career choice

[Guest tubbbs]

anybody else like me feeling unsure about what specialty they want to go into?

 

i know for sure that i want to which lifestyle friendly specialty. there's no way that i want to sacrifice my family, cause i know that without a solid family, i'm not going to enjoy my career no matter what i'm doing. the problem is that there's still quite a selection of lifestyle friendly specialties we can choose from. which one would you go for?

 

family meds

emerg

internal subspecialties like rheum, oncology, endo, nephro

neurology

radiology

anaesthesiology

 

all of these can be pretty exciting and they're not super competitive.

[Guest tubbbs]

there's a lot of people interested in lifestyle friendly specialties, and still many more being attracted. why are you leaning towards that one particular area?

[Guest moo]

Radiology not competitive? That's news to me...

 

I am leaning toward either FP/EM (if I return to Canada) or anesthesiology. Like you, medicine is not my life, nor do I want it to be. I see a lot of my friends right now in their 20s enjoying life, while I am stuck in the hospital 80-90 hours a week, and I'm only finishing up my third year. I remember while on urology, my residents were staying until 9-10 routinely, and they'd start rounding at 6am. Not to mention that they had to be on call q4 too. (And these were sixth year residents.) I just can't see myself doing that... (and of course urology is supposed to be a "lifestyle" specialty too)

[Guest UWOMED2005]

Emerg is also pretty competitive.

 

And internal medicine subspecialties might not be supercompetitive in terms of getting into internal medicine, but many of the subspecialty fellowships are competitive.

[Guest wattyjl]

doesn't 'lifestyle-friendly' typically refer to post-residency? aren't most internal residents spending 80h /wk in the hospital?

[Guest moo]

Yes an internal medicine residency is tough. We used to have a q2 call schedule for residents here at Northwestern until the 80 hour work week came into effect. A Medicine residency is not benign. There are some good lifestyle subspecialties after like allergy, ID, GI, rheum, etc. But like UWO said it's pretty competitive and you'll have to be prepared to pretty much go anywhere if you want a spot. The competition never ends!

[Guest Valani9]

Anybody know what an internal residency schedule is like here in Canada (hours/week, etc)?

 

I've spent tons of time thinking about what I'm interested in, but I think I need to look more at the demands on lifestyle. I'm not willing to sacrifice the rest of my 20's just to be in internal or one of it's subspecialties.

 

It's hard to know where to draw the line, before it takes over your life. I know that, for me, an 80 hour work week will not be compatible with happiness.

[Guest cheech10]

Q4 call while on team medicine, variable while doing subspecialty months, often none.

[Guest Kirsteen]

Hi there,

 

I've just spent the last few days here in the UK, in Glasgow. During my time here my two cousins took me around the hospital in which they work (one is an orthopod, the other, a gyne oncologist). I was shocked to hear that they're mandated to work no more than 54 hours per week. Generally they start work at 8:30 and are out by 5:30. Quite the contrast to similar, average Canadian experiences.

 

Cheers,

Kirsteen

[Guest moo]

Yeah, but they get paid a lot less too.

[Guest Valani9]

Speaking of getting paid - I met a derm resident who's married to an ophth resident. I sometimes wish I liked those specialties enough to actually do them.

 

That said, I would also have to get into them, I suppose...

[Guest Kirsteen]

Hi there moo,

 

Yep, you're absolutely correct re: the lower pay. The public system is not fee for service--all the doctors seem to be on a pay scale that is created by the NHS. My cousin mentioned that the average public system specialist will take in around 120-200,000 pounds per year. If they also work in the private sector then they're looking at adding 50-100,000 pounds to their public system salary.

 

Cheers,

Kirsteen

[Guest moo]

Kirsteen,

 

Your friends probably have better lives than their counterparts in North America. I remember on my urology rotation, which is known as one of the more lifestyle friendly surgical specialties, my residents were working hard. They'd show up at 6am to round and frequently won't leave till 7 or 8, finishing up cases late. Of course they'd take call frequently as well, an average of q3-4. As an attending, your life gets better but not much better. If cases run late, they stay.

 

For me, I'd take the lower pay in return for lifestyle any day. Call me lazy, but medicine just doesn't get me excited enough to make me devote my life to it.

[Guest cheech10]

200,000 pounds per year isn't much less than specialists get here: medical specialties average 250 to 300k, surgical specialties are around 300 to 350k. There are exceptions, but on average, things look pretty even with the exchange.

[Guest tubbbs]

family docs actually can make pretty good money. you just have know how to bill better. most gp's don't bill to what they fully can and end up not being paid what they should have been. that's what makes it attractive: good money and good lifestyle. i know a family doc with no extra training who opened up a acne clinic. all he does is prescribe the same acne meds with the ocassional dry ice application. and let me tell you, he's definitely raking it in.

 

people in surgery bust their butts off, have their family and friends suffer, and only avg 250k, making just slightly more than gps.

 

some internal subspecialties make a good raking too. specialties like cardio, gastro, and resp have decent lifestyles and fatten their wallets more than most docs. of course these ones are little harder to get into.

 

radiologists probably have it the easiest though. man, they don't ever have to get off of their soft cushy chairs. when they do, it's to go home, go golfing, or head out hawaii for their 5th vacation of the year...not that they need it of course .

[Guest moo]

you're right about FPs. My mom does taxes for them, and she tells me some of em gross 400k. After office expenses and stuff, they're down to 200-250 but that's still a nice sum.

 

Of course, there's also the prestige factor. Some people really care about that and that's what drives them to surgery, derm, rads, etc. For me, I'll trade that and money in for a nice lifestyle anyday.

[Guest endingsoon]

some internal subspecialties make a good raking too. specialties like cardio, gastro, and resp have decent lifestyles and fatten their wallets more than most docs. of course these ones are little harder to get into.

 

First off all, I don't know anyone who calls cardiology a decent lifestyle. Its a lot of hours, a lot of sick people (ie - CCU) and about 7-8 yrs of training....and its more than a little harder to get into. Resp also covers the resp ICU, which is no picinic either.

 

If you just want to make money (like that acne person you describe) then go to law school. It seems like all you are interested in is a easy lifestyle and high pay....bet you did not stress that at your med school interview! j/k...

 

Anyways to the person that was asking about internal, its about 1in4 call when you are on team medicine. Someone above said that there was no call on certain subspecilities...which one exactly is that, b.c I would love to pencil that in for a few months? They all have call (usually home call for most, 1in3) and you have to do flyin call for team medicine. The consensus seems to be you avg. 1 in5 call in yr1. It is about 80-90hrs/week, and not many free weekends. Also, when you do IM call you are pretty much up the whole night...if not doing consults then covering the ward.

 

Think long and hard about IM being easy b.c you think stuff like endo and rheum look easy (which, btw do not pay more than most GPs).

[Guest cheech10]

Ok: home call for many subspecialties (rheum, endocrine, heme, ID, resp). And how often do they get called? Zero (or close enough). Except for cards, neuro, and the occasional GI call, the home call rotations are light