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Was enough wearing green, eh?
In some ways. It's not terrible, but I just want complete control over my life. Since, you know, it is mine and all.
Was enough wearing green, eh?
I got two questions for you guys.
1. This post started off by saying that psych salary is about 200k, with some regions reaching (225k, midwest). Now we are talking about how that is only possible outpatient once you have an established practice, and not salaried at the hospital.
I got two questions for you guys.
1. This post started off by saying that psych salary is about 200k, with some regions reaching (225k, midwest). Now we are talking about how that is only possible outpatient once you have an established practice, and not salaried at the hospital. What are the real chances of making that much? Comparing it to PM&R, IM, Neuro?
2. How does a psych intern year differ from ones for em, im, neuro, pm&r? Are there any differences?
I agree passionately with Leo above. The salary was heavy on my mind for a a while as I contemplated the sum total of my loans. But....what I decided was that I can manage that by living more spartan. Not by compromising what I want to do with my life.
I'm now looking around for what would be a stimulating and rewarding career in psych. You should do the same wherever you go.
Regarding the intern year it's typically much lighter and less grueling than a full medicine year. Which is I think what neuro, PM&R, and of course medicine do. EM you'll have some off service months and then x amount of shifts per month in the ED. You should consult those forums or colleagues for specifics.
And it varies a lot program to program. For instance I'm working like a medicine intern in a busy NYC hospital. 80 plus/week. With some more human friendly spurts of neuro.
Some psych programs have a mix of ED and outpatient medicine months.
But all of us will do 6 months of medicine and neuro and 6 months of inpatient and ED psych as interns.
If you're thinking of doing IM. Stop. And punch yourself in the nuts. Feel that pain. It's a tiny fraction of what you have in store. Contemplate. Correct. And go PM&R or psych or ED.
What's wrong with IM again? I ask because I'm on a psych elective right now and am contemplating if I want to do it. Now I'm wondering if I should do IM. I think I've largely forgotten what it was like since I did a year ago (research this year). Care to remind me of what I may be blocking?
What's wrong with IM again? I ask because I'm on a psych elective right now and am contemplating if I want to do it. Now I'm wondering if I should do IM. I think I've largely forgotten what it was like since I did it a year ago (research this year). Care to remind me of what I may be blocking?
Well. There this this effect of being a useless clerk that tends to distort the fun of solving IM academic puzzles. Which become by comparison a fun skill building exercise. You like it when you get that UWorld question about cystic fibrosis right that only 15% of people did. And so on. So it seems interesting. After you clerk for some hours where you have little responsibility and you're rarely on call or there until late. And you cut out for holidays and lectures and whatever you can make up for not being there. It seems ok in this light. And you imagine it's awesome being a Real Doctor.
Then you become an intern. And get strapped, like a beast of burden, to pull all the details of patient care along for long boring hours. Clicking your life away under the fluorescent lights. Where thinking and studying up on the stuff coming at you means the difference between getting out of there to catch the last glimpse of sunlight. Or living a completely subterranean existence. Like a mole.
You'll never know the pure ecstasy of dropping a rec and hauling @ss. Or being able to gently cut off a patient who wants to know who will take of their cat while they're in the hospital and wants to know if you can call their cousin Edna in Long Island to tell her about the cat...etc...etc....etc...by saying yeah...uh...you're going to need to follow that up with your primary team. MmmmK. Thanks. Tootles.
Well that poor f@ck in the middle of everything. Who's everyone's b!tch. Is you. If you go IM and don't compete like hell, with everyone else who discovered what a **** train you all are on, to get one of the sweet fellowships to get you off it.
Being square in the middle of the medical bureaucracy puts your dumb ass in the middle of The **** Show.
You've been warned.
Well. There this this effect of being a useless clerk that tends to distort the fun of solving IM academic puzzles. Which become by comparison a fun skill building exercise. You like it when you get that UWorld question about cystic fibrosis right that only 15% of people did. And so on. So it seems interesting. After you clerk for some hours where you have little responsibility and you're rarely on call or there until late. And you cut out for holidays and lectures and whatever you can make up for not being there. It seems ok in this light. And you imagine it's awesome being a Real Doctor.
Then you become an intern. And get strapped, like a beast of burden, to pull all the details of patient care along for long boring hours. Clicking your life away under the fluorescent lights. Where thinking and studying up on the stuff coming at you means the difference between getting out of there to catch the last glimpse of sunlight. Or living a completely subterranean existence. Like a mole.
You'll never know the pure ecstasy of dropping a rec and hauling @ss. Or being able to gently cut off a patient who wants to know who will take of their cat while they're in the hospital and wants to know if you can call their cousin Edna in Long Island to tell her about the cat...etc...etc....etc...by saying yeah...uh...you're going to need to follow that up with your primary team. MmmmK. Thanks. Tootles.
Well that poor f@ck in the middle of everything. Who's everyone's b!tch. Is you. If you go IM and don't compete like hell, with everyone else who discovered what a **** train you all are on, to get one of the sweet fellowships to get you off it.
Being square in the middle of the medical bureaucracy puts your dumb ass in the middle of The **** Show.
You've been warned.
"Compete like hell?" Lol, wut? If you're a decent medical student from an American school, then you'll likely match into a decent academic institution. If you're from a decent academic institution, then you should have zero issues matching into whatever specialty you pick as long as you aren't a total dumba**. Hospitalist at a private hospital can be a sweet gig, but I agree that it isn't the most glamorous thing in the world. If you go into IM, I would not think twice about doing a fellowship. GI, cardio, pulm/CC, heme/onc are all sweet gigs that I would take in a heartbeat over the likes of ED, psych, and PM&R. Even the lesser known IM subspecialties are hidden gems like allergy&immunology, and even rheumatology (about to explode with new biologics = lucrative infusion centers a la heme onc).Well. There this this effect of being a useless clerk that tends to distort the fun of solving IM academic puzzles. Which become by comparison a fun skill building exercise. You like it when you get that UWorld question about cystic fibrosis right that only 15% of people did. And so on. So it seems interesting. After you clerk for some hours where you have little responsibility and you're rarely on call or there until late. And you cut out for holidays and lectures and whatever you can make up for not being there. It seems ok in this light. And you imagine it's awesome being a Real Doctor.
Then you become an intern. And get strapped, like a beast of burden, to pull all the details of patient care along for long boring hours. Clicking your life away under the fluorescent lights. Where thinking and studying up on the stuff coming at you means the difference between getting out of there to catch the last glimpse of sunlight. Or living a completely subterranean existence. Like a mole.
You'll never know the pure ecstasy of dropping a rec and hauling @ss. Or being able to gently cut off a patient who wants to know who will take of their cat while they're in the hospital and wants to know if you can call their cousin Edna in Long Island to tell her about the cat...etc...etc....etc...by saying yeah...uh...you're going to need to follow that up with your primary team. MmmmK. Thanks. Tootles.
Well that poor f@ck in the middle of everything. Who's everyone's b!tch. Is you. If you go IM and don't compete like hell, with everyone else who discovered what a **** train you all are on, to get one of the sweet fellowships to get you off it.
Being square in the middle of the medical bureaucracy puts your dumb ass in the middle of The **** Show.
You've been warned.
... I would not think twice about doing a fellowship. GI, cardio, pulm/CC, heme/onc are all sweet gigs that I would take in a heartbeat over the likes of ED, psych, and PM&R. Even the lesser known IM subspecialties are hidden gems like allergy&immunology, and even rheumatology (about to explode with new biologics = lucrative infusion centers a la heme onc)...
Well, yeah. I mean, you do what you like - no one can tell you otherwise. What I was saying about the IM subspecialties is that many offer incredible pay and lifestyle. It's cool that you don't like colonoscopies (me neither), but you can't go wrong with making $450k with regular hours and minimal call. The thing with IM is that it's easily the most versatile field you can go into, because of the wide variety of different subspecialties you can choose from. There is the intense, almost-surgery field like interventional cardiology, or you have derm-lite with allergy & immunology. And then you have everything in between. I personally think rheumatology is one of the most fascinating fields in all of medicine, and it's set to explode. I think it's at a point where heme onc was 20 years ago. I'm expecting competitiveness of rheumatology to shoot up in about 5 years when people realize you can set up your own shop (Arthritis Center of [insert city]), do injections, DEXA scans, and own infusion centers while working 45 hours a week. You also have longitudinal care for patients with fascinating diseases like scleroderma, lupus, vasculitis, etc.It's great to get perspective on things around here. Very refreshing to read your post bronx.
I'm glad those specialties appeal to you. Let me quickly share my take on them:
GI is all about fitting 10 colonoscopies into a day. Yes, I worked for a GI clinic for a summer and that's the pace. That's frankly not how I want to spend my time. Too dirty.
Cardio.... I love cardiology, but it's exhausting hours. Spoke to a few cardiologists and they all said you'll spend more time in the hospital than anywhere else. They looked pale and tired.
CC, I loved it and was really good at it in med school. But hey, tweaking vent settings and having intubated patients wasn't my thing. I need patients to communicate with.
Heme/onc, another rotation I actually did in med school and loved. But it made me very sad 1) seeing doctors break terminal news to patients, and 2) seeing patients who are slowly dying.
ED, I agree with you 100%. There's no way in hell anyone is going to get me out of bed in the middle of the night away from my family. Night time is my private time. Protected. Sacred.
PM&R, nobody knows who or what they do outside of medicine. It's the new kid on the block, too new for my liking. It tries to be neuro light and ortho light without the surgery.
Surgical specialties are fascinating, but I personally hated being in the OR.
Well, that's my 2 cents. Psych is all about what I consider most important, the patient-doctor therapeutic alliance. And it's ALWAYS interesting.
Huge misconception all medicine residencies are brutal. Sure, there are programs that are malignant that will work you 90+ a week, but those are going by the way of dinosaurs. Don't get me wrong, IM residency isn't a cake walk, but it is very very manageable, and is borderline easy if you find a supportive program. Out of all my friends that are doing IM at academic centers, only one is at a shop that is "old-school." Everyone else rarely ever breaks or even comes close to breaking hours. I average 65 hours at my institution while on service months, and around 35 hours on elective/clinic months.first you have to survive the first three yrs of im residency
how bad is the job market honestly? if its really that that bad why do students keep taking the risk of going into it
Huge misconception all medicine residencies are brutal. Sure, there are programs that are malignant that will work you 90+ a week, but those are going by the way of dinosaurs. Don't get me wrong, IM residency isn't a cake walk, but it is very very manageable, and is borderline easy if you find a supportive program.
Wow, that certainly jogs some memories, mainly the unhappiness I felt in IM. Although if you can stick it out, some of those fellowships are pretty sweet gigs.
Speaking of cats, I actually spent about 2 hours today trying to find a home for three cats who belonged to one of my patients on the adult inpatient psych unit I'm on. I enjoyed it though, and the team was very appreciative of my work.
are you in residency or med school?
I agree passionately with Leo above. The salary was heavy on my mind for a a while as I contemplated the sum total of my loans. But....what I decided was that I can manage that by living more spartan. Not by compromising what I want to do with my life.
I'm now looking around for what would be a stimulating and rewarding career in psych. You should do the same wherever you go.
Regarding the intern year it's typically much lighter and less grueling than a full medicine year. Which is I think what neuro, PM&R, and of course medicine do. EM you'll have some off service months and then x amount of shifts per month in the ED. You should consult those forums or colleagues for specifics.
And it varies a lot program to program. For instance I'm working like a medicine intern in a busy NYC hospital. 80 plus/week. With some more human friendly spurts of neuro.
Some psych programs have a mix of ED and outpatient medicine months.
But all of us will do 6 months of medicine and neuro and 6 months of inpatient and ED psych as interns.
If you're thinking of doing IM. Stop. And punch yourself in the nuts. Feel that pain. It's a tiny fraction of what you have in store. Contemplate. Correct. And go PM&R or psych or ED.
I think that's my biggest problem. Money is "heavy on my mind" as well.
I think that's my biggest problem. Money is "heavy on my mind" as well.
Nasrudin and Leo, thank you for some validation of what I have been trying to say. You put it better than I did, but I will try again. If you cannot live below your means as a psychiatrist, you have some really wicked expenses that far exceed medical school. It would take a cocaine problem, a large dysfunctional family with personal weak boundaries, or a huge medical problem to exclude psychiatry as a viable option for most medical graduates. We do make enough money for a reasonable person. If you need to be Donald Trump, you missed that boat when you got into medicine.
No apology necessary. You are smart enough to figure this out. Not so sure Vistaril will ever be content. Vistaril, if you are so unhappy with psychiatry, why do you persist? Psychiatry feeds most of us enough and we feel rewarded enough. Not so sure you will be content here if it is all about pay and hours worked.
Do you happen to know when the new fee schedule is meant to kick in?They're not poor. See the new 2014 Medicare fee schedule for all specialties. Which specialty got the biggest boost this year in reimbursements? Was it Derm? Plastics? Immunology? GI or Cardiology?
Nope.
The greatest boost went to mental health providers including psychiatry. Now we won't get rich off these increases, but the Centers for Medicare and Medicaid Services (CMS) are putting more money in our Psych pockets, giving us more credence as a specialty. Essentially the CMS is saying mental health really matters.
Notsureifsrs.From The Pardoner's Tale that follows The Physician's Tale: "Radix malorum est cupiditas". Also featured in another famous book.
I personally see very little practical difference between the salaries of 225k and 450k even though one is twice as much as the other.
From The Pardoner's Tale that follows The Physician's Tale: "Radix malorum est cupiditas". Also featured in another famous book.
I personally see very little practical difference between the salaries of 225k and 450k even though one is twice as much as the other.
Totally serious.
Why do you want to retire early? Is it because you don't like/enjoy your work?
Also, all those years of toil getting educated just so you can retire early with money in hand seems a bit futile to me.
You seriously enjoy work more than your hobbies? Time to get new hobbies, bro. Like BallerMD said, if I was born into money, I would laugh at the thought of going to med school.Totally serious.
Why do you want to retire early? Is it because you don't like/enjoy your work?
Also, all those years of toil getting educated just so you can retire early with money in hand seems a bit futile to me.
Well you have to do something. I think a lot of people idealize things like 'retiring early' - but then what? Most common thing is sitting on one's ass waiting to die.
Yes there's hobbies- but many people don't have true hobbies. Is painting un-noteworthy pictures or photographing birds really going to do something for you? (and if it does- maybe you should have pursued that to begin with).
I get the "options" thing- but really what would you do? There's travelling but you can travel throughout your life (and you should before you grow old and it becomes more difficult/burdensome).
A lot of jobs can pay bills.
Not if you want a Porsche...