What specialty is the best kept secret in medicine?

[gravitywave]

I agree. I would add sleep to it also, but it is a fellowship.

Rad Onc is a secret to M1-M2 student, and most students don't realize what an awesome job it is until it is too late. It is very competitive, but if you knew about it early on, you can get your research on and get yourself into shape to get a residency spot.

true enough, but most M1-2s wouldn't be interested anyway because they are biology students who would be horrified at the physics knowledge required

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[Siverhideo1985]

true enough, but most M1-2s wouldn't be interested anyway because they are biology students who would be horrified at the physics knowledge required

If I could do maths and physics I wouldn't be in medicine, haha

 

[k488k488]

Sleep

You've got less than 1/3 of those suspected of having your bread-and-butter diagnosis actually diagnosed, with game-changing innovative non-invasive therapies approaching the market, plus a litany of fascinating other ailments to face every day. You can open a dozen labs in 6 different cities and essentially collect a percentage, remote score and make as much as you want to work, or open your own center and make it what you want. Work 9-to-5 or work all day and night. Almost no emergencies to ever attend to.

BINGO!!!!

You're almost right on all points, except that the American Academy of Sleep Medicine says that you're only allowed to be medical director at 3 labs. However, you CAN open a lab and hire someone else to be the medical director. The ailments are fascinating, you actually make someone FEEL better, and if there's an emergency, you say "Call 911". Unfortunately, it doesn't pay as much as before, and reimbursements for in-lab sleep studies are getting crushed. However, I couldn't imagine not doing sleep. I'm trained in Pulmonary and Critical Care -- why would ANYONE do that? Yup, sleep medicine is AWESOME! BTW, you're wrong on another point -- I work less than 9-5.

 

[k488k488]

I agree. I would add sleep to it also, but it is a fellowship.

Rad Onc is a secret to M1-M2 student, and most students don't realize what an awesome job it is until it is too late. It is very competitive, but if you knew about it early on, you can get your research on and get yourself into shape to get a residency spot.

Oh SOOOOO TRUE!!!!!!! If I had known about Rad Onc when I was an M1-M2 a decade and a half ago, I would have done just that. Very wise, my friend.

 

[k488k488]

I agree. I would add sleep to it also, but it is a fellowship.

Rad Onc is a secret to M1-M2 student, and most students don't realize what an awesome job it is until it is too late. It is very competitive, but if you knew about it early on, you can get your research on and get yourself into shape to get a residency spot.

Oh, and I didn't see until just now what you wrote about sleep. Again very true, and yes it requires a fellowship. The fellowship is usually pretty benign, but getting to the fellowship can be a bit harder, depending on how one wants to hurt themselves. Rad Onc pays WAAAAAY better, but Sleep Medicine may have more rewards in terms of giving a patient their life back. Obviously, Rad Onc gives you your physical life back but in Sleep, a patient actually FEELS better.

 

[danielmd06]

You find factual comments unusual? Why?

It doesn't matter who disagrees with me but Sleep Medicine is not an official ABMS specialty. That's a fact. You can't disagree with a fact.

See here: http://www.certificationmatters.org/abms-member-boards.aspx

Facts? Awww. Better check back with the ACGME and the ABPN and ABIM etc. Sorry.

Thanks for playing...please deposit 0.25$ to play again.

It's an official specialty to any who are truly interested.

 

[Radonkulous]

Facts? Awww. Better check back with the ACGME and the ABPN and ABIM etc. Sorry.

Thanks for playing...please deposit 0.25$ to play again.

It's an official specialty to any who are truly interested.

He's a bitter neurosurgeon envious of sleep (in more than one way).

 

[Doctor4Life1769]

Medical students talking about residents/fellows/attendings being bitter.

 

[DrYES]

I will say this once and only once: Podiatric Surgery


1. Easy to get in - 3.2-3.4 with a 23-25 MCAT

2. 40 hrs a week tops on average

3. Low-stress specialty with a good amount of surgery and procedures

4. MGMA 2010 Physician Compensation Survey - Foot and Ankle Surgical Podiatrist mean salary $287,449

5. Diabetic population exploding leaves only room for growth


-most people do not even know podiatrists are DPMs not MD or DO = best kept secret

 

[Jack is Back]

General surgery is the best kept secret in medicine.

 

[45408]

4. MGMA 2010 Physician Compensation Survey - Foot and Ankle Surgical Podiatrist mean salary $287,449

whoa, I did not know that...

 

[Jack is Back]

whoa, I did not know that...

General podiatry is 216k.

Here are some other MGMA gems:

PMR: 278k
General Surgery: 360k
Hosptialist: 225k
Infectious disease: 221k
Neurologist: 268k
Pathology: 281k
Pediatrics: 211k
Sleep: 367k
Urgent care: 222k

According to MGMA, it difficult to not break 210k...

 

[Prodromo]

Can you guys describe Rad Onc for us M2's that know nothing about it? I've been considering rads but not entirely sure and the prospects of its future scare me.

 

[Slack3r]

According to MGMA, it difficult to not break 210k...

Outside of academics, it's not...

 

[45408]

I really doubt that the average general surgeon is pulling $360K. Although I'd love to be proven wrong.

 

[cincincyreds]

I think the best kept secret in medicine was giving propofol to crazy, sleep deprived rich/celebrity person in a bedroom with no backup equipmentwho has a bunch of little boys running around. 150k/ month cash, which equate to 1.8 million for the year as long as you don't pay your taxes. Sounds like an easy gig to master.

 

[thomprya]

I think the best kept secret in medicine was giving propofol to crazy, sleep deprived rich/celebrity person in a bedroom with no backup equipmentwho has a bunch of little boys running around. 150k/ month cash, which equate to 1.8 million for the year as long as you don't pay your taxes. Sounds like an easy gig to master.

Unfortunately for him the secret is out. First death ever via propofol, congrats to him....

 

[SoundofSilver]

Would anyone vote for anesthesiology?

Way less competitive than it's commonly thought to be, high reimbursements, good fellowship options, etc.

 

[45408]

Would anyone vote for anesthesiology?

Way less competitive than it's commonly thought to be, high reimbursements, good fellowship options, etc.

Rule #1 about a specialty being a secret: if it's in the ROAD acronym, it's not a secret.

 

[Jack is Back]

Would anyone vote for anesthesiology?

Way less competitive than it's commonly thought to be, high reimbursements, good fellowship options, etc.

Plus many wonderful colleagues like CRNAs.

 

[Jack is Back]

Rule #1 about a specialty being a secret: if it's in the ROAD acronym, it's not a secret.

Rule #2 about a specialty being a secret: IF IT'S IN THE ROAD ACRONYM, IT'S NOT A SECRET.

 

[Charles_Carmichael]

Can you guys describe Rad Onc for us M2's that know nothing about it? I've been considering rads but not entirely sure and the prospects of its future scare me.

Check out the FAQ in the radonc forum; it's well-written. Beyond the imaging part, there isn't much similarity between radonc and rads (as far as I know). There's also lots of patient interaction in radonc; I was very pleasantly surprised when I saw attendings scheduling consults, etc, for hour-long sessions. Very cool! It's a very academic field and research is essentially an unwritten requirement to have a chance at matching into it.

 

[Rollo]

I really doubt that the average general surgeon is pulling $360K. Although I'd love to be proven wrong.

You're saying the figure is too high or too low?

 

[Jack is Back]

You're saying the figure is too high or too low?

He's thinking too high.

 

[Radonkulous]

I really doubt that the average general surgeon is pulling $360K. Although I'd love to be proven wrong.

What do you think they're really pulling in? 300k?

 

[45408]

You're saying the figure is too high or too low?

way high

What do you think they're really pulling in? 300k?

I'm used to numbers more like $250K.

 

[Thaitanium]

Dermatopathology.

 

[dragon529]

what about plastic surgery? It's pretty hard to match into (almost same caliber as derm), but I think that's more for the integrated program and not the general surgery route..?

 

[Slack3r]

what about plastic surgery? It's pretty hard to match into (almost same caliber as derm), but I think that's more for the integrated program and not the general surgery route..?

It's the most competitive residency for a reason...hardly a secret.

 

[LexGunsta]

what about those private FM docs in rich neighborhood where patients pay high monthly fees but have unlimited immediate access to their FM docs?
I remember reading an article on it and it was saying those FMs pull close to 600.. but i might be dead wrong. anyone knows anything on this?

 

[smq123]

what about those private FM docs in rich neighborhood where patients pay high monthly fees but have unlimited immediate access to their FM docs?
I remember reading an article on it and it was saying those FMs pull close to 600.. but i might be dead wrong. anyone knows anything on this?

It's called Concierge Medicine. Yes, they do make a lot of money and they're spared a lot of the insurance paperwork headaches that outpatient doctors (in all specialties) have to face. That being said, it's only sustainable in certain high-end regions where the patients have enough money to afford this. It's not a good option for someone who is fresh out of residency either, because people will only trust you with that kind of money if you have some kind of a reputation to back you up.

In the area where I work, there are 3-4 concierge doctors, with a couple more planning to open similar practices in the coming year. All of those doctors, though, are in their 40s-60s, have many years of practice, have stellar reputations, and already have large numbers of patients who have been seeing them for years and trust them. Someone coming out of residency will not have those advantages.

 

[45408]

It's called Concierge Medicine. Yes, they do make a lot of money and they're spared a lot of the insurance paperwork headaches that outpatient doctors (in all specialties) have to face. That being said, it's only sustainable in certain high-end regions where the patients have enough money to afford this. It's not a good option for someone who is fresh out of residency either, because people will only trust you with that kind of money if you have some kind of a reputation to back you up.

Also viable in some low-income rural areas where people don't have insurance but will pay $50 to have a laceration sutured. It's not big bucks though, but it's a cool business model, IMO.

 

[danielmd06]

This argument is still going on?

Ortho, rads, and derm are great. But everyone knows this...

The best kept secrets are...sleep medicine, rad-onc, and pm&r. Mark my words. If you doubt...do your homework.

 

[Rollo]

This argument is still going on?

Ortho, rads, and derm are great. But everyone knows this...

The best kept secrets are...sleep medicine, rad-onc, and pm&r. Mark my words. If you doubt...do your homework.

Rad-onc is pretty competitive so I fail to see how it's exactly a secret...

 

[Sheldor]

Rad-onc is pretty competitive so I fail to see how it's exactly a secret...

Exactly, with an average step score of 240 it certainly seems like its not a secret.

 

[DrBowtie]

Rad-onc is pretty competitive so I fail to see how it's exactly a secret...

Exactly, with an average step score of 240 it certainly seems like its not a secret.

Its more of the small number of spots and the super academic/research focus that makes it competitive. The fact remains is that there are barely any topics that cover Rad/Onc in the basic sciences, and is not a required clerkship makes is still a secret.

If you polled an M1 class, I'd bet few would say that they were considering the field.

 

[Rollo]

Its more of the small number of spots and the super academic/research focus that makes it competitive. The fact remains is that there are barely any topics that cover Rad/Onc in the basic sciences, and is not a required clerkship makes is still a secret.

If you polled an M1 class, I'd bet few would say that they were considering the field.

PMR doesn't get any coverage in basic sciences years and most M1 wouldn't be considering the field either if you polled them.

 

[DrBowtie]

PMR doesn't get any coverage in basic sciences years and most M1 wouldn't be considering the field either if you polled them.

....which is exactly why I said PM&R and Rad Onc /thread above.

 

[DreamingTheLive]

Agree with PM&R >>>> Rad Onc. Both are not exactly mainstream, but, as alluded to many times above, most (a lot) M1s would know that Rad Onc is a small and selective specialty in medicine, while most M1s might would believe that Physiatry is either for PTs or Psychs.

Both have the potential to be super cush, PM&R is more a "secret" but most would probably agree that Rad Onc is the better gig, personal preferences aside.

 

[danielmd06]

Yes, rad-onc is competitive, but I believe it flies below the radar of many who are actually competitive for it because it's relatively unknown.

 

[r90t]

Not many know what we do. Hours are great, call has few emergencies and the pay is decent. Most rewarding, pts will actually follow your orders to get better. Worst part, treating a youth or young adult knowing that they have a grim prognosis. Some people can't handle that part and would rather treat less acute issues.

 

[Frank Nutter]

Best kept secret is probably leaving clinical medicine altogether, and going into something like consulting/research/writing that is less burdened by regulation and outside interference. Pay can't be much worse than residency, 4 year's worth of loan interest avoided, greater sense of gratification, and much less stress. Oh, and you won't get sued.

 

[thomprya]

How about Pain Med? No call, great pay, mix of procedures and patient work. Everyone always states it a bad pt population but if you can handle some drug seekers I think that could be a good way to go. Also, I have to agree sleep med is pretty cush right now, a doc in my area pulls high six figures for <40hrs a week and no call. Sleep studies and reading complex eeg's are quite lucrative right now. I was chatting with him and in reading two eegs over breakfast he made more then I made in one month at my job

 

[Rollo]

Best kept secret is probably leaving clinical medicine altogether, and going into something like consulting/research/writing that is less burdened by regulation and outside interference. Pay can't be much worse than residency, 4 year's worth of loan interest avoided, greater sense of gratification, and much less stress. Oh, and you won't get sued.

Not sure if I'd get greater sense of satisfaction by telling others how to run their practice or if that information on the Hernias pamphlet is accurate or writing about how socialized medicine is a bad idea RATHER than by actually treating an acute injury and saving somebody's life.

 

[JackShephard MD]

Best kept secret is probably leaving clinical medicine altogether, and going into something like consulting/research/writing that is less burdened by regulation and outside interference. Pay can't be much worse than residency, 4 year's worth of loan interest avoided, greater sense of gratification, and much less stress. Oh, and you won't get sued.

It amazes me that people fight so hard to get into medical school when they don't want to be practicing physicians.

 

[officedepot]

Not sure if I'd get greater sense of satisfaction by telling others how to run their practice or if that information on the Hernias pamphlet is accurate or writing about how socialized medicine is a bad idea RATHER than by actually treating an acute injury and saving somebody's life.

so easy to say that now but just wait 30 years and see how you feel. Why do you think almost every attending doc I tell that I'm going radiology all say "wow that's a great choice." it's because rads makes a lot more money than them and don't have as many crap hours and don't have to deal with a lot of bull that patients bring. Priorities change when you get older.

 

[torontodoc]

I'd say Psychiatry because of good pay, great working hours and avg score of 210+ or something like that...
or even Emergency Medicine. Great pay and you only work for 6-7months a year. avg score of around 230, if I remember correctly.

Again as many folks already mentioned on this thread, it all comes down to personal preference. I just finished a rotation in Emergency Psychiatry. Totally loved it!!!

 

[Rollo]

so easy to say that now but just wait 30 years and see how you feel. Why do you think almost every attending doc I tell that I'm going radiology all say "wow that's a great choice." it's because rads makes a lot more money than them and don't have as many crap hours and don't have to deal with a lot of bull that patients bring. Priorities change when you get older.

Thank you, The Oracle!

 

[JackShephard MD]

so easy to say that now but just wait 30 years and see how you feel. Why do you think almost every attending doc I tell that I'm going radiology all say "wow that's a great choice." it's because rads makes a lot more money than them and don't have as many crap hours and don't have to deal with a lot of bull that patients bring. Priorities change when you get older.

Remember that the landscape of radiology will be completely different 30 years from now. You don't know if radiology will pay well and not have "crap hours" in 3 decades.

This is why making decisions based upon transient factors is a recipe for failure. Find a specialty you are passionate about, $ and lifestyle can change at any moment. I would agree if you are equally enthusiastic about multiple specialties then chose the one with better peripheral factors but don't let those drive your choice.

 

[Frank Nutter]

Not sure if I'd get greater sense of satisfaction by telling others how to run their practice or if that information on the Hernias pamphlet is accurate or writing about how socialized medicine is a bad idea RATHER than by actually treating an acute injury and saving somebody's life.

Being self reliant, getting by independently, by not relying on a monopoly, I can see being pretty satisfying. Direct voluntary exchange at least ensures one's service is appreciated in direct proportion to his income.