellowships. Their residency is a one long interview; and quite often, a few leaves for the States, as the job market is not that great for intervention cardiology. 

If you are talking about mostly outpatient work, I think that most of the people who want to be cardiologists, can't imagine themselves seeing mostly bread and butter of heart failure, HTN without any sort of hand-on intervention; it's not what attract them to this field in the first place. Just my two cents

[JohnGrisham]

32 minutes ago, LittleDaisy said:

The cardiology residency is very tough and involves long hours. I know a few cardiology residents who do GIM locum night shifts on top of being the senior at CCU unit. You have to be highly motivated, okay to sacrifice your personal lives and extremely hard-working and able to multi-task, it takes a group of talented and extremely type A ++++ personality. 

The job market nowadays is saturated. To work in a community hospital, most of the cardio fellows are looking for at least 1-2 years of fellowships. Their residency is a one long interview; and quite often, a few leaves for the States, as the job market is not that great for intervention cardiology. 

If you are talking about mostly outpatient work, I think that most of the people who want to be cardiologists, can't imagine themselves seeing mostly bread and butter of heart failure, HTN without any sort of hand-on intervention; it's not what attract them to this field in the first place. Just my two cents

Definitely, for sure, just stating my minimal experience with primarily outpatient cardiologists who seem otherwise happy and very well remunerated.