Difficulty of Entering GI?

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I agree. GI is a one-trick pony and is popular only because medical students have the perception of scoping = $$$. If reimbursements are cut (which they probably will be), then GI would be no more popular than Endo or Rheum. Also see the rise of nurse endoscopists, which makes sense because much of GI is a relatively simple technical procedure. The physician is needed mostly to evaluate an image of the colon.

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I definitely see your point, but disagree that it is a "one trick pony." I love GI because it allows me to focus on a single system (and therefore can know MORE about LESS, which I prefer) with a relatively simple physiology (again, preferred by me), with a vast variety of pathology (owing to the multiple organs that function as a single unit of "digestion").

Like microbiology? GI's got it.
What about autoimmune? Check.
Hmmm...oncology? Yep.
Psychosocial issues? Uh huh.
Metabolic medicine? Si.
Environmental? Da.
Procedural skills? You betcha.

GI entails all the fun of getting to use your IM diagnostic skills AND the added awesomeness of being a procedural special ops agent.

Honestly, even the lowest paying field in medicine is still 6 figures...that's much, much more than most people make. I'll take GI for the medical content, the money will come and go as legislators please...I don't have the time, tolerance, or willingness to give a colonic cast about it.

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I definitely see your point, but disagree that it is a "one trick pony." I love GI because it allows me to focus on a single system (and therefore can know MORE about LESS, which I prefer) with a relatively simple physiology (again, preferred by me), with a vast variety of pathology (owing to the multiple organs that function as a single unit of "digestion").

Like microbiology? GI's got it.
What about autoimmune? Check.
Hmmm...oncology? Yep.
Psychosocial issues? Uh huh.
Metabolic medicine? Si.
Environmental? Da.
Procedural skills? You betcha.

GI entails all the fun of getting to use your IM diagnostic skills AND the added awesomeness of being a procedural special ops agent.

Honestly, even the lowest paying field in medicine is still 6 figures...that's much, much more than most people make. I'll take GI for the medical content, the money will come and go as legislators please...I don't have the time, tolerance, or willingness to give a colonic cast about it.

This is true but it is competitive due to $$ and lifestyle also all fields of medicine give you this scope also your knowledge base while growing more about GI will shrink in the other areas. Even then you can not be an expert unless you are in academic medicine you are a specialist just like a pediatrician or an anesthesiologist.
 
This is true but it is competitive due to $$ and lifestyle also all fields of medicine give you this scope also your knowledge base while growing more about GI will shrink in the other areas. Even then you can not be an expert unless you are in academic medicine you are a specialist just like a pediatrician or an anesthesiologist.
All fields of medicine that are competitive is because of $ and lifestyle. I just don't understand your point? People are talking about salaries going down, but do people really think average salaries will drop below 300k?
 
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People told me that. So I tried it. Get out of academics into the real world. Colonoscopies and EGDs are bread and butter for GI docs in non-academic practices. Simple. And guess what, looking at half-cleaned colons all day long for polyps is not only a turn-off for me, but for 99.99% of the population. But feel free, judge.

Medical students and residents are like buffalo. They chase what's most competitive even if it's off a cliff. Do GI if you truly enjoy it. But don't pretend it's so amazing that it warrants its competitive bent.

Yup. I'm always amazed at how easily people can convince themselves they 'love' something when there's money involved.
 
All fields of medicine that are competitive is because of $ and lifestyle. I just don't understand your point? People are talking about salaries going down, but do people really think average salaries will drop below 300k?

People overplay the expert part that being a specialist gives you. "Oh I want to become an expert!" Just say you like an organ system because like I explained. How much GI gets paid is dependent on how scopes are reimbursed because scopes are why GI can make $$ above medical specialties
 
Reimbursement will come and go. 30 years ago they couldn't give away GI spots fast enough...I'm sure it'll happen again. I really couldn't care less though, because I happen to love the content. I am quite glad that you guys enjoy other parts of medicine! I cannot imagine being a Pathologist or a Gynecologist or a Radiologist...all excellent and important fields that we need excellent doctors to specialize in.

Anyone can make the same arguments about any field of medicine. Here's the gist of it: If you like digestive issues, procedural work, and getting to diagnose like an internist without dealing with medical complaints of systems various and sundry, then there isn't another field like GI.
 
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Reimbursement will come and go. 30 years ago they couldn't give away GI spots fast enough...I'm sure it'll happen again. I really couldn't care less though, because I happen to love the content. I am quite glad that you guys enjoy other parts of medicine! I cannot imagine being a Pathologist or a Gynecologist or a Radiologist...all excellent and important fields that we need excellent doctors to specialize in.

Anyone can make the same arguments about any field of medicine. Here's the gist of it: If you like digestive issues, procedural work, and getting to diagnose like an internist without dealing with medical complaints of systems various and sundry, then there isn't another field like GI.

This sounds delightful.
 
All fields of medicine that are competitive is because of $ and lifestyle. I just don't understand your point? People are talking about salaries going down, but do people really think average salaries will drop below 300k?

I thought endo, rheum, nephro, and ID all made ~$250k median as IM subspecialists, largely because they aren't very procedure heavy. If procedures are the main thing propping up GI salaries and they get a big reimbursement, GI could wind up in the same boat. Predicting reimbursement changes is kinda impossible though.

I've heard that nephrology decades ago was very highly compensated, and now the fellowships are partially filling with foreign grads because the money isn't there anymore.
 
I thought endo, rheum, nephro, and ID all made ~$250k median as IM subspecialists, largely because they aren't very procedure heavy. If procedures are the main thing propping up GI salaries and they get a big reimbursement, GI could wind up in the same boat. Predicting reimbursement changes is kinda impossible though.

I've heard that nephrology decades ago was very highly compensated, and now the fellowships are partially filling with foreign grads because the money isn't there anymore.

I think nephro's compensation is less now because dialysis is owned by private companies now rather than physicians. I may be wrong.
 
I thought endo, rheum, nephro, and ID all made ~$250k median as IM subspecialists, largely because they aren't very procedure heavy. If procedures are the main thing propping up GI salaries and they get a big reimbursement, GI could wind up in the same boat. Predicting reimbursement changes is kinda impossible though.

I've heard that nephrology decades ago was very highly compensated, and now the fellowships are partially filling with foreign grads because the money isn't there anymore.

This gets very old. GI is literally the only specialty in medicine where both procedures and medicine is incorporated into the care of a patient (including cardiology as the vast majority of general cardiologists do not perform interventions and typically only those in IC or EP which account for a percentage of cardiologists to interventions.) Yes, procedures are highly profitable for hospitals, and reimbursements can decrease. This goes back to the recommendation, don't pursue medicine to make money, because at the end of the day its not the most profitable profession. Similarly, don't pick GI if you believe its the most profitable specialty. Pursue your career and subspecialty based off what you enjoy doing most. Of course good compensation helps GI attract more candidates. But at the end of the day, if you don't like what you do, no amount of money will be worth it. I don't believe nephrology was every "highly compensated.". But multiple factors including a decade of oversaturating the market with fellow plus lack of significant advancement in the field, and overall probably an also the fact that many people don't enjoy nephrology has made nephrology popularity and compensation decline.
 
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