Mid-3rd year crisis: switching from peds to radiology

[freeski]

Hey guys. I would really really appreciate your advice.


I’ve been gung-ho peds for most of my medical school career. UNTIL I started my radiology rotation, and (shockingly) I’m loving it, no offense to all of the radiologists and budding radiologists. I just never thought I would enjoy it as much as I do. I find radiology to be very intellectually stimulating, and of course, the life style is very appealing. I am particularly drawn to pediatric radiology.


Until now, I’ve been pretty blindly heading down the path of becoming a pediatrician, but I’ve been re-evaluating this decision for several reasons. I do enjoy working with patients and clinical medicine, but I’m starting to understand all of the baggage that comes with it; dealing with insurance, administrative work, being on call, sick and dying children etc. I can already tell that this aspect of clinical medicine is going to wear me down. I’ve been thinking a lot more about what it will be like to raise a family, and pursue interests outside of medicine.


Things that concern me about radiology include lack of patient or human interaction and sitting still in a dark room all day (I tend to like to move around).


So, am I crazy for considering radiology? Is there anyone out there heading towards a career in radiology or currently a radiologist who enjoyed interaction with patients in medical school? Do you ever miss that?


I think my stats are fairly competitive (260s Step 1, honors in all rotations so far, good leadership positions/ECs in med school). The only thing I’m lacking is research. I will be a co-author on a paper that came out of research from undergrad, but I haven’t done any research during med school. Is it absolutely necessary that I have radiology research under my belt?


I’m sorry for the long post. I have spent some time perusing the radiology forums and I can’t really find a discussion that pertains to my situation. I would sincerely appreciate if we avoid talking about the future of radiology/changes in reimbursement/compensation since there are already a lot of threads discussing these issues. Thank you all!

---

Members don't see this ad.

 

[Kaputt]

I'll let the other folks make remarks about your concerns about patient interactions, but I can comment on the research aspect.

I had similar stats as you (and decided halfway through 3rd year to pursue radiology), with no radiology research but some publications that came out of undergrad research (plus a non-radiology research project in med school that didn't amount to anything). I had little trouble matching a "top" program, so I would say radiology research isn't "absolutely necessary". That being said, there were some interviews I didn't get that I suspected was because of my lack of radiology research. Doing radiology research helps also with networking and getting to know the people in your department.

 

[rule out normal]

I'll let the other folks make remarks about your concerns about patient interactions, but I can comment on the research aspect.

I had similar stats as you (and decided halfway through 3rd year to pursue radiology), with no radiology research but some publications that came out of undergrad research (plus a non-radiology research project in med school that didn't amount to anything). I had little trouble matching a "top" program, so I would say radiology research isn't "absolutely necessary". That being said, there were some interviews I didn't get that I suspected was because of my lack of radiology research. Doing radiology research helps also with networking and getting to know the people in your department.

I didn't have rads research, I had lower step 1 than you and I matched at a top program in the southeast.

Hey guys. I would really really appreciate your advice.


I’ve been gung-ho peds for most of my medical school career. UNTIL I started my radiology rotation, and (shockingly) I’m loving it, no offense to all of the radiologists and budding radiologists. I just never thought I would enjoy it as much as I do. I find radiology to be very intellectually stimulating, and of course, the life style is very appealing. I am particularly drawn to pediatric radiology.


Until now, I’ve been pretty blindly heading down the path of becoming a pediatrician, but I’ve been re-evaluating this decision for several reasons. I do enjoy working with patients and clinical medicine, but I’m starting to understand all of the baggage that comes with it; dealing with insurance, administrative work, being on call, sick and dying children etc. I can already tell that this aspect of clinical medicine is going to wear me down. I’ve been thinking a lot more about what it will be like to raise a family, and pursue interests outside of medicine.


Things that concern me about radiology include lack of patient or human interaction and sitting still in a dark room all day (I tend to like to move around).


So, am I crazy for considering radiology? Is there anyone out there heading towards a career in radiology or currently a radiologist who enjoyed interaction with patients in medical school? Do you ever miss that?


I think my stats are fairly competitive (260s Step 1, honors in all rotations so far, good leadership positions/ECs in med school). The only thing I’m lacking is research. I will be a co-author on a paper that came out of research from undergrad, but I haven’t done any research during med school. Is it absolutely necessary that I have radiology research under my belt?


I’m sorry for the long post. I have spent some time perusing the radiology forums and I can’t really find a discussion that pertains to my situation. I would sincerely appreciate if we avoid talking about the future of radiology/changes in reimbursement/compensation since there are already a lot of threads discussing these issues. Thank you all!

I matched at a very good academic radiology program in the southeast. I did not have rads research (though was first author on a publication) and my numbers are significantly less impressive than yours.

 

[JoshSt]

You'll have a long rad residency to figure out if you miss patient interaction. If you do, you can do IR and have all the patient interaction you want - you can even do pediatric IR.

You can try to get in a little research before ERAS but you'll get excellent interviews.

 

[Substance]

I say go for it. Switching from rads to peds is a lot less difficult than going the other way. Plus, radiology is on the cutting edge of medical advancements and you will get to use your brain every day. You can help far more people as a radiologist than as a pediatrician, its just that they won't know you helped them (unless you do mammo or IR). And no matter what anyone says about the job market, it isn't as bad as some other specialties nor will the pay ever reach peds lows.

 

[radman123]

Seasoned attending here posting an opinion. While it may seem interesting watching someone reading films for a few hours, you should spend some time looking into the issues facing radiology. While all of medicine is facing difficulties, radiology has had an especially bad time recently. The job market is very poor. The quality of jobs available is low especially near desirable areas. The return on your investment of 6-7 difficult years of training will be low. It is very likely that you will not come anywhere near the averages posted for salary or work anywhere near where you want to.

Sitting all day is toxic for your health. Giving up significant patient contact may make you unhappy given what you wrote. Please talk to as many fellows and attending in the community as you can. Radiology is not a lifestyle field. You will work many off hours since radiology is now a 24/7 operation non stop. The volume demands in many practices will steal any enjoyment of the field. I would personally steer clear if I could go back. Would choose smething that was not as easy to outsource to the lowest bidder. Something with a better outpatient lifestyle. A field that controls its numbers better. A field that does not eat its young as bad.

 

[rule out normal]

Seasoned attending here posting an opinion. While it may seem interesting watching someone reading films for a few hours, you should spend some time looking into the issues facing radiology. While all of medicine is facing difficulties, radiology has had an especially bad time recently. The job market is very poor. The quality of jobs available is low especially near desirable areas. The return on your investment of 6-7 difficult years of training will be low. It is very likely that you will not come anywhere near the averages posted for salary or work anywhere near where you want to.

Sitting all day is toxic for your health. Giving up significant patient contact may make you unhappy given what you wrote. Please talk to as many fellows and attending in the community as you can. Radiology is not a lifestyle field. You will work many off hours since radiology is now a 24/7 operation non stop. The volume demands in many practices will steal any enjoyment of the field. I would personally steer clear if I could go back. Would choose smething that was not as easy to outsource to the lowest bidder. Something with a better outpatient lifestyle. A field that controls its numbers better. A field that does not eat its young as bad.

Best of luck for the upcoming application cycle.

 

[Puff-of-Snow Sign]

Seasoned attending here posting an opinion. While it may seem interesting watching someone reading films for a few hours, you should spend some time looking into the issues facing radiology. While all of medicine is facing difficulties, radiology has had an especially bad time recently. The job market is very poor. The quality of jobs available is low especially near desirable areas. The return on your investment of 6-7 difficult years of training will be low. It is very likely that you will not come anywhere near the averages posted for salary or work anywhere near where you want to.

Sitting all day is toxic for your health. Giving up significant patient contact may make you unhappy given what you wrote. Please talk to as many fellows and attending in the community as you can. Radiology is not a lifestyle field. You will work many off hours since radiology is now a 24/7 operation non stop. The volume demands in many practices will steal any enjoyment of the field. I would personally steer clear if I could go back. Would choose smething that was not as easy to outsource to the lowest bidder. Something with a better outpatient lifestyle. A field that controls its numbers better. A field that does not eat its young as bad.

More like "blackened" attending, if you ask me...

To OP, radman is disgruntled and, while he probably has every right to be, his opinions are extremely biased. He wants you to believe that it is "very likely" that you'll wind up as miserable as he clearly is with radiology. But no one can predict the future...certainly not radman, otherwise he'd be a hospitalist right now and probably just as miserable, but for different reasons...and certainly not me or anyone else I know. However, it is reasonable to gain as much information as you can about a specialty before choosing to pursue it for your career.

I would suggest you speak with as many real-life rads who can't hide under the cloak of internet forum anonymity - academic/private, happy/not - and get a feel for why they chose the path they did and what they might do differently. Don't let any one person's opinion carry too much weight. Just take it FWIW and use it to inform your own decision. Rads may be more of a risk than some other medical specialties right now, but there's no telling what direction the job markets will take in the coming years, so the climate may be entirely different (for better or for worse) when you finish residency. If you're doing something you enjoy and it gives you the lifestyle you need to do the things you love, odds are that you'll find yourself having made the right choice for you.

Good luck!

 

[Rjnichols33]

.

 

[colbgw02]

I'm generally tired of radman's schtick. When you have to start your post with an appeal to authority, you're probably doing it wrong, but he/she is right about one thing - you should not consider radiology a lifestyle field. There's a natural tendency for medical students to extrapolate what they see at university programs, but that's not reflective of the reality of private practice radiology. The volume can be oppressive. Also, if you don't like call, don't go into radiology, because it's a 24/7/365 field (types the guy whose alarm went off at 3am on a Sunday).

 

[DermViser]

Seasoned attending here posting an opinion. While it may seem interesting watching someone reading films for a few hours, you should spend some time looking into the issues facing radiology. While all of medicine is facing difficulties, radiology has had an especially bad time recently. The job market is very poor. The quality of jobs available is low especially near desirable areas. The return on your investment of 6-7 difficult years of training will be low. It is very likely that you will not come anywhere near the averages posted for salary or work anywhere near where you want to.

Sitting all day is toxic for your health. Giving up significant patient contact may make you unhappy given what you wrote. Please talk to as many fellows and attending in the community as you can. Radiology is not a lifestyle field. You will work many off hours since radiology is now a 24/7 operation non stop. The volume demands in many practices will steal any enjoyment of the field. I would personally steer clear if I could go back. Would choose smething that was not as easy to outsource to the lowest bidder. Something with a better outpatient lifestyle. A field that controls its numbers better. A field that does not eat its young as bad.

To be fair there is a lot patient BS in residency that the OP has not been exposed to yet, esp. in Inpatient Pediatrics.

 

[radman123]

Not an appeal to authority simply stating that I am not your typical premed or med student posting here.

I clearly stated that you should do your research about radiology and talk to as many people away from your program and in the community about what it is like in the real world.

If you came to me as a young med student where I work, my tone would be much different about radiology, not as truthful and forthright, The cloak of anonymity allows me to be truthful about how I feel and what I see around me. I am not saying to not go into radiology, but you should be fully aware of the issues facing this field and what options you will have when you finish your training with 6 figure debt.

Talk to fellows about difficulty getting jobs and what kind of jobs they are getting. Are they working anywhere near where they want to? Doing what they were trained to do? Employee, scam partnership or true partnership? Would they do it again? Ask attendings in the community about their job and enjoyment of the field. How often do they take call? Do they feel overburdened by their workload? Do they feel like they have options to switch jobs if they are not happy? Unfortunately doubt many will be truthful. Squashing a med students hopes is not most want to do.

 

[freeski]

I'll let the other folks make remarks about your concerns about patient interactions, but I can comment on the research aspect.

I had similar stats as you (and decided halfway through 3rd year to pursue radiology), with no radiology research but some publications that came out of undergrad research (plus a non-radiology research project in med school that didn't amount to anything). I had little trouble matching a "top" program, so I would say radiology research isn't "absolutely necessary". That being said, there were some interviews I didn't get that I suspected was because of my lack of radiology research. Doing radiology research helps also with networking and getting to know the people in your department.

Thanks for your input. Congrats on matching! If I do end up going down this route, I will talk to some radiologists in our department about research projects.

 

[freeski]

I'm generally tired of radman's schtick. When you have to start your post with an appeal to authority, you're probably doing it wrong, but he/she is right about one thing - you should not consider radiology a lifestyle field. There's a natural tendency for medical students to extrapolate what they see at university programs, but that's not reflective of the reality of private practice radiology. The volume can be oppressive. Also, if you don't like call, don't go into radiology, because it's a 24/7/365 field (types the guy whose alarm went off at 3am on a Sunday).

Thanks for the input, I appreciate the perspective. I'm obviously pretty naive about the realities of radiology practice since I'm only just now looking into the field. I think if I did go into radiology, I would want to stay academic. I enjoy the collegiality and collaboration with other physicians. I realize I'm probably looking at this through rose colored lenses but I've worked with pediatric radiologists at 2 different academic institutions and it seems like they work pretty closely with pediatricians in NICU/PICU and pediatric surgeons to manage complex patients and I find this very appealing. Is it crazy difficult to aim for academics? I realize I would definitely need to up my research game.

 

[freeski]

Not an appeal to authority simply stating that I am not your typical premed or med student posting here.

I clearly stated that you should do your research about radiology and talk to as many people away from your program and in the community about what it is like in the real world.

If you came to me as a young med student where I work, my tone would be much different about radiology, not as truthful and forthright, The cloak of anonymity allows me to be truthful about how I feel and what I see around me. I am not saying to not go into radiology, but you should be fully aware of the issues facing this field and what options you will have when you finish your training with 6 figure debt.

Talk to fellows about difficulty getting jobs and what kind of jobs they are getting. Are they working anywhere near where they want to? Doing what they were trained to do? Employee, scam partnership or true partnership? Would they do it again? Ask attendings in the community about their job and enjoyment of the field. How often do they take call? Do they feel overburdened by their workload? Do they feel like they have options to switch jobs if they are not happy? Unfortunately doubt many will be truthful. Squashing a med students hopes is not most want to do.

Hey radman, I definitely will speak to different radiologists about their satisfaction and what they would have done differently. I was actually just thinking about the fact that it is very difficult to get some attendings to be truthful about their experiences in different fields, and I can imagine I would have a hard time crushing the fragile souls of medical students if I was in that situation.

 

[freeski]

Hey radman, I definitely will speak to different radiologists about their satisfaction and what they would have done differently. I was actually just thinking about the fact that it is very difficult to get some attendings to be truthful about their experiences in different fields, and I can imagine I would have a hard time crushing the fragile souls of medical students if I was in that situation.

Also, do you think you could comment on your hours? What are hours like in private practice vs. academics?

 

[radman123]

Also, do you think you could comment on your hours? What are hours like in private practice vs. academics?

I take weekend call every 3 rd week since I am in a small practice. This involves working from 8-5 sat and sun at the hospital reading hundreds of studies followed by call from home until 10 pm. Then nighthawk takes over doing prelims until next morning. I read the cases as finals the next morning. When I have weekends, I typically have only one day off in the 12 day cycle.

I work about once a week from 2-11 pm again reading hundred of studies.

I typically work about 3 holidays.

Work days are typically 7 am to about 5-6 pm plus commuting time.

I take about 8 weeks of vacation a year.

My salary has gone down about 25% since I started working. I am working harder now.

There is little stability since my private practice has been taken over by a hospital system and I am now an employee. They have complete control. They can lay me off and lower my salary at a whim. My productivity is being monitored closely with pressure to hit certain benchmarks.

I have roots in my community and can not switch jobs by moving 800 miles. I am afraid to take another job because it will likely be worse. There is a lot of abuse out there right now given the terrible surplus our field is facing.

Most of the other practices in my large metro area are not hiring and have already been taken over by hospital systems/corporations or are in danger of being taken over. There is little opportunity to start your own practice or business as cuts have made independent imaging centers non sustainable.

Academics is also tight around here. They usually look for specific fellowships so you have to get lucky when you are looking, The salaries and time off is much lower. Hours and call better since you have residents.

 

[meister]

The reason volume is so oppressive is you private dudes don't want to lower your income even more than it already has been lowered via aggressive CMS cuts and thus aren't hiring more rads.

At some point the income assumption will go away and everyone will just accept the new normal of lower salaries.

 

[rule out normal]

The reason volume is so oppressive is you private dudes don't want to lower your income even more than it already has been lowered via aggressive CMS cuts and thus aren't hiring more rads.

At some point the income assumption will go away and everyone will just accept the new normal of lower salaries.

Radiologists aren't the ones ordering the studies.

 

[colbgw02]

The reason volume is so oppressive is you private dudes don't want to lower your income even more than it already has been lowered via aggressive CMS cuts and thus aren't hiring more rads.

At some point the income assumption will go away and everyone will just accept the new normal of lower salaries.

Radiologists aren't the ones ordering the studies.

True, but not relevant. Whether or not too many imaging studies are performed isn't the same question as to whether or not to hire a new radiologist to lighten the load.

 

[talkingcheese]

I take weekend call every 3 rd week since I am in a small practice. This involves working from 8-5 sat and sun at the hospital reading hundreds of studies followed by call from home until 10 pm. Then nighthawk takes over doing prelims until next morning. I read the cases as finals the next morning. When I have weekends, I typically have only one day off in the 12 day cycle.

I work about once a week from 2-11 pm again reading hundred of studies.

I typically work about 3 holidays.

Work days are typically 7 am to about 5-6 pm plus commuting time.

I take about 8 weeks of vacation a year.

My salary has gone down about 25% since I started working. I am working harder now.

There is little stability since my private practice has been taken over by a hospital system and I am now an employee. They have complete control. They can lay me off and lower my salary at a whim. My productivity is being monitored closely with pressure to hit certain benchmarks.

I have roots in my community and can not switch jobs by moving 800 miles. I am afraid to take another job because it will likely be worse. There is a lot of abuse out there right now given the terrible surplus our field is facing.

Most of the other practices in my large metro area are not hiring and have already been taken over by hospital systems/corporations or are in danger of being taken over. There is little opportunity to start your own practice or business as cuts have made independent imaging centers non sustainable.

Academics is also tight around here. They usually look for specific fellowships so you have to get lucky when you are looking, The salaries and time off is much lower. Hours and call better since you have residents.

Thank you for your insight. MS4 here that just matched into radiology, and was aware beforehand of the lifestyle ahead. Just a couple questions, how big of a city/area in the country do you work? I'm from a small town and anticipate living in one later in life, just curious to your situation. And if since we're in the cloak of anonymity here, how much do you make?

 

[radman123]

Thank you for your insight. MS4 here that just matched into radiology, and was aware beforehand of the lifestyle ahead. Just a couple questions, how big of a city/area in the country do you work? I'm from a small town and anticipate living in one later in life, just curious to your situation. And if since we're in the cloak of anonymity here, how much do you make?

One of 5 largest cities in the country. 325k minus 401k, health, dental, etc. gets me down to high 2s before taxes. In the metros and surrounding areas, we are usually below country averages. There are however still plenty of takers and few openings. Sounds like good money but if you consider how long training is and how many hours we work, not so much. There are few true partnerships/private groups left in my area. The salary will only go down also. There are no raises or inflation adjustments. The cost of living is high also.

 

[talkingcheese]

One of 5 largest cities in the country. 325k minus 401k, health, dental, etc. gets me down to high 2s before taxes. In the metros and surrounding areas, we are usually below country averages. There are however still plenty of takers and few openings. Sounds like good money but if you consider how long training is and how many hours we work, not so much. There are few true partnerships/private groups left in my area. The salary will only go down also. There are no raises or inflation adjustments. The cost of living is high also.

Thanks for the honest info. I'm sure it's a much harder adjustment for someone who's been in rads since it was in it's prime and watch the job market/income decline, but it's been drilled into my head since MS1 that rads is not a lifestyle field. I just take solace that when I asked myself if all specialties made 200k and worked 60h/week what I'd go into, I'd pick radiology over anything else.

 

[UCLA2014]

One of 5 largest cities in the country. 325k minus 401k, health, dental, etc. gets me down to high 2s before taxes. In the metros and surrounding areas, we are usually below country averages. There are however still plenty of takers and few openings. Sounds like good money but if you consider how long training is and how many hours we work, not so much. There are few true partnerships/private groups left in my area. The salary will only go down also. There are no raises or inflation adjustments. The cost of living is high also.

After reading many of your posts, it seems as if you've made plenty of poor life choices (radiology not being one of them). Either that, or you are a very sad IMG troll. I talked to many fellows from all over the country this past year and the picture is not nearly as bleak as you are making it out to be.

I have a feeling you would be miserable no matter what field you were in. Go back to AuntMinnie please.

 

[radman123]

After reading many of your posts, it seems as if you've made plenty of poor life choices (radiology not being one of them). Either that, or you are a very sad IMG troll. I talked to many fellows from all over the country this past year and the picture is not nearly as bleak as you are making it out to be.

I have a feeling you would be miserable no matter what field you were in. Go back to AuntMinnie please.

Why not just ignore my posts if you do not like them? Why do you have to be offensive? This is an open forum where people are free to post their opinions anonymously, whether positive or negative. I gain nothing by posting here. I am one person working in one region of the country and have my opinions based on MY experience. I have first hand knowledge of being an attending in this field and would have liked hearing this type of perspective when I was in your shoes. If you find what I write to be untrue than simply move on. No need to be a jerk.

 

[shark2000]

To the OP:
This is no way a lifestyle field. It is not like outpatient pediatrics. It is not an 8-5 job in pp. It is more like NICU work.
The volume is high crazy. The expectations are high.

Having said that, it is a satisfying job. Like everything else, being in the right practice setting is very important for overall satisfaction.

 

[DermViser]

Thanks for the honest info. I'm sure it's a much harder adjustment for someone who's been in rads since it was in it's prime and watch the job market/income decline, but it's been drilled into my head since MS1 that rads is not a lifestyle field. I just take solace that when I asked myself if all specialties made 200k and worked 60h/week what I'd go into, I'd pick radiology over anything else.

Rads may not be a lifestyle field, but the problem is that other fields are SO MUCH worse - i.e. IM or Surgery, or example.

 

[rule out normal]

Rads may not be a lifestyle field, but the problem is that other fields are SO MUCH worse - i.e. IM or Surgery, or example.

It seems like people are nicer in radiology as a whole. At my institution, medicine and surgery are where most of the over-the-top people are.

 

[DermViser]

It seems like people are nicer in radiology as a whole. At my institution, medicine and surgery are where most of the over-the-top people are.

Exactly. There's a reason why for many people what they think they want to go into does a complete 180 once they see what it is like on their MS-3 clerkships. MS-3 year is like a liquor store. All the bad, cheap EtOH is up front - IM, Psych, Peds, Surgery, etc. all the good stuff: Derm, Rads, PM&R, Rad Onc, ENT, Urology, Ophtho, is hidden in the back.

 

[freeski]

To the OP:
This is no way a lifestyle field. It is not like outpatient pediatrics. It is not an 8-5 job in pp. It is more like NICU work.
The volume is high crazy. The expectations are high.

Having said that, it is a satisfying job. Like everything else, being in the right practice setting is very important for overall satisfaction.

Yes, clearly I was a little bit misled in thinking that rads is a lifestyle field, and I now realize that its not. But in general peds, 8-5 would be great but is probably not realistic. You have dictations, tons of paper work, returning of phone calls, not to mention parents calling you at all hours of the day and night about a sneeze. These are the things I'm concerned about that are not an issue in rads.

 

[freeski]

It seems like people are nicer in radiology as a whole. At my institution, medicine and surgery are where most of the over-the-top people are.

I agree. I really like the rads people I've met at my institution for the most part. Super chill and happy. And a little apathetic, which I really appreciate.

 

[je355804]

If apathetic is the personality that fits well into a radiology program... I'm in trouble.

 

[freeski]

If apathetic is the personality that fits well into a radiology program... I'm in trouble.

Ha sorry. Didn't mean to be offensive. I guess I just meant, tend not to freak out about small stuff, not pretentious, etc.

 

[je355804]

Haha no offense taken! It was just an interesting point you made. I tend to be the opposite of apathetic, and quite honestly I haven't spent tons of time with radiology residents... so I don't know if they have stereotypical behavior patterns like one could say about "surgeons or IM" for instance.

 

[Substance]

Exactly. There's a reason why for many people what they think they want to go into does a complete 180 once they see what it is like on their MS-3 clerkships. MS-3 year is like a liquor store. All the bad, cheap EtOH is up front - IM, Psych, Peds, Surgery, etc. all the good stuff: Derm, Rads, PM&R, Rad Onc, ENT, Urology, Ophtho, is hidden in the back.

I've been saying that for years!

 

[DermViser]

I've been saying that for years!

Yes, you're the one I quoted! I was wondering where on SDN I saw that. Thought it was a perfect analogy. I'm convinced it's a nefarious plot so that medical schools can lock students into the "primary care" specialties and boast about how most of their students are doing primary care.

 

[Substance]

Yes, you're the one I quoted! I was wondering where on SDN I saw that. Thought it was a perfect analogy. I'm convinced it's a nefarious plot so that medical schools can lock students into the "primary care" specialties and boast about how most of their students are doing primary care.

I think so too. The medical curriculum is based on the severely outdated Flexner model, which was developed before concepts like the existence of DNA, antibiotics, EBM, advanced imaging and safe anesthesia. It was all ether and leeches, and "dropsy" was a diagnosis.

Hospitals and bureaucrats want a limitless pipeline of hard working scutmonkeys for primary care, inpatient medicine, and emergencies like surg and OB, in the hopes that most students will never find out how much better derm or rads is from them. For instance, I wasn't even aware radiation oncology was its own specialty until late into medical school, and I'm not the only one who had that experience. If every student knew about the "stuff in the back" then few would want to drink the swill in the front (without significant cost to the bureaucracy)

 

[Baller MD]

I think so too. The medical curriculum is based on the severely outdated Flexner model, which was developed before concepts like the existence of DNA, antibiotics, EBM, advanced imaging and safe anesthesia. It was all ether and leeches, and "dropsy" was a diagnosis.

Hospitals and bureaucrats want a limitless pipeline of hard working scutmonkeys for primary care, inpatient medicine, and emergencies like surg and OB, in the hopes that most students will never find out how much better derm or rads is from them. For instance, I wasn't even aware radiation oncology was its own specialty until late into medical school, and I'm not the only one who had that experience. If every student knew about the "stuff in the back" then few would want to drink the swill in the front (without significant cost to the bureaucracy)

Is anesthesia considered cheap liquor?

 

[DermViser]

I think so too. The medical curriculum is based on the severely outdated Flexner model, which was developed before concepts like the existence of DNA, antibiotics, EBM, advanced imaging and safe anesthesia. It was all ether and leeches, and "dropsy" was a diagnosis.

Hospitals and bureaucrats want a limitless pipeline of hard working scutmonkeys for primary care, inpatient medicine, and emergencies like surg and OB, in the hopes that most students will never find out how much better derm or rads is from them. For instance, I wasn't even aware radiation oncology was its own specialty until late into medical school, and I'm not the only one who had that experience. If every student knew about the "stuff in the back" then few would want to drink the swill in the front (without significant cost to the bureaucracy)

I agree. Medical school has not changed when GME education has changed immensely where it is fragmented into various specialties for a good reason. This explains ALL the extra work piled on students in medical school due to a "primary care" mission: outpatient clinics some schools do during Years 1-2, sub-Is during Year 4, etc. When questioned, the response is no matter what field you go into, it's a "good foundation" to have. BS.

The funniest thing is that you would think at the match, medical schools would tout those who do primary care, but instead are bragging and holding up all those who got the hot, competitive specialties. The "we love primary care" motto is only for lip service, media relations school website pages, and local channel media news clips. For those in primary care, they have a life of never ending governmental regulation and paperwork, that most specialties are highly shielded from.

 

[Substance]

Is anesthesia considered cheap liquor?

Not in my part of the world. It's Blue Label.

 

[Substance]

I agree. Medical school has not changed when GME education has changed immensely where it is fragmented into various specialties for a good reason. This explains ALL the extra work piled on students in medical school due to a "primary care" mission: outpatient clinics some schools do during Years 1-2, sub-Is during Year 4, etc. When questioned, the response is no matter what field you go into, it's a "good foundation" to have. BS.

The funniest thing is that you would think at the match, medical schools would tout those who do primary care, but instead are bragging and holding up all those who got the hot, competitive specialties. The "we love primary care" motto is only for lip service, media relations school website pages, and local channel media news clips. For those in primary care, they have a life of never ending governmental regulation and paperwork, that most specialties are highly shielded from.

The "good foundation" argument would be a bit more believable if it was based more on scientific principles at the beginning instead of social work. It would also be more believable if each specialty was represented, which clearly is not the case. One can go through medical school without stepping behind the curtain in anesthesiology, suiting up for an ortho procedure, or getting behind the microscope in path. Yet, find me one student who hasn't delivered babies (or at least stood around while the female students did it) or interviewed a borderline personality disordered individual about their nth suicide attempt.

This is why most docs have no idea what the hell any other docs from other specialties do. Rads is freaks in dark rooms and barium, path is autopsies, derm is wet-dry-biopsy-cosmetics-$$$, PMR is ?, rad onc doesn't exist, anesthesia is boring, and ortho is for jocks etc. I think this adversely affects patient care and interprofessional communication.

The "primary care" focus is all PR BS. Everyone knows it. Going to medical school and seeing it first hand turned me from a fairly laid-back student to the most cynical MFer around. What lip service and double standard! If primary care was so damn good, HMS would be putting them out like clockwork.

Here in Canada, where primary care is doing better than it is in the US, most docs don't practice it. They go in, do their 2 years of residency (why its 3 in the states boggles the mind), and then go work in an emergency room somewhere or open a sports or cosmetic clinic. The whole Normal Rockwell fantasy is a farce.

 

[DermViser]

Is anesthesia considered cheap liquor?

Definitely not.

 

[colbgw02]

Not to rain on everyone's metaphorical parade, but why would a liquor store keep all of the top shelf liquor hidden in the back? Is the profit margin higher on cheap liquor or something?

 

[Substance]

Not to rain on everyone's metaphorical parade, but why would a liquor store keep all of the top shelf liquor hidden in the back? Is the profit margin higher on cheap liquor or something?

It's to prevent its theft or accidental breakage.

 

[colbgw02]

It's to prevent its theft or accidental breakage.

Haha. Good to know. And I see the metaphor deepens.

 

[meister]

Family medicine being three years really is pretty dumb anymore. And last I checked there's a movement to make it four which is just.....

 

[deleted500612]

Family medicine being three years really is pretty dumb anymore. And last I checked there's a movement to make it four which is just.....

In Canada it's 2 years!

 

[Substance]

In Canada it's 2 years!

And our family docs are pretty good - no worse than American trained ones. Plus they are very active in doing EM in even major centers; Toronto has a lot of CCFP EM trained docs at downtown hospitals like Mike's.

 

[DermViser]

One of 5 largest cities in the country. 325k minus 401k, health, dental, etc. gets me down to high 2s before taxes. In the metros and surrounding areas, we are usually below country averages. There are however still plenty of takers and few openings. Sounds like good money but if you consider how long training is and how many hours we work, not so much. There are few true partnerships/private groups left in my area. The salary will only go down also. There are no raises or inflation adjustments. The cost of living is high also.

Can't believe you're complaining about a 325K salary, when you don't have to deal with the patient BS that most IM and Peds people have to deal with. Seriously, get a life.

 

[Substance]

Can't believe you're complaining about a 325K salary, when you don't have to deal with the patient BS that most IM and Peds people have to deal with. Seriously, get a life.

325 looks like crap when 650 used to be the norm.