Torn between PM&R and Allergy

[pathanon]

Hey everyone,
I'm considering going into one of the aforementioned fields.In allergy I just love almost all the science behind it;in pm&r I'm primarily interested in msk,emg,Botox,sports med(I'm really into sports myself).So which one would you recommend in terms of:

• easy-ness of setting up a p.p
• Patient population(I've heard pain patients in pm&r are "difficult" compared to allergy ones)
• Lifestyle during and post residency

My concerns:Even though PM&R sounds great on paper I'm afraid I'll struggle financially as rehab patients don't self refer and you have to rely on whatever Ortho/Neuro sends your way.I've also heard mixed things about allergy how pcp,ent, pneumo,peds like to play allergists.

In your experience what kind of personalities does allergy vs PM&r attract?

(I've posted this in the IM sub section but got no replies.Hopefully it'll get some traction here.)
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[DMBandFan86]

I doubt most of us know much about Allergy medicine. It’s a small field and most of us never rotated through it. I mean there are very little things in common with physiatry and allergy.

Do you want to touch and examine patients closely, perform procedures and injections?

Or do you want to order lab tests and skin tests and prescribe medications (for which a lot of them are OTC anyways)?

 

[j4pac]

My best friends is an allergist. He likes his job. Allergy is a fellowship, whereas PM&R is a residency. Do you like IM or Peds? Because you had to get through the residency first.

 

[pathanon]

I doubt most of us know much about Allergy medicine. It’s a small field and most of us never rotated through it. I mean there are very little things in common with physiatry and allergy.

Do you want to touch and examine patients closely, perform procedures and injections?

Or do you want to order lab tests and skin tests and prescribe medications (for which a lot of them are OTC)

Both fields involve thorough p.e of patients which I don't mind.PM&R is more procedure heavy when it comes to treatment and that appeals to my hands-on nature.I agree allergy is more cerebral with very few procedures.Maybe that's the reason people find it boring?

With that said,I can see myself being happy doing either,it's the post residency/fellowship concerns which make me have second thoughts...

My best friends is an allergist. He likes his job. Allergy is a fellowship, whereas PM&R is a residency. Do you like IM or Peds? Because you had to get through the residency first.

Strong NO to peds;I'll pull through IM like a champ though,if it means becoming an allergist

 

[DMBandFan86]

Maybe that's the reason people find it boring?

Well you said it, but that’s my personal opinion as well. I had an attending in residency that made me consult allergy one time. They came by and recommended Zyrtec and acted like it was such a high level decision.

Anyways you’re asking people who didn’t want to be internists, about the most internisty-type specialty of all internal medicine. If you feel like you could do IM like a champ, maybe your calling is IM. PMR is a nearly opposite specialty. The only time we do IM is inpatient, and you didn’t list that as something you like about the specialty. Most of the field is more related to orthopedics, pain and neurology.

In PM&R you can probably make more money. 50% MGMA is about 300k. If you open up some type of allergy sweat shop then I’m sure you can also make decent money. But otherwise you salary would be less in allergy.

I think you just need to decide if you want to do MSK and procedures or be more of a thinker. From what you’ve posted, I think you are an internist.

 

[Dantes]

Well you said it, but that’s my personal opinion as well. I had an attending in residency that made me consult allergy one time. They came by and recommended Zyrtec and acted like it was such a high level decision.

Anyways you’re asking people who didn’t want to be internists, about the most internisty-type specialty of all internal medicine. If you feel like you could do IM like a champ, maybe your calling is IM. PMR is a nearly opposite specialty. The only time we do IM is inpatient, and you didn’t list that as something you like about the specialty. Most of the field is more related to orthopedics, pain and neurology.

In PM&R you can probably make more money. 50% MGMA is about 300k. If you open up some type of allergy sweat shop then I’m sure you can also make decent money. But otherwise you salary would be less in allergy.

I think you just need to decide if you want to do MSK and procedures or be more of a thinker. From what you’ve posted, I think you are an internist.

Allergy probably has the best income when taking into account lifestyle of the IM subspecialties. Median MGMA was around 330k a couple years ago.

That said, they really are two different specialties OP. Also people will be coming in via peds and IM for AI fellowship, and at least during training you'll handle both adults and kids. What attracts you to both? I would shadow or do electives and see which day to day you find more interesting.

 

[j4pac]

I agree with the money side. Better money in PM&R on average…with a higher floor. But I wouldn’t look at the money. Allergists make very good money and the hours can also be so reasonable. The question is if you’d prefer to do internal medicine or help people with their rehab needs

 

[drusso]

Hey everyone,
I'm considering going into one of the aforementioned fields.In allergy I just love almost all the science behind it;in pm&r I'm primarily interested in msk,emg,Botox,sports med(I'm really into sports myself).So which one would you recommend in terms of:

• easy-ness of setting up a p.p
• Patient population(I've heard pain patients in pm&r are "difficult" compared to allergy ones)
• Lifestyle during and post residency

My concerns:Even though PM&R sounds great on paper I'm afraid I'll struggle financially as rehab patients don't self refer and you have to rely on whatever Ortho/Neuro sends your way.I've also heard mixed things about allergy how pcp,ent, pneumo,peds like to play allergists.

In your experience what kind of personalities does allergy vs PM&r attract?

(I've posted this in the IM sub section but got no replies.Hopefully it'll get some traction here.)
Thank you for stopping by!

Allergy all the way.

 

[Prehealth1011]

• easy-ness of setting up a p.p
• Patient population(I've heard pain patients in pm&r are "difficult" compared to allergy ones)
• Lifestyle during and post residency

I'm an IM resident so obviously biased. Based on the bold, I would pick Allergy. I just came off of it and you can churn through multiple patients. They typically don't have long problem lists, don't usually complain about pain, notes are the shortest I've ever seen, and it's not as draining as some other clinics. If you actually wanted to run a sweatshop, you probably can in Allergy. Can't comment on running a pp though and the lifestyle will suck more as an IM resident. Others are correct as well you should really explore how much you like the MSK and hearing about MSK complaints

 

[pathanon]

I'm an IM resident so obviously biased. Based on the bold, I would pick Allergy. I just came off of it and you can churn through multiple patients. They typically don't have long problem lists, don't usually complain about pain, notes are the shortest I've ever seen, and it's not as draining as some other clinics. If you actually wanted to run a sweatshop, you probably can in Allergy. Can't comment on running a pp though and the lifestyle will suck more as an IM resident. Others are correct as well you should really explore how much you like the MSK and hearing about MSK complaints

Any idea about other fields stealing cases?I know there's overlap in every specialty,but is it any worse for A/I?Are the nr of cases that you end up seeing enough to keep a practice afloat?thanks