Specialty choice, hours worked, income expected

Based on the talk on various threads, it appears that many of us premeds have some unrealistic expectations about the practice of medicine. I thought it might be interesteing to speculate on our futures, with the knowledge that things could be drastically different 5, 10 years from now. So here goes:

Specialty choice: Pathology and I’m 1,000,000% sure of this choice for me. I hope to practice at a governmental insitution/academic setting and occasioanlly moonlight as a n Adjunct Professor at a Community College.

Hours worked: Based on observation of the Pathologists I currently work for and around, it looks like a 7AM - 6PM will be a “typical” schedule, with call a few days/per month. So while I won’t be able to chaperone every fieldtrip or attend every tennis match, I should be around for a few.

Income expected: This is a little tricky since doctors are making less money then they did in the past. Average physician salary in Gov’t seems to hover around 120K and I’m PERFECTLY happy with that. An acceptable lower limit for me would be at least 80K.

This is my “reality”. What’s yours?

Specialty: Trauma/CC Surgery or Ortho Surgery within Navy. Moonlight at local civilian facilities dependent on case load at base hospital. This is mainly to keep the skills learned. I’ve learned many military surgeons begin to lose their skills due to lack of cases.
Hours worked: 7am-7pm not to include call. While deployed time won’t matter. Once state side the case load will determine the need for moonlighted cases which will lenghten the hours worked. Everything is dependent on case load.
Income expected: The civilian equivalent would be around $200-250k. Not to include any moonlighted money. This is again for skills and not income.
With all the time I will have to repay I will be 52-55 when I get out of the Navy. I would like at that time to work at a practise somewhere…preferably North Carolina or Florida. 20 years and counting…

This is my perception. Doc’s am I even close?

Speciality Choice: Trauma Anesthesia/Surgical Critical Care Medicine in an urban setting; I would also like to teach as well.
Hours Expected To Work: I’m not quite sure what the call rotation would be for this type of career choice but, all of the docs that I’ve talked to and worked with at my RT clinical sites that practice Anesthesia/Critical Care Medicine are in house all day with surgeries, teaching, and treating patients as well as taking call so I know that life will definately be hectic but managable…my partner will see to that(especially that she gets “her time” )
Expected Salary: Probably around $200K…help me out Old Man Dave(Anesthesiologist Mentor of mine!!! ) but, it won’t be spent being a member of a country club that’s for sure!!!

>Probably around $200K…


A good friend of mine is an anthesiologist. Based on my conversations with him - though I’ve never directly asked about numbers - I’m guessing that the $200k you cite may be a significant overestimate for this profession today with the whole NA phenomenon, etc.

Perhaps Dave can clear it up, or if you’d like, I can ask him directly.

Specialty choice: Emergency Medicine, and I too am 1,000,000% sure of this choice for me. I hope to practice at one of the local hospitals in the two communities closest to me (9000 and 12,000 people respectively).

Hours worked: Given my background and my fiance’s (a CNA) schedule preferences, I think I’d like to work more weekends than weekdays and PM day/AM night hours (back side of the clock). I don’t know if that will be possible or not. I’d say that 10 to 12 hour days would be about the maximum I’d be willing to work.

Income expected: I lost contact with the last ER physician I knew several years ago and so have no current salary data but given the length of time involved and debt load I’d incur I would expect a minimum of $120k as a salary.


>Probably around $200K…


A good friend of mine is an anthesiologist. Based on my conversations with him - though I’ve never directly asked about numbers - I’m guessing that the $200k you cite may be a significant overestimate for this profession today with the whole NA phenomenon, etc.

Maybe I can shed some light on this…and you are correct in that Kim’s estimate is a bit off, but not in the direction that you imply. On average, recent graduates of anesthesiology programs walking into an academic practice can expect in the range of $180k ~ 225k/year. If you opt for private practice, you can easily obtain $300k plus. And if you are willing to go areas of need, land in excess of $400k to $500k/year starting. By “areas of need” I am not necessarily referring to inner-city (you will not find too many private practices here - mostly university/academic ones) or BFE. From the jobs I have seen advertised & heard about via recruiters (yes, as a CA-1, I have already been approached by recruiters a few times), these higher paying jobs tend to either be in smaller, more rural locales or w/i high volume private practice groups that are located across the entire gamute of city & town sizes.
Why are the salaries so high? There is a severe shortage of anesthesiologist & nurse anesthetists. For multiple reasons, the perceived takeover by NAs you mentioned being just one of them, the 90s were SLIM times for physician recruitment into anesthesiology. The nadir of less than 400 physicians going into anesthesiology was hit, I believe, in 1996. According to what I have read, we need to sustain approx 1300 anesth graduates/year just to keep up with the growth in med service usage due to the aging of the gen population…only in the last 2 cycles have the number of physicians entering anesth broached that 1300/class mark. The population certainly had not held back their aging process for us either!
Not only was there a significant downturn in the number of physicians entering anesth, that trend was mirrored by CRNAs in the 90s too. Therefore, both groups have a skewed age distribution w/i their own ranks of practitioners. In short, both professions have an inordinate clustering of older practitioners (implying: nearing retirement) & a deficit of younger people. The physicians entering have in the most recent 2 to 3 year begun to make up for the lag yielding a sort of bi-modal age distribution amongst physician anesthesiologists - young & older, but a skinny middle range. On the other hand, CRNA applications have as yet to pick up the pace - meaning they are still in “lean years”. This implies that the shortage may as yet worsen prior to improving. The info in this paragraph was contained in an article in the Amer Soc of Anesth Newletter approx 12 to 24 mos ago.
So, yes - the money for going into gas is AWESOME these days. But, the $$ should NOT be a motivator for choosing your specialty! Being a physcian is a tough life & not just in your residency years. To endure the life style, maintain your sanity & avoud evolving into a class-A bastard, you must love what you are doing and NO AMOUNT of $$$$ can salve the misery of practicing a style of medicine that you do not enjoy. Plus, eventually, the shortage will be made up & salaries will trend back to a more rationale level. Those of entering anesthesiology now are just very lucky to have chosen something at the perfect time. Sort of like picking up Microsoft stock as an IPO when no one knew crap about them.

Amen, Dave! When I started library school over a decade ago, articles on the “graying of the profession” and “where will the next generation of librarians come from?” were all over the place. When I graduated 18 months later, reference librarians applying for positions in academic institutions were facing applicant pools of over 200 applicants. I was a cataloger, but still wound up taking a job in a little tiny town where my husband couldn’t get a job.
Two years ago, “The graying of the profession!” “Where will all the librarians come from?”. The cover article on the last issue of Library Journal I read was, "Where are all the jobs?"
Choose what you love. The state of the market will change, unpredicatbly, by the time you’re done.

I agree with OldManDave in that the range of salaries differs greatly. A friend of mine is an anesthesiologist, who left a hospital for the same job in a competing hospital. She went from approx. $200,000 per year to $300,000 per year. The two hospitals are 40 miles apart!
Working conditions vary too. She is on call less often.
Hope this helps!