Choosing a Medical Specialty - What You DON'T Think About

[@InformalGreeting]

I see several med students in the comments. You don’t know me so take this for what it is worth. But if you are undecided on what you want to do internal medicine is the answer. Tons of sub specialties that can allow you to go any direction. And it opens the door to the best job in medicine. Hospitalists tend to be scheduled for 14-16 shifts per month. On paper those shifts are 10-12 hours. In reality if you aren’t on call many of those days may be 4-5 hours. The pay isn’t neurosurgeon money but dollar per hour worked is hard to top. $300,000 for 180 days worked with the bulk of those being half days is a great life.

[@milkywayandbeyond]

Why the discrepancy between on paper and in reality?

[@janburgstaller5661]

Where are you from?

[@LGinux]

Is hospitalist a specialty that is exclusive to the US healthcare system or does it exist in other parts of the world too?

[@InformalGreeting]

@@janburgstaller5661 currently in Oklahoma. Jt that’s been the case in Kentucky, Georgia, and Virginia as well.

[@InformalGreeting]

@@LGinux I have no idea if they do it anywhere else. If not they should. Patient outcome is much better.

[@hollyc4624]

I’m so glad to see a doctor who has finished training discuss these topics. Most Med students don’t think about what their lives may look like years into practice. I gave this info as a talk to pre-Med students (because I knew everyone else would focus on how to get into Med school) and they seemed to find it useful. I know we never thought much about lifestyle or hours as students. We chose specialties that were liked. It wasn’t until we had kids that the realization of what shift work would look like to the children, if one of us were doing 3 mid shifts in a row, the kids in school would go several days without seeing us. It was quite a wake up call. Great content and congratulations on being out in practice!

[@SillyBilly5689]

Great video! I really really wanted to do Radiology, ironically, as soon as I hit my mid 30s, multiple sclerosis shut me out. I encourage my friends to do what they want to do today, because we don't know what tomorrow has in store for us.

[@edwmac]

I didn’t really decide to go into medicine. I decided to go into Pediatrics. I never wanted to take care of adults. That 210K number for Pediatricians includes a lot of part time doctors. I work full time and do quite well. I do take call but if you love your job, it’s not a big deal. Pediatricians do work into their 70’s traditionally. We love what we do so we don’t want to retire. Pediatricians have the lowest suicide rate of all physicians. I never hear Pediatricians yelling at each other. I can’t say that for other specialties. Our specialty is full of idealists. The idea that a physician should be aiming to retire in their 50’s sounds like this guy is the worst kind of doctor. Make as much money as possible and get out. Any doctor working at his craft should be at the height of their skills at that age. Why retire when you have the most to offer? I’m 67, having the time of my life and hope to work another 13 years, assuming my brain is functioning well.

[@spencermessina4065]

You have an inspiring view of your career thanks for your insight

[@funsize198]

great advice Doc. As a non traditional guy medstudent myself, I narrowed down my specialties based on what I can keep doing when older and with kids.

[@DrCellini]

It’s a tough decision for sure!

[@shamrockgirl6595]

Very wise

[@ivan_9386]

I will do the same, probably. I just don't want to work more than 50-60 hours per week. So family medicine/PM&R/occupational medicine are on my radar now. Very low stress compared to IM, surgery, peds, gyno etc.

[@judahb3ar]

Was med school manageable for you as a non traditional with children? How possible is it to match into more competitive specialties as a non-trad? I’m also non-trad with children considering med school, it’s a difficult decision

[@yeehawtomahawk]

It makes me sad that doctors who choose to specialize in anything pediatrics make less than if they did the same thing for adults

[@Letstalk-zx7jx]

They can always start a private practice, and that income will multiply. There are children and teenagers everywhere.

[@wspeer10]

Intraspecialty salary differences typically are more than interspecialty salary differences, which isn't mentioned in the video. This is important to keep in mind when choosing a specialty.

[@drdumbo9124]

Great video.. The lack of call and ability to practice anywhere was a huge reason I decided on psychiatry. It's also incredibly easy to go part time and work as long as you want. Some surgical specialties as you age you just might not be capable of the work anymore

[@liv0003]

It is true but neurosurgeons can switch from being crazy hour OR workers when they are young enough to researchers when they get older for example. There is no need for a neurosurgeon to work into his 80s with crazy hours in the operating room. Many of them can even already afford to retire happily and wealthy enough at 50 for that matter

[@noraaa8479]

Hi, I’ve been thinking about psychiatry for a while but still undecided is there work life balance? And what kind of personality do you think fits it most?

[@dudedelrey]

Starting MS1, this came at a perfect time for me :) Trying to keep my mind open going forward but have been leaning towards surgery since I can remember. Thank you Dr. Cellini!

[@esahoosa]

Same, good luck!

[@Zephyr6083]

Hi Dr. Cellini! Since rank list submissions are coming up soon, could you do a video on tips and considerations when ranking residency programs (especially for people with partners, SOs)? Thanks for your insightful work!

[@Doov9]

^^^ this

[@kylehrabovsky8248]

Would love to hear you talk about what you liked about going to an osteopathic med school, and how that had a role in you choosing your specialty and if it made it any more difficult.

[@GG-yy4yx]

Since I️ started watching your videos in late 2019/early 2020, I’ve gone through a crazy rollercoaster. But since I’ve applied and just got accepted to my top choice school. So this video came at such a good time. Now that I️ start med school in the fall, I️ really wanted to start navigating specialty decision making processes.

[@jsWarrior58]

Thanks for the advice! Non traditional OMSII here. These are all the same reasons why I'm pretty set on DR/IR. Thanks for reinforcing my choice!

[@DrCellini]

Glad I could help

[@nickdenezza6762]

Fantastic advice! Especially thinking about what you want to be doing not just now, but also at age 50.

[@DrCellini]

Yep!! Thanks.

[@joshmcgoo]

I applied for EM in the match right now (time flies) and I feel like people don't realize the income differences WITHIN a specialty vary much more than between specialties. Sure, Derm > peds for income. But... Things like academic FM makes MUCH less than private practice/locums/med-legal/urgent care/nocturnist FM. There are so many ways to bolster your clinical income if you're willing to go off the beaten path a bit.

[@Djme2]

^^^

[@em5616]

what's academic FM/locum FM/med-legal?

[@joshmcgoo]

@@em5616 I would google: locum tenens, malpractice physician jobs, and physician consulting. Lots of hustles outside the beaten path

[@veraserah]

Yeah, I was gonna say the family medicine/internist primary care practice I worked in (private practice) physician owner makes >$500k in a year, working 40 hours a week (4days/wk) with probably 10-20 hours a week on the business end. Another physician in the practice works 2.5 days a week and makes $180k, a work-life balance choice that still pays extremely well especially considering she's not the breadwinner and she could be present for drop off and pick up to for her kids everyday. Added in all the programs to knock off student loan debt for those going into primary care, it's a sweet package.

[@noraaa8479]

@@veraserah wow what’s her specialty?

[@gil5111]

Great video. MS3 applying later this year, these are pretty much the points I'm deciding on now. Between ortho vs anesthesia vs rads. I genuinely like all of them enough to do them, at this point trying to figure out what will I will be happiest doing when I have kids or am 50. Seems like anesthesia and rads on average get way more vacation time and have the ability to scale back way easier than ortho, which as someone who wants to travel and fully or partially retire early, really has me leaning towards them (even though if I'm being honest ortho is my favorite).

[@khalidmohamed6389]

Honestly go for ortho you won’t regret it

[@happytobehere-o4j]

Another thing I think not many incoming medical students think about is just literally what you can feasibly get into grades wise. I am not someone who is going to match Ortho, Derm, Plastics…. I’m just not smart enough. People will say this is just imposter syndrome but I think it’s so important to be realistic and make a plan for yourself. Even as a FM doc, you can get stake in multiple private practices or get into a good group and make more than $250K a year. Maybe not $500K, but maybe $310k or so and that’s nice

[@kfcm53]

I love your more frequent posts and I love seeing your brother. My husband of 35 years is a Veterinarian, so I am very very interested in listening to both of y’all. I was born in and have lived in Georgia all my life.

[@empyrealsaturn3848]

The part about age at the end is very true. I'm not allowed to sit down at my job, and I can be on my feet for over 11 hours per shift. I've already developed some rather bothersome back pain a couple years into the job. Just grocery shopping hurts now, too, sometimes very badly. I'm not even in my 30s. I have a sit-stand desk, but I never even use it properly because it just hurts to stand up for long at all. I'm uncertain I can stick with this career in the long term. It wasn't something I really thought would be so bad until I was in the thick of it, and I didn't think it would happen to me so soon.

[@nycdwellerfornow4310]

Thanks for the thoughtful breakdown--location constraints are definitely not something I've thought much about (though fortunately, for now at least, I like cities). Work-life balance I think is the most important consideration for me at least, and some may say don't go into medicine if you like to have a healthy work-life balance, but I don't think that's really fair, evidenced by people like you.

[@ryankelly8077]

I’m glad you calculated pre-tax versus tax income.. ppl often don’t calculate that when factoring In finances

[@draconiusultamius]

Yeah, I still don't see myself doing anything but surgery. The OR is the best place in the hospital, away from all the congested hallways and scary medicine people that can vomit up a textbook of material at any given moment. It's also so satisfying to watch operations occur and I love it.

[@PowerPerPound]

6:22 Can confirm south Georgia wants nothing to do with specialized pediatric surgery. But otherwise you'll find some killer salaries down here.

[@LJStability]

I love how all these medical specialty charts on income never have neurology like it doesn't exist. The only one here was child neurology lol

[@unhealthyhomeostasis]

I thought the same thing but realized the charts were top 20 highest paying and top 20 lowest paying, so regular neuro is probably in between those

[@alisons268]

Thank you for this video! I wasn't sure about the pro/cons of Pediatric Cardiothoracic Surgery, yet this definitely makes the message clear.

[@sherrydawson6253]

I think it's so cool how u educate the Med students and Residents. Your awesome 👌👏

[@HelloMoto_]

I worked with an EM doctor who completed his IM residency first and he said midway through he realize he didn’t like it.. Incredibly bright individual, but goes to show how important this decision is. Specially because time is precious in medicine!

[@olinblair7385]

MS-1 here considering EM in South Georgia myself. While working as a scribe with a group that ranges majority 40-50’s I think it is possible to be happy at that age in this specialty.

[@3q8qjkqp]

Dear Dr. C., thanks for your advice, it helps me a lot! I still cannot decide between internal medicine and radiology and as time goes ( graduation is only 1 year apart) I feel myself more and more ashamed that I haven’t made a decision yet. Anyways, it can be helpful thinking it over with your points.

[@ltl9728]

Hey Dr. C, I'm heavily considering DR as a third year. I'm still a little wary of how mentally exhausting being on all day can seem, but there's no way to really tell until you're reading yourself. Has reading gotten easier and subsequently less stressful for you as you've gotten further in your training? Do you think the "mental marathon" comparisons are a bit overhyped?

[@stevehardy204]

This is an awesome question.

[@user-bx7ek5dl5h]

Did you match? Im applying DR this cycle and my app is literal trash.

[@belindab4640]

In Australia, we don't go straight into a residency. After medical school, we all do an intern year where there are 5 rotations we need to complete, 3 are compulsory (general medicine, general surgery and emergency) and then 2 optional rotations (for example I did cardiology and orthopaedics). After that, we can do a different stream (e.g. surgical stream, medical stream, general stream), but not necessarily be on any program!! (You are unaccredited). I'm' doing a general year and the rotations are 3 months of psychiatry, paeds and obstetrics/gynae with relief at the end (covering people's leave). Will be interesting working in these areas to decide whether any of them are right for me when I get experience! Specialities seem different as a medical student compared to as a junior doctor compared to a consultant (attending in the US), so it's important to consider the life of a consultant aswell!

[@nstorm2415]

Here in panama we have 2 years on internship. The first year can only be done on third level hospitals. And for the 2nd year you can choose a 2nd or third level hospital for 8 months and you finish with 3 months on a small 1st level hospital on any community close to where you live

[@Number_99]

⁠Here in Belgium we have 4 and half years of theory/courses and then 18 months of internships in different specialties before choosing one. When you’re accepted into a specialty you become an intern for 4-6 years before becoming a specialist. My family has plans to move to Australia so maybe I can ask you about this. I recently contacted the PMCWA to ask if I could apply for an intern position in 2025. Their answer was very clear but I’m still not sure if this ‘internship’ is the specialisation itself or the thing you just described. You don’t need to answer but if you could it would help me out a bunch :)

[@kristenroberts9335]

Another thing! Do you fit in with the people in a certain specialty? Can you see yourself hanging out with these people forever? It sounds shallow, but once you experience it, you can understand.

[@aweisen1]

@Dr. Cellini, great video, some very good points. The biggest issue with this video, from my p.o.v. regarding US students, is how choosing a specialty isn't necessarily a given-certainty, unless one exceeds USMLE Step score cutoffs for a particular specialty. If one got a 260+ on step1* and/or 2* they'd almost certainly be able to choose whatever they want but, a majority do not get these scores. The preface to this video probably should've been about initial scores. *Step 1 is now (as of Jan 2022) pass/fail. Step 2 CK scores will almost certainly take the place of the importance of Step 1 scores along with med school grades, recommendations and publications.

[@DrCellini]

I don’t think that’s a problem with my video lol. Sounds like you have a problem with the medical education system

[@aweisen1]

@@DrCellini it was just a minor critique to the video but, it’s a major point for prospective docs and med students to consider. You are certainly correct. Med Ed and Admin certainly need an overhaul. Hopefully the Step-1 changes will prove to be positive for healthcare and catalyze further improvements.

[@VintageAfro]

Great advice! 4th year Med student from 🇪🇹

[@Simple.Wordless]

There is also the opportunity cost of not making doctor pay as fast as a pediatrician if you are still in your neurosurgery residency.

[@guillaumel2049]

Hi Michael! Again, love the mic! The sound is better.

[@DrCellini]

Thanks!! Glad the audio is up to speed

[@saramovsesian7497]

Hello, talking about specialties and emphasizing salary, one need to remember the skills of an MD or another doctor. Some are strong in theory and speaking skills, some have excellent hand skills. You do not want to compare Physicians to Surgeons. I believe that needs to be distinguished. You may somehow end up in surgery, because you had outstanding academic career, and you can suck at it!

[@tayoajetunmobi7678]

Hooray, I was the first person to Like this video. Love your channel doc

[@DrCellini]

Lesssgooo

[@murraysolomon4924]

Diagnostic radiology is a fast changing specialty. Transitioning from IR to Diagnostic Radiology at age 50 will be difficult if you do not keep up with both IR and Diagnostic Radiology advances.

[@Pearlfect3]

This was gold!! Thanks☺️

[@philoaviaticus]

i had a double career as flight surgeon in reserves ang state psychiatrist, i liked the former far more but was harder to make a living.

[@PunkForever-yu1fg]

I am interested in being a psychiatrist. I have worked in hospitals as a CNA before and done alot of stuff. I've also been a psych patient during my toughest times in the past. Other psychiatrists feel I would be a good psychiatrist too.

[@reallyjoewillyoutdoors]

MS3 here trying to make up my mind - great video!

[@DrCellini]

Thx so much!

[@CJ-yf5cr]

Thanks for clearing that up for us definitely something to consider. Would really appreciate it if you could do a video on how you read the x-ray image. What techniques do you use? And comparing a healthy image to one that has cancer or etc.

[@bobjacobson858]

I was a research associate for several years in a med. school, and I was able to get to know many of the med students. There was one, I was told by the others, who hated every rotation he went through, but already had so much money invested in his education that he was going to complete the program. Eventually I lost contact with the members of that class, but I wonder whether he continued toward a medical career, and if so, what he chose and how well he did. Some of his classmates joked that they wouldn't want to be his patient!. In the same class was an anatomy professor who had resigned to enter the MD program, found his niche and is currently practicing.

[@ahoneyman]

One of my dad's better friends had a similar story. Ended up completing the residency, passing the boards, and practiced for about three years. Now he's an investment councilor for people in the medical field.

[@bobjacobson858]

@@ahoneyman That was probably a good decision, and he's probably thankful when working with each of his clients because I assume he has much less stress.

[@dr.maazasif5424]

Very helpful video. Thanks alot.❤

[@joyleenstrozier4295]

Hi Dr. Cellini, I like your content. I love watching your videos.

[@philtastic1]

Love your financial advice videos!

[@Letstalk-zx7jx]

Well, you can always lift weights and work the legs and core even as you get older , standing all day wouldn't be a problem , you better like working out .

[@davidlakhter]

Great video doc!

[@zhvanrekani1408]

Thank you . That's great information 👍

[@forevereveru]

Dr. Cellini, you are going to make the Rad residency application waaaaay more competitive again! 😅😭

[@americanpsychonaut]

..what did you think most people think about? Salary, amount of call, and length of residency are like the first 3 things people consider. It's why derm is the most competitive, not because everyone's gung ho about skin lol

[@yarnmaniacs8936]

Love the video!

[@forevereveru]

Thank you for the great video, can you also touch on which specialties are more likely to gear toward private practice vs staying academic/employed?

[@hemar7543]

Doc I wanted to ask...should a person be a little flexible with the choice of branch in case he/she doesn't really get score matching their dream branch....or Is it ok to take exam multiple times just to get into their dream branch?

[@tomare6479]

The answer is no. Don't go repeating the test. Find a way to thrive. Clinical work is just one part of your time if you have other interests(i like to push advocacy, business, social media, a mix of them)

[@hemar7543]

@@tomare6479 thank you for replying sir

[@Danny_jrt]

solid video!!

[@xunyangful]

Very Helpful!

[@yl5694]

Lmao I love how you leave in your bloopers. You always get pissed off at your monitors every single video.

[@simoncotter1606]

very good advice!

[@MA-dd9dd]

GREAT VIDEO THANK YOUUU

[@afafhdd]

So what specialty would be good for untraditional med students, starting in their mid 30’s and don’t want to sacrifice all their time for medicine? Also, if they don’t necessarily want to be seeing patients for the rest of their life.

[@liv0003]

Pathology could be for you maybe?

[@kycezaiter4012]

You could make 10 more videos on this topic even more in depth and my friends and I would appreciate it greatly.

[@DrNeuro17]

Would you consider anesthesiology a lifestyle specialty? I get mixed reviews for that question. Some say yes it is and some say hell no. So I’m not quite sure where the answer is on that.

[@spencermessina4065]

Every single minute a surgeon or OBGYN is up at night, an anesthesia is too…….. It can still be a great life for many reasons, but people just see dollar signs and don’t realize it’s only because the hours are substantial and the call is no joke

[@littlemissunshine7846]

No wonder we have a shortage of doctors here in Florida

[@Heezybeats1]

Is it OK to go for none and just be a general practitioner?

[@liv0003]

General practitioner / family doctor is a specialty , 3 years of residency after medical school.

[@hemaldholakia3905]

I know you were into anesthesia for a while, but ultimately chose rads. Do you think you could make late career transitions like that with anesthesia, like you could with IR? I'm wondering if anesthesia could transition to something else once they get older and don't wanna wake up at 5 am for surgery.

[@hb2998]

Waking up at 5 am is always going to remain for most anesthesiologists and anesthesia sub specialists. The fellowships after anesthesia which can give you more freedom are pain, critical care and palliative care. With OR based anesthesia such as pediatrics or cardiac anesthesia you will work a ton. 5 years out, I’m pedi, still working 60-80hrs a week, and see my partners in their late 50s early 60s that work just as much.

[@esahoosa]

I’m in MS1 considering either Anesthesiology or Radiology! I love both both specialties!

[@aritrachatterjee9090]

fantastic video and great advice doctor. medicine is the best profession ever it is beyond comparison. myself 1st year med student in india. never miss your videos and huge fan. keep up the great work.. you are my inspiration though i wanna go into cardiothoracic surgery

[@inzayn1d]

pfp 😭👌

[@18ignat]

First, get your hands dirty, then chose and be so optimistic 😜

[@eiranbarkhordarian4353]

Watching this from the UK is insane....

[@kawaiiblume9421]

Why?? Please let me knw

[@mercenary9397]

Hi Dr Cellini, I was wondering do Diagnostic Radiologists usually get called in the middle of the night? And if so, how often?

[@mamajayscrazylife6323]

Would you be open to discussing the PA role in interventional and diagnostic radiology from your perspective? I'm considering the PA route, but I'm concerned I won't be prepared as a PA for this specialty or be able to have some autonomy if I get a job in radiology. Thanks!

[@Coolwindzz]

There are no roles for PAs in IR/DR.

[@triggaht8623]

Is tax 42% or the 68% take home salary is after other expenses incurred?

[@unicornscandab7980]

Can you talk about radiation therapist?? You work with them right???

[@walleball29]

Hey Dr. Cellini. How much do tax brackets affect this discrepancy between specialties.

[@georgeaxle007]

Doesn't matter what you choose. The practice of medicine is repetitive and boring no matter the specialty. Basic day labor.

[@SuccessfullyBad]

Hey Dr. Cellini, what do you think about Mercury being in retrograde??

[@DrCellini]

I don’t care about it lol

[@mandalorian4620]

Bruh, i needed to google because i thought you meant the element mercury being used in some esoteric interventional or fluoro procedure lol

[@mandalorian4620]

@@DrCellini Can I ask you if vascular surgery is worth it even though i am absolutely disgusted by necrotic feet etc or if i should just do IR and not think twice about it? In other words how much of a big deal are foot ulcers, gangrenes and such in regular vascular practice? Since you are in IR I thought you probably know a bit about that.

[@SuccessfullyBad]

@@DrCellini big aquarius energy! ♒ Only kidding I saw your IG story and couldn't help it :)

[@SuccessfullyBad]

@@mandalorian4620 lmao if only there was actually science behind astrology

[@Cosmystery]

no psychiatry on your list? oof. I also disagree with the salary end on it.. You just said you should be happy with what you do then you proceed to talk about how important the salary is.. My opinion is fuck the salary.. its all decent pay and is more important to be happy in your career.

[@bughesamiombu2909]

Love your response

[@JtXwb]

Hey man! What about dermatology, is it limited to where u can work?

[@BethanystarYT23]

Pls reply to me Sir Between oncologist and radiologist which is more in demand

[@torih.6612]

Dr. Cellini, does getting MH with anesthesia preclude one from pursuing IR?

[@ewppkl]

best specialties for decent work-life balance and better pay?

[@jerrymccorkle5779]

I didn't see dentist or podiatrist on the list they must not make that much

[@zehraanwar14]

Can you give your views on osteopathic medicine as compared to allepathic medicine please

[@bookworm_md4140]

Hey Dr. Cellini, thanks for the video! 4th year med student and small KZbinr here. I love your content especially your vlogs and videos about investing! Just waiting for match day over here and nervous about making my rank list lol :) any advice would be great!

[@BoltCRNA]

I'm more and more grateful I chose anesthesia as I grow into the profession. 34 and already no call, no weekends, no late nights, 1099 indie practice, great salary. I guess I need to pick up golfing or something for all this free time. ; )

[@kathydelarosa1286]

Sounds amazing !

[@liv0003]

@@sipho2158 he's CRNA not a physician anesthesiologist.

[@johnnypeck1448]

Doc you doing ok? Sound a little down in this video. Hope you are well!

[@edwinshumaker5849]

6:32 Dr. Cellini got hacked lol. Good content

[@jasonb4254]

ROADS only.

[@TheZuhaabtemuri]

@3:04 yo, where's psych?

[@ShowTheOreo]

Dr. Cellini what is your work schedule like?

[@MrJbee1982]

Most people want the highest paying specialties when becoming doctors. Lets not beat around the bush.

[@Naijagyal22]

not true at all

[@dr916]

I chose diagnostic radiology 😌

[@ThePaulcolon]

Im just trying to graduate doc 🤣

[@DrCellini]

Lol. You’ll get there

[@ThePaulcolon]

@@DrCellini Appreciate the vote of confidence lol.

[@Letstalk-zx7jx]

I didn't see psychiatrist on that list .

[@jenniferwatts3777]

Cool in memory of Brooke and Lynn RIP

[@kissed_by_fire_art1338]

Why does your room look like a Sims room? 😁👍

[@stephensuhayda1966]

Yeah neurosurgeon can live a better life because they pay off their loans faster. That was your main point? smh.

[@RichardRobertsonP]

Jokes on you Dr, neurosurgery residents finish residency at 50 🤔

[@jenniferwatts3777]

Alright