How has your perception of radiology changed?

[librenacho]

I'm an MS3 pretty much set on radiology as a career choice, but I feel that it is a very difficult field to get a good feel for how residency or practice will actually be day in and day out, even though I've shadowed plenty. How has your perception of radiology changed over the course of residency or as you've moved into fellowship or practice? Is it what you expected it to be? Any major perks or downsides you didn't foresee?

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[radman123]

I'm an MS3 pretty much set on radiology as a career choice, but I feel that it is a very difficult field to get a good feel for how residency or practice will actually be day in and day out, even though I've shadowed plenty. How has your perception of radiology changed over the course of residency or as you've moved into fellowship or practice? Is it what you expected it to be? Any major perks or downsides you didn't foresee?

Exciting , cool, well paid, lifestyle field as medical student.

Now as attending 7 years out, not a lifestyle field at all,bordering sweat shop conditions especially when alone in evenings and weekends, high fatigue at end of day usually, low political status more like contract workers, difficult to find employment in areas you want to live, pathology outside academia is very routine- very rarely see interesting cases, pay decreasing every year with no end in sight. Few good/fair practices in desirable areas.

The field has been financially rewarding but came out with 1/2 the debt on average. Debt is gone and mortgage is paid off. Net worth in low 7 figure range. I am however making less this year than my first year in practice!

 

[radman123]

I still don't get posts like this. All jobs that are financially rewarding to that degree are exhausting, including derm and private equity. I also don't get the use of the phrase "sweat shop" lately. How does earning $300k sitting in an air-conditioned room in a $200 chair dictating into a mic with $20,000 worth of high-tech computing at your fingertips anything even resembling a sweat shop? I also don't get why a high net worth individual like yourself would bother with poor working conditions. If it's just the volume and diversity, you can easily switch to academics or a pseudo-academic pp since you're already financially independent. Moreover, if pp radiology were even close to being what people make it out to be, there would be no reason for the massive amount of elderly practicing radiologists. They are clearly financially independent by 60+ years so continuing on in "sweat shop" conditions when they are both old and already wealthy seems highly unlikely, even if their nest egg didn't hit the $15 million mark that they originally planned.

Not financially independent more like comfortable. So have to work another 10-15 years to get there.

Working hard is something to be expected when you enter medicine. But every ounce of productivity is being squeezed out of radiologists right now especially in PP. You miss stuff you can get sued or hurt patients. But you gotta read real fast to keep up with the work especially when you are alone covering multiple ERs by yourself. And as you know, studies have hundreds-thousands of images these days. I do not have a schedule when I come in to call shifts like many other doctors. There is no limit to how much I may have to read.

There are many different kinds of private practices and many different kinds of radiologists. Some are very careful and take their time, while others are real fast and do not care much if they miss stuff. You will not know where you will fit in until you get out there on your own. So high volume practice with slower careful radiologist may result in an unhappy radiologist who refers to his practice as sweat shop conditions. Other speedy rads may think that PP is easy because they are in a "lifestyle" group and everything in between. Some rads are more money hungry than others, etc. Not sure about elderly rads and why they stick around. My guess bad financial planning, divorces, ? want to stay busy, who knows?

 

[xrevision]

I've talked to quite a few physicians in my own family, which includes a couple radiologists, the newer physicians that have recently graduated have less complaints because they aren't seeing their lifestyles contract. The people in my family who are having a harder time adjusting are the ones who were used to a certain lifestyle but are needing to contract their spending. It's likely that because we didn't see the heyday of radiology that we won't know what we were missing out on, and wont be as disgruntled.

 

[Silent Cool]

I still don't get posts like this. All jobs that are financially rewarding to that degree are exhausting, including derm and private equity. I also don't get the use of the phrase "sweat shop" lately. How does earning $300k sitting in an air-conditioned room in a $200 chair dictating into a mic with $20,000 worth of high-tech computing at your fingertips anything even resembling a sweat shop? I also don't get why a high net worth individual like yourself would bother with poor working conditions. If it's just the volume and diversity, you can easily switch to academics or a pseudo-academic pp since you're already financially independent. Moreover, if pp radiology were even close to being what people make it out to be, there would be no reason for the massive amount of elderly practicing radiologists. They are clearly financially independent by 60+ years so continuing on in "sweat shop" conditions when they are both old and already wealthy seems highly unlikely, even if their nest egg didn't hit the $15 million mark that they originally planned.

Dumb,

I have to say....I love this post. You are right on. I'm not a radiologist but I have read enough about the "sweatshop" (LOL, really? ) conditions from various posters that I trust what you say.

 

[Silent Cool]

I've talked to quite a few physicians in my own family, which includes a couple radiologists, the newer physicians that have recently graduated have less complaints because they aren't seeing their lifestyles contract. The people in my family who are having a harder time adjusting are the ones who were used to a certain lifestyle but are needing to contract their spending. It's likely that because we didn't see the heyday of radiology that we won't know what we were missing out on, and wont be as disgruntled.

Yup. Human nature is such that you will hate going from 700K to a mere 450K. But if all you've ever tasted is 50-60K, then 300K sounds pretty damn good.

 

[shark2000]

I still don't get posts like this. All jobs that are financially rewarding to that degree are exhausting, including derm and private equity. I also don't get the use of the phrase "sweat shop" lately. How does earning $300k sitting in an air-conditioned room in a $200 chair dictating into a mic with $20,000 worth of high-tech computing at your fingertips anything even resembling a sweat shop? I also don't get why a high net worth individual like yourself would bother with poor working conditions. If it's just the volume and diversity, you can easily switch to academics or a pseudo-academic pp since you're already financially independent. Moreover, if pp radiology were even close to being what people make it out to be, there would be no reason for the massive amount of elderly practicing radiologists. They are clearly financially independent by 60+ years so continuing on in "sweat shop" conditions when they are both old and already wealthy seems highly unlikely, even if their nest egg didn't hit the $15 million mark that they originally planned.

I totally agree with radman123. I am new than him to pp and have not seen the so called good old days.

I always recommend med students to go into radiology, but it is no way close to what you think.

Without doing pp radiology you don't have any idea what you are talking about. Elderly are in the game, because they can dictate their scope of practice. I agree with you that with a reasonable planning, you have to be financially independent by the age of 60, but you will become surprised when you see the real life, that how many of high paid doctors can not retire. Among of of our referring doctors, there is a 65+ orthopod who is doing just medical outpatient ortho very minor procedures without any OR. Once he told me, plan for your future to avoid ending up like him.

Your post is typical for a MS or junior radiology resident. It is exactly like when a college student thinks medicine is easy, because you just go to the hospital, chat with people, write some notes and make money. It seems sweet, isn't it?

In pp you can not control the flow or your workload. Esp, if you are a junior even a junior partner, you have to do what others want you to do.

Academic jobs are difficult to come by in these days. The volume is lower, but you have to deal with a lot of politics and also there is a great push for publication. I was interested in doing it, but after close evaluation, I decided that it is not for anybody.

The price of the microphone does not mean anything. Come on. Also the more advanced the technology, the more expectation are. For example, in old days radiologists used to give a verbal or one line written prelim on the ER studies and in many cases the report was out after 1-2 days. These days, expecting final report in 15-20 minutes is typical.

Many things happening in radiology is not specific to this field and is seen in many fields. I don't say we have it better or worse. But radiology is no way what a medical student thinks after doing a 3 weeks rotations. PP is way different from what a junior or even a senior resident thinks. Radiology as a career can be very rewarding, however it needs its own personality. Mentally it can be really tiring.

I was covering ER earlier this week. For technical reasons, my reports did not go to EMR for a few hours. I got almost non stop phone calls the whole morning, everybody complaining. This was in addition to non stop phone calls we get on routine days. One of the referring doctors who was waiting for me in the reading room, said: "Oh, it seems that you guys also can have bad days, as bad as us or probably worse." He left the room, told me that his case is not as emergent as others.

Radiology can be a good job only and only if your have the right personality and also only if you know what you are doing to your life. Lower your expectations.

 

[vm26]

I'm an MS3 pretty much set on radiology as a career choice, but I feel that it is a very difficult field to get a good feel for how residency or practice will actually be day in and day out, even though I've shadowed plenty. How has your perception of radiology changed over the course of residency or as you've moved into fellowship or practice? Is it what you expected it to be? Any major perks or downsides you didn't foresee?

I'm a fellow and can share my experience and thoughts on the field. It's April and I still don't have a gig lined up for July (despite being willing to move anywhere outside of Guam) which is not only demoralizing given 6 years of training but also a constant source of stress for practical reasons (living situation, student loan payments etc). Radiologist's use the term "sweatshop" because in the real world of radiology, you basically get to work and sit at your work station for 11-13 hours or so in a row, only getting up for the occasional piss-break or getting food to bring back to eat at your station, and basically just crank through studies at a rate that is way beyond a normal person's comfort zone while still being held accountable for the quality/accuracy of the report. You have minimal qualitative value, it's all about your numbers. There is little to no time for chatting with your colleagues or discussing interesting cases and so it is very isolating. There is little to no camaraderie. You do not get intrinsic rewards such as gratitude from patients. The only time you hear back from a referrer or a patient is when you miss something, never a thank you for a job well down. You are asked to read studies that are not within your area of expertise but yet you are still held to similar standards in terms of accuracy/efficiency (sorta like asking the GI guy to go do a pulmonary consult). The jump in volume between trainee and attending is ridiculous. A buddy of mine is an anesthesiologist, as a resident he never had more than 1 patient at a time, as an attending he still never has more than 1 patient at a time, just more responsibility. As a radiology resident/fellow I read maybe 20-25 cross sectional a day, as an attending I will be expected to read twice that amount plus an additional 50-60 plain films/ultrasounds/mammograms/fluoro-studies (that's over 100 patients per day that I am potentially liable for). I am not sure how far along some of you are with your training but watching someone dictate studies looks far easier than doing it yourself. It's honestly mentally (and emotionally) draining. If you zone out mentally for a second you easily miss crap, there is no auto-pilot mode (as opposed to a surgeon who's hands are almost working on their own after their 1000th lap-chole). Also all your misses are electronically/objectively recorded, they're pretty black and white. In terms of money, it's all about expectation, are you ok with making progressively less each year despite having more experience and being more efficient and working longer hours? 10 years from now, will you be ok with making less money than what attending's are making now? I am not talking about 700--> 400K, more like 200K (sorta like pathology but with longer training and work hours, evenings, and weekends). Radiology will continue to be a prime target for reimbursement cuts as we don't deal with patient's directly and thus have little influence over CMS's actions. As an example, this past year medicare reduced reimbursement for MSK extremity MRIs by 30% Dealing with these types of cuts year after year is just brutal and there is no reason to think these will stop as the government is bankrupt. Maybe I am just a greedy bastard but the idea of making less money each year was not on my mind as a med-student. I had the crazy idea that people's incomes increased with more experience and skill. So in summary after rereading my post I guess my opinion is that radiology sorta sucks as a field. Despite the above, you may decide that you still find it a fulfilling, worthwhile career. If I had kids interested in medicine I would recommend that they become a nurse practitioner, medicare is apparently reimbursing their services at 85% of primary care physicians so why even deal with med school/residency/loans etc

 

[shark2000]

I'm a fellow and can share my experience and thoughts on the field. It's April and I still don't have a gig lined up for July (despite being willing to move anywhere outside of Guam) which is not only demoralizing given 6 years of training but also a constant source of stress for practical reasons (living situation, student loan payments etc). Radiologist's use the term "sweatshop" because in the real world of radiology, you basically get to work and sit at your work station for 11-13 hours or so in a row, only getting up for the occasional piss-break or getting food to bring back to eat at your station, and basically just crank through studies at a rate that is way beyond a normal person's comfort zone while still being held accountable for the quality/accuracy of the report. You have minimal qualitative value, it's all about your numbers. There is little to no time for chatting with your colleagues or discussing interesting cases and so it is very isolating. There is little to no camaraderie. You do not get intrinsic rewards such as gratitude from patients. The only time you hear back from a referrer or a patient is when you miss something, never a thank you for a job well down. You are asked to read studies that are not within your area of expertise but yet you are still held to similar standards in terms of accuracy/efficiency (sorta like asking the GI guy to go do a pulmonary consult). The jump in volume between trainee and attending is ridiculous. A buddy of mine is an anesthesiologist, as a resident he never had more than 1 patient at a time, as an attending he still never has more than 1 patient at a time, just more responsibility. As a radiology resident/fellow I read maybe 20-25 cross sectional a day, as an attending I will be expected to read twice that amount plus an additional 50-60 plain films/ultrasounds/mammograms/fluoro-studies (that's over 100 patients per day that I am potentially liable for). I am not sure how far along some of you are with your training but watching someone dictate studies looks far easier than doing it yourself. It's honestly mentally (and emotionally) draining. If you zone out mentally for a second you easily miss crap, there is no auto-pilot mode (as opposed to a surgeon who's hands are almost working on their own after their 1000th lap-chole). Also all your misses are electronically/objectively recorded, they're pretty black and white. In terms of money, it's all about expectation, are you ok with making progressively less each year despite having more experience and being more efficient and working longer hours? 10 years from now, will you be ok with making less money than what attending's are making now? I am not talking about 700--> 400K, more like 200K (sorta like pathology but with longer training and work hours, evenings, and weekends). Radiology will continue to be a prime target for reimbursement cuts as we don't deal with patient's directly and thus have little influence over CMS's actions. As an example, this past year medicare reduced reimbursement for MSK extremity MRIs by 30% Dealing with these types of cuts year after year is just brutal and there is no reason to think these will stop as the government is bankrupt. Maybe I am just a greedy bastard but the idea of making less money each year was not on my mind as a med-student. I had the crazy idea that people's incomes increased with more experience and skill. So in summary after rereading my post I guess my opinion is that radiology sorta sucks as a field. Despite the above, you may decide that you still find it a fulfilling, worthwhile career. If I had kids interested in medicine I would recommend that they become a nurse practitioner, medicare is apparently reimbursing their services at 85% of primary care physicians so why even deal with med school/residency/loans etc

Try to call groups and see what comes by. You just need one offer.

If you are geographically flexible, you should be able to find a decent job. It has become tough in desirable locations, but still people find jobs outside big cities.

What fellowship are you doing?

 

[vm26]

Try to call groups and see what comes by. You just need one offer.

If you are geographically flexible, you should be able to find a decent job. It has become tough in desirable locations, but still people find jobs outside big cities.

What fellowship are you doing?

mixed MR fellowship...I've come close to landing some gigs but a couple of the groups are holding off hiring due to potential buy-outs/mergers. I completed residency in a large desirable city so my contacts there can't do much as market is sealed shut...I've been turned down from less desirable rural places due to "lack of ties" to the area so it's been tough but I'm hopeful that something will turn up, maybe over the summer when there are less fellows to complete with

 

[deleted116380]

...In terms of money, it's all about expectation, are you ok with making progressively less each year despite having more experience and being more efficient and working longer hours?

The more efficient you and the rest of the economy are at doing work, the more your pay will decrease. Sounds counter-intuitive, but not from government workers. There's no incentive to work more...probably what they're trying to get at.

Sec. 3401

Subtitle E—Ensuring Medicare Sustainability
SEC. 3401. REVISION OF CERTAIN MARKET BASKET UPDATES AND INCORPORATION OF PRODUCTIVITY IMPROVEMENTS INTO MARKET BASKET UPDATES THAT DO NOT ALREADY INCORPORATE SUCH IMPROVEMENTS.
(a) INPATIENT ACUTE HOSPITALS.—Section 1886(b)(3)(B) of the Social Security Act (42 U.S.C. 1395ww(b)(3)(B)), as amended by section 3001(a)(3), is further amended—
(1) in clause (i)(XX), by striking ‘‘clause (viii)'' and inserting ‘‘clauses (viii), (ix), (xi), and (xii)'';
(2) in the first sentence of clause (viii), by inserting ‘‘of such applicable percentage increase (determined without regard to clause (ix), (xi), or (xii))'' after ‘‘one-quarter'';
(3) in the first sentence of clause (ix)(I), by inserting ‘‘(determined without regard to clause (viii), (xi), or (xii))'' after ‘‘clause (i)'' the second time it appears; and
(4) by adding at the end the following new clauses: ‘‘(xi)(I) For 2012 and each subsequent fiscal year, after determining the applicable percentage increase described in clause (i) and after application of clauses (viii) and (ix), such percentage increase shall be reduced by the productivity adjustment described in subclause (II).
‘‘(II) The productivity adjustment described in this subclause, with respect to a percentage, factor, or update for a fiscal year, year, cost reporting period, or other annual period, is a productivity adjustment equal to the 10-year moving average of changes in annual economy-wide private nonfarm business multi-factor productivity (as projected by the Secretary for the 10-year period ending with the applicable fiscal year, year, cost reporting period, or other annual period).

Pg 398 of the act: http://housedocs.house.gov/energycommerce/ppacacon.pdf

 

[radman123]

mixed MR fellowship...I've come close to landing some gigs but a couple of the groups are holding off hiring due to potential buy-outs/mergers. I completed residency in a large desirable city so my contacts there can't do much as market is sealed shut...I've been turned down from less desirable rural places due to "lack of ties" to the area so it's been tough but I'm hopeful that something will turn up, maybe over the summer when there are less fellows to complete with

I have seen more positions on the ACR site in the last couple of months so maybe market is opening up a bit. Not sure how many applicants there are for these positions as we had 50 people apply for 1 spot!

I would also be careful with partnership type jobs these days. A lot of groups undergoing major changes with buy-outs/mergers, transition to employees, Obamacare coming etc. These groups will make you work for lower salary for years to reap potential benefits which may never come. Not to mention buy ins. Would rather take an employed position in the current environment if available.

To the younger people on here, I would avoid MR fellowships. Although it may be true that you will be doing everything in some groups, there are private groups where you end up being the body/general guy as there will be fellowship trained MSK/Neuro people around. In academics, you will have a hard time fitting in. Pure outpatient jobs are rare these days. And it may not matter whether you are good at MSK or Neuro. I personally think that the days of small groups with guys doing everything are dwindling.

 

[vm26]

it does seem like more openings but competition is fierce, a friend of mine was told by a practice that they received >100 CVs for 1 opening in one week's time, not good odds

I have thought a lot about the partnership issue, most groups have been upfront and have said that as of now the partnership track is open but that there are no guarantees that the group won't be bought out by the hospital in 2-3 years time in which case there will be no partners. Interestingly the partnership tracks have offered the highest starting salaries. The employee positions I have heard about are groups comprised of a handful of partners with a bunch of employed radiologists working for them (basically a 2-tier system). These employed positions also have had low-ish starting salaries and did not seem to have a significant amount of less frequent call or volume. Ideally I would like to avoid this type of practice if possible.

I don't disagree with you with respect to doing a true subspecialty for fellowship but I do not think it's the reason why I don't have a gig right now. I know of very good neuro fellowships where most of the fellows have nothing lined up and the one that does will be working as a generalist. I do think the future will favor subspecialists as imaging is being pushed backed into hospitals which is ironic given that medicine as a whole is being pushed away from subspecialization (much cheaper to pay a GP to do some cardiology then pay a cardiologist).

I have seen more positions on the ACR site in the last couple of months so maybe market is opening up a bit. Not sure how many applicants there are for these positions as we had 50 people apply for 1 spot!

I would also be careful with partnership type jobs these days. A lot of groups undergoing major changes with buy-outs/mergers, transition to employees, Obamacare coming etc. These groups will make you work for lower salary for years to reap potential benefits which may never come. Not to mention buy ins. Would rather take an employed position in the current environment if available.

To the younger people on here, I would avoid MR fellowships. Although it may be true that you will be doing everything in some groups, there are private groups where you end up being the body/general guy as there will be fellowship trained MSK/Neuro people around. In academics, you will have a hard time fitting in. Pure outpatient jobs are rare these days. And it may not matter whether you are good at MSK or Neuro. I personally think that the days of small groups with guys doing everything are dwindling.

 

[shark2000]

it does seem like more openings but competition is fierce, a friend of mine was told by a practice that they received >100 CVs for 1 opening in one week's time, not good odds

I have thought a lot about the partnership issue, most groups have been upfront and have said that as of now the partnership track is open but that there are no guarantees that the group won't be bought out by the hospital in 2-3 years time in which case there will be no partners. Interestingly the partnership tracks have offered the highest starting salaries. The employee positions I have heard about are groups comprised of a handful of partners with a bunch of employed radiologists working for them (basically a 2-tier system). These employed positions also have had low-ish starting salaries and did not seem to have a significant amount of less frequent call or volume. Ideally I would like to avoid this type of practice if possible.

I don't disagree with you with respect to doing a true subspecialty for fellowship but I do not think it's the reason why I don't have a gig right now. I know of very good neuro fellowships where most of the fellows have nothing lined up and the one that does will be working as a generalist. I do think the future will favor subspecialists as imaging is being pushed backed into hospitals which is ironic given that medicine as a whole is being pushed away from subspecialization (much cheaper to pay a GP to do some cardiology then pay a cardiologist).

I am MSK trained and relatively new to pp. I was lucky to find a job in a desirable coastal location through connections just before starting fellowship.

I don't want to give you false hope, but if you look for it, you will find something. I have seen people found jobs in May and June. I have seen people who have been out of work for a few months and then all of a sudden they have found something in September. In many cases, the September job may be better than the one you find it right now under pressure.

I agree that the job market is tight, but you just need one spot. And in many many groups, there are senior people who may go part time or may retire very soon and you may see an opening any time.

Good Luck.

 

[radman123]

I am MSK trained and relatively new to pp. I was lucky to find a job in a desirable coastal location through connections just before starting fellowship.

I don't want to give you false hope, but if you look for it, you will find something. I have seen people found jobs in May and June. I have seen people who have been out of work for a few months and then all of a sudden they have found something in September. In many cases, the September job may be better than the one you find it right now under pressure.

I agree that the job market is tight, but you just need one spot. And in many many groups, there are senior people who may go part time or may retire very soon and you may see an opening any time.

Good Luck.

Given that the market has been tough now for what 4-5 years, bet there are many rads in crappy jobs and fellows doing second fellowships also competing for the few openings. What we put out 1000 rads every year? I do not think I have seen anywhere close to that number of jobs advertised and I keep a close eye on that.

I am hoping that once all the uncertainty is gone and reimbursement cuts quite down, groups/hospitals will start hiring again. It is a real crappy feeling knowing that if I lose my job for whatever reason, I will likely struggle trying to find another decent one. Uprooting family to move across the country is not a good option at this point in my life.

I feel real bad for the fellows, many of whom are in their 30s, with 6 figure debt, house payments, growing families, etc. coming out into this mess. Many I bet would have chosen a different path had they known how things would turn out. Seems to me like many of us go through the tough, long expensive training for the guarantees medicine offers. Unfortunately, the guarantee/promise is no longer there.

 

[shark2000]

Given that the market has been tough now for what 4-5 years, bet there are many rads in crappy jobs and fellows doing second fellowships also competing for the few openings. What we put out 1000 rads every year? I do not think I have seen anywhere close to that number of jobs advertised and I keep a close eye on that.

I am hoping that once all the uncertainty is gone and reimbursement cuts quite down, groups/hospitals will start hiring again. It is a real crappy feeling knowing that if I lose my job for whatever reason, I will likely struggle trying to find another decent one. Uprooting family to move across the country is not a good option at this point in my life.

I feel real bad for the fellows, many of whom are in their 30s, with 6 figure debt, house payments, growing families, etc. coming out into this mess. Many I bet would have chosen a different path had they known how things would turn out. Seems to me like many of us go through the tough, long expensive training for the guarantees medicine offers. Unfortunately, the guarantee/promise is no longer there.

I agree.

1000 is too many. I don't think we need so many rads. Nobody know how many job openings are every year, as many jobs are not advertised. But, it seems there is over-supply.

Old rads are not retiring. There are really not. In my group, half of the people are near retirement, but I have not seen any talks about it or even talking about going half time.

It is sad, how on one hand, people have to work when they are 65+, full time and on the other hand, people with 6 years of higher education after medical school are struggling to find a job. What has happened really? At least I expect to retire after doing this for 30 years.

Probably going towards an employment system is not bad in the long run. Job security is more, work pace is less and job openings are probably more. All these together, can easily compensate for less pay. If you have to do it till the age of 70+, at least let's have a reasonable life style.

 

[kstreet]

Could another attending/fellow provide another positive perspective?

 

[long]

You guys are depressing.

 

[vm26]

Part of the issue is that hospital radiology departments really rely on resident labor for overnights, weekend, and holiday call shifts. My former program just added spots this year. Unfortunately programs feel no obligation to hire their former residents/fellows.

I think a lot of fellows/new attending's do have deep regrets about our career decision making and now we feel stuck. It's very depressing to get to this point despite many years of hard work, sacrifice, and financial investment. Also very hard on family and friends who see us struggling and cannot understand how the market could be so bad. I'm hopeful something will come up in terms of a job but with that said, I'll be walking on thin ice for next few years, knowing that I need to be prepared to uproot myself at any time (one of the reasons I'm postponing starting a family). Pathetic that I know new attending's already thinking 5-10 year exit strategy.

Given that the market has been tough now for what 4-5 years, bet there are many rads in crappy jobs and fellows doing second fellowships also competing for the few openings. What we put out 1000 rads every year? I do not think I have seen anywhere close to that number of jobs advertised and I keep a close eye on that.

I am hoping that once all the uncertainty is gone and reimbursement cuts quite down, groups/hospitals will start hiring again. It is a real crappy feeling knowing that if I lose my job for whatever reason, I will likely struggle trying to find another decent one. Uprooting family to move across the country is not a good option at this point in my life.

I feel real bad for the fellows, many of whom are in their 30s, with 6 figure debt, house payments, growing families, etc. coming out into this mess. Many I bet would have chosen a different path had they known how things would turn out. Seems to me like many of us go through the tough, long expensive training for the guarantees medicine offers. Unfortunately, the guarantee/promise is no longer there.

 

[radman123]

Could another attending/fellow provide another positive perspective?

Well radiology remains radiology. Like with many fields of medicine, you can have a very positive impact on the lives of your patients. In 7+ years the landscape may be much different and jobs will be more plentiful with decent salary, probably still higher than the average primary care doctor.

Maybe when more of us are employed work conditions will be better. This job drought has happened before in the mid 90s and we recovered from that into a truly golden era of growth and prosperity for radiology.

No one knows for sure what will happen in the future to this field. If you truly like radiology go for it. Maybe things will work out well for you. There are fellows out there that still get jobs where they want and like radiology.

On the other hand, if you are an excellent med student consider other fields that have had more balanced job markets historically, better lifestyles, and interesting work. I do not think that a medical student in a 1-2 month rotation can truly appreciate how radiology will be once you start working as an attending anyways. There is a lot of risk going into this field right now given the length of training, lack of jobs, and other negative trends as discussed above.

 

[shark2000]

Well radiology remains radiology. Like with many fields of medicine, you can have a very positive impact on the lives of your patients. In 7+ years the landscape may be much different and jobs will be more plentiful with decent salary, probably still higher than the average primary care doctor.

Maybe when more of us are employed work conditions will be better. This job drought has happened before in the mid 90s and we recovered from that into a truly golden era of growth and prosperity for radiology.

No one knows for sure what will happen in the future to this field. If you truly like radiology go for it. Maybe things will work out well for you. There are fellows out there that still get jobs where they want and like radiology.

On the other hand, if you are an excellent med student consider other fields that have had more balanced job markets historically, better lifestyles, and interesting work. I do not think that a medical student in a 1-2 month rotation can truly appreciate how radiology will be once you start working as an attending anyways. There is a lot of risk going into this field right now given the length of training, lack of jobs, and other negative trends as discussed above.

I agree with the first part, but not the second part.

Many things that we talk about is not specific to radiology. It is the case in most specialties. There are fields that have been off the radar, but there is no guarantee that those fields will be immune.

You recommend medical students other fields. But is there really a field that is immune? Is there a field that you can guarantee good job market, good life style and good pay?

1- IM sub-specialties: Cardiology: has it as bad as us. No job in big cities. Most are hospital employees. GI: Still a good gig. No guarantee what will happen in the future. Also CTC impact on their income is not clear. Hem-Onc: Is the next in line for pay cut. Pul/CC: horrible hours. Nephro, Endo, ...: pay is bad.

2- Surgical subspecialties: Ortho and NS are the only ones with good job market and good pay. Ophthalmology already got hit bad. ENT job market is bad. Vascular surgery is worse than IR. OB has bad hours. CT surgery went down the drain a decade ago.

3- Derm: Really a good gig. Still good job market.

Bottom Line: Personally from pure financial perspective, I only choose NS, Ortho, Derm and plastic surgery over Radiology. Other fields may be good now, but I don't expect them to remain good. If you are really ortho or NS type, probably you even do not think about radiology, so they are out of question for a classic radiology applicant. Derm is a good gig and will remain good.

My recommendation for medical students: If you are Nueurosurgey or orthopedics type, probably you are not even reading this forum. If you think about Derm versus radiology, honestly go for Derm. It is better from any perspective. I can not do it and never like it, but I wish I were. But if you think between radiology and for example surgery or IM sub-specialties, still choose radiology, though it is not better.

For Premed: Don't do medicine. You are wasting your time. Family medicine is a joke. If you want to go that way, go to PA or NP school .Or CRNA. PAs make the same and CRNAs make more than PCPs. You may make even a lot of money in medicine, but the cost is the best years and the best hours of your time. Don't look at salary numbers. They are the average of boonies and big cities. Also they are the salary of people in their 50s.

Good Luck

 

[radman123]

I agree with the first part, but not the second part.

Many things that we talk about is not specific to radiology. It is the case in most specialties. There are fields that have been off the radar, but there is no guarantee that those fields will be immune.

You recommend medical students other fields. But is there really a field that is immune? Is there a field that you can guarantee good job market, good life style and good pay?

1- IM sub-specialties: Cardiology: has it as bad as us. No job in big cities. Most are hospital employees. GI: Still a good gig. No guarantee what will happen in the future. Also CTC impact on their income is not clear. Hem-Onc: Is the next in line for pay cut. Pul/CC: horrible hours. Nephro, Endo, ...: pay is bad.

2- Surgical subspecialties: Ortho and NS are the only ones with good job market and good pay. Ophthalmology already got hit bad. ENT job market is bad. Vascular surgery is worse than IR. OB has bad hours. CT surgery went down the drain a decade ago.

3- Derm: Really a good gig. Still good job market.

Bottom Line: Personally from pure financial perspective, I only choose NS, Ortho, Derm and plastic surgery over Radiology. Other fields may be good now, but I don't expect them to remain good. If you are really ortho or NS type, probably you even do not think about radiology, so they are out of question for a classic radiology applicant. Derm is a good gig and will remain good.

My recommendation for medical students: If you are Nueurosurgey or orthopedics type, probably you are not even reading this forum. If you think about Derm versus radiology, honestly go for Derm. It is better from any perspective. I can not do it and never like it, but I wish I were. But if you think between radiology and for example surgery or IM sub-specialties, still choose radiology, though it is not better.

For Premed: Don't do medicine. You are wasting your time. Family medicine is a joke. If you want to go that way, go to PA or NP school .Or CRNA. PAs make the same and CRNAs make more than PCPs. You may make even a lot of money in medicine, but the cost is the best years and the best hours of your time. Don't look at salary numbers. They are the average of boonies and big cities. Also they are the salary of people in their 50s.

Good Luck

Agree. Stay away from medicine if you have still have time

Go to this site which has many physician jobs listed by specialty http://www.practicelink.com.

Notice how radiology has less than 20 jobs posted while most specialties with less than 1/2 the trainees have many more. Even niche areas like Bariatrics have nearly the same number of jobs posted! I think we are at the level of pathology right now but they may have fewer trainees finishing every year?

 

[Taurus]

Bottom Line: Personally from pure financial perspective, I only choose NS, Ortho, Derm and plastic surgery over Radiology.

Of those fields, I would only pick derm over radiology.

Surgery residency, especially ortho and NS, is a killer. Life as an attending surgeon is brutal as well. Furthermore, ortho and NS are definitively not immune. In addition to imaging, ortho, spine, and pain are in the crosshairs of CMS. It's only a matter of time before they get hit. Like derm, plastics is only good if you know how to successfully run your own cosmetics practice, which is a lot harder than most appreciate. If not, you'll be doing debridements and flaps for decubitus ulcers for the rest of your career.

 

[deleted116380]

For Premed: Don't do medicine. You are wasting your time. Family medicine is a joke. If you want to go that way, go to PA or NP school .Or CRNA. PAs make the same and CRNAs make more than PCPs. You may make even a lot of money in medicine, but the cost is the best years and the best hours of your time. Don't look at salary numbers. They are the average of boonies and big cities. Also they are the salary of people in their 50s.

Good Luck

Anyone considering non-imaging and non-surgical fields should become a PA if they just want to deal with patients. I honestly had no idea about that field and the path it takes until I already started school. Unfortunately, radiology requires med school and a bs intern year on top of that. What a waste.

 

[vm26]

If you think about Derm versus radiology, honestly go for Derm. It is better from any perspective.

I agree but derm is definitely no walk in the park. One of my former-coresident's sister is a dermatologist in an employed position, she makes good money but works like a dog seeing >60 patients/day. Running a cosmetic practice would be the way to go but easier said than done (have to be business savy) and I would imagine that competition is fierce

 

[cowme]

I'm a fellow and can share my experience and thoughts on the field. It's April and I still don't have a gig lined up for July (despite being willing to move anywhere outside of Guam) which is not only demoralizing given 6 years of training but also a constant source of stress for practical reasons (living situation, student loan payments etc). Radiologist's use the term "sweatshop" because in the real world of radiology, you basically get to work and sit at your work station for 11-13 hours or so in a row, only getting up for the occasional piss-break or getting food to bring back to eat at your station, and basically just crank through studies at a rate that is way beyond a normal person's comfort zone while still being held accountable for the quality/accuracy of the report. You have minimal qualitative value, it's all about your numbers. There is little to no time for chatting with your colleagues or discussing interesting cases and so it is very isolating. There is little to no camaraderie. You do not get intrinsic rewards such as gratitude from patients. The only time you hear back from a referrer or a patient is when you miss something, never a thank you for a job well down. You are asked to read studies that are not within your area of expertise but yet you are still held to similar standards in terms of accuracy/efficiency (sorta like asking the GI guy to go do a pulmonary consult). The jump in volume between trainee and attending is ridiculous. A buddy of mine is an anesthesiologist, as a resident he never had more than 1 patient at a time, as an attending he still never has more than 1 patient at a time, just more responsibility. As a radiology resident/fellow I read maybe 20-25 cross sectional a day, as an attending I will be expected to read twice that amount plus an additional 50-60 plain films/ultrasounds/mammograms/fluoro-studies (that's over 100 patients per day that I am potentially liable for). I am not sure how far along some of you are with your training but watching someone dictate studies looks far easier than doing it yourself. It's honestly mentally (and emotionally) draining. If you zone out mentally for a second you easily miss crap, there is no auto-pilot mode (as opposed to a surgeon who's hands are almost working on their own after their 1000th lap-chole). Also all your misses are electronically/objectively recorded, they're pretty black and white. In terms of money, it's all about expectation, are you ok with making progressively less each year despite having more experience and being more efficient and working longer hours? 10 years from now, will you be ok with making less money than what attending's are making now? I am not talking about 700--> 400K, more like 200K (sorta like pathology but with longer training and work hours, evenings, and weekends). Radiology will continue to be a prime target for reimbursement cuts as we don't deal with patient's directly and thus have little influence over CMS's actions. As an example, this past year medicare reduced reimbursement for MSK extremity MRIs by 30% Dealing with these types of cuts year after year is just brutal and there is no reason to think these will stop as the government is bankrupt. Maybe I am just a greedy bastard but the idea of making less money each year was not on my mind as a med-student. I had the crazy idea that people's incomes increased with more experience and skill. So in summary after rereading my post I guess my opinion is that radiology sorta sucks as a field. Despite the above, you may decide that you still find it a fulfilling, worthwhile career. If I had kids interested in medicine I would recommend that they become a nurse practitioner, medicare is apparently reimbursing their services at 85% of primary care physicians so why even deal with med school/residency/loans etc

Location: NYC i see.

Not surprised.

For potential applicants, I would think long and hard before taking a residency position in new york. Ive heard horror stories about job hunts there

 

[DrMasochist]

Just a naive MS3 here, but I feel that for the medical students out there, we shouldn't make a career decision on what the job market looks like today, because who knows what will happen in 5-6 years when we finish residency (and when OBUMA is out of the White House). Maybe the job market will fire back up, I mean those old radiologist that aren't retiring now have to retire some day! From what older physicians have told me, medicine seems to be cyclical. One day such and such specialty is making bank and then ten years later there is another hot specialty raking in the money. Medicine is really ****ty right now but so is everything else from business to engineering. It's funny because my friend is a financial analyst 3 years out of grad school and he tells me that things are doom and gloom in his field as well.

 

[shark2000]

Just a naive MS3 here, but I feel that for the medical students out there, we shouldn't make a career decision on what the job market looks like today, because who knows what will happen in 5-6 years when we finish residency (and when OBUMA is out of the White House). Maybe the job market will fire back up, I mean those old radiologist that aren't retiring now have to retire some day! From what older physicians have told me, medicine seems to be cyclical. One day such and such specialty is making bank and then ten years later there is another hot specialty raking in the money. Medicine is really ****ty right now but so is everything else from business to engineering. It's funny because my friend is a financial analyst 3 years out of grad school and he tells me that things are doom and gloom in his field as well.

What is the average salary of an engineer or financial analyst? Probably 80k, but you have not screwed up your life. You had a nice life in your 20s.

What is the average salary of a family doctor? 150K, but you have f..ed up the best years of your life, studying, going to school or taking H&P in the hospital.

What is a successful financial analyst doing in NYC? He is working 70 hours a day, but he makes make in 4-5 mil range. Still he has not f.. up his 20s. Also he get to sleep at night.

What is a successful doctor doing in NYC? He is an IR doctor or a Neurosurgeon who is embolizing a Hep C GI bleeder at 3 am or is draining a subdural hematoma at 2 am on a demented alcoholic to make 300-400K (that is the tops salary in NY for a doctor, if you don't believe me. Most are making 200-250K even in high paid fields).

Decide yourself. If your IQ is just above the IQ of a snail, go to med school. You are guaranteed a life above the average and if you become successful, you are working like a dog to make salary more than above the average.
If you have a touch of talent , you are crazy to do medicine.

This is what my cousin told me 18 years ago. He quit med school in the middle. Then he entered law school. He is now 50, almost retired. Living is his 5 mil dollar home, completely paid off. Oh, I forgot that he has a few other properties, a lot of investment, in addition to driving his Maserati and taking care of his very high maintenance wife and also paying for his two children college expenses. But, my dream is to become like the senior partner in my group who is still working at the age of 68 and is hoping to save enough money to be able to retire in 2-3 years.

 

[DrMasochist]

If you go into medicine for the money, you're an idiot.

 

[qxrt]

What is the average salary of an engineer or financial analyst? Probably 80k, but you have not screwed up your life. You had a nice life in your 20s.

What is the average salary of a family doctor? 150K, but you have f..ed up the best years of your life, studying, going to school or taking H&P in the hospital.

What is a successful financial analyst doing in NYC? He is working 70 hours a day, but he makes make in 4-5 mil range. Still he has not f.. up his 20s. Also he get to sleep at night.

What is a successful doctor doing in NYC? He is an IR doctor or a Neurosurgeon who is embolizing a Hep C GI bleeder at 3 am or is draining a subdural hematoma at 2 am on a demented alcoholic to make 300-400K (that is the tops salary in NY for a doctor, if you don't believe me. Most are making 200-250K even in high paid fields).

Decide yourself. If your IQ is just above the IQ of a snail, go to med school. You are guaranteed a life above the average and if you become successful, you are working like a dog to make salary more than above the average.
If you have a touch of talent , you are crazy to do medicine.

This is what my cousin told me 18 years ago. He quit med school in the middle. Then he entered law school. He is now 50, almost retired. Living is his 5 mil dollar home, completely paid off. Oh, I forgot that he has a few other properties, a lot of investment, in addition to driving his Maserati and taking care of his very high maintenance wife and also paying for his two children college expenses. But, my dream is to become like the senior partner in my group who is still working at the age of 68 and is hoping to save enough money to be able to retire in 2-3 years.

You're placing too much emphasis on salary. As long as you make above a certain threshold (which is possible in many careers), your career satisfaction matters more than whether you're making $300k as a physician or $5mil as a financial analyst (never mind that this kind of salary is exceedingly rare and unrealistic).

If you have general ability, then you can make a living in many different fields. It becomes more important to find what you like or can tolerate doing vs what makes the most money. If you want anecdotes, my sister just recently dropped out of Yale law school because she hated the work. Is that something most people would think is crazy at first sight? Probably. She would have been pretty much guaranteed a job and likely a good salary and high prestige. But in the long run, I think she will be happier for dropping out. It wasn't making her happy, despite potential salary.

 

[shark2000]

You're placing too much emphasis on salary. As long as you make above a certain threshold (which is possible in many careers), your career satisfaction matters more than whether you're making $300k as a physician or $5mil as a financial analyst (never mind that this kind of salary is exceedingly rare and unrealistic).

If you have general ability, then you can make a living in many different fields. It becomes more important to find what you like or can tolerate doing vs what makes the most money. If you want anecdotes, my sister just recently dropped out of Yale law school because she hated the work. Is that something most people would think is crazy at first sight? Probably. She would have been pretty much guaranteed a job and likely a good salary and high prestige. But in the long run, I think she will be happier for dropping out. It wasn't making her happy, despite potential salary.

Good Job!

Every doctor that I know, from radiologist to orthopod to family doctor will change his career with a guy who is making 5 mil in a heart beat. Otherwise, he should be admitted to a psych facility.

I always talk about internal satisfaction. But medicine lacks internal satisfaction. You talk like a premed or early med student. You clearly do not know what the story is about. You think that you will become the hero surgeon who goes to OR, drains the epidural hematoma and the patient jumps out of the table and gives you hug and says: Oh, thanks doc. You saved my life.

Last year, Medscape survey showed that less than 50% of the doctors will choose medicine if they want to do it again. This is a disaster. Go to doctor's lounge. They are all complaining. Radiologists are among some of the most satisfied doctors and still many are talking about early retirement. Boy, you are seeing too much Grey's anatomy or ER. Grow up and see the real life.

 

[Taurus]

Sure, listen to shark and go to law school like his cousin. Maybe you can use the paper the degree is printed on for toilet paper someday.

Law students face uncertain future with jobs scarce and debt high

http://jdunderground.com/all/

There have been ad nauseum articles written in the past few years about how lousy legal market is and it's not getting any better. Your cousin lucked out. The law for most people these days is a soul destroying money trap.

Law job market makes the radiology job market look like a dream. Keep things in perspective guys. It's not as bad as you think it is.

 

[qxrt]

Good Job!

Every doctor that I know, from radiologist to orthopod to family doctor will change his career with a guy who is making 5 mil in a heart beat. Otherwise, he should be admitted to a psych facility.

I always talk about internal satisfaction. But medicine lacks internal satisfaction. You talk like a premed or early med student. You clearly do not know what the story is about. You think that you will become the hero surgeon who goes to OR, drains the epidural hematoma and the patient jumps out of the table and gives you hug and says: Oh, thanks doc. You saved my life.

Yes shark2000, I want to be the hero radiologist who comes in and saves the day every day, and I'll even do it for free. Forgive me for saying money isn't everything, clearly anyone who says so is crazy.

 

[shark2000]

Yes shark2000, I want to be the hero radiologist who comes in and saves the day every day, and I'll even do it for free. Forgive me for saying money isn't everything, clearly anyone who says so is crazy.

Good Luck.

If you read my earlier post, I didn't talk about money. I even said 80K in other fields is a "better money" than 200K as a doctor. No matter what you make and what you do as a doctor, your life is f... up. It is not about money. It is about missing all the family occasions. It is about missing your first child birth. It is about your parents passing away, and you regret that you have not spent enough time with them because you had a shift at the hospital or you had to study.

You get it wrong because you can not think beyond the dream of becoming a doctor and income. To you life is summarized in becoming a doctor. That is the only thing important to you. That is beyond income, lifestyle, life, family or friends to you. This type of personality is not uncommon in medicine. There are people who are happy enough to just be called a doctor, even if they have f.. up lives. I have seen that.

For many "work" is a way to escape a messy life, or at least to justify it. You can not live and enjoy a normal life, you escape it by hiding behind a busy job.

I hope your opinion does not change when you are a 40 year old attending with 300K loans, a fat mortgage, family and friends who think you are a rich doctor and you go to work at 7 am, have 150 studies on your list, and you get paid 30% of your productivity because the hospital CEO wants to maintain his 3 mil income.

Remember this talk. You may ignore yourself, but do you think your children deserve such treatment? You never see them because you are making the manager's pocket bigger.

Our Society really needs people like you.

 

[qxrt]

No, you've got it wrong. I am happy going into medicine because I've worked as an engineer and know how ****ty and unfulfilling the job can be. I've seen my sister miserable in law school and drop out despite potential for one of the best law careers imaginable. I see my close family friend working as a financial advisor working 100+ hours a week, earning good money but spending many nights in the office without even going home. You talk about engineering, law, and business jobs as if they are some kind of ideal where you get to live the best years of your life or earn a good salary with job security -- they are not. Physicians like you take too many things for granted, complaining every time something is less than ideal. I have no such expectations for the field and expect to work hard. Why? Because I know that other fields are not better. Do you really think engineers, lawyers, and business folks have it better than us? Do you really think physicians are the only ones who work insane hours or have a terrible life? At least we do not suffer from unstable jobs, uncertain incomes, or top business/law hours.

 

[DrMasochist]

Shark, who said medicine is ****ing easy???


Sacrifices come with everything bro, sorry to bust your ideal lifestyle bubble.
And I highly doubt as a DIAGNOSTIC RADIOLOGIST you are going to miss the birth of your children, birthday parties, and all that family stuff. Just be lucky you're not a General Surgeon. And it seems to me that you have some free time on your hands since you post on this forum quite frequently.

You are in it for the long haul, so suck it up and stop bitching and being so negative. Go to auntminnie for that ****.

 

[cowme]

kinda scary to watch shark get more jaded with every passing month...

 

[vm26]

Location: NYC i see.

Not surprised.

For potential applicants, I would think long and hard before taking a residency position in new york. Ive heard horror stories about job hunts there

Residency in NYC but now a fellow in the mid-west looking nationwide for work. Ironically my former co-residents who stayed in NYC have all gotten good gigs in the tri-state area due to connections while myself and another co-resident who also left NYC, are still jobless

 

[badasshairday]

The thing that I don't get is that so many rads talk about the "sweat-shop" conditions of reading at a ridiculously fast pace due to enormous imaging volume... But at the same time, there is a glut of residents. Why not decrease the volume read per rad and hire new graduates!

 

[Taurus]

Residency in NYC but now a fellow in the mid-west looking nationwide for work. Ironically my former co-residents who stayed in NYC have all gotten good gigs in the tri-state area due to connections while myself and another co-resident who also left NYC, are still jobless

It's not completely hopeless. We have three MRI fellows and all have found employment.

I don't recommend modality based fellowships. The consensus opinion I get is that MRI fellowships will disappear like the CT and ultrasound fellowships of yore. If you do an MRI fellowship, you're in expert in what? Neuro? The neuroradiology CAQ guys who did 2 year fellowships don't think so. MSK? The MSK guys don't think so either. Go with an organ-based fellowship like MSK, neuro, body, mammo. Mammo is hot but the question is how long before that saturates. Neuro and MSK have been on the decline. The 30% cuts will probably decrease the interest in MSK even more. I think body has a very interesting future. The ACR leadership thinks that body is the next hot area in radiology. Lots of new technologies coming out. Body MRI getting better, virtual colonoscopy, CT lung screening, dual-energery CT, contrast ultrasound, more PET agents, etc.

 

[colbgw02]

The thing that I don't get is that so many rads talk about the "sweat-shop" conditions of reading at a ridiculously fast pace due to enormous imaging volume... But at the same time, there is a glut of residents. Why not decrease the volume read per rad and hire new graduates!

Trying to figure out if this is rhetorical or if you're really idealistic...

 

[shark2000]

Totally agree. That describes >80% of people in medicine. In some fields, close to 100%.

I do think your opinion of rads is shared by about half of radiologists. However, it seems it is strongly influenced by the current job market (i.e., your current job status). You seemed to have liked/loved radiology residency and fellowship. Another important factor is that you are at the lowest point of your career...it will only get better as you will eventually be a full partner, will be better compensated, have voting rights, the economy will recover, and you will be able to better control your scope of practice.

Probably you are right. I was and still am overwhelmed by a nightmare I had yesterday.

Things will be fine. As I said before, Still I choose radiology over every other field in medicine.

I make a good money and I still like what I do. But there are times that I wish I could do 20% less work for 20-30% less pay. 30% less that what I make, even as a junior person, is enough to have a decent life. But, 30% decrease in work and income, will double my quality of life.

Yesterday was a disaster. It was my Sunday shift and I started at 7 a.m. and left work at around 10 p.m. (my shift was only till 7 p.m, but had to clean my work). Non stop work. I checked a few E-mails and posts in between. I watched two or three 5-10 minutes youtube video clips just for fun. Went to Starbucks 2 times. Went to cafeteria to grab sth to eat at work station, and I was paged by the tech in the middle. Other than that, non stop work. And in a scale of a pp radiologist, even experienced, I am considered fast. By the end of the day, I read 154 studies, about half of them cross sectional. Got endless calls from ED during the day. I did one joint aspiration and one LP. Also had to put a drain in a live abscess. Did one esophagram, though limited one in a post op patient with questionable leak. I had to call the tech for some X-rays since the X-ray tech is new and he is not good at getting a lot of views (I am MSK and probably a little obsessed with the angles).

Didn't complain, but then all of a sudden, a third year medical student jumps in and tells me how my job is much better than a CEO of the hospital who was probably playing golf the whole Sunday and is making 2 Mil.

I know, I understand. I did not end up in this planet yesterday from Mars. I have seen business people working their ***** off. I have seen them went from top to completely broke to the point that they became almost homeless in the street. But just said that there are jobs that have a better balance between life and work and Medicine, the way it is practiced these days is not one of them.

If the way we practice medicine changes, we may see better balance between life and work. The upcoming changes in healthcare system, my in fact benefit us, though not apparent at the first glance.

 

[badasshairday]

Trying to figure out if this is rhetorical or if you're really idealistic...

I'm being serious.

 

[deleted116380]

I'm being serious.

Why cut more slices into the pie? Not all practices want to cut the volume per radiologist especially when it means it will cut their salary. Not to mention the extra cost of a new hire with medicare and SS matching, retirement and health benefits, etc. Cheaper to have 1 radiologist on staff than 2 that have full benefits assuming the 2 combined do the same work as 1.

 

[greenmanNavy]

Shark- Long-time reader… mucho appreciate the honest input. For us getting ready to apply to residency, it is crucial to hear the hard truth. My target was Rads but I may steer away from Rads altogether after reading several negative outlooks on SDN. Considering Derm 'cause I have to do something, so why not.
I suppose these days a specialty is a winner if it is not uninteresting, makes decent $$, PLUS has a schedule amenable to family life.

 

[Taurus]

One huge positive of radiology is that we don't have midlevels who can replace us.

Be very careful of those fields where midlevels basically perform the same function as physicians, ie, primary care, hospital medicine, ED, etc. It's really hard to pick a field these days because of so much volitility. Pick a field because you enjoy it. Based on my interests and personality, radiology is a good fit for me.

Erasing inequities between doc, advanced practitioner pay

Craig Samitt, M.D., president and chief executive of the Dean Health System in Madison, Wis., further suggested Medicare should reduce doctor's pay by 15 percent for services better left to APRNs or PAs, reported MedPage Today.​

Did people really think that they would increase the reimbursements for 100k midlevels to match physicians? Not in our broke system. More likely they will decrease reimbursements to match that of midlevels so that every is even. The primary care folks sold medicine out to Obamacare. Now it's payback time.

 

[deleted103644]

Shark- Long-time reader… mucho appreciate the honest input. For us getting ready to apply to residency, it is crucial to hear the hard truth. My target was Rads but I may steer away from Rads altogether after reading several negative outlooks on SDN. Considering Derm 'cause I have to do something, so why not.
I suppose these days a specialty is a winner if it is not uninteresting, makes decent $$, PLUS has a schedule amenable to family life.

If you can get into dermatology and can stomach it, why are you even thinking about the choice?

People will always be willing to pay out of pocket for their skin even if they expect the life-threatening stuff to be covered for free. You will be less insulated from economic downturns, but the supply of dermatologists has been kept low enough you will always be in demand.

Personally there's not enough money in the world for me to go into derm...

As for salaries for physicians vs law/business, people keep focusing on the top earners and ignoring the median or even the 25th percentile. Being a physician essentially guarantees you a six figure income assuming you can get a license and don't do anything profoundly stupid.

The median salary for lawyers is $60k. Analysts at Lehman who may have earned a half million over a few years right out of college are now serving grande lattes.

There is much more variance in salary for business and law, medicine is the better path for the risk averse.

 

[colbgw02]

I'm being serious.

Sure, but seriously rhetorical or seriously idealistic?

 

[Doctor D]

After doing a seen elective and seeing multiple "real housewives of X" type patients coming in for Botox, I decided that I could never do derm even if it paid double of radiology.

 

[deleted116380]

After doing a seen elective and seeing multiple "real housewives of X" type patients coming in for Botox, I decided that I could never do derm even if it paid double of radiology.

You don't have to do derm to do that. My friend's mom was FM/peds for a long time, but decided near the end of her career to do those procedures and other small things with simple certifications to retire earlier. Easily ended up doubling her salary by doing it, but she had a lot of friends that aren't too far from what you describe. Then their friends would hear about it, etc etc...and it ended up expanding through referrals.

Pretty sure I wouldn't have the same results as her even if I tried doing it as I don't have a lot of girlfriends like that. i.e. tupperware party things.