I don’t think you can stress enough how important it is to find a specialty which works with your personality and aspirations for work/life balance.
I know an oncologist who pretty much functions like a professor. Sees patients in his own office one day a week. Sees patients at the hospital one day a week. And then attends conferences, plenty of phone time consulting with colleagues, reviewing data from clinical trials, has a gig advising a start up life sciences company, sits on the board of a drug company. His role is not to hold hands, supervise the nurses who administer the drugs, or sit by someone’s bedside at 2 am- his role is to be a scientist and to help diagnose, then sift through an ever-widening set of options and help the patient choose the optimal treatment course and then move on to the next case.
Very family friendly lifestyle (now) although the training years were brutal.
Anesthesiology? The two I know have better hours than virtually any corporate professional at the same stage of their careers. They are shift workers- they know their commitments months in advance, they take tons of vacation time, they are NOT on call when they are not scheduled. Nobody is waking them at 3 am- there is someone at the hospital at all times covering for emergencies and when it’s you it’s tiring and stressful and when it’s not, it’s paradise.
My son’s psychiatrist told me that quite a few child/adolescent psychiatrists in Maine are retiring. He estimates that there are about 1,000 young people who need to find a new doctor!! He said there’s no way he can take more than a few. I’m thankful he agreed to continue seeing my son, even though he’s almost 24 now. We are so lucky this doctor is such a good match for our family! We respect him a lot, and he has told us the feeling is mutual.
If you are looking for the top “life style” specialty, the well known fact is that it is dermatology. Also the well known fact is that it is the second hardest one to match to after plastic surgery. I do not know stats for this year, but in 2015, only about 60% of those who applied to derm. matched. I also do not know what happened to 40% who did not match. There is no “scramble” type of procedure for derm. (whatever is the name, not sure) that exists for other specialties when applicants do not match. I imagine that it simply takes another year and there is no any kind of guarantee at the end of it.
“i would imagine that folks who didn’t match for dorm on March 15 were able to apply for other residencies just like anyone else who didn’t match.
Plus, I thought all dem residents were first year residents in internal medicine first. Ami I wrong about that?”
-Incorrect assumptions. The facts are that there is no process to find - “scramble” - for an open spot if you did not match to derm and it is unlike other specialties. Another fact is correct - they have mandatory prelim / transitional year. If they match to the first year, which is the vast majority of cases, they are all set for the next year. We are not talking about the next year though. We are talking about the one after. I heard that those who do not match to derm get absorbed by some research programs and re-apply the following cycle. But as I mention, it makes the residency longer by at least one year or maybe longer than that unless, they eventually decide on other than derm. specialty. However, I heard that this year cycle was not as competitive as the last year cycle.
The decision about derm is pretty straight forward though. If you do not get the top score in Step 1, you have to consider something else. You cannot retake Step 1, you can do it only if you fail. So you have only one chance to make it or forget about derm. This one number means that you are not automatically rejected , but in addition, you must have a lot of other things including top grades.
Are you talking about first year residents…or second year which I believe is when the derm concentration actually begins?
I’m talking about the first year.
ETA…some folks do NOT want to be dermatologists. Period. Doesn matter what the other positive things are…doesn’t matter that it is competitive. They don’t want to do it. Period.
This. If I had to do derm, I would have left medicine instead. Ditto many other specialties. While there are some who choose a specialty primarily based on factors such as lifestyle or pay, I think most people end up in a field that suits them best based on personality, interest or aptitude. Both of my decisions regarding choosing a specialty and then a subspecialty was pretty obvious as I rotated through various fields, first as a med student then as a resident. Life is too short to spend 40-80hr/week doing something that doesn’t appeal to you.
I chose the field first, then looked for practice situations that suited my desired lifestyle. If you are not tied to a specific highly desired geographic location, my sense is that there is a lot of flexibility available.
@thumper1, derm and some other specialties (anesthesia, radiology, neurology, psychiatry etc) usually require a generic ‘prelim’ year before starting in the specialty. While this is often done in Internal Medicine, I don’t think it is required for it to be so. For example, some anesthesia bound folks will do general surgery as a prelim. Also, I believe some programs have moved to not requiring a prelim year.
Two - physician married couple here. Two intensive, high stress, up-all-night specialties. Not the most conducive to raising our children who were our priority - so alternative plans were made early on. Need to comment on Miami’s post that her D in first year of residency ( if I understand correctly) is saving lives by herself and running the floor by herself. This does not happen in modern medicine . Wanted to clarify so that OP’s D gets a realistic impression and does not glamorize the hard work of residency. Also wanted to assure the non-medical among us that first year residents in this day and age are heavily supervised and are not running anything “on their own.”
Back in 2010, when I was asking input from a doctor couple about what my young high school aspiring to be doctor daughter should think about without sacrificing the entire personal life, this is what they suggested.
There is a group of specialities in medicine recommended for women due to better lifestyle called the ROAD to happiness. These include Radiology, ophthalmology, anesthesiology, and dermatology.
Now that she is actually starting medical school, I am certain she is not interested in any of these fields. However, I am sure there is something out there that suits her over achieving personality she would be most comfortable with, most likely going into academics.
The old book (but still quoted, from what I hear) “House of God” lists 6 specialties he called no patient contact: Rays, Gas, Path, Derm, Ophthalmology, and Psychiatry. These are the ones where doctors are supposed to have normal working hours after finishing training.
@mikemac - Is gas short for Gastro? One of our GI friends is always rushing off to save someone from choking on a foreign body which means lots of contact? It is always interesting to hear the stories from her non-doc husband who is driving her at 1 AM to attend to an emergency because he is more a night owl and she goes to work at 6 AM.
My wife and I are both psychiatrists and have been working for 24 years. We have one child. My wife has always worked half time. My work has varied from half time to more than full time. As someone else said, psychiatry might be considered a good lifestyle job but in fact it is very stressful. We are still on call 130 nights a year and work 26 weekends of the year. Call is not physically demanding but a quarter century of being awakened at night gets a little old.
There are paradoxes in regard to work. In our specialty there is a huge shortage, especially outside of urban areas. However, the more we work, the more we pay in tax to such an extent that the added time and stress are not worth it for extended periods of time.
Many women (not all) go into specialties that are more conducive to motherhood meaning that the jobs are more structured, have less or no call, and are more conducive to part-time work.
I don’t see medicine as a “calling” anymore in the sense that it used to be. There is no way that an adolescent could conceive of the actual practice of medicine - it is more of a fantasy than a calling. And healthcare has changed so much. The intergenerational dysfunction among doctors is increasing each decade meaning that the “old-timers” are getting younger and younger in proportion to the increasing absurdities in the practice of healthcare.
If your daughter does decide on medicine, encourage her to choose a specialty that allows her to vary her productivity over different developmental periods of her life. Encourage her to avoid debt absolutely, even after she is working.
Someone said that doctors are just like everyone else. I think that is not entirely true. The rigors of the education and training lead to a prolonged adolescence, seemingly endless delayed gratification, and quite a bit of interpersonal oddness. Ask any non-physician medical administrator how much fun it is to work with doctors. After the eye-rolling you will get some good stories.
@thumper1
I’ve sent the OP a PM with a some of my thoughts. Since I have 2 young physician daughters, I have some reservations about the sacrifices the life of a physician requires, but I would never, ever suggest either follow a different path. Both are compassionate, skilled physicians who find fulfillment in their choice.
But, I admit there are days when DH’s scientist joke isn’t particularly funny. (When DH was asked how he about he felt about his daughter going to med school, he replied: “I can’t believe she gave up grad school to become a plumber.”) There are days (variable in frequency depending on what’s going on at the hospital) when I think either or both of them would have been much happier if they had gone to grad school. Medicine is a tough life.
"Need to comment on Miami’s post that her D in first year of residency ( if I understand correctly) is saving lives by herself and running the floor by herself. This does not happen in modern medicine "
Of course not. Those of us who are physicians or are married to them can see right through this nonsense. No first-year is running any floor, anywhere.
OK, you can tell whatever you wish. I wish though that it come true some day because it is NOT true at all. There is one MD in a floor during night and if this MD happened to be an intern, she still has to perform whatever it takes, And this is true, not the wishful thinking. I wish though that it was not and 30 hour shifts are not part of the intern’s training, but it is in the programs that are part of the ongoing study. Some other parents here have their intern kids in the programs that participate in this study or friends. We cannot rely on the wishful thinking, we have to face the facts that are out there. And my D. did save at least 2 lives, maybe more and there is nothing special about it as I am sure that other interns have had similar experiences.
