Wednesday, March 19, 2008

medical students, effect of culture - Medical Students Seek Residencies Leading to Good and Balanced Life

What - Residency matching program results are about to be announced, and medical students are most desirous of being placed in dermatology and plastic surgery residencies. Last year only 61% of students got their first choice in dermatology residences, and only 63% got their first choice in plastic surgery residencies.

Why - The allure of dermatology and plastic surgery careers is obvious – high incomes, a balanced life style, few critically ill patients, and no night or weekend call.

When - The push for matches in dermatology and plastic surgery has been going on for at least five years as the word is out among medical students about low pay, long hours, and a grueling work load in other specialties like family medicine, internal medicine, and pediatrics.

How - Students generally apply for matches in multiple programs. A NYT March 19 article ,”For Top Medical Students , An Attractive Field, “ described a Harvard senior medical couple who applied to 90 dermatology residency programs each, and even though already $330,000 in debt, the couple borrowed $20,000 to travel to two dozen interviews each.

Where - In dermatology and plastic surgery, a limited number of residencies are available, and students will go where they are accepted. At Harvard, six dermatology residencies are available for 330 applicants – not very good odds, especially if you are a couple who want to be placed in the same program.

Who - Who is being matched? The following table tells all.

U.S. Seniors Matched in 2007

% Matched # of Positions Average Salary

Dermatology 61% 320 $390.000

Plastic Surgery 63% 92 $408,000

Orthopedic Surgery 80% 616 $476,000

ENT 82% 270 $369,000

Radiation Oncology 82% 142 $488,000

Ob-Gyn 89% 1146 $297,000

General Surgery 90% 1057 $330,000

Diagnostic Radiology 91% 1035 $450,000

Emergency Medicine 92% 1384 $258,000

Anesthesiology 94% 334 $372,000

Neurology 96% 539 $255,000

Pediatrics 96% 2624 $188,000

Internal Medicine 98% 5517 $192,000

Family Medicine 99% 2603 $179,000

Sources: National Residency Matching Program, Association of American Medical Colleges, Medial Group Management Association


Gary M. Levin said...

These are very interesting statistics. In my day Ophthalmology was the "top gun".
Now reimbursements, patient loads, separation from the hospital medical staff has dried this up unless one is interested in refractive surgery.........

IVF-MD said...

After my lectures, I ask my 3rd-year medical students what factors they take into account when choosing specialties and the answer is overwhelming - LIFESTYLE, which some of them defined as "the best salary for the least hassle". Doctors do not differ from engineers, lawyers or plumber in this respect. Human motivation for optimizing ones state does not necessarily rule out a place for personal integrity and compassion. In fact, in a free-market environment (which we don't have) the hardest-working, most ethical, most compassionate, most caring doctors would be the most attractive to patients and command the most favorable compensation. Sadly, in the artificial model we have today, only the most idealistic souls would enthusiastically embrace a career in primary care, and it's arguable how long their idealism will sustain them after facing a few years or even a few months of reality. If economics holds true, what will happen is a severe shortage of primary care doctors (already happening) and then a cyclical increase in demand as people suddenly become willing to pay what's reasonable in order to have access to the sparse pool of good primary care doctors. However, medicine does not follow normal economic models the way it's set up now.