Best Specialties for Dr. Moms

[melissainsd]

I have heard Radiation Oncology, Emergency Medicine (though I am not sure why EM), and dermatology. Any others?

---

Members don't see this ad.

 

[Pemberley]

I have heard Radiation Oncology, Emergency Medicine (though I am not sure why EM), and dermatology. Any others?

From reading the EM board, it seems that what people like about EM is that when you're on shift, you're on; and when you're off shift, you're off. No call. The shift schedule may be wacky, but at least it's complete. Not personal experience, just parroting.

I'm guessing that "family friendly" could actually mean different things to different people -- the love-it/hate-it nature of EM shift work is probably the most dramatic example. Regarding other specialties (derm on one hand, surgery on the other) we're likely mostly to agree. (You still couldn't pay me enough to do derm! but that's beside the point.)

This is a great question for discussion on this board. Do any honest-to-goodness doctors hang out on this board besides njbmd (did I even get all those letters in the right order?) I'd love to hear them throw around pros and cons, if they do.

 

[Kateb4]

I've also heard a bit about hospatilist positions, and would love to hear more about that! From what I understand, you are a hospital employee, do not have an office, and therefore are on when you are on, and off when you are off.

 

[justwondering]

if u dont need the money, family med would be good--easy to work part time.

 

[OphthoBean]

I think ophthalmology is a family friendly field. Even though compensation is sucking overall these days in CA, I still managed to pull in more than the average FP salary while working between 30-40 hrs a week. And since I am just a year and a half out of training I am not even that busy yet during those 30-40 hours so I am not stressed. I do have call but only a few times/month and it is from home and I have only had to go in once since I started (and I cover a regional trauma center along with 2 other community hospitals). 2 other hospitals I am on staff with do not mandate ophthalmology call so I am off the hook. I don't have inpatients to round on or admits to do. I do surgery a few days a month but they are not long arduous cases. I hope when I get busier I will inch up to the average ophtho salary of 250K, but since I am married and part of a 2 income family I could keep my schedule light or reduce my work hours and still come out okay.

I have a 2 1/2 year old son and I find my family life very satisfactory. I am relaxed and have a lot of time to spend with him and my hubby. I had my son at the end of my 2nd year of residency and found it very doable. I was able to pump breastmilk for a full year while patients dilated or between cases at the OR. Very family friendly.

If you are surgically inclined, consider ophtho. Lifestyle is great and it is a fun and interesting field.

 

[melissainsd]

I think ophthalmology is a family friendly field. Even though compensation is sucking overall these days in CA, I still managed to pull in more than the average FP salary while working between 30-40 hrs a week. And since I am just a year and a half out of training I am not even that busy yet during those 30-40 hours so I am not stressed. I do have call but only a few times/month and it is from home and I have only had to go in once since I started (and I cover a regional trauma center along with 2 other community hospitals). 2 other hospitals I am on staff with do not mandate ophthalmology call so I am off the hook. I don't have inpatients to round on or admits to do. I do surgery a few days a month but they are not long arduous cases. I hope when I get busier I will inch up to the average ophtho salary of 250K, but since I am married and part of a 2 income family I could keep my schedule light or reduce my work hours and still come out okay.

I have a 2 1/2 year old son and I find my family life very satisfactory. I am relaxed and have a lot of time to spend with him and my hubby. I had my son at the end of my 2nd year of residency and found it very doable. I was able to pump breastmilk for a full year while patients dilated or between cases at the OR. Very family friendly.

If you are surgically inclined, consider ophtho. Lifestyle is great and it is a fun and interesting field.

Wow- thanks for the great post. I had no idea ophtho was so surgery-heavy (or that they make such a good living). Although I am in no means driven my $$, my husband is a police officer and therefore I need to keep it in consideration.

 

[CNphair]

I chose Radiation Oncology...great hours, great pay and a really rewarding pt base.

Radiology was the most favored specialty among moms/future moms in my class. Radiology has the added benefit of being very friendly to part time work. Because you don't have obligations to specific pts, it is easier to take a few years of part time work while you have kids then go back to full time when you are ready.

Derm is always an excellent choice...very laid back and family friendly. Especially good if you are in a dual income situation because you tend to make a little less than others that subspecialize. But you are working < 40 hrs a week and that is priceless.

Also, don't forget something like Allergy-Immunology, PM&R, and pathology...these aren't always listed among lifestyle specialties, but definitely provide flexible schedules.

And as far as hospitalists, there are definitely some great jobs out there...Our hospitalists work 14 days on, 14 off. And they have houset staff to do all the dirty work. Not bad for $200,000 a year. You just have to like internal medicine.

 

[deleted87716]

I have heard Radiation Oncology, Emergency Medicine (though I am not sure why EM), and dermatology. Any others?

Family medicine, pediatrics.

 

[Pemberley]

And as far as hospitalists, there are definitely some great jobs out there...Our hospitalists work 14 days on, 14 off. And they have houset staff to do all the dirty work. Not bad for $200,000 a year. You just have to like internal medicine.

Do you know anything about pediatric hospitalists (salary, availability of jobs, etc)?

 

[oldbearprofessor]

Do you know anything about pediatric hospitalists (salary, availability of jobs, etc)?

One of my very favorite pediatricians (and a mom of twins, now early teens) is a hospitalist here. Spends a lot of time in the Level 2 nurseries and has won multiple resident teaching awards. I think she works pretty much 8 to 5 M-Fri hours, although I've seen her here a bit later sometimes. Don't know her salary, expect it is mid-range for general pediatricians. Not a lot of hospitalists in pedi yet, but it will increase. Limitations in residency hours and number of months on in-patient services will also help drive this trend.

I point out, as I am fond of doing, that virtually every neonatology fellow and attending is a parent, and since about 1/2 of these are moms (presumably the other half are dads), they must be making it work. I know most of the kids of the ones here and they seem pretty normal. This includes some of my current fellows (and one future one ) who are moms who are lurking here (I KNOW ) and should post!

 

[outofhere]

Psychiatry is great for family life also. It is easy to work part-time, and there are a lot of options: inpt, outpt, therapy, psychopharm, private, county...etc.

Another thing to remember is that it isn't just about the flexible hours. It is also about how wearing is the job emotionally. It is hard to be with people that complain all day to go home and find a toddler who is also complaining. For me, I found it difficult to work even just 8-5 in clinic. Sure, at 5, it is over, but then, my mind is still buzzing with all that complaining.

For now, I work about 4-5 hours M-F, with some weekend call, as an inpt psychiatrist. Of course, I wish I could do without the weekend call, but I am not ready to go all outpt yet (pregnant with number two.)

The compensation for psychiatry is also so much better than primary care.

As for radiology- I think it is a great field, in the long run, but I have heard (don't know if actually true) that all that radiation exposure during pregnancy isn't so good. And I imagine, even worse for interventional radiologists?

I personally think medicine is one of the most flexible fields out there for moms.

 

[Kateb4]

Wow, I want to thank everyone for sharing here. My worries in applying havn't been with getting in, but have been mostly about if this will hurt my family. It's good to hear that there are ways that I can fit medicine into my life and my family won't have to be last. Ok, I know that med school will still be tough on us, but I can't change that. Still, it's really good to know that this will work out!

 

[MOHS_01]

Pathology, Radiology, Radiation Oncology, Dermatology, Rheumatology, Allergy/Immunology, Reproductive Endocrinology, Endocrinology, EP cardiology, neurodiagnostics, hospitalist, on and on and on....

your lifestyle is your's to determine -- with few specialties presenting unique problems that preclude a controllable lifestyle.

The big problem in the years to come will not be the traditional lifestyle headaches, it will be compensation. In the vast majority, if not all specialties, your lifestyle is what you make it. If you are only willing to be on call one night/week or one weekend/month, you simply find that job. You may take it on the chin and wind up being paid like a nurse, but that choice is yours to make. Unfortunately, many of us are saddled with large student loans that require repayment, are not trust fund babies and have to plan for retirement and support our own families, not to mention the fact that you are 30 before drawing a real paycheck. Regardless of what many self profess, the cold hard truth of the matter is that it is not worth enduring that which one has to endure to become a doctor without the financial reward in the end.

 

[tiredmom]

At our hospital back home, the hospitalists worked their tails off! They were hands down the busiest docs in the hospital. The great hours thing depends on how many is in the hospitalist group. I know when they were only 2 in the group - each one was easily working 85-100 hours per week.

I chose Ob/gyn, because it is a job I enjoy to do. I'm able to leave it at the door and not constantly be thinking about it when I'm off. I know the hours are more rough than with some other specialties, but with the predominance of women in the younger generations of doctors, there should be more opportunites for part time work. Other things I liked but didn't love, and just didn't feel like I would be doing my family justice to be unhappy all the time.

Developmental peds is a great field for moms, so I've heard. Office hours, no call, no true emergencies to wake you in the middle of the night.

 

[Kateb4]

At our hospital back home, the hospitalists worked their tails off! They were hands down the busiest docs in the hospital. The great hours thing depends on how many is in the hospitalist group. I know when they were only 2 in the group - each one was easily working 85-100 hours per week.

I chose Ob/gyn, because it is a job I enjoy to do. I'm able to leave it at the door and not constantly be thinking about it when I'm off. I know the hours are more rough than with some other specialties, but with the predominance of women in the younger generations of doctors, there should be more opportunites for part time work. Other things I liked but didn't love, and just didn't feel like I would be doing my family justice to be unhappy all the time.

Developmental peds is a great field for moms, so I've heard. Office hours, no call, no true emergencies to wake you in the middle of the night.

Hi Tiredmom,

I am also interested in going into OB/Gyn and am curious how many hours per week you actually work. I think that ideally I'd like to get into a practice with a few other docs so we can rotate call, but then I understand that your call days are busier. I have heard some discouraging things form other OB's but I have always had an interest, and after going through some infertility issues, and now my third pregnancy, I really think that this would be the field for me.

I have a long way to go, but would love to get some insight now.

Thanks!!

 

[tiredmom]

Hi Kateb4!
I'm only an MS4 so I can't swear to the hours, but they really vary based on the setting. Academics probably has the best hours. A group practice that has enough docs in it will be really busy on your call nights, but I feel it's worth it to have more nights off. An average sized group with say 5 docs would be on call one night per week and every 5th weekend (ob/gyns often take a full weekends worth at a time and have a backup call for when you've got too much going on for one person to handle). I can handle 1 busy night per week. Solo practice is crazy and I'm not considering it. Another thing to consider is how many hospitals are your priviledges at... and how far apart are they. I would ideally be only at one hospital because its much less chaotic that trying to manage patients at two (or more) different places at 3 am! I read an average somewhere that said ob/gyn work 48 hours per week and spend another 10 hours a week in administrative/paperwork/managing the business type work... but I don't know how old that data is.
I'm glad to hear you're interested in ob/gyn. I love it... it's so much fun and really rewarding. I hope this answers your question.

 

[lilnoelle]

Hey moms! I need some advice. I'm an M1 with two young children (18 months and 3 1/2 years). I currently am using a loan repayment program that is paying my tuition (out of state) and a stipend. The total amounted to about $55K this year. The commitment is that I'll work in underserved primary care for 4 years after residency. The fine for dropping out after first year is rather steep. Primary care is defined as general IM, FM, EM, or Peds. I can do a fellowship in the above after my four year commitment is over, but not before. I actually like all of those fields and would probably be more than happy in one of them. I have no problem working in an underserved area since I grew up in very rural Iowa (dad was a farmer). The thing is that I'm not absolutely certain that I won't find another field that I fall in love with. Surgery (not general) is something that sort of interests me. I might also like Radiology.

So I don't know what I should do. If I don't use the repayment plan I'll be left with $330K in debt when I graduate. (~$70K a year plus interest). If I do use it, I'll have less than $100K in debt. With the possible decline of salaries and the fact that I have a family to be responsible for, I'm really sort of scared of building up a huge amount of debt.

So what do you mom's think?

 

[tiredmom]

So what do you mom's think?

Its an option to do another residency after your service time is up also, so your experience won't go to waste. You can't find too many jobs where you can repay $230K in 4 years time, so it's not a bad offer. If you can stomach the work and feel like a few more years of servitude, that is!!! Now, once you are out making money, you may not want to give it up to go back to residency again either... but that's only if you don't end up wanting to do the primary care specialty you started with.
Good luck!

 

[lilnoelle]

How would going into a second residency work once you've been out of med school for a while, especially if you are trying for something competitive? Would it be harder to get a competitive residency if an individual has been out practicing for a while in comparison to an individual straight out of med school? (provided they had good references from their first residency and for all intensive purposes have been a good physician while they have been in practice) Would that individual still go through the match?

I did some more figuring, and by the time I'm out of residency, my loans will have ballooned up to greater than $400K! Interest alone will amount to about $30K a year. State and federal programs that pay off med school debt pay off about $30K a year so if I should choose to go into primary care and not use this program, all other programs will do is pay my interest!!! Thats nuts.
I talked to my hubby last night and he showed some hesitancy to have me make a commitment to this program because it might limit my options. I'm not sure what I should do. At this point, I'm still a part of the program (haven't cancelled it yet). We were perfectly happy with it until I started feeling some doubt a month ago. Now I'm sort of freaking out about the idea of what my loans will be like without the program.

If I could go into another field and guarantee I'll pull ~$250K, then I could probably pay the $400K loan off in a matter of years. But the chances of the above are rather slim. The more I think about it, the more I think that I have to keep this repayable loan.

 

[tiredmom]

The only people who HAVE to use the match are US allopathic seniors... everyone else can prematch if it's offered. I've known a few docs who've changed specialties/gone back for fellowship after a few years of practice - you just have to have a great reason, which you have. I can't see anyone argueing that paying off your loans quickly with a few years of public service as being a bad choice (can you tell I'm used to talking to a 6 year old... good choice, bad choice? ) But, if you go straight through to whatever field you are wanting, you'll still be able to pay off your loans, it will just take a lot longer. But with the way interest rates are going (supposedly decreasing again if the Democrats get their way), I've heard you are better off keeping the student loan and paying off the other stuff that's at a higher rate - cars, houses, etc, since you are paying less % interest on the student loan. That's from some program that they did at our school.

 

[lilnoelle]

The only people who HAVE to use the match are US allopathic seniors... everyone else can prematch if it's offered. I've known a few docs who've changed specialties/gone back for fellowship after a few years of practice - you just have to have a great reason, which you have. I can't see anyone argueing that paying off your loans quickly with a few years of public service as being a bad choice (can you tell I'm used to talking to a 6 year old... good choice, bad choice? ) But, if you go straight through to whatever field you are wanting, you'll still be able to pay off your loans, it will just take a lot longer. But with the way interest rates are going (supposedly decreasing again if the Democrats get their way), I've heard you are better off keeping the student loan and paying off the other stuff that's at a higher rate - cars, houses, etc, since you are paying less % interest on the student loan. That's from some program that they did at our school.

If interest rates were really gonna drop I think I wouldn't mind the loans as much. But the way I understand the bill that is being considered in legislation, they are only going to lower the interest rates on undergraduate subsidized loans, and even that is going to be over the course of five years.

I was really excited about the interest rate deduction until I read up on it.

I've talked to a few people who reminded me of the possibility that I could get some help with my student loans through whatever practice/hospital I sign up with. Does this happen a lot?

 

[loveumms]

How would going into a second residency work once you've been out of med school for a while, especially if you are trying for something competitive? Would it be harder to get a competitive residency if an individual has been out practicing for a while in comparison to an individual straight out of med school? (provided they had good references from their first residency and for all intensive purposes have been a good physician while they have been in practice) Would that individual still go through the match?

I did some more figuring, and by the time I'm out of residency, my loans will have ballooned up to greater than $400K! Interest alone will amount to about $30K a year. State and federal programs that pay off med school debt pay off about $30K a year so if I should choose to go into primary care and not use this program, all other programs will do is pay my interest!!! Thats nuts.
I talked to my hubby last night and he showed some hesitancy to have me make a commitment to this program because it might limit my options. I'm not sure what I should do. At this point, I'm still a part of the program (haven't cancelled it yet). We were perfectly happy with it until I started feeling some doubt a month ago. Now I'm sort of freaking out about the idea of what my loans will be like without the program.

If I could go into another field and guarantee I'll pull ~$250K, then I could probably pay the $400K loan off in a matter of years. But the chances of the above are rather slim. The more I think about it, the more I think that I have to keep this repayable loan.

I have been talking to people on the interview trail and heard something interesting about starting a residency after you are board certified in another field (ie switching specialties). I was told that residency programs are reluctant to take board certified physicians because they do not get as much compensation from the government for those residents. The government gives residency programs a certain amount of money for each resident (was told its around 100K). I was told that the program doesn't get as much for residents who already completed a residency in another field. Not sure the truth to this but, it's something you should look into. I know a lot of people that have started residencies and then switched and I've met a few who are board certified in one field and are trying to get into a different field but, it is much harder then just going into your desired field right off the bat (especially if it's competitive).

I applied for the same program that you are involved in. Since, I was sure I wanted to do endocrinology I figured I would go into the Health Service and get my education paid for. I am SO glad that I didn't get accepted because I have totally switched my specialty (now going into anesthesia) and I would have been totally screwed. My advice to you is to really think about if you are completely sure you want to go into a primary care field. Also remember that underserved populations also include prisoners and illegal allien populations. Just in med school I have taken care of some prisoners (since we have a floor devoted just to incarcerated individuals) - some are easy to deal with, others are not (I have been spit on, cused at and hit on). In talking with some others who have some experience in prisons I've heard that they really abuse the docs, especially woman (some of the stories were really gross ... being urinated on for instance).

Anyway, my point is if you are even slightly unsure as to what you want to do, please think it over really hard. It's a great opportunity but, there are a lot of down sides that they don't tell you about. All of us are in serious debt after med school - it sucks but, we also are going to make a good deal of money. It is easier to pay off a 400K loan then to hate what you are doing for eight years. Also, if you do two residencies (depending on how long they are), that is eight to ten years that you are making 40K. If you only do one then you are making an attending salary during the time you would have been completing your second residency (figure average 150K times 4 years = 600K = plenty enough to start paying off those loans).

 

[fabu1ous]

I too have started looking into some of the loan forgiveness programs... it really is a hard call not having the advantage of even starting school yet and pre-choosing what you will be doing... I think subspecialties is a good thought-- but I assume you'd have to match into the proper program as I know some residenties are for main/sub simultaneously (a med student I spoke with was matched into an internal medicine/endocrinology combined program-- very cool as it took about 2 years off of the time she would normally be a resident).

2 questions for you all-- is ob/gyn considered primary care? I've seen conflicting views...

And, do any of you have info/opinions on military programs? i.e. Airforce reserves, etc. I live close to an air force base, and wouldn't mind serving at the base, but I have no interest in having the military move me anyplace else... I wonder if you can choose before hand where you will be stationed (or is that crazy to even think that could be done?)

 

[deleted87716]

is ob/gyn considered primary care?

It isn't truly primary care, but it's "considered" primary care from an insurance standpoint (meaning women don't need to obtain a referral in order to see an OB-Gyn, similar to most mental health and substance abuse services.) As far as loan forgiveness goes, you may find some opportunities as an OB-Gyn.

Primary care: The "medical home" for a patient, ideally providing continuity and integration of health care. All family physicians and most pediatricians and internists are in primary care. The aims of primary care are to provide the patient with a broad spectrum of care, both preventive and curative, over a period of time and to coordinate all of the care the patient receives.

Source: http://www.medterms.com/script/main/art.asp?articlekey=5042

 

[Pemberley]

And, do any of you have info/opinions on military programs? i.e. Airforce reserves, etc. I live close to an air force base, and wouldn't mind serving at the base, but I have no interest in having the military move me anyplace else... I wonder if you can choose before hand where you will be stationed (or is that crazy to even think that could be done?)

That's not going to be possible on active duty.

Entering the military would be a set of trade-offs, and one of the big factors is the fact that you WILL move every 2-3 years. If your lifestyle is young-and-out-to-see-the-world, this is a good thing. If you're rooted in an area and opposed to moving your family (which sounds like what you were saying) then you'll want to consider other options.

I can't say authoritatively that the guard & reserves have no options, but I've been looking myself, and haven't really found anything. You'll probably want to ask a recruiter -- but make sure that you see anything they tell you in writing before you sign anything. Your state's National Guard or Air National Guard would be the best bet for not wanting to move.

 

[lorianncw]

I just want to thank you all for sharing your insights on this topic!

I just read a REALLY depressing thread in the pre-med forum about physician's lack of a life. It was so nice to read this encouraging and informative thread....written by many women who are already physicians. I have read similar info on MomMD and it was nice to see it reinforced on SDN.

 

[lilnoelle]

I just want to thank you all for sharing your insights on this topic!

I just read a REALLY depressing thread in the pre-med forum about physician's lack of a life. It was so nice to read this encouraging and informative thread....written by many women who are already physicians. I have read similar info on MomMD and it was nice to see it reinforced on SDN.

I'm curious as to what thread your talking about.... I think its important to realize that pre-med students probably have no clue as to what being a doctor will be like. (I guess I don't have a clue either as a first year med student).

 

[LADoc00]

pathology. The less hyper competitive super driven market focused specialists in path, the better I do. Please pathology.

 

[1Path]

pathology. The less hyper competitive super driven market focused specialists in path, the better I do. Please pathology.

Yeah, I'm VERY suprised to see Pathology not listed before now.

As for the idea that you have to be a doctor to know what being a doctor is like, that depends on 1) How old you are, 2) How many experiences you have in the medical profession/how long you've been there, and 3) Plain common sense. For example, who needs to be a surgeon to know that being a surgeon is hard especially for a Mom?

 

[LADoc00]

Pathology for Dr. Moms:
No in house call ever, not even during internship, giving you plenty of time to get pregnant
Private practice hours are between 20-35 week, extra time to get pregnant if you still havent by the end of residency (although honestly there is no excuse you have so much time off)
3-day weekends at least every other week if not weekly
Can rest your Dr. Mom babybelly in your office chair for 90% of the day, staying off your feet
Can easily take numerous bathroom breaks
Self paced workload
3 months of vacation and no one on the staff will even realize you were gone
Time to call/IM your baby's daddy through the day with fetal movement updates
Can reconfigure office to have small baby crib in corner, no one will notice as no one actually comes into your office, ever
Can convert schedule to part time (<50%) on a 2 week notice often, especially if you give up controlling interest/partnership
Can snack on odd things throughout the day that you might have a craving for, pickles-n-ice cream? No problem! Simply chomp away growing that belly while you read your slides.
Can bring luck to your partners/co-workers by allowing people to rub your belly, maybe even charging a small fee per rub (say 25 cents).

 

[da me ka don]

Pathology for Dr. Moms:
No in house call ever, not even during internship, giving you plenty of time to get pregnant
Private practice hours are between 20-35 week, extra time to get pregnant if you still havent by the end of residency (although honestly there is no excuse you have so much time off)
3-day weekends at least every other week if not weekly
Can rest your Dr. Mom babybelly in your office chair for 90% of the day, staying off your feet
Can easily take numerous bathroom breaks
Self paced workload
3 months of vacation and no one on the staff will even realize you were gone
Time to call/IM your baby's daddy through the day with fetal movement updates
Can reconfigure office to have small baby crib in corner, no one will notice as no one actually comes into your office, ever
Can convert schedule to part time (<50%) on a 2 week notice often, especially if you give up controlling interest/partnership
Can snack on odd things throughout the day that you might have a craving for, pickles-n-ice cream? No problem! Simply chomp away growing that belly while you read your slides.
Can bring luck to your partners/co-workers by allowing people to rub your belly, maybe even charging a small fee per rub (say 25 cents).

This is the greatest post ever!!!! Go mom friendly specialties...haha.
I'm a young lowly premed but worried to death about being a Dr. Mom... you guys are awesome.

 

[SexiMexi]

Path sounds perfect for me!

 

[foreverLaur]

The only mom I know in Emergency Medicine regrets it. She said if she could do it all over again she would do dermatology.

She said she would go days without seeing her kids because of how her shift work conflicted with her husband and kids' daily shcedules.

She said it got better as the years went on, but she missed a lot of her kids younger years.

 

[docsri]

What about being an Internist? Or in Critical Care? Or any other IM subspecialities? Anyone want to weigh in on that?

 

[montessori2md]

How would going into a second residency work once you've been out of med school for a while, especially if you are trying for something competitive? Would it be harder to get a competitive residency if an individual has been out practicing for a while in comparison to an individual straight out of med school? (provided they had good references from their first residency and for all intensive purposes have been a good physician while they have been in practice) Would that individual still go through the match?

I did some more figuring, and by the time I'm out of residency, my loans will have ballooned up to greater than $400K! Interest alone will amount to about $30K a year. State and federal programs that pay off med school debt pay off about $30K a year so if I should choose to go into primary care and not use this program, all other programs will do is pay my interest!!! Thats nuts.
I talked to my hubby last night and he showed some hesitancy to have me make a commitment to this program because it might limit my options. I'm not sure what I should do. At this point, I'm still a part of the program (haven't cancelled it yet). We were perfectly happy with it until I started feeling some doubt a month ago. Now I'm sort of freaking out about the idea of what my loans will be like without the program.

If I could go into another field and guarantee I'll pull ~$250K, then I could probably pay the $400K loan off in a matter of years. But the chances of the above are rather slim. The more I think about it, the more I think that I have to keep this repayable loan.

I've been contemplating this same puzzle. I don't know that I have any great wisdom for you, but:
1) loan repayment is typically 20G/year, but varies from state to state and program to program. My impression is that typically a public service repayment option also entails a slightly below market rate for salary, so to me, it's a wash, and just a way to make it affordable to work in underserved communities.
2) What you said about 2nd residencies being compensated less is true. There are posts about this over in the residency forums, maybe in finaid too. BUT if you are working in a clinic just 40 hrs/wk, it seems possible that you could go make friends at nearby hospitals to get an "in" with the program you were interested in.
3) A lot of specialties require a transitional year anyhow, so you'd have that knocked out ahead of time.
4) If you're on the public health scholarship, be aware that it's up for renewal, and some of the criteria may change (for better or worse) -I'm thinking the most likely specialty changes would be to allow mixed specialties in (med/peds, etc) and maybe EM, to be included.

Could you spend some time shadowing MDs in the non IM specialties to help yourself collect more data? For myself, just visiting a dermatologist was enough for me to know that I despise dermatology. Maybe you could spend some time between your M1/M2 years.

I would think really really hard about throwing away the scholarship. But I'm a midwesterner too, and was programmed to believe debt=bad from conception.

 

[LADoc00]

Path sounds perfect for me!

I can envision an army of pregnant 20 and 30 something year old pathologists working for me..babies lined up in cribs. Some futuristic version of a super pimp where Id call myself the "Great Prophet" and strut around the hospital having surgeons hold up the back of my fur robe while I tapped my ivory cane on the tile, the signal to the house staff to bring me a double latte and small chocolate biscotti...each baby trained from childhood in pathology like a scrub-wearing ninja army....Awesome, awesome.

 

[TexasRose]

I can envision an army of pregnant 20 and 30 something year old pathologists working for me..babies lined up in cribs. Some futuristic version of a super pimp where Id call myself the "Great Prophet" and strut around the hospital having surgeons hold up the back of my fur robe while I tapped my ivory cane on the tile, the signal to the house staff to bring me a double latte and small chocolate biscotti...each baby trained from childhood in pathology like a scrub-wearing ninja army....Awesome, awesome.

I love this post and your previous one!

 

[kelbearTU]

The pathology thing is so true. The last four paths at the hospital I work at have been female. When the old guys retire it will be all females. wow