IM vs Anesthesiology

[rokshana]

Anesthesiology average annual income: $350,000
Internal medicine average annual income: $190,000

so...

$350,000 - $190,000 = $160,000

Do you love internal medicine so much that you would be willing to pay $160,000 per year for the privilege of practicing it?

hmm...hospitalist...$250,000...AND

26 weeks off....

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[lost007]

Guys...I have one week to make up my mind and keep flipping back and forth. I don't know what to do

 

[gutonc]

Guys...I have one week to make up my mind and keep flipping back and forth. I don't know what to do

Sack up?

Seriously...for your sake I hope you're trolling. Using the intarwebs to decide your entire career is pretty much the worst idea ever.

 

[bigkahunaburger]

IM is the way to go, you really want to watch a monitor the rest of your life?

 

[ger8]

Guys...I have one week to make up my mind and keep flipping back and forth. I don't know what to do

If you can't make up your mind by now, I will suggest rank both randomly or by the location you want to live, then the computer will make a pick for you. Since you applied to Anesthesia probably you had applied also to transition or prelim positions. You might need to rank only the transition or prelim. This way you have an extra year to think about IM or GAS.

 

[silvervman]

Sorry dude, you're in a tough situation. I was there too actually. I dual applied into anesthesia and internal medicine but withdrew my anesthesia application after going on a handful of interviews. I think I always knew I wanted to do IM and some kind of fellowship after but it's a long road. Anesthesiology was the easy way out for me. Shorter residency, better lifestyle and similar (or more) money to the IM subspecialties I'm considering. At the end of the day though, I felt that I would have more pride in my job if I went into IM. I didn't like the fact that CRNA's could pretty much do what an MDA could do. I don't want to be managing multiple OR rooms, I want to be the one that's actually running the show. When I did my anesthesia rotation, alot of attendings would tell me that their life is sweet. They make alot of money and have great lifestyles. When I talked to IM docs and IM subspecialty docs, they would tell me how much they love what they do. That was the kicker for me. If lifestyle is the big deal breaker for you, remember that lifestyle is controllable. I've talked to interventional cardiologists that have told me lifestyle is what you make of it. You want to make over a million dollars? Go ahead and do solo practice and be on call everyday. You're ok with 300? Work in a big group and take call once very 10 to 14 days.

Either way, both fields are great and I'm sure you'll be happy doing either one. There's really no wrong answer. The reasons I gave are my own and no one elses. I'm sure there are anesthesiologists that are extremely passionate about what they do, I just didn't run across them as often as I saw passionate IM docs. Good luck!

 

[tallash]

Sack up?

Seriously...for your sake I hope you're trolling. Using the intarwebs to decide your entire career is pretty much the worst idea ever.

+1

seriously

 

[silvervman]

Also, don't leave your decision up to fate and intermix IM and anesthesia programs on your rank list. You're not leaving it up to faith, you're leaving it up to some stupid computer program. Whatever decision you make, at least be able to say it was your decision and not Skynet's.

 

[SpasticNerfBag]

I faced a similar issue.

1) If you interviewed at either UCSD or Stanford, you could have a chance to do both in five years by switching to the combined program next year (note: there is at least one other program that will likely have this program running next year and probably more).

2) If the two really are equal in your mind (I doubt this) flip a coin or rank them both and let the algorithm flip for you.

3) Solution to your dilema is likely honest introspection. A question I felt was helpful -- Which specialty do you respect more?

 

[bola]

Practically speaking, you can try to match into IM at a place with a good anesthesia program, start your intern year and around Jan-Feb, figure out where you stand with IM (granted it's easy to hate it as an intern). If you want to jump ship, then start the process of finding a CA-1 position with no time lost since you will have to do a med or surg intern year prior to anesthesia anyway. Anesthesia program directors are usually very welcoming to career changers. The hard part is having the awkward conversation with your medicine program director.

Most of us pick our careers with ridiculously little information and it's mostly a huge gamble. Good luck!

 

[LovelyBRass]

If you haven't decided by now, pick anesthesia. No flakes plz

 

[usermike8500]

hmm...hospitalist...$250,000...AND

26 weeks off....

Whenever I google "hospitalist" positions, it seems like $160,000 is more the norm for 7 on 7 off 12 hour shift work. Then again, I'm just a student and don't know anything about the business of medicine.

Can you really find employment as a hospitalist or nocturnist with a reimbursement of $250,000 per year? That sounds amazing.

 

[rokshana]

Whenever I google "hospitalist" positions, it seems like $160,000 is more the norm for 7 on 7 off 12 hour shift work. Then again, I'm just a student and don't know anything about the business of medicine.

Can you really find employment as a hospitalist or nocturnist with a reimbursement of $250,000 per year? That sounds amazing.

well let's see, $120/hr x 12 hours x 7 days x 26 weeks...you do the math (its 262,800 gross btw)...and that is on the lower end (130 is closer to the norm, though some places you can get 150+ but its rare).

now can you get that in NYC? no...the NE is terrible for compensation in general and at best you get 100/hr..but more like 75-85/hr...which puts you closer to 160-170K.

 

[donkeykong1]

well let's see, $120/hr x 12 hours x 7 days x 26 weeks...you do the math (its 262,800 gross btw)...and that is on the lower end (130 is closer to the norm, though some places you can get 150+ but its rare).

now can you get that in NYC? no...the NE is terrible for compensation in general and at best you get 100/hr..but more like 75-85/hr...which puts you closer to 160-170K.

Would being contracted as a hospitalist at one hospital restrict one in signing on at a light locum tenens or part-time gig somewhere else on "off days"

 

[rokshana]

Would being contracted as a hospitalist at one hospital restrict one in signing on at a light locum tenens or part-time gig somewhere else on "off days"

contracts vary, but generally no it shouldn't...your of days are your off days.
some hospitals will ask that if you want to work extra days, then to work those extra shifts at the home hospital.

 

[donkeykong1]

just thought i'd post the medscape 2012 IM compensation report found off google

http://www.medscape.com/features/slideshow/compensation/2012/internal-medicine

 

[Extracts]

The mean compensation based on this survey from today's hospitalist is 227k. http://www.todayshospitalist.com/index.php?b=articles_read&cnt=1380
A lot of the figures from the medscape survey including other specialties are low. A lot of my friends are hospitalist and average around 250k for 7 day on 7 off. I have one friend who has two gigs. One that pays 220k and another 270k ==> 490k as a hospitalist. Both gigs are pretty easy for him. One job has residents and he's out by 3 or 4 when not on call.

I wonder sometimes why I did a fellowship.

 

[gutonc]

I wonder sometimes why I did a fellowship.

Because once you've put the bullet in your head, half a mill a year is useless to you.

Do what you like. You can make a metric f***ton of money in any specialty but you'll have to sacrifice something (time, location, sanity, not having to appear in front of a federal grand jury, etc).

I have a (IM subspecialty) job that I love. It pays me well enough in a great location that I'm not looking any further.

I could easily double or triple that salary...and my daughter would have a nice trust fund, but not a dad.

 

[donkeykong1]

The mean compensation based on this survey from today's hospitalist is 227k. http://www.todayshospitalist.com/index.php?b=articles_read&cnt=1380
A lot of the figures from the medscape survey including other specialties are low. A lot of my friends are hospitalist and average around 250k for 7 day on 7 off. I have one friend who has two gigs. One that pays 220k and another 270k ==> 490k as a hospitalist. Both gigs are pretty easy for him. One job has residents and he's out by 3 or 4 when not on call.

I wonder sometimes why I did a fellowship.

I agree. it varies on location starting salaries after pgy3 anywhere from 190k [east] up not including the ability to work additional hours.

Does a hospitalist position count for loan repayment opportunities?

 

[Extracts]

Because once you've put the bullet in your head, half a mill a year is useless to you.

Do what you like. You can make a metric f***ton of money in any specialty but you'll have to sacrifice something (time, location, sanity, not having to appear in front of a federal grand jury, etc).

I have a (IM subspecialty) job that I love. It pays me well enough in a great location that I'm not looking any further.

I could easily double or triple that salary...and my daughter would have a nice trust fund, but not a dad.

I did say "sometimes". I don't think I could be hospitalist for the rest of my career.

However, my buddy who makes 490k found two relatively cush gigs and has been doing it for the last 5 years. He's also paid of his mortgage (lives in a high cost of living area) and is creating a nice trust fund for himself.

To the OP. I understand your situation. I switched from Anesthesia to Medicine. It is difficult to switch during residency, but possible. Go on to a field that you think will make you happy. You can make a decent living no matter what area you go into.

I suggest doing a prelim medicine year with anesthesia. That would give you some time to make a decision. If you want to switch to medicine, you at least fulfill first year requirements. That's what I did.

Good luck, it's not the end of the world if you end of changing your mind during residency.

 

[ArkansasHogMD]

I did say "sometimes". I don't think I could be hospitalist for the rest of my career.

However, my buddy who makes 490k found two relatively cush gigs and has been doing it for the last 5 years. He's also paid of his mortgage (lives in a high cost of living area) and is creating a nice trust fund for himself.

To the OP. I understand your situation. I switched from Anesthesia to Medicine. It is difficult to switch during residency, but possible. Go on to a field that you think will make you happy. You can make a decent living no matter what area you go into.

I suggest doing a prelim medicine year with anesthesia. That would give you some time to make a decision. If you want to switch to medicine, you at least fulfill first year requirements. That's what I did.

Good luck, it's not the end of the world if you end of changing your mind during residency.

One of the hospitalist at a community hospital I do part time tech workw with told me he made 325K with bonus last year. They do one week on, one week off.

 

[LoudBark]

One of the hospitalist at a community hospital I do part time tech workw with told me he made 325K with bonus last year. They do one week on, one week off.

To make that he would have to be doing A LOT of extra shifts on his 7 days off..........or be in a hospitalist job where they see 20-25 patients a day. No way he makes that much doing a routine 7 on 7 off seeing 16-18 pt a day. Even in the south or rural midwest where they pay more, that seems a little much not doing extra work or seeing a boat load of patients a day.

 

[happygilmore]

Bump

 

[lost007]

Bump

I ended up matching in IM. Part of me kinda regrets not going into gas. But I think I'm gonna stick with IM and go into cards/GI

 

[dozitgetchahi]

I ended up matching in IM. Part of me kinda regrets not going into gas. But I think I'm gonna stick with IM and go into cards/GI

Good on ya, mate. Don't regret it. I had the same dilemma you did but the choice was obvious once it became clear that the CRNA phenomenon was going to gut the practice of anesthesiology from the inside out.

 

[bronx43]

Good on ya, mate. Don't regret it. I had the same dilemma you did but the choice was obvious once it became clear that the CRNA phenomenon was going to gut the practice of anesthesiology from the inside out.

Bingo. This is exactly the reason I avoided anesthesia like the plague. Even my buddy, a current CA-2 who vehemently downplayed the dangers of CRNAs prior to starting residency, is now admitting that CRNAs have the potential of completely destroying the anesthesiology job market.