Is a Poor Job Market a Good Reason to Not Pursue a Specialty?

[Turk]

Hi guys, 

This post is related to one of my previous posts, regarding the poor job market in GI. I was planning on not pursuing GI anymore due to the poor job prospects. However, many people in GI have told me that I shouldn't forgo GI just because of a bad job market. My reasoning in no longer applying to GI was that in other specialties with poor job markets in the past (such as ortho), there wasn't really any improvement in job prospects, and for example in ortho, many orthograds continue to remain underemployed.

 

I was just wondering everyone's thoughts were on not pursuing a specialty just because of the job market. And if you think the GI job market will improve significantly (i.e. with the possibility of privatization of health care in Ontario)  

[bearded frog]

Job market is certainly a factor to take into consideration, but shouldn't be the only thing. It will almost certainly be different in 10-20 years and who knows if for better or for worse. If you can't see yourself doing anything else, you probably should not weigh it highly in your career decision. If you are split between GI and something like psych and you have to work in the GTA for other reasons, then it may be the thing that makes the decision for you.

[jb24]

I might be wrong, but in IM you can probably still do CTU/MTU even as GI, so the jobs prospects are probably better than say.. ortho 

 

[Turk]

9 minutes ago, jb24 said:

I might be wrong, but in IM you can probably still do CTU/MTU even as GI, so the jobs prospects are probably better than say.. ortho 

 

Yeah, I was thinking about that. But my only concern doing that is losing my scoping skills if I were to do predominantly CTU while waiting for a GI job to open up in the GTA

[rmorelan]

11 hours ago, Turk said:

Yeah, I was thinking about that. But my only concern doing that is losing my scoping skills if I were to do predominantly CTU while waiting for a GI job to open up in the GTA

Did they give you any idea of how sluggish the GI market will be and for how long? It is a hard question possibly but probably important to get a sense.

One of the problems with the surgical specialities is there is zero incentive it seems to stop putting out residents/fellows even with a bad market - academic surgical programs implode without resident/fellow support and they don't seem to ever adjust things regardless. Other fields do seem to reduce supply in the face of no demand (rad onc for instance did that). Where does GI sit in the mix on that? 

 

 

[Edict]

22 hours ago, Turk said:

Hi guys, 

This post is related to one of my previous posts, regarding the poor job market in GI. I was planning on not pursuing GI anymore due to the poor job prospects. However, many people in GI have told me that I shouldn't forgo GI just because of a bad job market. My reasoning in no longer applying to GI was that in other specialties with poor job markets in the past (such as ortho), there wasn't really any improvement in job prospects, and for example in ortho, many orthograds continue to remain underemployed.

 

I was just wondering everyone's thoughts were on not pursuing a specialty just because of the job market. And if you think the GI job market will improve significantly (i.e. with the possibility of privatization of health care in Ontario)  

I think you just need to be upfront with what you mean by a bad job market. If a good job market means being able to get a GTA community scoping GI job with relative ease or a GTA academic GI job with one advanced endo fellowship and solid academic credentials, then I would agree with your assessment. A lot of these specialties like GI, ortho etc. will likely always have a tight job supply in competitive locations. However, if you are flexible with moving to the US or non-GTA, then the job market for these specialties likely is not as bad and even if bad now, could easily improve by the time you graduate. 

The other aspect I would consider is how passionate you are about the field. If you are passionate about it, or passionate about medicine in general, I find you will do fine. In the end, someone lands the job even in a bad job market and it could be you. 

[blah1234]

It can be hard to predict how job markets in specialties will develop exactly over that 5-6 year time frame. I think doing something you'll enjoy is an important consideration though as I have friends that chose specialties that they ended up not being as passionate about and I think their days feel a lot longer than they should. Luckily, I think most students have a couple of fields they would likely be happy in.

Additionally, I would say if you're interested in GI you still have some time to think about it and gather information during your IM training. Often times what you might enjoy as a clerk you might not enjoy as a resident or staff. It's sometimes funny to compare what you thought you wanted in medical school vs. down the line (one of my preceptors entered medical school wanting to be a psychiatrist and fell in love with gen surg).

I also caution students that people's life goals and priorities often change down the line. It is easy to make career goals while you are in the "student" phase of your life. As random things come up (e.g., dating, children, illness, family, etc.) the job of medicine may not be the only thing you want to worry about. This often creates geographic inflexibility which can make things tough. However, for people that are truly flexible with their job setup and location things generally aren't that bad. I just find that people overestimate their flexibility in their youth before other life issues come up.

[ACHQ]

I agree with most of what has been said already, and alot of this will depend on your personally. I will add a few thoughts and comments:

- The GI market is really tough in the GTHA, there are tons of grads out there to fill positions and limited endo time (which is what you want). Most GI's are young-ish, meaning the market I suspect will remain tight for the foreseeable future.

- The ?"good" thing about GI is that yes you can do GIM, and do some GI call for places that need you to fill in for vacations/holidays/mat leaves etc... You might be working alot of weekends/holidays/nights but at least you can pay your bills (easily)

- If you want to keep up your scoping skills you can try to see if there are outpatient endoscopy clinics needing any GI's. You'll have a crazy overhead (30-50%), but at least you can keep those skills up while waiting for a job to open up.

 

Ultimately you have to do some of your own soul searching.

You have to decide what you would be happier with: to be in GI ANYWHERE (in Canada or the U.S.)? vs [insert specialty/subspecialty with good job prospects right now here] in the GTA?

The chances of you having your dream specialty and location with a permanent full time job in a market/specialty which is super tight is probably around 1% or less (not impossible but probably really hard).

Are you willing to do 1-2 extra fellowships, locums, GIM call, academic training/masters/PhD etc... until a job opens up (which could take *several* years...) or would you be equally as happy in another specialty without that extra baggage and being able to practice in your ideal location? Or are you so into GI that you are willing to travel anywhere in the country and live anywhere as long as you get to practise that specialty to its full potential/scope (pun intended)?

Only you can really answer those questions. Answering them might help lean you towards going for GI or not.

[kitchenlover]

How are we defining poor job market here for GI? Like if you can’t work in the GTA, that sucks because of family and friends but it isn’t the worst thing. Even in the US, you sometimes can’t work in the city you want. Personally, I wouldn’t mind being unable to work in the GTA. But I understand that many people’s circumstances are different.
 

If you can’t work in any urban area (not even London or Edmonton), that’s on a whole other level! 

[Turk]

On 3/13/2023 at 5:43 AM, rmorelan said:

Did they give you any idea of how sluggish the GI market will be and for how long? It is a hard question possibly but probably important to get a sense.

One of the problems with the surgical specialities is there is zero incentive it seems to stop putting out residents/fellows even with a bad market - academic surgical programs implode without resident/fellow support and they don't seem to ever adjust things regardless. Other fields do seem to reduce supply in the face of no demand (rad onc for instance did that). Where does GI sit in the mix on that? 

 

 

No one told me anything for certain, but it sounded like it would be sluggish for at least the next 5-10 years based on what I've been hearing :/ And I haven't seen any decrease in GI spots recently. If anything, I've seen program adding spots haha

[Turk]

On 3/13/2023 at 3:11 PM, ACHQ said:

I agree with most of what has been said already, and alot of this will depend on your personally. I will add a few thoughts and comments:

- The GI market is really tough in the GTHA, there are tons of grads out there to fill positions and limited endo time (which is what you want). Most GI's are young-ish, meaning the market I suspect will remain tight for the foreseeable future.

- The ?"good" thing about GI is that yes you can do GIM, and do some GI call for places that need you to fill in for vacations/holidays/mat leaves etc... You might be working alot of weekends/holidays/nights but at least you can pay your bills (easily)

- If you want to keep up your scoping skills you can try to see if there are outpatient endoscopy clinics needing any GI's. You'll have a crazy overhead (30-50%), but at least you can keep those skills up while waiting for a job to open up.

 

Ultimately you have to do some of your own soul searching.

You have to decide what you would be happier with: to be in GI ANYWHERE (in Canada or the U.S.)? vs [insert specialty/subspecialty with good job prospects right now here] in the GTA?

The chances of you having your dream specialty and location with a permanent full time job in a market/specialty which is super tight is probably around 1% or less (not impossible but probably really hard).

Are you willing to do 1-2 extra fellowships, locums, GIM call, academic training/masters/PhD etc... until a job opens up (which could take *several* years...) or would you be equally as happy in another specialty without that extra baggage and being able to practice in your ideal location? Or are you so into GI that you are willing to travel anywhere in the country and live anywhere as long as you get to practise that specialty to its full potential/scope (pun intended)?

Only you can really answer those questions. Answering them might help lean you towards going for GI or not.

Thanks for the reply. In terms of doing GIM and picking up GI call as needed, do you know if the places you could pick up GI call are generally near the GTA (or are they in more remote areas generally)?

And I feel like I would be fine working an hour or so from the GTA if needed. Do you think that would make any difference in job prospects?

[Turk]

On 3/13/2023 at 4:58 PM, kitchenlover said:

How are we defining poor job market here for GI? Like if you can’t work in the GTA, that sucks because of family and friends but it isn’t the worst thing. Even in the US, you sometimes can’t work in the city you want. Personally, I wouldn’t mind being unable to work in the GTA. But I understand that many people’s circumstances are different.
 

If you can’t work in any urban area (not even London or Edmonton), that’s on a whole other level! 

For me, I think I'd be fine working outside of the GTA as long as it is within an hour from the GTA (commuting distance).

[ACHQ]

On 3/19/2023 at 9:03 AM, Turk said:

For me, I think I'd be fine working outside of the GTA as long as it is within an hour from the GTA (commuting distance).

the GTHA is MASSIVE, when I refer to it I mean from Oshawa to Hamilton in the east-west direction, and as North as Newmarket.

If you mean you are willing to commute anywhere within an hour of a such as a massive area as described above you are basically referring to most of southern Ontario, but if you are referring to Toronto proper, then 1 hour would likely get you only somewhere else within the GTHA hahahahaha. Also you say commuting 1 hour from the GTA, realize (and I speak as a staff that commutes) sometimes a place "1 hour from the GTA" is more like 2-3 hours in traffic. I used to commute from one end of the GTA (east) to the northwest. off hours it would be 40 min. With traffic it was 90 min....and when you add in snow well good luck!

On 3/19/2023 at 9:02 AM, Turk said:

Thanks for the reply. In terms of doing GIM and picking up GI call as needed, do you know if the places you could pick up GI call are generally near the GTA (or are they in more remote areas generally)?

And I feel like I would be fine working an hour or so from the GTA if needed. Do you think that would make any difference in job prospects?

I can't comment fully on how good the locum GI market is... I know at my centre we don't have locums anymore (we had one covering mat leave a year ago). Each centre is different. You will only know once you are out there.

[bearded frog]

6 hours ago, ACHQ said:

1 hour would likely get you only somewhere else within the GTHA

I was going to say this... here is 1 hour drive time from Queen's Park... you don't even leave the GTA