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Aside from Allergy what are the medicine subspecialties that allow a good lifestyle....................(is there such a thing as a doc who can work 9-5 and still make over 200K)...........
Specialty Lifestyle
- Thread starter orthoguy
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Rheum is also a pretty good lifestyle, but unfortunately the $$$ isn't there. It's a bummer to do a fellowship and then make less money than if you had just stayed in general internal medicine!
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GI is probably the closest to that...but it is highly dependent on where you practice. In most spots, you still won't work a 9-5 every day...maybe some days, maybe even less some days, but never all the time. There are some in cities where they make way over 200K, but also work like mad. There are others who work in groups and don't take on too much of a load, but make less. However, in GI this is still a lot.
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right now rheum guys can do great! infusions have created monster income for them.
my neighbor is a rheumatologist. he told me he made well over 400k last year.
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this might be the first time in history someone recommended interventional cardiology in response to a lifestyle question.
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I have never heard anyone referring to GI or Interventional Cards as fields with good lifestyles.
I would love to see a practice that lets you set yourself up as only being in the lab all day. I'm sure there is a group like that somewhere, but probably one in a million. You will for sure be taking night call and admitting patients to the hospital at all hours as a private practice Cardiologist. Get used to it. As a Gastroenterologist, you will be consulted on abdominal pain, elevated LFTs and scoping day and night for the cardiologists and surgeons admitting patients to the hospital.
Definitely NOT Allergy or Rheum.
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those large practices exist where you can do nothing but caths. i know of one major one...like i said, it's not every interventional cardiologist, but if you can find the right situation, you can do caths only and not worry about general cardiology. but the truth is, in any specialty, if you set yourself up in the right business situation, you can have everything you want.
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Agreed, but that would only be after so many years in practice doing all the other crap everyone else did to become partner as well. You probably couldn't plug into a good situation of your own design right out of residency. Also, most large groups only have 5-7 people who do intervention exclusively, so that still puts you on call at night for PCIs for those who don't do them.
Cush situations come after years of sacrifice and working for the group to get you into that situation, not right out of training.
Cush situations come after years of sacrifice and working for the group to get you into that situation, not right out of training.
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academic cardiology has a reasonably good lifestyle. depends on what you expect. it proabbly still is the busiest internal medicine subspecialty, but nothing like private practice.
depends on how career minded you are and whether you are also trying to build a career in basic science or not. if you are doing nothing but clinical you have 7-5 ish hours, and if you are not in clinic you can be flexible and time shift if you need to.
interventional lifestyle will depend on how many interventional people there are vs need and whether the cath lab will open on nights/weekends. can be brutal or not so bad, depending on those factors. there is an immense shortage of academic interventionalists.
depends on how career minded you are and whether you are also trying to build a career in basic science or not. if you are doing nothing but clinical you have 7-5 ish hours, and if you are not in clinic you can be flexible and time shift if you need to.
interventional lifestyle will depend on how many interventional people there are vs need and whether the cath lab will open on nights/weekends. can be brutal or not so bad, depending on those factors. there is an immense shortage of academic interventionalists.
How about Nuclear Medicine? I believe there are two routes into the field. Do a prelim yr, then 2 yr Nuc Med, or finish a 3 yr med residency program and then 1 yr Nuc Med.
Pays over $200 K and affords a great lifestyle similar to radiologists. Cinch to get into.
Gecko
Pays over $200 K and affords a great lifestyle similar to radiologists. Cinch to get into.
Gecko
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Yes, this subject sounds interesting, indeed.
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GI lifestyle will vary in terms of where you go for fellowship and where you end up for practice.
Fellowship -- For the most part, your days at work are busy between endoscopy, consults, and clinic. After hours calls are primarily related to bleeders and probably the occasional acute hepatitis. Remember, 80% of bleeding resolves on its own, so for the most part you can probably help manage these patients over the phone if you have residents you trust on the other end. However, among your goals in fellowship is to get your hands on the scope as much as possible and to develop your own level of comfort with what can wait and what can't, so more often than not, at least during the early part of your training, you'd go in. That's probably the proper thing to do anyway. From what I've seen at my own institution, first-year fellows in July thru September come in all the time, then as the year goes on and they develop their own acumen and comfort level, they will come in for selected cases only. Otherwise, keep the pt. NPO +/- bowel prep and we'll scope them in the morning. Otherwise, your procedures are elective or semi-urgent, and can be done during fairly reasonable hours. I guess the exception is if you are the fellow on biliary and someone needs a stone taken out -- you want the ERCP, so you go in. You get the idea.
For most fields (GI, Cards, etc.) I don't think that fellowship is a true representation of what life in practice will be like, in so far as in fellowship your responsibilities are somewhat segmented by rotation. In the real world, you are the consult fellow, the biliary fellow, the liver fellow and the endoscopist all at the same time. Same as in Cards fellowship -- you are on consult, cath, ECHO, all as separate rotations. Plus, you have residents around to help do all the grunt work.
As for the real world, I think the type of lifestyle you'll have will depend on your practice situation, e.g. # of partners, how long you've been with the group, how many hospitals the group covers, etc. From what I've observed, private practice GI docs are crazy busy during the time they are awake, but probably not up as much at night as say people in Cards are with angina and arrhythmia. However, the realities of being a referral based specialty can make cases that could wait till the morning happen sooner rather than later, e.g. scope the pt. now to please the referring physician, rather than putting it off till the AM when your schedule is full anyway. One of my co-residents' Dad is a private practice GI doc who has been in practice a long time, one of the senior partners in his group. She tells me he hasn't gone in at night in a LONG time, but that he is on the phone quite a bit at night giving orders, etc. for bleeders (for example). But his days are jam-packed. He is probably more typical of GI docs who have been in the game a long time. When you're low man on the totem poll, you have a practice to build, but as you get more senior, you can choose what you do and don't want to do.
Hope this helps.
Fellowship -- For the most part, your days at work are busy between endoscopy, consults, and clinic. After hours calls are primarily related to bleeders and probably the occasional acute hepatitis. Remember, 80% of bleeding resolves on its own, so for the most part you can probably help manage these patients over the phone if you have residents you trust on the other end. However, among your goals in fellowship is to get your hands on the scope as much as possible and to develop your own level of comfort with what can wait and what can't, so more often than not, at least during the early part of your training, you'd go in. That's probably the proper thing to do anyway. From what I've seen at my own institution, first-year fellows in July thru September come in all the time, then as the year goes on and they develop their own acumen and comfort level, they will come in for selected cases only. Otherwise, keep the pt. NPO +/- bowel prep and we'll scope them in the morning. Otherwise, your procedures are elective or semi-urgent, and can be done during fairly reasonable hours. I guess the exception is if you are the fellow on biliary and someone needs a stone taken out -- you want the ERCP, so you go in. You get the idea.
For most fields (GI, Cards, etc.) I don't think that fellowship is a true representation of what life in practice will be like, in so far as in fellowship your responsibilities are somewhat segmented by rotation. In the real world, you are the consult fellow, the biliary fellow, the liver fellow and the endoscopist all at the same time. Same as in Cards fellowship -- you are on consult, cath, ECHO, all as separate rotations. Plus, you have residents around to help do all the grunt work.
As for the real world, I think the type of lifestyle you'll have will depend on your practice situation, e.g. # of partners, how long you've been with the group, how many hospitals the group covers, etc. From what I've observed, private practice GI docs are crazy busy during the time they are awake, but probably not up as much at night as say people in Cards are with angina and arrhythmia. However, the realities of being a referral based specialty can make cases that could wait till the morning happen sooner rather than later, e.g. scope the pt. now to please the referring physician, rather than putting it off till the AM when your schedule is full anyway. One of my co-residents' Dad is a private practice GI doc who has been in practice a long time, one of the senior partners in his group. She tells me he hasn't gone in at night in a LONG time, but that he is on the phone quite a bit at night giving orders, etc. for bleeders (for example). But his days are jam-packed. He is probably more typical of GI docs who have been in the game a long time. When you're low man on the totem poll, you have a practice to build, but as you get more senior, you can choose what you do and don't want to do.
Hope this helps.
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For your excellent contri.
My 0.5 cent contri is I worked with a Peds GI doc that has been in practice a long time and works his tail off. He has two clinics in different parts of town and admits to two hospitals. He is always available for consults and sees them ASAP. He does clinic almost daily and also does scopes on a scheduled and urgent basis. My impression was this is how he chooses to work.
My 0.5 cent contri is I worked with a Peds GI doc that has been in practice a long time and works his tail off. He has two clinics in different parts of town and admits to two hospitals. He is always available for consults and sees them ASAP. He does clinic almost daily and also does scopes on a scheduled and urgent basis. My impression was this is how he chooses to work.
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peds gi and adult gi have very little in common
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Thanks for your astute observation. I did mention it was a 0.5 cent contri and tried to focus on practice habits/choices as opposed to actual pathology.
I have been exposed to both, they have more in common in terms of patterns than you may imagine.
Consults, Clinics, Scoping.
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amazingly most medical practices have consults and clinics. they must be pretty similar.
the proportion of scoping to the rest of the practice is higher in adult than pediatric. the population base required to support a pediatric gastroenterologist is enormous relative to that required for an adult gastroenterologist. pediatric guys generally must cover multiple hospitals while adult gastroenterologists may or may not.
the money is multiples apart.
