What Exactly Are the ROAD Specialties?

Hoover  16 Mar, 2007  Lifestyle

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.

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11 Comments so far »

  1. Cherokee said

    March 16 2007 @ 9:33 pm

    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?

  2. Hoover said

    March 16 2007 @ 11:35 pm

    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

  3. Yan said

    March 17 2007 @ 1:56 am

    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.

  4. Cherokee said

    March 17 2007 @ 9:49 am

    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.

  5. Hoover said

    March 17 2007 @ 10:06 am

    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.

  6. John said

    March 17 2007 @ 10:16 am

    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.

  7. Hoover said

    March 17 2007 @ 11:14 am

    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.

  8. Panda Bear said

    March 17 2007 @ 11:16 am

    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.

  9. Scott said

    March 17 2007 @ 11:30 am

    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.

  10. Yan said

    March 17 2007 @ 1:17 pm

    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.

  11. Hoover said

    March 17 2007 @ 1:26 pm

    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. ;)

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