Veteran readers, I know this is a topic you guys are very familiar with. Please bear with me. =)
I’ve seen several hits in my stat logs from people looking for the ROAD specialties. For many students new to medicine, this might be something that you’re hearing for the first time.
The ROAD specialties are specialties that are generally considered “lifestyle” specialties in medicine. Lifestyle specialties are those that offer good pay with minimum work hours, low patient loads, above average working conditions, and typically low on-call time.
Historically, the ROAD specialties are Radiology, Opthalmology, Anesthesiology, and Dermatology. More recently, the mnemonic has been revised to E-ROAD or ADORE to include Emergency Medicine.
Anesthesiology is on the high-end of work hours, while specialties such as Pathology aren’t included. Expect the lifestyle specialties to change slowly over time as working conditions, hours, and pay fluctuate.
Other specialties that I consider to be lifestyle specialties are radiation-oncology, radiology (which is included in ROAD, but diagnostic only), pathology (mentioned above, but not included in E-ROAD), and reproductive endocrinology. Watch out, though, as reproductive endocrinology is an OB/GYN fellowship. If you can stomach the traditional OB/GYN residency and manage to match into repro-endo, your life should improve dramatically.
One specialty of special mention is Orthopedic Surgery. Despite the fact that it is insanely competitive, do not believe for a minute that it falls into the lifestyle category. The work hours are long, the work is manually intense, but the pay is great. I think the fascination with orthopedic surgery stems from manual labor with drills and saws coupled with an athletic or “appealing” build seen in most residents.
One last thing I wanted to mention is Anesthesiology. I’ve always heard the work hours and free time is great. Some of the most up-to-date data we have says otherwise. Anesthesiologists are actually working on-par with surgeons. I’m looking forward to seeing some more recent data on work hours before my argument can hold any weight. The students are still pouring into Anesthesiology as of 2006.
Path is a rare specialty that can also have a relatively good lifestyle DURING residency. It’s in a category all its own!
So in keeping with the anesthesiology rumor, I say we forget anesthesiology add pathology, and then the acronym can be
PEDRO
By the way, why isn’t pathology including in the acronym, Hoover? Because it’s not as competitive?
Pathology is indeed in a class of it’s own. Good life during residency and a good life after residency as you mentioned. Where else can you get that? Even radiology requires you to do a shitty prelim year in medicine. That alone would make me not do rads. Oh well, I guess I’m biased.
I really dig PEDRO…you’re getting rid of Anesthesiology and replacing it with Path. GAS guys – you’ve been pwned!
=D
Hoover, Why would you accept the point of view that doing a prelim year makes doing rads not worthwhile?
Your disposition to avoid temporary inconvenience appears very shortsighted and almost along the lines of people who decide not to wear a condom for the sole reason that the sex feels better but at the same time failing to take into account all the other risks and concomitant long term effects.
If I may speak for Hoover, as well as myself, part of it has to do with getting sick of the bullshit. “Only 10 years of torture and you have a great job!” Sick of all the hoops of suffering.
Where do you draw the line? One year? Five years? Plastic surgeons can have relatively good lifestyles (from what I understand), but you have to go though a surgery residency. I’m with Hoover, and that’s one reason I’m doing Pathology. I mean, I actually like it, so it’s not just a lifestyle thing.
I suppose if I was REALLY interested in a specialty I might suffer for one year to get to it. But at the end of medical school, I’m jaded. I don’t expect the world to hand me a career, and I don’t mind hard work, but I want something palatable and reasonable.
Yan,
I care fuck all for radiology and your comparison to sex without a condom is childish. I bet you’re the guy in class who always fucking argues, am I right?
It’s not a “disposition to avoid temporary inconvenience” as you said, it’s me making my own fucking choices. Maybe you should grow a pair and start doing a little bit of the same.
It sounds like you’re somebody that has already decided you’ve got to be “inconvenienced” for your whole life. That’s a shame, really. At least I’ll be happy.
does the kind of lifestyle you want to live in have a role in the type of field you should pursue. for example, i live in NYC and i would love to stay in NYC,so are there any fields that would be best for the city as compared to other rural areas? such as othopedic surgery, i have a keen interest in orthopedic surgery.
John, I don’t think so. You can pretty much find all training programs in the big cities such as NYC. As long as you are competitive enough, you’ll have a lot of say in where you want to go.
Hey, great topic and once again, I bow to Hoover’s superior blogging prowess.
But while Emergency Medicine has reasonable residency hours and very little call after you get through with the off-service stuff, I wouldn’t call it a lifestyle specialty during residency. I like it a lot but you will work pretty hard. It’s true, for example, that we only work 55 hours or so a week but we are working flat out for the entire 55 hours. If you interview for EM and intimate that you are interested in it because you don’t want to work as hard as, say, people going into IM your interviewer will laugh.
I think the definition of a lifestyle specialty in residency should be one that comes closest to the idea of a forty-hour-per-week, Monday through Friday Job. Derm, Path, and Optho seem to fit this criterion.
Whats a condom?
I think Repro/Endo shouldn’t really be considered a lifestyle specialty. Yes, you are likely raking in the bucks, but like you mentioned in the blog, you have to suffer through an OB/GYN residency. Additionally, you have to be a slave to your patients’ ovulatory cycles. I worked with one for a month, and she was coming into her clinic every single day including weekends to do serial ultrasounds and trigger ovulation. She couldn’t take vacation very easily without causing an uproar.
Hey Hoover,
I enjoy your hostility and disgust, its refreshing in a world where everyone says that their “doing well” or that their “good”, perpetually.
Obviously you have a particular aversion for many residency programs but I suppose I’ve hit a raw nerve with you by standing my ground and thinking that a distasteful prelim year may well be worth it for someone who wants to do rad.
Hoover said “I bet you’re the guy in class who always fucking argues, am I right?”
Actually Im the guy who sits calm as a cow, mostly silent, and occasionally annoyed, by people who ask superfluous questions to engorge their intellectual clitoris.
And by the way, I do respect your right to make a choice, but I believe just as much In my right to disagree (If anything this means I still have balls) with you while also making fun of you in a caustic fashion(bigger balls).
And I do appreciate your low blow insults, it reminds me of my childhood in Brooklyn.
Yan, thanks for the honesty.
A distasteful prelim year would be worth it for somebody genuinely interested in radiology. That’s not me, though. As a result, it wouldn’t be worth it for me to go through a prelim year in medicine simply because I am not interested in doing radiology. That was the basis for my comment.
If radiology didn’t have a prelim year associated with it, would I me more interested? Actually, no. There’s a lot about radiology that doesn’t appeal to me. For one, I really love the technology, but the residency itself is chocked full of procedures (interventional stuff) that just isn’t my cup of tea.
You didn’t so much hit a nerve with me as I had just gotten out of bed when I wrote that first comment. You’re right though, I am pretty honest with my opinions.
I think it is preposterous to consider ortho a life-style specialty. Yes, you’ll make bank, but someone else is going to have to spend it for you. May I suggest that one look beyond the residency experience to your long-term practice as an attending. Personally, I think EM sucks as an attending, for more reasons than I have time to go into here. Yes, shift work, but which shifts? Believe me your outside life suffers from the rotating shifts, weekends, holidays. One can argue that you’re often off when other people are at work and so the lines at the bank and the store are shorter, but the grind gets old. If it works for you, great, but that’s more of a personality issue than cushy-specialty issue, which I would say EM is not one. See Panda Bear’s post above – I concur.
Consider adding to the list PM&R (Physical Medicine & Rehabilitation) or (Plenty of Money & Relaxation). I am switching out of EM into PM&R. I stipulate that some people can’t take the patients, their indolent courses, or their stories.
Physiatrists make less than orthopods, but you won’t be all stressed out at work, you’ll have a stable schedule (mostly M-F, 8-5), you will see the sunshine and sleep most nights without being disturbed – priceless.
Stay clear of Internal Medicine. I went into this s… to become interventional cardiologist and finished with no opportunity to specialize.
Life style sucks. Pay sucks. You compete with Family Docs and Nurse Practitioners for patients. Usually you get old, crazy or poor ones.
It became a dumping ground for all specialists. When they are finished with “wallet biopsy” you need to take care of the rest including most of the complications of someone else work.
Your services are always in demand but rarely paid for. You will have to provide most of uncompensated care.
Some of IM attendings drive worse cars than nurses.
Even if you like it now, you will hate it before you retire.
You spelled “Ophthalmology” wrong.
Pingback: Tugging on Superman’s Cape | The Health Care Blog
No one ever includes psychiatry as a lifestyle specialty either. I know they don’t make what dermatologists make, but if you set up in private practice, you can do pretty well and still work 9-5.
agreed 100%.
Best lifestyle specialties?
By lifestyle I’d say a specialty which has decent hours, a regular or controllable schedule, little call, and decent pay.
I’ll try to frame the specialties in terms of what you don’t mind i.e. negatively. Also, the context is full-time work, not part-time work. You can work part-time in many if not most specialties, but usually you have to take a pay cut or not make partner or something else. Finally I mean lifestyle post-residency. Residency is probably pretty crazy for most specialties. I think what people mainly care about is lifestyle post-residency.
If we can use the acronym “3PEDRO”:
Pathology. If you don’t mind lack of patient interaction. If you don’t mind icky stuff. If you don’t mind your clinical skills fading a fair bit.
PMR. If you don’t mind dealing with chronic pain.
Psychiatry. If you don’t mind people thinking of you as a fake doctor.
EM. If you don’t mind shift work. If you don’t mind being a generalist.
Dermatology. If you don’t mind a different vocabulary.
Ophthalmology. If you don’t mind surgery.
Radiology. If you don’t mind reading film in dark rooms.
Anesthesiology. This might be worth adding if you don’t mind working about 60 hours per week and some call too (yes, even as an attending). Also if you don’t mind some controversy with mid-levels. A lot of other specialties face mid-levels, but it’s particularly pronounced in anesthesiology. If you don’t mind working with surgeons. If you don’t mind patients sometimes or often treating you like a tech rather than a doctor.
Oops sorry for putting Radiology after Ophthalmology and turning 3PEDRO into 3PEDOR.
By the way, I’d add, with anesthesiology and EM, you can often be pretty flat out while working. Not really a lot of time for breaks. A good interview with an anesthesiologist here. Anesthesiologists can subspecialize (e.g. critical care) and be more of a “complete” doctor though.
And a decent but not great interview with an ophthalmologist here.
As the father of a college student looking to ‘become a doctor’, I am curious about the anesthesiology specialty – it seems very unique in its ‘project’ structure and I would like to ask if I have this wrong. As for long hours, we know a several anesthesiologists that seem to have lots of home time.
For better or worse (depending on what you want from a medical career), anesthesia seems to offer someone to work the hours they want (do anesthesiologists typically work for a hospital, surgery center / not on their own?). You can take a week or 2 off and since there’s no long term bonding with patients, you don’t have the concerns that the patient will want to see you rather than a sub doctor. There’s no second guessing / self doubt that you caught all the cancer, read the xray and didn’t miss a small but fast growing tumor, don’t have patients calling after surgery about pain or infection from the work you did or problem you didn’t solve.
If the patient wakes up at the end of the procedure, you did your job and can put it behind you? Versus the chance that you diagnosed the issue as a cold and it really was something fatal and you spend your free time wondering ‘should I have made a different / better diagnosis’?
Am I mistaken?
Thanks for sharing this post. This is a very helpful and informative material. Good post and keep it up. Websites are always helpful in one way or the other, that’s cool stuff, anyways, a good way to get started to renovate your dreams into the world of realityhttp://www.airmaxltdnikeshoes.com
Pingback: Orthopedic surgery lifestyle – Orthopedic surgery | Orthopedics » Blog Archive
Pingback: “Main Residency Match” Post-Game | Training Family Doctors