Is it wrong to pick specialty by location?

[Fiesty Doc]

Hi gang. I'm a third year now and I'm thinking about all the specialties I got to know this year and I just can't make up my mind. I have it narrowed down to PMR and Psych, but I can't choose between them. The deciding factor for me is going to come down to location. My husband and I want to stay in New England for residency and practice so as psychiatrists, how would you say the job opportunities are in northern New England (Vermont, Maine, and New Hampshire)? I'm going to cast my net wider for residency to include all of New England and a few other places, but I'm looking for a sense of the opportunities after residency since I don't want my own solo practice.

Any help is appreciated!

Also, I'm a DO student, not MD.

---

Members don't see this ad.

 

[Indryd]

Regardless of what specialty I eventually choose, I will be picking my residency at least 90% based on location.

:hate:Baltimore:hate:

 

[billypilgrim37]

There will always be job opportunities for people who actively want to live in places where other people actively do not want to live. Given your preference for "out in the middle of nowhere," you sound like you're going to be just fine no matter.

 

[silas2642]

Hi gang. I'm a third year now and I'm thinking about all the specialties I got to know this year and I just can't make up my mind. I have it narrowed down to PMR and Psych, but I can't choose between them. The deciding factor for me is going to come down to location. My husband and I want to stay in New England for residency and practice so as psychiatrists, how would you say the job opportunities are in northern New England (Vermont, Maine, and New Hampshire)? I'm going to cast my net wider for residency to include all of New England and a few other places, but I'm looking for a sense of the opportunities after residency since I don't want my own solo practice.

Any help is appreciated!

Also, I'm a DO student, not MD.

Maine is always looking for qualified psychiatrists. Always.

 

[masterofmonkeys]

as is new hampshire. I assume vermont even more so, since they don't have a big program like dartmouth around.

 

[psych]

There is a much bigger demand for psychiatrists than physiatrists anywhere you are. That is a downside to PM&R - limited job opportunities.

 

[OldPsychDoc]

There is a much bigger demand for psychiatrists than physiatrists anywhere you are. That is a downside to PM&R - limited job opportunities.

Disagree--we're begging for PM&R to manage chronic pain pts. If you could do interventional pain procedures, you'd have a kickin' practice.

 

[Gabby]

Disagree--we're begging for PM&R to manage chronic pain pts. If you could do interventional pain procedures, you'd have a kickin' practice.

Aren't pain fellowships open to psych residents also? Or do PM&R and anesthesiology folks get first dibs on those?

 

[OldPsychDoc]

Aren't pain fellowships open to psych residents also? Or do PM&R and anesthesiology folks get first dibs on those?

Yes theoretically, and yes primarily.

 

[Gabby]

Good to know. I didn't realize there were preferences among the specialties.

 

[psych]

Disagree--we're begging for PM&R to manage chronic pain pts. If you could do interventional pain procedures, you'd have a kickin' practice.

I guess I could be wrong buy my understanding is that you can pretty much work anywhere you want as a psychiatrists vs going where the job is at as a physiatrist.

 

[nancysinatra]

Good to know. I didn't realize there were preferences among the specialties.

I think I read somewhere that pain fellowships were in theory open to almost all specialties, but that anesthesiology and PM&R people got the most spots and after that neuro. A few spots might go to psych, and after that it sounded like there wouldn't be much left.

I've always wondered which programs might be most open to a psych person, and how the fellowship works if it is incorporating people from such different specialties. Do psych-trained pain specialists do much by way of procedures?

 

[TexasPhysician]

Disagree--we're begging for PM&R to manage chronic pain pts. If you could do interventional pain procedures, you'd have a kickin' practice.

True, but I have heard from many that without that fellowship, the job opportunities are quite slim.

 

[BobA]

To the OP, I don't think you should feel guilty about letting location affect your specialty choice. As long as you could see yourself being happy in either specialty.

Contrary to popular belief, we're not genetically programed to be happy in one and only one specialty. But that's how the specialty selection process can feel sometimes - at least it did for me.

Do what's gonna make you happy and location can be a big part of that.

 

[whopper]

I don't think there's anything wrong with picking specialty by location given your factors. I've seen several applicants loving more than 1 field, and to me that shows broad interests. Medicine in general is not just 1 specialty. Even in the specialities, they will at times converge & interact with the other fields of medicine. I sometimes find myself in shock when I get a patient transferred to my unit with a number of medical problems that the psychiatrist didn't attend..e.g. elevated cholesterol, HTN etc. Yeah its not our field, but you just can't let someone with high cholesterol who's going to spend several months in inpatient go on that same track. At the very least consult the IM doctor.

Also factor in location is an important life choice. Several end up practicing as attendings where they do residency. Programs should factor in that location is a major life altering decision, and have some empathy for their candidates who may be moving away from friends & family into an alien environment.

However--a warning, programs may not look upon this favorably. Several will be more turned on by a candidate that is completely gung ho for the field they apply. Their perspective is they have hundreds to thousands of applicants for a handful of spots. The candidate who is conditionally wishing to go into a field based on location may not look as favorable as the one who says they only want the one field.

 

[heyjack70]

Disagree--we're begging for PM&R to manage chronic pain pts. If you could do interventional pain procedures, you'd have a kickin' practice.

My limited exposure to PMR docs is that they aren't that jacked about chronic pain management and prefer to leave the prescribing to the internists. What are your opinions?