Monday, November 3, 2008

Lifestyle specialties

I work in a field called Physical Medicine and Rehabilitation (PM&R), which means that I'm pretty much constantly explaining what I do...

"I'm a PGY4 in PM&R."
"You're a what in what?"

Basically, we deal with sports and other musculoskeletal injuries, as well as the subacute medical management of patients with neurological injuries, including brain and spinal cord injury. It's supposedly a "lifestyle" specialty, which is illustrated by the joke that PM&R stands for Plenty of Money and Relaxation.

Of course, it's not all money and relaxation, especially during residency. But considering I had no in-house call, even during my first year after internship, I can't complain too much.

Lifestyle specialties are usually popular among all applying med students, not just women who want to have kids. That or skin is just SUPER interesting. It's definitely a lot easier to have children if you're in a specialty where the hours are manageable. I won't lie and say that lifestyle wasn't a significant part of my decision.

PM&R is somewhat like psychiatry in that it's a lifestyle specialty that isn't terribly competitive, probably because people don't want to do what we do or don't know about it. The more competitive lifestyle specialties are dermatology and radiology. Family medicine is another favorite among women who want to have kids (it's got "family" in the name, so it MUST be family-friendly). There are some internal medicine specialties that seem to attract more women, like rheumatology and endocrinology; cardiology, not so much.

Anesthesiology was extremely popular among women in my med school class. I never quite understood that, because the hours in residency seemed pretty rough, and it's one of those residencies that tends to get harder as you progress, with more responsibility. But apparently, the jobs after residency are great.

As everyone knows, the field that is probably most dominated by women is OB/GYN, which is decidedly NOT a lifestyle specialty. But I guess you have to do what you love, even if it doesn't necessarily have hours you love.


  1. You always here that you can have what ever lifestyle you want in what ever field you go into. Therefore, don't let lifestyle alone drive your decision. But that is only true to a point. I have to be honest and say that lifestyle definitely influenced what I chose to do (although, during interviews, I have to have a much better reason than that.)

  2. You can choose to make it easier or harder on yourself. Given that your job will occupy the majority of your waking hours of the week in all probablility, it pays to pick something you really enjoy. It's hard, I find, to justify being away from your kids or something else you really enjoy unless you also love what is taking you away from them. I picked oncology, which is a notoriously difficult field in which to have good work-life balance. The patients are sick--really sick, often; the families and the patients are a demanding population which is perfectly understandable considering what they are dealing with, and there is really little to no tradition of working part-time, as there is in many other specialties such as rheum, general peds, or derm to name a few Though I found no part-time onc jobs advertised at the end of my fellowship, once I began interviewing and making it clear that I was interested in positions, but only if they could be made part-time, I actually had not 1 but 3 part-time oncology jobs to choose between within a 25 mile radius of our home.

    If you really do genuinely like well-child care or skin or inflammatory diseases, then by all means, pick a lifestyle specialty. No one can deny that it will be a much easier to achieve good work-life balance in one of those jobs. But if you like something with a bad lifestyle, don't automatically count it out. Work hard so that people will want to recruit you, and then name your conditions. You make your own destiny.

  3. When premed students ask me for advice, I always tell them to remember they'd rather spend 90 hours a week doing something they love than 20 hours a week doing something they just tolerate.

    I work a lot, being a full time neurosurgeon. There's no such thing as part time, nor would I want there to be. I love what I do, and I love my patients. I make time to spend with my family, and I chose to have one child partially because I felt I couldn't do more than one justice with my schedule. I can't imagine a different life, and I wouldn't have it any other way.

    I'll never look back at the end of my life and say, "What if I had...?"

  4. Well I'm the proverbial dermatologist who works 3 days a week and spends 4 with my children and truthfully it is wonderful. I feel very fortunate.


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