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Best specialty for lifestyle?


Orcamute

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Some people use ROAD - although I think that is a bit out of date in many ways :) Other fields like rad onc, nuc med, path, psych (and more) have really sweet lifestyles.

 

Agree with the above, plus rheumatology, geriatrics, PM&R, family (debatable, depending on your workload/patient population), med onc. Some consider Emerg to have a good lifestyle, not myself.

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Agree with the above, plus rheumatology, geriatrics, PM&R, family (debatable, depending on your workload/patient population), med onc. Some consider Emerg to have a good lifestyle, not myself.

 

Yeah I wouldn't :) - still some people swing it. There are those docs that solely do the night shift for the much higher pay. That means there are other docs potentially that can do mostly/entirely days. Plus they do have the amazing ability to vanish if desired for extended trips (if you have been working 10+ years having the option of taking a 3 month trip is quite impressive I think. The money situation is pretty solid so that could be pretty amazing.)

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Dunno if night shift pays that well. I know they get paid more per patient, but the volume really dies down towards the end. At my hospital, the cash-money shift is certainly the 3-11. With the 11-7 shift, by 4-5 AM you will usually have hardly anyone to see.

 

must depend on the centre - just did my emg at Ottawa and we were pretty busy all night just clearing the back log. Got all those drunk and drunk related stuff post 2am/bar close that overloaded us until the morning usually.

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I have heard of PEDRO = psych, emerg, derm, radiology, ophthalmology.

 

Anesthesiologists can only bill by time and will require an OR, even at a community hospital. It is somewhat enticing to do "a little bit" less than surgeons during surgeries. However, it is super stressful when things go wrong, simply because you usually don't get much time to find out what the problem is exactly or to fix it.

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I have heard of PEDRO = psych, emerg, derm, radiology, ophthalmology.

 

Anesthesiologists can only bill by time and will require an OR, even at a community hospital. It is somewhat enticing to do "a little bit" less than surgeons during surgeries. However, it is super stressful when things go wrong, simply because you usually don't get much time to find out what the problem is exactly or to fix it.

 

But you will also have clinics. You will be doing pre-anesthesia clinics, and you can also choose to do chronic pain.

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Please don't consider emerg to be a lifestyle specialty. It really isn't due to the shift work. Albeit shifts can have an advantage - I rarely have to drive in traffic (who's on the road at 2am!), the lines at the grocery store are pretty short at 11am, and chances are I'll be able to get to the bank or the dentist while they are open and I can pretty much always get a hair appointment on short notice.

 

But most of your shifts in emerg are going to be evenings and weekends. This may not bother you until you try and share your life with someone who works "normal" work hours. And while I don't have kids, I imagine adding them to the equation makes things that much harder. Have that 15h00 shift a couple of days in a row? Well, you're not going to see your kids for a couple of days.

 

Everyone in the world will expect you to conform to a regular schedule. On weekends and holidays when you have to work, people won't understand why you are not up for joining in their parties either before or after work, despite the fact that during the weekdays when you have your free time, those same people do not want to do things with you due to their work.

 

Forget signing up for any kind of regularly scheduled class.

 

And then there's vacation - for the rest of your working career, if you want to take time off to go away, you will need to stack your shifts or try and give them away to someone who will take on the extra work, because you will always be expected to work you allotted number of shifts.

 

And nevermind the havoc caused to your circadian rhythm.

 

All that being said, I think if things get unmanageable from a lifestyle perspective it is easier to work part-time in emerg than some specialties. And alot of emerg docs do tend to work part-time, at least later on.

 

Emerg certainly isn't a terrible lifestyle specialty. But at the same time it's hard to consider anything involving "shift work" to be lifestyle oriented, especially with all the literature that exists supporting how bad it is for your health.

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But most of your shifts in emerg are going to be evenings and weekends. This may not bother you until you try and share your life with someone who works "normal" work hours. And while I don't have kids, I imagine adding them to the equation makes things that much harder. Have that 15h00 shift a couple of days in a row? Well, you're not going to see your kids for a couple of days.

 

Everyone in the world will expect you to conform to a regular schedule. On weekends and holidays when you have to work, people won't understand why you are not up for joining in their parties either before or after work, despite the fact that during the weekdays when you have your free time, those same people do not want to do things with you due to their work.

Valid points, except a lot of other specialities work on weekends too, and have much longer hours AND call. I don't consider ER to be a lifestyle specialty like derm, psych and path, but I do consider it a good gig, especially when compared to any surgical specialty and a lot of internal medicine sub specs.

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Anesthesiologists can only bill by time and will require an OR, even at a community hospital. It is somewhat enticing to do "a little bit" less than surgeons during surgeries. However, it is super stressful when things go wrong, simply because you usually don't get much time to find out what the problem is exactly or to fix it.

 

Anesthesiologists are not doing "a little bit" less than surgeons in the OR. They're delivering lethal doses of anesthetics, opioids, and paralytics and keeping patients alive while surgeons cut out pieces of liver and bowel. They deal with such stressful situations via a 5-year residency with extensive simulation training.

 

The main lifestyle downsides concern a general lack of control over your own schedule and day, and the potential to be doing in-house call essentially forever, albeit at reasonable intervals.

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Is GI considered lifestyle specialty?

And I don't think ROAD was solely based on lifestyle. Isn't it based on lifestyle/income?

 

GI has great income but definitely not a lifestyle specialty. People with bleeding varices requiring intervention come in all hours of the day.

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Valid points, except a lot of other specialities work on weekends too, and have much longer hours AND call. I don't consider ER to be a lifestyle specialty like derm, psych and path, but I do consider it a good gig, especially when compared to any surgical specialty and a lot of internal medicine sub specs.

 

Emerg isn't terrible. It is manageable.

 

Call does not mess with your circadian rhythm as much as shifts. Crazy enough, I was not as tired on my rotations with call. And recently was discussing with an off-service resident rotating though emerg who felt the same.

 

And if you're staff on-call in an academic centre - you have your residents doing most of your work.

 

That being said there exists a small percentage of people who do well with shifts - I think the number is around 10% (if that's you, great!). There is another roughly 10% who absolutely can't do it. Everyone else just tolerates it. Trouble is, you won't know where you fall on this spectrum until you've done a few months of emerg and it all catches up to you. I think I'm not quite at the can't tolerate end of the spectrum, but fairly close. It took me about a year to realize it. I'm thinking as staff, once the added time demands of studying, research and half-days are gone, and given that full-time staff work fewer shifts than residents, things will be better though!

 

Not trying to discourage people from emerg. Just want to be upfront about some of the challenges, if someone is trying to choose a specialty for lifestyle. There are worse choices. But there are better ones.

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  • 2 weeks later...
How about rheum, rad and derm?

 

about what you probably already expect for most. Derm and Rheum are quite chill and depending on how you structure your rads career so can that (obviously interventional rads is more like surgery. There is call for rads but it is distributed. Private practice can be a bit more routine etc).

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  • 5 months later...
GI has great income but definitely not a lifestyle specialty. People with bleeding varices requiring intervention come in all hours of the day.

That and other truly hemodynamically unstable bleeds don't tend to happen very often though, at least in my experience. So they can often wait until the next AM.

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i should add that a lot of people don't think rads is a lifestyle specialty anymore and eventually will run with staff 24/7 with all imaging. Seems like the older approach of clinical stabilizing people until imaging can be done later is less of an option. People want even arguably (and we argue) imaging at all hours if for no other reason than to keep things moving. It is going to get messy :)

 

our program director thinks that is one of the reasons applications to rads are down over the past few years and may have longer term effects on the make up for radiology.

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Doesn't it just simply depend on your own preferences? Income and hours are obvious ways to evaluate a speciality's lifestyle, but some may need more than others. I know my cousin is in ophthalmology but he has said that it is because they grew up with lots of money and luxuries I can't even begin to imagine, and he'd like to (a) continue living that way and (B) want his children to live that way since it gave him enough opportunities in life to end up in ophtho. It may be a personal choice based on my interests in the field and my 'jack of all trades' mentality, but FM is more than enough for me. I like the social side of things, breadth of knowledge, know your patients (and their families) for years, and it is also a satisfying lifestyle of regular hours and if you do enough collab with other FMs, it's a comfortable time in the clinic...and I'm sure there is enough time for vacations and family time and what not. Growing up with minimal finances just lets me be fine with whichever path is interesting for me, and I don't feel pressured to maintain a lifestyle that I've grown up with, like my cousin.

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It may be a personal choice based on my interests in the field and my 'jack of all trades' mentality, but FM is more than enough for me. I like the social side of things, breadth of knowledge, know your patients (and their families) for years, and it is also a satisfying lifestyle of regular hours and if you do enough collab with other FMs, it's a comfortable time in the clinic...and I'm sure there is enough time for vacations and family time and what not. .

I like your thinking... Basically my attitude going in. We'll see what exposure to the"cool" specialties does to such a prejudice.

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I like your thinking... Basically my attitude going in. We'll see what exposure to the"cool" specialties does to such a prejudice.

 

Everyone has told me "when you get into med, you'll forget all about your family med excitement"...well maybe but nothing can even appeal to what I want to do except FM. Emerg is up there because I've worked with some ER docs who do research on the homelessness and drug abuse problems they encounter, or (even above FM), PHPM because they have everything I love about public health but as clinical rotations (eg. aboriginal, immigrant, inner city, multicultural, etc.) 

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a lot of people once they get in gain FM excitement when they see what everyone else is actually doing - there is a definite pull towads family when people see the lifestyle and long training time in other fields, plus the potentially repetition there the more you specialize.

 

Just think if I was in family medicine I would be out, living life as it were in 10 more months. I have another 5-7 years :) Some people just cannot deal with that kind of delay.

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  • 1 month later...

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