Ranking ROAD

[Melisende]

I would think anesthesiology would allow you to use your knowledge about drugs and pharmacology.

[Satsuma]

yeah, anesthesiology is a good one for pharm...though your range of drugs is maybe a bit narrow. though you would have to know how other meds would interact with your anesthetic drugs etc.

 

ER could work too...especially given you can do a fellowship in toxicology.

[illa]

From a pre-med perspective, what about dermatology entices you?

 

I'm really interested in skin diseases and the such but I would also be happy doing cosmetic (eg. teen acne), with the cosmetics having great skin is such a confidence booster and even though it sounds corny I would be happy giving people that confidence. But i really got interested in dermatology when i got to see my aunt (who is a dermatologist) at work, it just seems like the perfect specialty for both my personality and my interests.

[ploughboy]

Is there any specialties where a pharmacy degree (and hospital residency) would come in handy?

 

Clin Pharm (accessible through internal or emergency medicine) or toxicology

[alphacow]

I think derm and optho salaries really need to be sliced in half... for optho their pay hasn't caught up with the fact that the procedures take an 8th of the time to do now... derm at a million plus... seriously that's pathetic when there are IM docs saving peoples lives at a third of the salary

 

For me Rads and Anes deserve their salaries, the knowledge-base in radiology is ridiculous.. tons of respect... Anes also has such a huge knowledge-base and potential for disaster with a dec call sched that they deserve it, imo

 

personally i think anesthesia seems the most exciting out of the bunch... i like the cerebral nature of rads, but i've seen them in their dark rooms all day and i couldn't do that

 

Personally though, i think I can handle the Porsche over a couple Lambo's, this is Canada after all...

 

 

If you think that's unfair, what about Orthodontists? Mine bills 4 million a year, 55% overhead. And he STRAIGHTENS TEETH. Plus he's never on call, works 35h/week. Training is pretty short too. I think he was accepted into dental school after 2 years undergrad, so 4 year dental school + 2 year Ortho residency = orthodontist at 26.

 

I think people who can match to ophto or derm residencies would have no problem getting into a ortho residency.

 

The only downside i can think of is that the ortho graduates with alot of debt and has to invest quite a bit of money to start his practice.

[future_doc]

hey guys, if you are against plagiarism, I encourage you to report the ^ above poster who is selling term papers.

[apache]

btw, when you get into medicine, save yourself the trouble of killing yourself to get into derm and do a fm residency and get a bunch of certifications in cosmetics, you can essentially do the same job... i know a gp in the suburbs that does all cosmetic work after he got fed up with geriatrics...

 

I'm really interested in skin diseases and the such but I would also be happy doing cosmetic (eg. teen acne), with the cosmetics having great skin is such a confidence booster and even though it sounds corny I would be happy giving people that confidence. But i really got interested in dermatology when i got to see my aunt (who is a dermatologist) at work, it just seems like the perfect specialty for both my personality and my interests.

[apache]

wow, i agree, that's a boatload of cash, didn't know they made that much!

 

If you think that's unfair, what about Orthodontists? Mine bills 4 million a year, 55% overhead. And he STRAIGHTENS TEETH. Plus he's never on call, works 35h/week. Training is pretty short too. I think he was accepted into dental school after 2 years undergrad, so 4 year dental school + 2 year Ortho residency = orthodontist at 26.

 

I think people who can match to ophto or derm residencies would have no problem getting into a ortho residency.

 

The only downside i can think of is that the ortho graduates with alot of debt and has to invest quite a bit of money to start his practice.

[Guest copacetic]

this is not surprising, its al out of pocket or through private insurance. it is highly unlikely that anybody making that much is simply working 35 hours a work.

[sgt.pepper]

this is not surprising, its al out of pocket or through private insurance. it is highly unlikely that anybody making that much is simply working 35 hours a work.

 

he def is over exaggerating. B/c orthodontics residency is longer than 2 years. and even with many associates you can't make 4million.

[hastin11]

he def is over exaggerating. B/c orthodontics residency is longer than 2 years. and even with many associates you can't make 4million.

 

Ya, and orthodontics is insanely competative--like worse than plastics in meds. There is 4 Ontario spots/year last year.

[thatonekid]

btw, when you get into medicine, save yourself the trouble of killing yourself to get into derm and do a fm residency and get a bunch of certifications in cosmetics, you can essentially do the same job... i know a gp in the suburbs that does all cosmetic work after he got fed up with geriatrics...

Way to bring this thread back from about 9 months ago. lol.

[degoo_]

As I didn't apply to any of them, but want practice making ranking lists so here goes:

 

Anesthesia- Great variety of practice (large cases, small cases, pain management). Lots of good hands-on work. If you really want to make coin, I think its here. Some anesthesiologists work for dentists etc and just put people under and bill the dentist etc tons...

Someone said there was a lack of respect for anesthesiologists- I disagree. Amongst physicians they are well respected, they serve a vital bridge between medicine and surgery, they have mastery over the autonomic nervous system (the power!) and amongst the public they are very well respected, considering the anesthesiologist is whom you see before going under. Still interesting at 50, as each case is unique. And you can check your portfolio while the pt is under (one doc who does a lot of cases I'm scrubbed on just describes how his portfolio is changing in real time, and keeps us up to date as to the news)

 

Radiology- Amazing knowledge base and the focus is all on pathophysiology and anatomy, less on medical management. The ability to do some IR work is great. The relationship between other MDs and rads though can be tenuous at times, especially when advocating for a patient you can't get in for a scan. I attended some lectures recently where rads was teaching IM how to "consult properly", in order to avoid disputes and waste time. Well respected as well. Ability to work from your iphone is amazing as well. Major downside is the office like job of sitting in a dark room, watching film after films etc- bleh. I imagine it gets pretty boring by 50, imo.

 

Ophtho- never had an interest in it, although when I need one I'll be glad someone took the time to specialize in it. The money is fantastic, but as others said, its pretty much only when you're established and get the OR time to do cataracts etc. Still interesting at 50 for sure.

 

Dermatology- Gained respect for this specialty throughout medical school. Originally though it was just for people that want to prescribe accutane in a nice office and bill tons. But they do great work, they're great physicians and interestingly, out of all the ROAD specialties, i think these guys are the happiest. Although, I would rank it last, even after path and lab medicine. Also would be stimulating and interesting at 50 imo.

 

So I'm AROD.

[Lactic Folly]

Hey degoo, you're perfectly entitled to your own opinion and it may be that you might find radiology boring. However, for any medical students who are still exploring specialties, I just wanted to add that radiology is one of the most rapidly changing and expanding fields, with new technologies and applications to diagnose and treat an increasingly vast array of conditions. There is continual learning - some older docs started training when CT was just in its infancy, and have learned MRI along the way. Each study poses a clinical problem that you can help solve, and the toughest diagnostic dilemmas in the hospital tend to find their way to the radiology department, which makes for rewarding clinical consultations. There is also more walking around than most people think - fluoroscopy, barium, injections, biopsies, scanning in ultrasound, talking to patients in mammo, and checking patients on the table in CT and MR can all be part of a non-interventional radiologist's work.

 

The issue of access to scans (primarily MR) is an important one that has its roots in broader societal factors, and it's unfortunate that this affects relationships between radiology and referring physicians, since communication and teamwork are vital to patient care. Given current resource constraints, for every patient that is moved to the front of the line, other patients (who may have been waiting a long time) are bumped, and it can be a challenge to triage appropriately. However, I think this is mainly an issue with MR and the months-long waiting times (with scanners running around the clock and outpatients given appointment times at 3 or 4 a.m.). CT appropriateness centres more around avoiding unnecessary radiation due to the increased risk of cancer. I don't know if any medical schools really discuss this in their curricula.

[A-Stark]

I don't think the appropriateness of testing is a topic that gets addressed directly, no. Having said that, I think there are a few simple questions that anyone requesting imaging should consider: 1) What do you expect to find? 2) How would the results of the scan change the management?

 

And, well, that radiologists do indeed walk around occasionally doesn't make it any more appealing to me. I'd say that interventional neuro offers a lot of interest, but that's a long road to end up in one particular subspecialty. I wouldn't necessarily be confident that some of the interventional work won't be taken up more and more by other specialists either. Consider the case of a patient that bleeds during an aneurysm coiling; IR does the coiling, neurosurg ends up providing the bed and ongoing care.

[Lactic Folly]

Neurosurgeons doing interventional neuroradiology is probably more a function of not enough interest from radiology residents. There was a thread a while back on the different paths to interventional neuroradiology - would you rather be a neurosurgeon, neurologist, or radiologist at heart?

[deeman101]

I'd go rads (interventional), anesth, none of the rest. I'd rather be fam doc than optho or derm . Or worse....surgeon. *shudders*

 

 

 

 

Random sidenote: I did that thing today on AMCAS which lets you match your interests with specialties and came up with: IM, EM, physical med, rads. ROADs ain't looking too hot for me.

[tooty]

R>>>>>>>O>A>>>D imo

[leviathan]

btw, when you get into medicine, save yourself the trouble of killing yourself to get into derm and do a fm residency and get a bunch of certifications in cosmetics, you can essentially do the same job... i know a gp in the suburbs that does all cosmetic work after he got fed up with geriatrics...

 

That's assuming you're just in it for the boutique medicine and the money. I'm hoping at least some people out there actually want to do derm for the interesting pathology. Hoping...

[degoo_]

Well said. And you're right, the times when I've had issues with rads has been on very difficult diagnostic challenges or the need for urgent imaging. They are a helpful service, I just can't see myself doing it.

 

Hey degoo, you're perfectly entitled to your own opinion and it may be that you might find radiology boring. However, for any medical students who are still exploring specialties, I just wanted to add that radiology is one of the most rapidly changing and expanding fields, with new technologies and applications to diagnose and treat an increasingly vast array of conditions. There is continual learning - some older docs started training when CT was just in its infancy, and have learned MRI along the way. Each study poses a clinical problem that you can help solve, and the toughest diagnostic dilemmas in the hospital tend to find their way to the radiology department, which makes for rewarding clinical consultations. There is also more walking around than most people think - fluoroscopy, barium, injections, biopsies, scanning in ultrasound, talking to patients in mammo, and checking patients on the table in CT and MR can all be part of a non-interventional radiologist's work.

 

The issue of access to scans (primarily MR) is an important one that has its roots in broader societal factors, and it's unfortunate that this affects relationships between radiology and referring physicians, since communication and teamwork are vital to patient care. Given current resource constraints, for every patient that is moved to the front of the line, other patients (who may have been waiting a long time) are bumped, and it can be a challenge to triage appropriately. However, I think this is mainly an issue with MR and the months-long waiting times (with scanners running around the clock and outpatients given appointment times at 3 or 4 a.m.). CT appropriateness centres more around avoiding unnecessary radiation due to the increased risk of cancer. I don't know if any medical schools really discuss this in their curricula.

[deeman101]

You know whats interesting? O, A, and D have few spots in Canada. Like 20 to 50 or something like that. Rads actually has A LOT of spots! Definitely over a hundred. It has more spots than some of the less competitive specialties. I guess that speaks to how many applicants Rads programs see.

[Lactic Folly]

According to the CaRMS program directory, there are 89 Canadian spots in radiology this year. However, only 68 are English-speaking.

[Ian Wong]

One thing to mention is that the practice of these specialties can vary widely depending on your location.

 

I've noticed a lot more comraderie between radiologists and clinicians at the community hospitals where I've worked. At least some of this is due to the fact that being on the each other's good side is mutually beneficial. The radiologists get more studies (and hopefully appropriate studies to read), the clinicians get answers to their questions, and the patients get the correct diagnosis and treatment.

 

At the academic centers, there tends to be more ego at work, simply because you have high-profile people involved, and everyone wants to be right. Also, clinicians at these academic centers tend to be much more sub-specialized, and confident in their belief that they can interpret their imaging without radiology input. The more generalist the clinicians are, as tends to be the case at community hospitals, the more likely a radiologist can offer a lot to guide a workup.

 

In private practice, everyone (radiologists and clinicians alike) is working towards the same common goals: do well by your patient, get out at a reasonable hour, and make enough money to meet your goals. Being a jerk to the clinicians doesn't help with any of these three objectives. Similarly, clinicians who are known to be abrasive, rude, and irritating tend to have a tougher time getting their work done, because no one is going to go out of his/her way to help them.

 

Bottom line, don't judge a specialty completely by how it functions in your local academic center. If you can, try shadowing clinicians other environments. I say this because I'm thoroughly convinced that radiology is a fantastic specialty. If your personality fits with this field, there's probably nothing that it can't offer.

 

Ian

[tooty]

I'm hearing more and more of how much rads residents are expected to study with their free time. How many hours per week are we talking about here? Can they have a life during residency?

[Lactic Folly]

It's a bit like asking how much one should study during undergrad or medical school - in the end it comes down to how much you know and what you can do, rather than the hours spent. There is ongoing evaluation (by yourself and others) every time you review a case with staff or take a case at rounds, and I think you will know if you are performing adequately for your level or if you need to step it up. When at work, reading around studies, taking cases at rounds, paying attention during lecture, and performing studies on call all contribute to your learning in addition to your home reading. That being said, residents in every field have to study, not only to pass their exams, but to be competent and safe. Though radiology will occupy a major part of your time, people do fit in other things that are important to them, including having children during residency (don't ask me how they do it though). Generally, I think if you keep a regular study schedule and stick to it, you should be fine (that being said.. I have yet to enter exam prep mode!). As for PGY-1, I had quite a bit of free time during that year, being off-service the whole time.