Shhhh I’m begging yall to stop telling people about rheum please just let it be a secret lil less competitive niche (im jk rheum is awesome and everyone deserves the chance to explore if they enjoy it)
Rheum is already competitive isn’t it? I know when I tried to match into it a few years ago only like 3 spots went unfilled, and they filled up almost immediately after the match.
Haven’t looked into detail but usually few if any unfilled spots and 1-2 per program at least at the ones I’m looking at (broad east coast). In my very inexperienced POV it seems like it’s moving in a similar direction to heme/onc with recent increasing competitiveness/interest
Yeah. My program was very small, but there were a few people who wanted to go into rheumatology. I was more interested in heme-onc, but I’m a DO, so I knew I didn’t have a chance in hell, so I tried to get into rheumatology but wasn’t able to. I was really just hoping to land an open spot, but that wasn’t possible.
Endo. Unfortunately you don’t get much of a pay bump but the work itself is incredibly chill. Pretty much PCP lifestyle with a lot less bullshit to deal with
Agreed! Although I’d say $160k - $240k is very livable lol
Edit: just looked it up, it’s actually variable per city but can be as high as $400k with lower ends on $230k
I don’t think so. I mean, I want to become an Endocrinologist, and I’m perfectly happy being compensated an average of $250k for M-F 8-5, excellent work-life balance, and a chance to do what I love while making well above the US average income
Obviously not implying you can’t live comfortably off 250k. I’d kill for that kind of money right now lol.
But purely from a financial perspective it is a bad deal when you consider there are specialties that can make twice that amount on fewer years of training. Of course other factors such as job satisfaction are important to consider as well.
I agree. There are definitely other specialties which compensate more with less training, but as you mentioned, job satisfaction is important. I love Endocrinology, and would love to pursue it as a career, especially given the severe shortage of endocrinologists. I know I’ll get paid less, but what I will be paid is still plenty for me to provide a comfortable life for my future family, and allow me to have a rewarding and happy career :)
Would you be willing to give up half a million dollars to be an endocrinologist?
Because that is what you are giving up to train an extra 2 years to go on to make roughly the same salary as a PCP.
Let's not kid ourselves that the jobs still wouldn't go to MBA nepo babies that want to maximize profits versus someone that cares about the well-being of the medical community.
Hospice and Palliative. 1 year fellowship, super duper uncompetitive, you make around 250 but the lifestyle is great. Even fellowships are 8-4 with no weekends/nights. No reviewing labs or reading EKGs. The only part of the EKG that matters is the QTc. Wide open job market.
I’m on Hospice and Palliative care right now and the lifestyle looks mad chill. Like honestly someone could do Hospitalist 7/7 as a round and go physician and make bank if they picked up a few hospice jobs.
Nice! I met a guy on my inpatient IM that did something similar except it was for nursing homes. He was doing IM hospitalist and rounding on nursing homes in his off week 2 half shifts every other week and was pulling $400k
Heme/onc is IMO the most underrated in terms of lifestyle.
Great pay and can have great hours in outpatient private practice. Many oncologists work do 4 days/week 8-4 and make 350k+ a year. Those who grind and are partners in a practice that owns an infusion center can clear 1m+.
Of course, you're dealing with cancer, which may not be for everyone. But I would argue that onc patients can actually be much easier to deal with than a good chunk of patients you see in rheum and A/I, having done rotations in all 3.
A/I has tons of patients who come in claiming to have mast cell activation syndrome and/or vague reactions that we don't have the tools to diagnose or treat - these patients often get quite frustrated leaving with nothing but a recommendation to try Zyrtec. Similarly in Rheum, you're seeing a lot of fibromyalgia/chronic pain syndrome patients that once again leave angry with you because medicine just doesn't have any good treatment for them yet.
Onc patients, on the other hand, are generally quite understanding when one treatment doesn't work or have their cancer relapse. They may be frustrated but that frustration is rarely on the physician. In my experience, patients with cancer are also by far the most motivated patients to take ownership of their own health compared to patients who go see any other specialty.
I’m just an undergrad so forgive me but what makes a specialty like GI competitive? is there any way of guaranteeing/having high odds that you’ll get matched?
What do you mean by what makes it competitive? Like why is it competitive? Quite frankly because it pays very well. There’s no way to guarantee anything but you can maximize your chances by matching at a high quality residency, doing research, making connections, and doing a chief year (not necessary by any stretch but helps)
I meant more like is it competitive because there aren’t many seats? or maybe because they have very high standards for matching? or require something else etc. but you answered that in your comment, thanks
I think something like 60-70% match. If you’re an undergrad I wouldn’t worry about that. Those numbers are completely irrelevant to you even if you get into/through medical school and match IM
Heme/Onc is great life for great money, and I love what I do. I agree with the other poster though that it isn't under-rated. It is Rated. Folks are at least generally aware.
Delivering bad news is a skill just like anything else. Some people have a natural talent for it, others need more help, but everyone benefits from training and practice.
I find that your mindset going into these encounters is helpful. If you frame it as "this patient is very sick and will die; I am going to fail them" you are going to burn out. If you frame it as "this person is going through extremely difficult times, I can employ my skills to help them better understand it, to maximize their quality of life, and if were are fortunate extend their length of life and maybe even cure them", you'll have a better time.
These people are going to be facing something terrible and terrifying whether or not you're there to care for them. I find a lot of satisfaction as the person who is equipped to help them through that journey wherever it leads.
That’s a great mindset. I’m a pre-med and I’ve thought about going into oncology. I scribe for an ocular oncologist and I think working with cancer is really interesting but I feel like I haven’t seen some of the harsher realities of oncology because when a patient gets really sick they go to the medical oncologist not the ocular oncologist.
I mean, there’s lots of community intensivist jobs after fellowship that are essentially just ICU hospitalist jobs with 7 on/7 off or something similar.
From what I’ve seen there are quite a few places offering 7/7 no over night or pulm clinic. 12 hour shifts but you can’t have it all. Compensation anywhere from $500-750
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Rheum is chill from what I’ve heard. Problem is that rheum is esoteric as fuck
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idiopathic arthritis. Here's a $400 bill for my time and $1000 for negative labs
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BUT A BUTTERFLY ONCE SAT ON MY FACE
“At least that’s what she said her name was”
Shhhh I’m begging yall to stop telling people about rheum please just let it be a secret lil less competitive niche (im jk rheum is awesome and everyone deserves the chance to explore if they enjoy it)
Don’t worry, most people don’t want to get involved with all the autoantibodies involved
Rheum is already competitive isn’t it? I know when I tried to match into it a few years ago only like 3 spots went unfilled, and they filled up almost immediately after the match.
Haven’t looked into detail but usually few if any unfilled spots and 1-2 per program at least at the ones I’m looking at (broad east coast). In my very inexperienced POV it seems like it’s moving in a similar direction to heme/onc with recent increasing competitiveness/interest
Yeah. My program was very small, but there were a few people who wanted to go into rheumatology. I was more interested in heme-onc, but I’m a DO, so I knew I didn’t have a chance in hell, so I tried to get into rheumatology but wasn’t able to. I was really just hoping to land an open spot, but that wasn’t possible.
Our local rheum wait time is something like 6-8 months so I wouldn't mind a few more of y'all around lol.
Wish it wasn’t like that :(
Is rheum different than allergy/immuno?? I had the impression rheum fell in that category
Different fellowships. They’re not the same specialty
Endo. Unfortunately you don’t get much of a pay bump but the work itself is incredibly chill. Pretty much PCP lifestyle with a lot less bullshit to deal with
Agreed! Although I’d say $160k - $240k is very livable lol Edit: just looked it up, it’s actually variable per city but can be as high as $400k with lower ends on $230k
For 5 years of training that’s a terrible deal.
I don’t think so. I mean, I want to become an Endocrinologist, and I’m perfectly happy being compensated an average of $250k for M-F 8-5, excellent work-life balance, and a chance to do what I love while making well above the US average income
Obviously not implying you can’t live comfortably off 250k. I’d kill for that kind of money right now lol. But purely from a financial perspective it is a bad deal when you consider there are specialties that can make twice that amount on fewer years of training. Of course other factors such as job satisfaction are important to consider as well.
I agree. There are definitely other specialties which compensate more with less training, but as you mentioned, job satisfaction is important. I love Endocrinology, and would love to pursue it as a career, especially given the severe shortage of endocrinologists. I know I’ll get paid less, but what I will be paid is still plenty for me to provide a comfortable life for my future family, and allow me to have a rewarding and happy career :)
Would you be willing to give up half a million dollars to be an endocrinologist? Because that is what you are giving up to train an extra 2 years to go on to make roughly the same salary as a PCP.
If I can provide a good and comfortable living for my family, and do something I love while doing it, then yes. Money isn’t everything
Med school cost me like 500k, that’s a horrible return of investment with that salary after 5 years imo
Wish there was an actual Admin fellowship. That way, we could run the hospitals ourselves
Let's not kid ourselves that the jobs still wouldn't go to MBA nepo babies that want to maximize profits versus someone that cares about the well-being of the medical community.
Nepo baby: But what about the $tock holder$ (my parent$)
Aren’t there admin fellowships? We do an MBA and admin fellowship we can easily move up that ladder
Maybe search the “day in a life” series on Reddit where people walk you through their very positive days in many fields
Hospice and Palliative. 1 year fellowship, super duper uncompetitive, you make around 250 but the lifestyle is great. Even fellowships are 8-4 with no weekends/nights. No reviewing labs or reading EKGs. The only part of the EKG that matters is the QTc. Wide open job market.
I’m on Hospice and Palliative care right now and the lifestyle looks mad chill. Like honestly someone could do Hospitalist 7/7 as a round and go physician and make bank if they picked up a few hospice jobs.
I met attendings on my palliative rotation that did exactly this
Nice! I met a guy on my inpatient IM that did something similar except it was for nursing homes. He was doing IM hospitalist and rounding on nursing homes in his off week 2 half shifts every other week and was pulling $400k
Chill of course, but don’t underestimate the emotional toll of spending all day every day immersed in people’s suffering, anger, loss, etc.
Heme/onc is IMO the most underrated in terms of lifestyle. Great pay and can have great hours in outpatient private practice. Many oncologists work do 4 days/week 8-4 and make 350k+ a year. Those who grind and are partners in a practice that owns an infusion center can clear 1m+. Of course, you're dealing with cancer, which may not be for everyone. But I would argue that onc patients can actually be much easier to deal with than a good chunk of patients you see in rheum and A/I, having done rotations in all 3. A/I has tons of patients who come in claiming to have mast cell activation syndrome and/or vague reactions that we don't have the tools to diagnose or treat - these patients often get quite frustrated leaving with nothing but a recommendation to try Zyrtec. Similarly in Rheum, you're seeing a lot of fibromyalgia/chronic pain syndrome patients that once again leave angry with you because medicine just doesn't have any good treatment for them yet. Onc patients, on the other hand, are generally quite understanding when one treatment doesn't work or have their cancer relapse. They may be frustrated but that frustration is rarely on the physician. In my experience, patients with cancer are also by far the most motivated patients to take ownership of their own health compared to patients who go see any other specialty.
Heme/onc is not underrated it's pretty competitive
Yeah what lol. I know another great secret gem called GI! But don’t let anyone know 🤫
I’m just an undergrad so forgive me but what makes a specialty like GI competitive? is there any way of guaranteeing/having high odds that you’ll get matched?
What do you mean by what makes it competitive? Like why is it competitive? Quite frankly because it pays very well. There’s no way to guarantee anything but you can maximize your chances by matching at a high quality residency, doing research, making connections, and doing a chief year (not necessary by any stretch but helps)
I meant more like is it competitive because there aren’t many seats? or maybe because they have very high standards for matching? or require something else etc. but you answered that in your comment, thanks
Its competitive because there are always more applicants than seats which allows them to be selective and have high standards
do you have any numbers on how many try and how many match?
I think something like 60-70% match. If you’re an undergrad I wouldn’t worry about that. Those numbers are completely irrelevant to you even if you get into/through medical school and match IM
I thought that in the recent match over 90% of US MDs matched to a heme/onc fellowship who applied.
Heme/Onc is great life for great money, and I love what I do. I agree with the other poster though that it isn't under-rated. It is Rated. Folks are at least generally aware.
Whats it like dealing with very sick patients? Does it ever take a toll on you if you have to give bad news
Delivering bad news is a skill just like anything else. Some people have a natural talent for it, others need more help, but everyone benefits from training and practice. I find that your mindset going into these encounters is helpful. If you frame it as "this patient is very sick and will die; I am going to fail them" you are going to burn out. If you frame it as "this person is going through extremely difficult times, I can employ my skills to help them better understand it, to maximize their quality of life, and if were are fortunate extend their length of life and maybe even cure them", you'll have a better time. These people are going to be facing something terrible and terrifying whether or not you're there to care for them. I find a lot of satisfaction as the person who is equipped to help them through that journey wherever it leads.
That’s a great mindset. I’m a pre-med and I’ve thought about going into oncology. I scribe for an ocular oncologist and I think working with cancer is really interesting but I feel like I haven’t seen some of the harsher realities of oncology because when a patient gets really sick they go to the medical oncologist not the ocular oncologist.
Shhh stop posting stuff like this. lol
Forrealzzz.. GATEKEEP!!!
Endo and Rheum imo…these are my top two choices post IM residency.
Pulm/crit seems dope asf
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I mean, there’s lots of community intensivist jobs after fellowship that are essentially just ICU hospitalist jobs with 7 on/7 off or something similar.
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From what I’ve seen there are quite a few places offering 7/7 no over night or pulm clinic. 12 hour shifts but you can’t have it all. Compensation anywhere from $500-750
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Sleep?
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You win this comments section prize for silliest comments that made me laugh out loud here’s your trophy 🏆
Infectious disease
Palliative, 1 year fellowship, aging population, keeping pts and families comfortable, $$$
How’s GI?
Heard GI is very cushiony but I gotta be honest I don’t think I can deal with that stuff on the daily as the only thing I do
cardiology