CO2 specialties

[brooksbane]

............

[Med0123]

oh dear lord.

[justletmein]

brooksbane dont you have better things to do than trash family medicine?

time to find a new hobby.

[NLengr]

brooksbane dont you have better things to do than trash family medicine?

time to find a new hobby.

 

His points are pretty accurate though.

[holiday1001]

i'm not quire sure I understand why you're calling it CO2.. because we produced CO2?

[rmorelan]

Everyone knows about ROAD (radiology, ophthalmology, anesthesia, and dermatology) and how highly-coveted they are. "The ROAD to happiness" is often said. Very competitve. Many try. Many fail.

 

But what about the other side of the coin? What are the specialties where the only requirement for entry is CO2 production.

 

What are the CO2 specialties?

 

And more importantly, why?

 

I'll start:

 

Family medicine: way more spots than applicants, and due to the not-so-hidden curriculum, its not very popular with students. Perceived income disparities, perceived lack of intellectual rigor, varying standards of practice due to sheer numbers, the name is lame.

 

I am not sure you can say it isn't very popular with students - By definition it is actually the MOST popular speciality I think.

 

35-45% of my class will chose family medicine and that is similar to other schools. They are vast majority certainly not all failing to get their first choice and getting their "backup" - we track that sort of thing. For lifestyle reasons a big group of students simply want FM. Shorter residency, better hours, a pay that now is very close to internal without the pain in the ass factors, every weekend off if you want, flexibility beyond anything else, and recently a huge upwelling in public support? It may be easy to get a family medicine spot somewhere, but in many major centres (anything in TO for instance) it is an uphill battle.

 

Honestly many of our BEST students - including some of the smartest people I have ever meet - people with phds - are picking family medicine. These are people that could reach out and get whatever speciality the want.

 

On the flip side while thousands try for Family medicine for Rads there is just over a hundred who attempt it. How are you defining popular?

[rmorelan]

Because the only requirement for entry is that you produce CO2. It's a smart-ass way of saying being alive is the only prerequisite.

 

well by that standard I guess internal medicine is almost on the same playing field as family medicine. If you show any interest and don't completely mess up somewhere the odds are outstanding you will get in somewhere.

[rmorelan]

I'm not saying they're bad fields or whatever.

 

I'm saying the barrier of entry is lower.

 

Sure, getting a spot in FM in Toronto is tough. But then again, getting any spot in anything in Toronto is tough.

 

THe fact is if you apply to a CO2 specialty, you'll get it provided you apply widely since there are generally more spots than applicants. The same cannot be said for ROAD.

 

Sure - I was primarily focussing on your point of popularity I guess. Family medicine may have drawbacks (well of course it does - so does everything) but popularity remains high.

 

A lot of things are much more competitive than ROAD as well - many fields in surgery for instance

[tooty]

med0123 and i made some charts to compare spots vs. first-rankers for every specialty.

 

isn't that all you need to know?

[Gametime24]

med0123 and i made some charts to compare spots vs. first-rankers for every specialty.

 

isn't that all you need to know?

 

As did I, between us we have 5 years of data on it. Should pretty much finish the thread. Someone can dig it up maybe? Or maybe I will if I stop being lazy haha

[NLengr]

Psych would be in there too. Poorly defined conditions, no real standardized approach, no immediate solutions, difficult patients and lack of procedures knock it down the popularity ladder. Can be very frustrating for someone who likes well defined things (like most medical students).

[Gametime24]

Looks like we have our second listed CO2 specialty! IM!

 

So far we have:

 

FM: as per the first post

 

IM: spots are more numerous than applicants(though this may change), perception of endless rounding and mundane medical problems mostly related to lifestyle, more like social work than medicine, people don't want to have to subspecialize again

 

psych: for the reasons above stated by NLengr

 

path(this is for thebouque): dead people, invisible, perceived to be poorly paid commensurate to their training in most provinces, perceived to be the field for people with no social or clinical skills, dislike of microscopes, dislike of histology, no idea what they do.

 

and maybe even rad onc: zero medical school exposure, no idea what they do, perceived job market difficulties

 

 

 

Any others?

 

This list is meant to give a good idea as to what fields are more safe to use as backups than others, given their spots to applicants ratios is skewed in the applicants' favor.

 

We could also use the list to maybe discuss misconceptions about these fields and why they are so pervasive.

 

I'd be interested in this, as a 4th year UG, carms is still a long way away for me, but I'm always interested, particularly in rad onc because it's something that I think is super interesting but haven't looked at in too much depth yet. Why is it that so many people are saying it's super saturated atm? Is this true? Or only true in urban centres? etc.

[japlanet]

Medical Biochemistry (my program) - it's actually an amazing specialty, lots of jobs, salary far above average IM/path, no weekends, no call, academically interesting, lots of chance for research/teaching/clinical work.

 

No one has ever heard of it. I was the only applicant to my program last year. I'm not sure that CO2 production is the only pre-req but if you are genuinely interested and alive you'd get a spot.

[Gametime24]

Medical Biochemistry (my program) - it's actually an amazing specialty, lots of jobs, salary far above average IM/path, no weekends, no call, academically interesting, lots of chance for research/teaching/clinical work.

 

No one has ever heard of it. I was the only applicant to my program last year. I'm not sure that CO2 production is the only pre-req but if you are genuinely interested and alive you'd get a spot.

 

Any reason you can think of why it's not popular? What kind of hours are you working from mon-fri? Considering the no call and no weekends, that sounds awesome for lifestyle. I'm also interested in teaching to some degree. I'll be looking more into this now! Also, you mention "far above average IM/path". I'm not too knowledgeable about med salaries, what range would this fall in from a numbers perspective? Are you working in a hospital? (ie no overhead)

 

EDIT: My UG degree is in chemistry and I've really enjoyed the 2000-4000 level biochemistry courses, so I think this might be a great, *hidden* speciality for someone with my interests!

[NLengr]

Medical Biochemistry (my program) - it's actually an amazing specialty, lots of jobs, salary far above average IM/path, no weekends, no call, academically interesting, lots of chance for research/teaching/clinical work.

 

No one has ever heard of it. I was the only applicant to my program last year. I'm not sure that CO2 production is the only pre-req but if you are genuinely interested and alive you'd get a spot.

 

Medical microbiology is similar too.

[ellorie]

What exactly do medical microbiologists and medical biochemists do clinically? I've wondered about this for a while.

[japlanet]

Any reason you can think of why it's not popular? What kind of hours are you working from mon-fri? Considering the no call and no weekends, that sounds awesome for lifestyle. I'm also interested in teaching to some degree. I'll be looking more into this now! Also, you mention "far above average IM/path". I'm not too knowledgeable about med salaries, what range would this fall in from a numbers perspective? Are you working in a hospital? (ie no overhead)

 

EDIT: My UG degree is in chemistry and I've really enjoyed the 2000-4000 level biochemistry courses, so I think this might be a great, *hidden* speciality for someone with my interests!

 

Well the med biochemists at my centre are paid salary and benefits from the hospital and are thus on the Ontario "Sunshine List" - their salaries are in the 300-400k range, not including the billings they do for any patients they see in clinic.

 

Why is it not popular? Zero exposure, pure and simple, I think. 99% of people (i.e. residents) I talk to didn't even know it was an option. 80-90% of staff people don't even know it is a specialty.

 

Hours Mon-Fri are the usual, 8-4/9-5 sort of thing. There's a decent amount of admin/grunt type work but all the medical biochemists I know have clinic at least 1-2 half days a week as well. Call is home call and is 2 weeks at a time, basically you get call if a clinician wants a difficult/costly/slow test to be done urgently overnight for some reason. Often you say no. If you say yes then you have to organize the sample transport, call the techs in, etc.

 

The clinical areas of practice are very variable/flexible and basically each biochemist has a specialty area of practice related to their research and/or the clinical lab which they administer. Ex. Diabetes, CV risk prevention, lipid clinic, metabolic genetics/inborn errors of metabolism, bariatrics, Ca/bone disorders - often they work side-by-side IM subspecialists.

[Gametime24]

Well the med biochemists at my centre are paid salary and benefits from the hospital and are thus on the Ontario "Sunshine List" - their salaries are in the 300-400k range, not including the billings they do for any patients they see in clinic.

 

I'm assuming there is no overhead to take off of that 300-400k range?

 

Why is it not popular? Zero exposure, pure and simple, I think. 99% of people (i.e. residents) I talk to didn't even know it was an option. 80-90% of staff people don't even know it is a specialty.

 

Hours Mon-Fri are the usual, 8-4/9-5 sort of thing. There's a decent amount of admin/grunt type work but all the medical biochemists I know have clinic at least 1-2 half days a week as well. Call is home call and is 2 weeks at a time, basically you get call if a clinician wants a difficult/costly/slow test to be done urgently overnight for some reason. Often you say no. If you say yes then you have to organize the sample transport, call the techs in, etc.

 

The clinical areas of practice are very variable/flexible and basically each biochemist has a specialty area of practice related to their research and/or the clinical lab which they administer. Ex. Diabetes, CV risk prevention, lipid clinic, metabolic genetics/inborn errors of metabolism, bariatrics, Ca/bone disorders - often they work side-by-side IM subspecialists.

 

Seems like a field where a MD/PhD might also be useful? I wouldn't necessarily do it specifically for this once speciality, but I've been looking at doing one for about a year now, because I've really enjoyed my time doing research in my chem degree. Would this affect salary and/or the ability to find a job post-residency? I've heard with some other specialities that combining with a PhD actually lowers earning potential because it leads towards more work in academia and less practice, but if your field is already very research heavy, would this not be the case?

 

Do you know much about what the job market is looking like in the future? There has been a lot of talk about saturation, etc, but I would guess that isn't the case for a field that people haven't had a lot of exposure to?

[Laika]

Looks like we have our second listed CO2 specialty! IM!

 

IM was quite competitive this year. I know several people in my class (who most definitely are capable of producing of CO2) who did not match to IM in the first round. The very limited number of second round spots were in undesirable locations and were very competitive.

[Laika]

Seems like a field where a MD/PhD might also be useful?

 

Medical biochemistry is actually a field where many (most?) who practice have a PhD + 2 yr fellowship. Interesting field, but lots of lab management and QA/QC which may not appeal to all.

[japlanet]

Seems like a field where a MD/PhD might also be useful? I wouldn't necessarily do it specifically for this once speciality, but I've been looking at doing one for about a year now, because I've really enjoyed my time doing research in my chem degree. Would this affect salary and/or the ability to find a job post-residency? I've heard with some other specialities that combining with a PhD actually lowers earning potential because it leads towards more work in academia and less practice, but if your field is already very research heavy, would this not be the case?

 

Do you know much about what the job market is looking like in the future? There has been a lot of talk about saturation, etc, but I would guess that isn't the case for a field that people haven't had a lot of exposure to?

 

Yes, a MD/PhD would be a natural complement to the field but I would say less than 50% of MB has PhDs. There are also PhD clinical biochemists who do much of the same job in terms of lab administration/research/teaching but obviously without the clinical/patient contact component.

 

As for the job market, MB is slowly on it's way to becoming a subspecialty of IM. My year (I'm the first year to do this), we are doing the full 3 years IM then 2 years MB, as if it was a fellowship off IM but without the R3 CARMS match. Eventually (3-5 years from now), I suspect it will fully be a fellowship/R3 match off IM. The advantage for me is that I do the IM training, write the IM Royal College, and can practice as a GIM should I need/want to. That said there are a decent number of MB positions, especially if you do additional fellowships in one of the 'hotter' areas (ex. metabolic genetics). You are also within your scope to open an independent outpt practice in one of the clinical areas. In BC I believe some MBs have their own independent labs.

[goleafsgochris]

Lol I actually like the "CO2 specialties"concept

 

I agree with those mentioned above, but also:

 

-Public health and preventative medicine--possibly the easiest at this time, and you dont really need any electives, just a good app essay (this one you could actually get into in toronto with minimal effort, which you cant really say about even FM)

-I would add some of the un-competative surgicals now just b/c of job market. Neurosurg and cardiac come to mind. You WILL need an elective in these though

[NLengr]

Lol I actually like the "CO2 specialties"concept

 

I agree with those mentioned above, but also:

 

-Public health and preventative medicine--possibly the easiest at this time, and you dont really need any electives, just a good app essay (this one you could actually get into in toronto with minimal effort, which you cant really say about even FM)

-I would add some of the un-competative surgicals now just b/c of job market. Neurosurg and cardiac come to mind. You WILL need an elective in these though

 

Cardiac is lucky to fill 50% in the first round.

[Jochi1543]

Cardiac is lucky to fill 50% in the first round.

 

Cool, sign me up for a 20-year fellowship.

 

I shadowed Med Micro for like 2 hours and then I had to excuse myself.

[rogerroger]

 

A lot of things are much more competitive than ROAD as well - many fields in surgery for instance

 

 

Yup it is interesting to compare the top 7 more competitive specialties from 2012 to the least 7 most competitive. ROAD is competitive but many other things are more or just as competitive... There are good life style specialties at both end of the spectrum.

 

It will also be interesting to see how vascular surgery evolves being a new direct entry stream only this past year...

 

Most Competitive:

 

1. Vascular Surgery

2. Plastic Surgery

3. Dermatology

4. Opthomology

5. Emergency Medicine

6. ENT

7. Radiology

 

 

 

Least Competitive (All pathology combined):

 

1. Pathology

2. Medical Biochemistry

3. Public Health

4. Pediatric Neurology

5. Cardiac Surgery

6. Community Medicine

7. Nuclear Medicine