MS4: Ortho vs Rads

[ChrisTurkletonMD]

I am a fourth-year medical student who recently decided to pursue radiology rather than ortho. I made this decision primarily due to lifestyle concerns. While ortho is still the field that interests me most, I think it would be very hard on my wife and kids. In my personal circumstances, I think I would be selfish to pursue it. (I am just a guy who feels a lot of guilt when I don’t maximize family time. I don’t pass judgement on how anyone else chooses to spend their time. I know there are a lot of wonderful parents in demanding careers.)

I was always interested in surgery and I knew I wanted to do Ortho after a few days on the rotation. I loved the operations, the technical aspects, the relative lack of garbage consults and babysitting. I even enjoyed taking overnight call. For the first time, I didn’t hate spending some time in the ED. I think I got a pretty realistic experience: q4 call +/- post-call day. I averaged 80 hrs/week over the 4 weeks; the first week was 101 hours. I was tired but I enjoyed it. I still had some time to spend with my family too, though not as much I would have liked. My wife carried almost every home responsibility during this time. This made me feel guilty, though she never complained. We knew ortho demanded some rough years in residency, but we were confident we would get through it.

Doubts started to creep in as I made preparations for 4th year. I have a 3-year-old son and my wife is due with our second baby in the next couple months. I felt pretty crappy leaving them to do an away rotation. This prompted me to rethink everything. Why would I voluntarily leave my pregnant wife for a job? Why would I completely cede control of my schedule for the next 6 years? Why would I choose a field that generally requires frequent call? Aren’t all of those things antagonistic to what I value most? Isn’t my family my number one priority?

After weeks of indecision. I decided on rads primarily because it would be more family friendly during residency and it offers great vacation time as an attending. My wife did not pressure me into this. She has been extremely supportive. The pressure to prioritize family is 100% internal).

To be clear, I think rads is interesting. Throughout med school I always had rads in the back of my mind. During medicine, I would browse through patients’ imaging and try to find pathologies. With Ortho, I found that I really enjoyed looking at pelvic fractures and trying to make a read. This led me to believe that I would be happy in radiology. Some aspects of rads didn’t interest me (ex. neuro), but I thought that as I began to learn more about it, I would begin to enjoy it more. I hope so.

The only problem is that I am also interested in the next step. In evaluating pelvic fractures, I always considered what I would do next; I never just moved on to the next image. I am not sure I would be satisfied only identifying the problem, but not solving it. I love working with my hands, not just my mind. I’m not sure I can see myself sitting in front of a computer all day.

Since I decided on radiology, I have totally redone my 4th year schedule. Frankly during this time, I have been bummed out. It’s not an easy thing to give up on the vision you had for yourself. I always I identified with Alexander Hamilton’s refrain, “ I am not throwing away my shot.” Now, just like Hamilton did, I threw it away.

I dropped all of the ortho rotations I had scheduled and worry that I may have burned bridges. I suppose I could sign-up again, but I think word will get around. Nobody wants the ortho applicant who can’t even make up his mind if he wants ortho.

I could throw together an application. If I don’t match at least I don’t have to live my life knowing that I didn’t even try. The only thing that holds me back from doing that is that the lifestyle issues haven’t changed at all. My family still is and always will be my number one priority. My wife is still pregnant. My son still cries every time I go to the hospital. I still don’t want to leave for aways with a newborn at home.

I guess my biggest hope is that I can be happy in radiology. I really do hope that; but I am not sure if it is true. I know my family would like me to have better hours, but not if I comes at the expense of my happiness.

I hope that the more I learn the more I enjoy it. If I do it, I want to be a freaking good radiologist. Nobody wants a crappy radiologist who is only there because he heard it was easy. I know it’s not.

So, does rads get more enjoyable as you go along? Is it a mistake to do your second favorite specialty for the sake of lifestyle?

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[AzBasRad]

I guess my biggest hope is that I can be happy in radiology. I really do hope that; but I am not sure if it is true. I know my family would like me to have better hours, but not if I comes at the expense of my happiness.

You will be surprised how good work-life balance can influence satisfaction to one's profession. When you have the ability to make time for wife and your kids' important milestones, you will realize that you made the right choice in radiology. It's safe to say that most of us will be happy in >1 specialities. Many fields either overlap significantly or offer different subspecialties/ practice environments with different work demands.

The only problem is that I am also interested in the next step. In evaluating pelvic fractures, I always considered what I would do next; I never just moved on to the next image. I am not sure I would be satisfied only identifying the problem, but not solving it. I love working with my hands, not just my mind. I’m not sure I can see myself sitting in front of a computer all day.

**Hint Hint ** Interventional Radiology

 

[calivianya]

Not a mistake at all.

I was absolutely determined to go into IM -> pulm/crit when I started med school, but am applying rads for the same reasons you mentioned. No kids, but work/life balance is incredibly important to me. Looking at the average 70-80 hour weeks in FREIDA for IM residency and thinking about how worn down I felt during my IM rotations, and comparing it with the 40-50 hour weeks listed in rads residency and the better lifestyle after residency is over, it was a no brainer.

I also think I am going to enjoy rads.

 

[Thesimplelifeofamyloid]

Not a mistake at all.

I was absolutely determined to go into IM -> pulm/crit when I started med school, but am applying rads for the same reasons you mentioned. No kids, but work/life balance is incredibly important to me. Looking at the average 70-80 hour weeks in FREIDA for IM residency and thinking about how worn down I felt during my IM rotations, and comparing it with the 40-50 hour weeks listed in rads residency and the better lifestyle after residency is over, it was a no brainer.

I also think I am going to enjoy rads.

Wow, I was told FREIDA wasn't as accurate for residency information. Unrelated question, but are you worried about losing your nursing skills if you don't go into IM?

 

[brownman23]

Welcome to the dark side, my friend. Radiology is an amazing field with tons of variety. You’ll also thank yourself a million times over during residency that you’re able to spend time with your wife and kids.

 

[Chlorini]

I was you and I also picked radiology over Ortho for lifestyle concerns.

I’m a radiology resident now and I am so, so, SO glad I picked radiology. I arrive to work after the sun comes up. I leave on time. I just had the 4th of July 3 day weekend off (on ortho you most definitely wouldn’t).

About 15 days into my TY year I knew I made the right choice.

Good luck with whatever you choose.

 

[Angus Avagadro]

First, pick the specialty that interests you and you find the literature interesting. Picking rads as a lifestyle, I dunno. Currently, you sit at your reading station for 8 hrs a day. Sitting Is considered an unhealthy lifestyle. Secondly, you have little interaction with other Docs. It used to be different, where clinicians would troop to radiology to discuss cases. Since everyone has a subspecialty now,, it makes call more frequent.. One local uni affiliate requires 3 radiologist to read trauma.. Neuro,, chest,, and a body imager.Now, it's just assembly line throughput. You can't always read from home as some facilities require a physician on-site to cover contrast reactions. Lastly, our local MD uni this year matched only 1 student in radiology out of over 100 students. I would not go into Rads for the lifestyle. Go because you enjoy it.

 

[ChiDO]

Pick the specialty you will be happy in. Sounds like ortho over rads but you feel guilty. Yes, residency sucks and is hard, but it's a quick 5 years.

You don't want to be in the position that you're reading that pelvic xray as rads and wish you were the surgeon fixing it.

 

[Ho0v-man]

Seems like you know you’ll be happy in ortho vs. hoping you’ll be happy in rads. You’re obviously bummed that you’re not pursuing ortho and came here seeking validation for this decision. Well you came to the right place. SDN is very much the spot to approve going after lifestyle and money so I’m sure the bias will favor rads. If you enjoyed >100 hrs per week of ortho, I can’t imagine you actually liking rads as much.

 

[Dave1980]

Radiologist here. IR isn't lifestyle friendly and I don't think you'll like DR very much based on your post. Lifestyle in ortho post residency is actual decent from what I understand.

Vacation in rads is good. standard 8 weeks although some PP are crazy and give up to 12-16.

 

[Dave1980]

I would reconsider if I were you. ortho is cool

 

[Thesimplelifeofamyloid]

Radiologist here. IR isn't lifestyle friendly and I don't think you'll like DR very much based on your post. Lifestyle in ortho post residency is actual decent from what I understand.

Vacation in rads is good. standard 8 weeks although some PP are crazy and give up to 12-16.

Isn't this variable depending on what type of IR you practice? Obviously if you do anything vascular lifestyle will be worse, but in private practice or at a large academic center doing non-vascular work, I can't imagine the lifestyle being that terrible. For DR you're on call too.;

 

[Dave1980]

Isn't this variable depending on what type of IR you practice? Obviously if you do anything vascular lifestyle will be worse, but in private practice or at a large academic center doing non-vascular work, I can't imagine the lifestyle being that terrible. For DR you're on call too.;

It is very rare to have an IR job that is 8-5. Outpatient only PP or vein center but those are rare and becoming rarer.

Most groups are affiliated with a hospital and the hospitals want IR coverage. IR doesn't generate as many RVUs as DR so unless IR is providing a service (i.e. daytime IR and overnight/weekend call) radiology groups have no reason to want to grow or have that part of the business.

DR call is different. It is basically just a busy normal day but you aren't really on-call overnight. You likely have an overnight person in case tele goes down but that happens very rarely.

Bottom line is don't go into IR thinking you will find a lifestyle friendly practice. Go into it assuming you won't and there is a small chance you will be pleasantly surprised.

 

[Thesimplelifeofamyloid]

It is very rare to have an IR job that is 8-5. Outpatient only PP or vein center but those are rare and becoming rarer.

Most groups are affiliated with a hospital and the hospitals want IR coverage. IR doesn't generate as many RVUs as DR so unless IR is providing a service (i.e. daytime IR and overnight/weekend call) radiology groups have no reason to want to grow or have that part of the business.

DR call is different. It is basically just a busy normal day but you aren't really on-call overnight. You likely have an overnight person in case tele goes down but that happens very rarely.

Bottom line is don't go into IR thinking you will find a lifestyle friendly practice. Go into it assuming you won't and there is a small chance you will be pleasantly surprised.

Interesting to hear. At my surrounding hospitals, it's very rare for IR to come in overnight or on the weekend. Don't jobs that exist 50% IR and 50% DR exist?

 

[spartan25]

Pick the specialty you will be happy in. Sounds like ortho over rads but you feel guilty. Yes, residency sucks and is hard, but it's a quick 5 years.

You don't want to be in the position that you're reading that pelvic xray as rads and wish you were the surgeon fixing it.

“Just 5 years” is like 1/3 of the total time that your children will be at home before they move out on their own. And that doesn’t include fellowship, which is almost universal for ortho…

 

[Dave1980]

Interesting to hear. At my surrounding hospitals, it's very rare for IR to come in overnight or on the weekend. Don't jobs that exist 50% IR and 50% DR exist?

I'm sure they do but I don't really know how that works. If its 3 days IR and 2 days DR that might be OK but I would never want to do IR and be expected to read cases in my "downtime". Even in those cases you still will likely be the overnight and weekend coverage guy.

IR is a dumping ground at most places I've worked and trained but obviously different places will be different.

As a new fellow you likely won't be able to snag a unicorn job.

 

[brownman23]

Have you done a Radiology rotation, or tried to teach yourself some basic radiology?

I was in a similar predicament as you (considering IM to GI/Cards but didn’t like the lifestyle of the respective residency+fellowship), but I started to get drawn into Rads the more I got exposed to the field. Rads is an incredibly cool field (you get to master tons of imaging modalities, know anatomy+ddx of every organ system, etc) with great lifestyle. However, the residency (particularly R1+R2) is challenging since there’s SO much to learn. If you don’t see yourself becoming excited to master Radiology or have the motivation to grind through the early tough years, but you see yourself having that excitement/motivation for Ortho…you’re likely gonna regret doing a Rads residency.

I’d recommend having an open discussion with your partner, and figure out what y’all life goals are and how the both of you guys will be happy..not just now, but 20 years down the line as well.

 

[giguerex35]

can anybody comment on how different the salaries are after residency for both ortho and rads

 

[Angus Avagadro]

Medscape 2021 physician compensarion had ortho at 511k and Rads at 413k.
Ortho has potential to make much more in private practice than rads.

 

[Chelsea FC]

Why don’t you look into PM&R tons of ortho bros/gals who want more lifestyle do PM&R so much so the programs kinda have a chip on their shoulder about being a backup. Look into it

 

[OrthoTraumaMD]

I am a fourth-year medical student who recently decided to pursue radiology rather than ortho. I made this decision primarily due to lifestyle concerns. While ortho is still the field that interests me most, I think it would be very hard on my wife and kids. In my personal circumstances, I think I would be selfish to pursue it. (I am just a guy who feels a lot of guilt when I don’t maximize family time. I don’t pass judgement on how anyone else chooses to spend their time. I know there are a lot of wonderful parents in demanding careers.)

I was always interested in surgery and I knew I wanted to do Ortho after a few days on the rotation. I loved the operations, the technical aspects, the relative lack of garbage consults and babysitting. I even enjoyed taking overnight call. For the first time, I didn’t hate spending some time in the ED. I think I got a pretty realistic experience: q4 call +/- post-call day. I averaged 80 hrs/week over the 4 weeks; the first week was 101 hours. I was tired but I enjoyed it. I still had some time to spend with my family too, though not as much I would have liked. My wife carried almost every home responsibility during this time. This made me feel guilty, though she never complained. We knew ortho demanded some rough years in residency, but we were confident we would get through it.

Doubts started to creep in as I made preparations for 4th year. I have a 3-year-old son and my wife is due with our second baby in the next couple months. I felt pretty crappy leaving them to do an away rotation. This prompted me to rethink everything. Why would I voluntarily leave my pregnant wife for a job? Why would I completely cede control of my schedule for the next 6 years? Why would I choose a field that generally requires frequent call? Aren’t all of those things antagonistic to what I value most? Isn’t my family my number one priority?

After weeks of indecision. I decided on rads primarily because it would be more family friendly during residency and it offers great vacation time as an attending. My wife did not pressure me into this. She has been extremely supportive. The pressure to prioritize family is 100% internal).

To be clear, I think rads is interesting. Throughout med school I always had rads in the back of my mind. During medicine, I would browse through patients’ imaging and try to find pathologies. With Ortho, I found that I really enjoyed looking at pelvic fractures and trying to make a read. This led me to believe that I would be happy in radiology. Some aspects of rads didn’t interest me (ex. neuro), but I thought that as I began to learn more about it, I would begin to enjoy it more. I hope so.

The only problem is that I am also interested in the next step. In evaluating pelvic fractures, I always considered what I would do next; I never just moved on to the next image. I am not sure I would be satisfied only identifying the problem, but not solving it. I love working with my hands, not just my mind. I’m not sure I can see myself sitting in front of a computer all day.

Since I decided on radiology, I have totally redone my 4th year schedule. Frankly during this time, I have been bummed out. It’s not an easy thing to give up on the vision you had for yourself. I always I identified with Alexander Hamilton’s refrain, “ I am not throwing away my shot.” Now, just like Hamilton did, I threw it away.

I dropped all of the ortho rotations I had scheduled and worry that I may have burned bridges. I suppose I could sign-up again, but I think word will get around. Nobody wants the ortho applicant who can’t even make up his mind if he wants ortho.

I could throw together an application. If I don’t match at least I don’t have to live my life knowing that I didn’t even try. The only thing that holds me back from doing that is that the lifestyle issues haven’t changed at all. My family still is and always will be my number one priority. My wife is still pregnant. My son still cries every time I go to the hospital. I still don’t want to leave for aways with a newborn at home.

I guess my biggest hope is that I can be happy in radiology. I really do hope that; but I am not sure if it is true. I know my family would like me to have better hours, but not if I comes at the expense of my happiness.

I hope that the more I learn the more I enjoy it. If I do it, I want to be a freaking good radiologist. Nobody wants a crappy radiologist who is only there because he heard it was easy. I know it’s not.

So, does rads get more enjoyable as you go along? Is it a mistake to do your second favorite specialty for the sake of lifestyle?

If your family is your number one priority, now and forever, I think you made the right choice to switch into radiology.

 

[Taurus]

Diagnostic rad here. I get 15 weeks vacation. Weekend call is so infrequent like every 6-8 weeks. Call is 6-8 hours per shift. I do moonlighting to fill in the time at $400-500 per hour. Weekday work is 8-5 pm. Specifics depend on group though. Overall, rad is better lifestyle than ortho I would say. Pay is not too shabby either. 😉

 

[brownman23]

Diagnostic rad here. I get 15 weeks vacation. Weekend call is so infrequent like every 6-8 weeks. Call is 6-8 hours per shift. I do moonlighting to fill in the time at $400-500 per hour. Weekday work is 8-5 pm. Specifics depend on group though. Overall, rad is better lifestyle than ortho I would say. Pay is not too shabby either. 😉

Are these jobs possible in saturated markets? I’ve been hearing private equity is taking over a lot of cities, resulting in high burnout among radiologists.

 

[Taurus]

Are these jobs possible in saturated markets? I’ve been hearing private equity is taking over a lot of cities, resulting in high burnout among radiologists.

If you look at any of survey of cities, my city is usually ranked in top 5 for growth and desirability.

The radiology job market, as with any medical specialty, is cyclical. It’s really hot right now. We have 7 openings just in my subspecialty section alone. You shouldn’t pick a field based on job market or pay. You should look at the big picture. For me, I have no regrets going into radiology. It’s a great and diverse field. You can have lots patient interaction or none at all. You can do lots of procedures or none at all. You can go to work at the hospital everyday or only work from home. You can pick a field like mammo where you can work only 4 days per week and take no call at all. The pay isn’t too shabby either. 😁 For the most part, working in radiology reading study after study is like taking an exam, day in, day out. How do you feel about taking exams (college, medical school, SAT, MCAT, etc)? If it doesn’t bother you, you’ll be fine in radiology. The best part is you minimize patient interaction (they make it seem great in medical school but patient interaction and paperwork are the most soul sucking part of medicine).

 

[giguerex35]

If you look at any of survey of cities, my city is usually ranked in top 5 for growth and desirability.

The radiology job market, as with any medical specialty, is cyclical. It’s really hot right now. We have 7 openings just in my subspecialty section alone. You shouldn’t pick a field based on job market or pay. You should look at the big picture. For me, I have no regrets going into radiology. It’s a great and diverse field. You can have lots patient interaction or none at all. You can do lots of procedures or none at all. You can go to work at the hospital everyday or only work from home. You can pick a field like mammo where you can work only 4 days per week and take no call at all. The pay isn’t too shabby either. 😁 For the most part, working in radiology reading study after study is like taking an exam, day in, day out. How do you feel about taking exams (college, medical school, SAT, MCAT, etc)? If it doesn’t bother you, you’ll be fine in radiology. The best part is you minimize patient interaction (they make it seem great in medical school but patient interaction and paperwork are the most soul sucking part of medicine).

i asked this in another thread but do you happen to know anything about how tele-radiology works, in terms of pay, job market, how day-to-day operations look, etc. I have been hearing a decent amount about it lately and still dont quite grasp how it works

 

[DarkHorizon]

Diagnostic rad here. I get 15 weeks vacation. Weekend call is so infrequent like every 6-8 weeks. Call is 6-8 hours per shift. I do moonlighting to fill in the time at $400-500 per hour. Weekday work is 8-5 pm. Specifics depend on group though. Overall, rad is better lifestyle than ortho I would say. Pay is not too shabby either. 😉

Ortho trauma here, what kind of a paycheck are you looking at taking 15 weeks of vacation? If I took 15 weeks of vacation, my income would be down around 20-30 percent.

 

[Taurus]

Ortho trauma here, what kind of a paycheck are you looking at taking 15 weeks of vacation? If I took 15 weeks of vacation, my income would be down around 20-30 percent.

I don’t want to get into financial specifics on a public message board. 15 weeks is standard for our group. It varies from group to group. Most good groups give 12-17 weeks. Let’s just say with my wife’s income as a dentist our combined annual income is almost but not quite 7 figures.

 

[DarkHorizon]

I don’t want to get into financial specifics on a public message board. 15 weeks is standard for our group. It varies from group to group. Most good groups give 12-17 weeks. Let’s just say with my wife’s income as a dentist our combined annual income is almost but not quite 7 figures.

I love Ortho, couldn’t do rads, but this kind of set up would be nearly impossible to find without taking a major hit on compensation in Ortho.

 

[Dantes]

I'm also wondering why you didn't consider PM&R and possibly family med+sports med fellowship. That said, I haven't met an unhappy radiologist resident or attending yet.

 

[CherryRedDracul]

I'm also wondering why you didn't consider PM&R and possibly family med+sports med fellowship. That said, I haven't met an unhappy radiologist resident or attending yet.

I know an unhappy ex-rads resident who missed her surgery intern year and decided to switch into general surgery. I hear she is much happier despite a more grueling schedule.

But I know way more residents from other specialties who want to switch into radiology.

OP, my advice for surgical subspecialties (relayed from a trauma surgeon who advised me in med school): if you absolutely feel the need to be in the OR, do a surgical specialty. Otherwise, reconsider your options.

But don't do radiology because it's cush because while it's not physically taxing, it can be mentally exhausting when you're pushed to the limit. Choose it because you enjoy it. I chose radiology because I like being a diagnostician, viewing each study as a mystery to be solved (hopefully) and then moving onto the next one without the time-consuming patient interaction stuff, although I actually do like interacting with patients, especially for procedural stuff.

 

[orthovsrads]

How are you feeling about all this now? I'm in the same position except I bailed on ortho without withdrawing my application. Just sort of dragged my feet and then didn't match. Now I'm unsure if I should pursue a research year in ortho or just focus solely on rads. Lifestyle does matter