The Road More Frequently Traveled

At one time many medical school graduates pursued careers as generalists, opting for residencies in internal medicine or family practice. Historically, careers in these areas guaranteed long work weeks—daily office hours coupled with frequent overnight calls and emergencies—in exchange for median level salaries, with little time left for family life and leisure.

Nowadays, more and more graduates are opting to travel a different road, pursuing careers in Radiology, Ophthalmology, Anesthesiology, or Dermatology—the ROAD to reasonable hours, few emergencies and financial success.

Today’s New York Times carries an article about two recent graduates from Harvard Medical School, a husband and wife with two small children, both of whom have elected to pursue careers in dermatology. Both of these individuals have been stellar students throughout their academic careers; both are backed by degrees from prestigious universities. And together they are heavily in debt—over $330,000—not including the $20,000 they borrowed to finance their recent cross country treks to interview for those few select spots in dermatology residencies.

If their selections match, they will be set for life in jobs that will guarantee relative autonomy, reasonable working hours, and excellent salaries ($200,000 – $500,000/year).

Those of us slugging it out in the trenches of primary care medicine work long hours, servicing many more patients every day than we are comfortable seeing, for considerably less income. Most times our remuneration is determined exclusively by third-party payers. Perhaps we need to have our heads examined. But be forewarned—chances are you’ll have to wait at least three months to get an appointment with a psychiatrist: most of them work eight hour days and have their weekends free.


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