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[throwaway902100]

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[bronx43]

Dude.

Stay in radiology... and I’m saying this as an IM sub specialist that likes his cush job. There are always ways out of clinical medicine should you choose, but trust me - you do NOT want to be stuck as a hospitalist with nowhere else to turn.

 

[bronx43]

What is wrong with being a hospitalist? What specialty in IM are you?

Rheum, but I was a hospitalist before fellowship. To each his own, but hospital medicine wasnt for me and many of my colleagues who also went on to do fellowship. After one month on service, I turned in my fellowship application and never looked back.

 

[stcl]

As a current intern I'll say I think you should stick with radiology if you don't plan to practice clinical medicine at all. If you just want to complete residency and pay off your loans and then transition into a different career, I think radiology makes so much more sense. It's only 1 year more for you, and those years are going to be so much better lifestyle-wise as a radiology resident compared to IM: easier hours, near your SO, probably easier moonlighting. Plus you can pay off your loans MUCH easier as a radiology attending compared to a hospitalist. And save up money to pay for an MBA. Also, you said you're at a top radiology program, vs. an apparently less-prestigious community IM program? Is it possible your current more-prestigious program might help you more in transitioning to a non-clinical business career? (maybe not, but something worth thinking about).

Now, if you do want to practice clinical medicine, then I'd say sure, you should consider internal medicine. Since I do think it's really important to do a job you love, or at least can tolerate. If you really enjoy internal medicine and hate radiology that's something to consider.

I'm biased since I really don't enjoy internal medicine, and I literally count down the days till starting R1 in July (I loved anatomy, path, pathophys, basic science). Also as another data point, I've had many of my intern year attendings tell me they're envious of my spot as a future radiologist.

 

[bronx43]

Can you elaborate on why you didn't like it? I actually liked getting the input of consultants, writing notes, putting in orders, answering nursing calls, etc

It depends where you practice, but if you go to academia, their consultants have zero incentive to do anything. Patient wait for a scope for 4 days? They'll blame you. Patient dispo gets delayed because IR won't place a tunnel cath? That's on you.
In the private setting, it's better, but you still end up hearing most of the complaints.

Answering nursing calls is terrible, plus with the way the culture is changing, THEY run the show. Not you. If you don't do something they want, they have the power to write you up and have admin on your a** so fast your head will spin.

If you like writing notes and putting in orders, then sure... there's PLENTY of that in hospital medicine.

 

[VA Hopeful Dr]

It depends where you practice, but if you go to academia, their consultants have zero incentive to do anything. Patient wait for a scope for 4 days? They'll blame you. Patient dispo gets delayed because IR won't place a tunnel cath? That's on you.
In the private setting, it's better, but you still end up hearing most of the complaints.

Answering nursing calls is terrible, plus with the way the culture is changing, THEY run the show. Not you. If you don't do something they want, they have the power to write you up and have admin on your a** so fast your head will spin.

If you like writing notes and putting in orders, then sure... there's PLENTY of that in hospital medicine.

My wife, who gave up being a hospitalist 2 years ago, said the job was basically being a resident but better paid.

 

[Dave1980]

The problem is that the IM PD wants an answer by the end of this month, before I have my breast imaging rotation. Should I jump ship now or stick through with radiology? I couldn’t find any other positions to begin in July in either psych or IM. I highly, highly doubt I'd be able to find another program willing to take me if I turn this down and will be forced to stay in radiology. Thanks for reading my stressful situation.

You should jump ship. You won't like breast imaging. The majority of the work is interpreting images and making reports. It really isn't a lot of patient contact. You definitely don't get that warm and fuzzy feeling from a patient-doctor relationship.

 

[deleted746658]

i am in same boat. i will likely be switching out of rads as well. to the people who say "you're crazy" ... i don't think it's crazy at all, provided you can tolerate hospital medicine.

if you grind as a hospitalist, which means working your week on week off in addition to 2-3 extra shifts a month, you can easily make 300-330k. you will finish training 3 years sooner if you switch. hell, rads will start at this and i for sure do not see rads making much more than this by the time we are out into practice (w/ death of PP and only corporate gig postings)

radiology is primed to be destroyed in the coming years- PE, AI, falling reimbursements. radiology literally has nothing going for it.

now, i'm not saying hospital medicine doesn't have its own enemies (i see you midlevels), but at least you can get out there and start making money while the money is there. bc we all know every field won't be making what folks are making today.

TLDR: medicine as a whole is a dumpster fire. do what u can to make some dough, and then plan your exit route.

 

[VA Hopeful Dr]

What does she do now?

Outpatient primary care

 

[Lnsean]

Life's short. Do what makes you happy. 2 years is not much in the grand scheme of things.

 

[thatsrad]

You sound like you won’t really like hospital medicine, you just hope that you’ll hate it less than radiology. I mean you’d be switching to it in the hopes it’d be easier to bail.

Doubtful on both counts. You’ll probably just as miserable (if not more), and have a harder time finding the exit hatch from medicine.

I do agree with Dave that you will not like breast, so I wouldn’t put your hopes in that.

 

[risus_sardonicus]

i am in same boat. i will likely be switching out of rads as well. to the people who say "you're crazy" ... i don't think it's crazy at all, provided you can tolerate hospital medicine.

if you grind as a hospitalist, which means working your week on week off in addition to 2-3 extra shifts a month, you can easily make 300-330k. you will finish training 3 years sooner if you switch. hell, rads will start at this and i for sure do not see rads making much more than this by the time we are out into practice (w/ death of PP and only corporate gig postings)

radiology is primed to be destroyed in the coming years- PE, AI, falling reimbursements. radiology literally has nothing going for it.

now, i'm not saying hospital medicine doesn't have its own enemies (i see you midlevels), but at least you can get out there and start making money while the money is there. bc we all know every field won't be making what folks are making today.

TLDR: medicine as a whole is a dumpster fire. do what u can to make some dough, and then plan your exit route.

Come back in 10 yrs and read this post again so you can realize how inaccurate you’re prediction was. With the advent of AI, Rads is primed to explode in revenue at least in the near future (~30 yrs)


Sent from my iPhone using SDN

 

[Chemdude]

i am in same boat. i will likely be switching out of rads as well. to the people who say "you're crazy" ... i don't think it's crazy at all, provided you can tolerate hospital medicine.

if you grind as a hospitalist, which means working your week on week off in addition to 2-3 extra shifts a month, you can easily make 300-330k. you will finish training 3 years sooner if you switch. hell, rads will start at this and i for sure do not see rads making much more than this by the time we are out into practice (w/ death of PP and only corporate gig postings)

radiology is primed to be destroyed in the coming years- PE, AI, falling reimbursements. radiology literally has nothing going for it.

now, i'm not saying hospital medicine doesn't have its own enemies (i see you midlevels), but at least you can get out there and start making money while the money is there. bc we all know every field won't be making what folks are making today.

TLDR: medicine as a whole is a dumpster fire. do what u can to make some dough, and then plan your exit route.

You can do 1 week on 2 week off jobs as an ER nights radiology job making close to $500k. If your're willing to moonlight on your days off, you can make $~2500/day. It's a difficult job...but it's nowhere near as physically and emotionally taxing as a hospitalist gig.

Radiology has a lot going for it. You are either unaware or misinformed if you believe that radiology is 'going to get destroyed in the coming year.' The radiology market is currently on the upswing and will continue to improve in the near future as more older radiologists retire.

 

[GadRads]

You can do 1 week on 2 week off jobs as an ER nights radiology job making close to $500k. If your're willing to moonlight on your days off, you can make $~2500/day. It's a difficult job...but it's nowhere near as physically and emotionally taxing as a hospitalist gig.

Radiology has a lot going for it. You are either unaware or misinformed if you believe that radiology is 'going to get destroyed in the coming year.' The radiology market is currently on the upswing and will continue to improve in the near future as more older radiologists retire.

Radiology may not be as emotionally or physically taxing, but it's more mentally draining. I felt more tired after my all radiology call nights than most nights of call in my intern year. My co-residents felt the same. I did a full internal medicine year by the way.

Per unit of time, we do more mentally demanding work in radiology. I don't think 1 week on/1 week off as a night radiologist is sustainable.

That said, I still prefer radiology. It's an interesting specialty. It would be nice if the volume of studies went down a bit.

 

[CherryRedDracul]

As much as I do like clinical medicine (and I like it a lot), there's no way you make me switch out of radiology for the exact reasons bronx43 described.

Being a glorifed resident with a larger paycheck isn't quite my cup of tea.

 

[Splenda88]

Can you elaborate on why you didn't like it? I actually liked getting the input of consultants, writing notes, putting in orders, answering nursing calls, etc

Are you serious? I am saying that as a PGY2 IM resident...


If you like these aspects of IM (hospital medicine), you should definitely switch ASAP. While radiologists make banks (450k+), it's not that difficult to make 350-400k as a hospitalist.

 

[deleted746658]

Come back in 10 yrs and read this post again so you can realize how inaccurate you’re prediction was. With the advent of AI, Rads is primed to explode in revenue at least in the near future (~30 yrs)


Sent from my iPhone using SDN

AI is going to do anything but put more $ in radiologists' pockets. sure, some docs may benefit from automated reads (eg orthopods who read at the same level as DR and who no longer have to have their reads be signed off by a rad, bc AI+ortho read will suffice).

you really think once we shift more towards bundle payments that they won't try to squeeze the DR read out of the bottom line?

all they have to do is automate 'normal scans' and boom, DR market collapses. think if they just automated normal CXR, normal head CT wo, etc... that's a ton of volume.

 

[deleted746658]

Are you serious? I am saying that as a PGY2 IM resident...


If you like these aspects of IM (hospital medicine), you should definitely switch ASAP. While radiologists make banks (450k+), it's not that difficult to make 350-400k as a hospitalist.

this. i know multiple hospitalist that easily surpass 300k. save yourself an extra three years of training. and w/ IM training, all of your options remain open. it's a much safer long term option than DR

 

[deleted379552]

I'm sorry: Why I lost my love for medicine

I'm sorry, but I have to walk away from my dream.

www.kevinmd.com

More relevant to emergency room doctors, but hospitalists face many of the same pressures.

With that said, do what you like.

 

[Lnsean]

IM is only tough when you're a resident. A lot of the sub-specialties are pretty cush when you're an attending. I think med onc salaries are pretty high (I read some offers of 400-500k for newly minted attendings). It's definitely a good path if you're thinking IM (even though regular hospitalists make good money too).

 

[odyssey2]

AI is going to do anything but put more $ in radiologists' pockets. sure, some docs may benefit from automated reads (eg orthopods who read at the same level as DR and who no longer have to have their reads be signed off by a rad, bc AI+ortho read will suffice).

you really think once we shift more towards bundle payments that they won't try to squeeze the DR read out of the bottom line?

all they have to do is automate 'normal scans' and boom, DR market collapses. think if they just automated normal CXR, normal head CT wo, etc... that's a ton of volume.

I'm not sure I understand this--how would AI automate 'normal scans'? I have a hard time believing any patient is going to trust their scans to a machine completely even if they don't have a dire diagnosis in mind, since you never know when you're going to catch something else. AI will be involved but I don't see how patients will trust any scan without a human involved at some point in the process.

 

[Kuratz]

w/ IM training, all of your options remain open. it's a much safer long term option than DR

Hell no to becoming a Hospitalist. The nonsense they have to deal with is unbelievable, as does the ED. It honestly seems like the worst job of all the physicians in the hospital (ED up there too) purely on the crap they deal with daily. I'd much rather risk Rads going to **** down the road then do that. And even if it does I would rather do Palliative care, family med or finish surgical training. The hospitalists seem so sad and dejected all the time and it's not hard to see why. There are legitimate concerns with any field. Choose one that is reasonable and work hard. Don't overthink it.

 

[deleted379552]

For what it's worth, AI is a powerful tool and will affect every aspect of medicine for the better. A few example:

Pediatrics: The Pediatric AI That Outperformed Junior Doctors

Psychiatry: AI language analysis helps clinicians predict psychosis with 93% accuracy: Machine learning was able not only to detect speech patterns indicative of psychosis, but also to identify a new pattern associated with the prodromal phase of psychosis, enabling an algorithm to predict the later emergence of psychosis with more than 90 percent accuracy, according to a study published June 13 in npj Schizophrenia.

Radiation Oncology: Study: Crowdsourced AI faster than humans in segmenting cancerous lung tumors. A new study published in JAMA Oncology shows that artificial intelligence systems crowdsourced from data scientists can segment lung tumors as accurately as human experts can, and at much higher speeds.

Dermatology: 3Derm announces two FDA Breakthrough Device designations for autonomous skin cancer AI , AI Outperforms Humans in Diagnosis of Skin Lesions

OBGYN: AI outperforms clinicians, Pap smears in detecting cervical cancer: Researchers created a visual evaluation algorithm that uses deep learning to detect cervical precancer and cancer more accurately than human clinicians, according to a study published in the Journal of the National Cancer Institute.

Pathology: https://www.journalofclinicalpathwa...athologists-detecting-grading-prostate-cancer

Cardiology: Machine Learning Algorithm Outperforms Cardiologists Reading EKGs , AI beats doctors at predicting heart disease deaths , AI Algorithm Outperforms Most Cardiologists in Heart Murmur Detection

There are innumerable other examples. It's a pretty cool field for those interested.

I'll say it again, do what you like. I imagine we will all be working a lot harder for a lot less in the near future.

 

[jejudo]

AI is going to do anything but put more $ in radiologists' pockets. sure, some docs may benefit from automated reads (eg orthopods who read at the same level as DR and who no longer have to have their reads be signed off by a rad, bc AI+ortho read will suffice).

you really think once we shift more towards bundle payments that they won't try to squeeze the DR read out of the bottom line?

all they have to do is automate 'normal scans' and boom, DR market collapses. think if they just automated normal CXR, normal head CT wo, etc... that's a ton of volume.

Would you get on a plane without a pilot? Most flights are “normal” after all. Why is Boeing making the next generation of planes still with two pilot seats? Mind you auto land and autopilot has been around since the 1970s. If people can’t trust machines to transport them, how will they ever trust machines in life and death situations?

The same argument can be made for other specialties with bundled payments. How about we replace a hospitalist with a FNP or PAs supervised by a single MD who never sees any patients? Once you do enough radiology, you’ll see that radiologists are the modern day diagnosticians — a key player in healthcare.

 

[radsisrad]

I'm not sure I understand this--how would AI automate 'normal scans'? I have a hard time believing any patient is going to trust their scans to a machine completely even if they don't have a dire diagnosis in mind, since you never know when you're going to catch something else. AI will be involved but I don't see how patients will trust any scan without a human involved at some point in the process.

When's the last time you met someone outside of medicine who actually knows what a radiologist is?

Most people I've met think their scans are read by the techs who get them onto the CT.

 

[rheumomaniac]

everybody here has good points. I'll just add that think about what you can do for the next 20-30 years ( depending on your age). Maybe you want to make some money then get out of medicine, but most likely you will be doing medicine for some time.
I think as we get older the hospital shifts can be tougher, and maybe not the case with Radiology. Either case, do what you love ( which is sometimes hard to tell ) . Good luck.