 So after three years of being an internal medicine physician, here's why it's the best job in medicine. Let's get into it. Hey guys, welcome back to the channel. In case you're new here, my name is Lakshman, internal medicine physician here at the MD journey to help people just like you succeed on a medical journey but doing it with less stress. Now I made a video very similar to this when I was applying to residency back like three years ago at this point. So I'll link that video in case you guys are interested. It's definitely one of the more popular videos on this channel. And I basically was sharing the reasons that I picked internal medicine at that point. But to be quite honest, it was a little bit naive for me to make a video at that point because I was basically sharing the reasons I picked internal medicine, but really all I had done was maybe eight weeks of rotations and clinical rotations a sub eye and that was pretty much it. But now I definitely have much more experience than about three years into my residencies. I thought, why not make a video updating you of all different things that I love about the job. But in this video, I'm going to cover a variety of things when it comes to being an internist or an internal medicine physician. We'll talk about a few things that you may be interested in. Check out some of the timestamps down below. Feel free to jump in the video depending on what you may want to know. We'll talk about things like salary, job opportunities, lifestyle, flexibility, job satisfaction, and a whole bunch more. Let's get into it. So one of my favorite reasons of being an internal medicine physician is that you have to know a little bit about everything to truly help your patients. Now, I don't know about you, but my traditional picture of what a doctor was, one kind of knew a little bit about all the different organ systems to truly be able to help the patient at hand. But even those fields that are outside of internal medicine, you still have to know those things about, those things like opi-gyne, if I have a patient who is pregnant or is about to be pregnant or it's just cat or baby. There's a lot of different things to consider there. Things like pediatrics, and we think as an internal medicine doctor, you just work with adults, but when certain adults have congenital diseases, those pass on, those have to be things that I have to be aware of. Things like surgery, if they're having a surgery or had a history of it, it makes me think about different things if they're complaining about something like abdominal pain and they just had a certain, very specific gastroenterology procedure. I have to kind of know what that is. I may have patients who I just delivered or are planning to be pregnant or are currently pregnant. I have to know kind of what medicines I can give them and not give them. I may be patients who are currently more in the surgical realm and just had a procedure and I have to kind of know what they has that can think about different symptoms and differential diagnoses. But having that little bit of knowledge of every single field really helps me feel like that traditional sense of a doctor when I was originally going into medical school. And just to kind of share you a cool story here is a story about a patient that I called on when I was on a cardiology service who was basically just told, this heart rate is in the 30s, like come do something about it. Now, because I was on a heart service, the main question I had to ask is this heart? And if so, what should I do about it? And I walked in, went to the EKG and said, it doesn't look like this heart. It's heart functioning just normally as it should be. I didn't see anything when I ultrasound him. So now I have to use my internal medicine brain and start to ask myself, what do I know about every little field that could possibly contribute to somebody being brain cardiac or having a slow heart rate? And having experiences and knowledges, each of these little fields will force you to look at different clues. So for example, when I looked at this gentleman's blood pressure, I noticed there's a huge gap between his systolic and his diastolic blood pressure. And there's only a few things that can really cause that, whether you're adrenal insufficiency, whether you have cirrhosis, whether you have a crazy infection, or you may have a bowel that's not working. I already checked his heart, it's a new one, it's in his bowel. So I asked the team to check the other three and sure enough, the next day, he went from a heart rate of 30 to a heart rate of 70 because they were able to find the cause. So having that background knowledge and these golden nuggets from each of these individual fields can truly help you go into a patient's room regardless of what they're complaining of. Kind of have a tool belt of experiences and things you can consider, whether it be diagnosing or treatment. And truly you can just go in like we did with this guy with a low heart rate, come out with saying it's not his heart, but here's what we think it is. And then once you solve it, mic drop. And so the reason I start with this is one of my favorite things about internal medicine is I never really go into a room feeling uncomfortable because I already kind of have a tool belt that I can use. And even if I don't feel comfortable about a specific diagnosis, I know I can read it, but I have the background knowledge of other things that may be related to truly, again, help that patient. Number two, and probably my current favorite reason of being in internal medicine is that the job opportunities are just amazing. So everyone needs an internal medicine doctor. All those hospitals need physicians who can take care of adults with a variety of complaints and so that's where your typical internist will come. And so the beauty of internal medicine is that you can choose to be very general and kind of know a little bit about everything just like we talked about and that's like your general hospitalist or internist who works in the hospital with mispatients, takes care of them, discharges them, or you can choose to specialize in something that is more in the realm of your interest. So if you're interested in cardiology, maybe you become a cardiologist if you're interested in oncology, maybe you choose to go to hematology and oncology fellowship and then work in the hospital specifically in those fields. And the reason this is really applicable to me is right now I'm my last year of residency, so I really have to make a decision of what I'm going to do next year. Now currently my plan and I know a lot of you guys ask this on Instagram as well as YouTube in the comments down below is am I going to fellowship? Am I just gonna become a hospitalism? But as I'm making this video about all the fields that I really enjoy, cardiology is the one that stands out the most to me. So who knows, maybe in the next two years I'll be applying a cardiology fellowship after my year of hospitalist. But it'll give me a little bit of experience where you can dabble into something and saying, oh, I really actually enjoy this. Let me just go ahead and be a general hospitalist or maybe it wasn't for me, I didn't like this part of the job. I can actually still go on and become more specialized in the field that I still very much enjoy. And if you're watching this video and saying I rather actually prefer being in the clinic, there are definitely jobs in internal medicine that I'm a very clinic based. Or on the flip side, if you're more like me and saying I actually prefer to be in the hospital, there are jobs particularly for that. Or if you want a nice balance, again, there are fellowships and specialties that allow you to have a nice balance depending on what your personal preferences are. And the last part when we're talking about job opportunities compared to other fields that are much more competitive. Again, everyone in all the hospitals will need internal medicine doctors to kind of fill their spots in their hospitals. So it doesn't really matter if you're going for a big popular city or one that's really rural, there's always going to be an opportunity for you. Obviously, it may not be at the exact hospital in the city that you may want, but compared to other fields, there's a lot more flexibility. Now, number three, we're obviously gonna talk about money and in internal medicine, salary is very competitive. Here, as you guys can see, I just typed in general salary for a hospitalist. And depending on the state, you know, this says that you're making easily over 200,000 and some will argue that the salary is probably a little bit higher because one, you can work more shifts. And again, these are kind of based off of sites like Zip Recruiter. So not fully the most reliable, but I've definitely heard of salaries that are in the higher 200,000 to 300,000 ranges. And then I'll just pick a specialty that people really enjoy to talk about in terms of salary. So we took a general salary for a cardiologist. It says 260, don't really believe it. Like I said, you can go to other apps, so Doximity. So when we look at the Doximity data, as you guys can see, cardiologists make a lot more than Google may suggest versus other fields like oncology, which still do amazingly well. Now, keep in mind that these numbers also consider people that are much more procedural based. So interventional cardiologists, as well as electrophysiology will have higher salaries. And so the main raises average up compared to your general cardiologists, but having a figure in the 200 to 300 to 400,000 range is definitely more than the typical American needs. And you definitely will be in the top 1% of earning in terms of US households. So while it's important to know the numbers, especially if you're somebody like, I like these two fields the same, but this one pays higher salary, probably go to that one. But if you're trying to consider specialty based on the salary, just remember that the higher salary won't necessarily make you feel happy of going to a job that you don't really enjoy. So I see a lot of comments of like, can you tell me what the salary for such and such in residency and after graduation? Honestly, I don't like answering those comments mainly because if the salary is the main thing you're looking for and making a decision of what kind of doctor you're gonna be, you're probably gonna be more unhappy than the ones who just choose to go to a path that they really enjoy. All of them end up paying extremely well. And if you graduate medical school with medical school debt, just like I have, it doesn't really matter what field you're ultimately picked, you'll definitely be able to pay off your loans and your future. But having a nice comfortable range of salaries depending on whether I chose to be a generalist or a specialist is makes a very comforting that I made the right decision when I was graduating medical school that I won't be financially constrained depending on my interest. So generalists versus a field like cardiology, both will pay well and my family will definitely be able to be taken care of. And so having that flexibility just gives you more peace of mind. Now number four and probably my most enjoyable part as a third-year resident as I make this video is that you are always learning an internal medicine. I like to think about my current medical knowledge as like my little version. And every time I learn something new, it's like a version upgrade, just like you're updating different softwares. But I do notice that with my colleagues who are doing fields that are much more hands-on, procedural-based or people that are more in the clinic setting and start to see kind of the same things over and over again, they definitely become amazing at those but there always isn't an opportunity to learn more things because they kind of just get comfortable doing certain things. Especially for a lot of my colleagues who do things like general surgery or urology, a lot of them will start to niche down into one specific type of specialty and procedures that they end up doing. And that's kind of what they become really good at. But for me, in internal medicine, I always, again, have to know a little bit about everything. And so for example, recently I heard a case of a patient who had a germ cell tumor and it's been quite some time since I reviewed that the first aid in step one or seen a patient with it. And so it just kind of one keeps me humble that there's much more to know. And two, always forces me to create a system like, okay, what are you gonna learn today, Lux? That's possibly gonna help you become that version, small version upgrade of yourself to become a better doctor whenever you go into any patient's room. And so to highlight this, I'm gonna share with you guys another interesting case. I was working in the ICU as admitting physician for the evening and I get a call from the emergency room saying, hey, we have a female of this age who is just having some trouble breathing and we can't get our oxygen saturation above a certain number. And so we think she needs to come to the ICU. Now for this particular patient, I looked through all the different reasons of why they would be short of breath, whether it be things like a pneumonia or fluid or blood in their lungs or a different kind of infection or maybe they had chest pain or anxiety and really none of them panned it out. And despite how much I was cranking the oxygen level up, their O2 side or their saturation on the monitor stayed at 88%, normal is about 93% and above. Most patients we just see kind of breathing at 97 or 100. So 88 was definitely a problem. But that one experience told me one diagnosis that could cause that because sure enough, a week ago, a friend of mine was telling me a patient that had admitted and they basically said, we couldn't get their oxygen saturation over 85 and 88 and I'm like, oh, that patient had met hemoglobinemia, didn't they? And while it may seem like an obscure thing to know, from that one patient, I did a lot of reading and basically learned that if somebody has met hemoglobin, which can basically develop through a variety of different reasons, most commonly with medications like Dapsone, which is used for patients who are immunosuppressed, then they will have a weird kind of interaction with the way their oxygen sensor works and it won't be able to get the right wavelength. And then basically we'll always read 88 to 85%, despite how well their oxygen level actually truly may be. And so when I heard this on the story in the future, I was like, well, I've actually seen this before, I know what it is, I'm not brilliantly smart, but I've actually read about this, I know why it works. And that just serves as an example of how you're always learning in internal medicine and ideally you can use those bits of knowledge to help future patients even better. Now finally on the list is that you can have the job satisfaction that you truly desire. And you guys know as well as I do that in medicine, there are a lot of different personalities, some people who want to be the go-to person and some people who just realize that, I like this job, but I don't want my whole life to be just being a physician, it was totally cool. But internal medicine gives you that nice flexibility. There are some people that just want to be the guy or the gal when it comes to specific, I have attendings who have an entire clinic and because they are the person who take care of patients with cardiac sarcoid. Or have pulmonary attendings that have entire clinics built around one specific disease that is focused around pregnant females. And so those physicians in particular are the go-to, they're kind of the cream of the crop in terms of knowledge and expertise around those disease conditions. But not everybody wants that and that doesn't necessarily make everyone satisfied if anything it may stress you out. And finally you have internal medicine physicians who are kind of in the middle where they're kind of the go-to expert but they're not super specialized. So maybe somebody who's in endocrinology or rheumatology may know a little bit about various different diseases but you see them in the clinic and they're your doctor for those conditions. But they have a nice life balance. So no one calls them after five, no one calls them on the weekend and then when you come back on a Monday, they go back to work. So the beauty of internal medicine is not only do you have the opportunities of what kind of doctor you want to be but also how you want to serve as that particular doctor. You can be a very well-known cardiologist or you can just be well-known to your patients which may be good enough for you. And so having that spectrum of flexibility and opportunity truly makes the field one of a kind. Hopefully you guys enjoyed this video. If you did, go ahead and drop your comments down below whether it be questions and I'd love to answer them, give you a little bit more insight in case you're considering internal medicine. Hopefully you are after watching this video. And if you did, just go ahead and show your quick support by hitting that like button. One, it definitely tells me that you guys enjoy this content and keep making more like this. But two, and most importantly, maybe there's somebody out there on the YouTube universe that really wants to know like I'm considering internal medicine but I just need to hear certain things of why and why not to do it. Hopefully this video can give them a little bit more insight but maybe you hitting that like button will make it more likely that it'll show up on their feed. So go ahead and hit that like button. 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Finally, if you did enjoy this video then check out this video on how you could study like a pro from start to finish as well as this video and how you can use Anki like a pro full breakdown. With that being said guys, thank you so much as always for being a part of my journey. Hopefully that was a little help to you guys on yours and I'll see you guys in the next one. Peace.