 Welcome back to this channel, everybody. For those of you who are new around here, my name is Michael, AKA Dr. Chilini. And I'm a board certified diagnostic and interventional radiologist in the great state of New Jersey. Now on today's video, we're going to be talking about choosing your medical specialty and why it probably is more important than you may think. There's a lot that goes into choosing a medical specialty and it's probably the biggest decision of your life. So I wanted to touch on a few things that you might not have thought of when choosing a specialty. Let's get into it. So like I briefly mentioned in the intro there, your specialty matters way more than you may think. And I wanted to touch on some lesser known or lesser talked about things that you may not have considered when picking a medical specialty. So let's start off for the first reason why your medical specialty matters more than you may think. Now, this may not come as a shock to you, but your medical specialty is what you'll be doing the rest of your life. Like literally every single day, wake up, go to work, do your medical specialty and come home, repeat, do it all over again for like many, many decades. Some would say it's kind of a big decision and arguably the biggest decision of your medical career because once you choose your path into a certain specialty, you can't really go back. Well, you can go back, but it is quite difficult and I wouldn't recommend it. If you wanted to change specialties, you would basically have to start from scratch and start all over residency again and maybe even do two residencies. So let's just forget I ever said that and let's focus on only choosing one specialty for the rest of your life. Now the reason why I say it's so important because you're going to be doing it the rest of your life is if you're going to be doing something the rest of your life, you better enjoy it because if you hate it, the rest of your life is going to be miserable. This is why there's always so much pressure around picking a specialty to begin with. I remember when I was in medical school trying to figure this stuff out, I liked all different types of specialties. I didn't really know which one I wanted to pick and honestly, I just got kind of lucky. The reason I wanted to make this video is so that you all didn't have to be lucky to fall into a good specialty that you could make educated decisions on picking the right specialty for you based on many different factors. Specialty matters very much if you're going to be doing it the rest of your life but no pressure, right? I personally am pretty happy to go and endure it every single day and I know I've only been practicing for not even a year yet but I don't see that happiness slowing down anytime soon. I'm happy with my decision in interventional radiology and diagnostic radiology. It has a perfect work-life balance at my practice. I love it. And I want all of you to love it as well because so many times you hear doctors who are miserable with their jobs or their paths they have chosen and I don't want that to happen to you. So now let's get into the next topic about choosing a medical specialty and why it matters more than you may think. Let's talk about salary because everybody likes money and your salary may come into play way more than, just surprised by the mic there. Your salary may come into play way more than you probably may think. The reason I say that is because there is a very wide discrepancy and physician income throughout the United States and I think we'll just pull up one of these charts just so you get an idea. Do, do, do, do, do, do, do, do, do, do, do, do, do. So here we have the Doximity Compensation for 2021 based off of specialty. And as you can see here, neurosurgery tops the list at $773,000. And let's throw it all the way to the bottom over here and you'll see Peds Infectious Disease makes $210,000. Now I don't know how accurate these salaries are because I haven't really done research on where they got this information at or if they just polled certain people what the power of this study is but nonetheless I just wanted to pull it up so you see the differences in compensation per year. So 773,000 versus 210,000 for Peds Infectious Disease that is quite an alarming difference in salaries. You can probably see, yes, this person in neurosurgery did longer training. At the end of the day though, they're making almost four times as much as a Peds Infectious Disease Doctor and that is quite significant when it comes to building wealth, paying off your debt, living a good work-life balance and doing things you want. Just by looking at this data here, you can probably tell that a neurosurgeon can pay off 250, 300,000, even $400,000 worth of loans way faster than Peds Infectious Disease Doctor and it'll probably hurt way less, meaning it'll still come out of their paycheck the same chunk but that chunk will not make a dent in a neurosurgery's paycheck versus the Peds Infectious Disease Doctor. Say their loans are like $2,500 a month and the take home for a Peds Infectious Disease Doctor, I don't know what, 68% of the salary, it's 142,000 divided by 12, it's $11,900 per month, paying almost a quarter of that to loans versus a neurosurgeon who makes $773,000 times 0.68 divided by 12, that's $43,000 post-tax a month, which means they still have $41,000 per month to do whatever they want with. So as you can see, based off that small example, it's a little easier for the neurosurgeon to pay off their loans and again, I know you know this, more money equals easier to pay off loans, equals easier to buy nice things and live a better life, but I wanted to throw this out there because the last thing you wanna do when finishing your full medical career with student loan debt is have to worry about your finances. You finally reach that pinnacle of being done with your specialty and you don't wanna live that paycheck to paycheck life again because you did that. And before I get in the comments, $210,000 is enough money for anybody. Yes, that is a very large sum of money for anybody. However, the whole point of this was just to share the differences between different specialties across the U.S. And one thing we didn't talk about with this higher salary is the neurosurgeon can retire a lot earlier or a lot younger than someone who is in say, Peds Infectious Disease. The neurosurgeon, if they invest appropriately, may retire before 50 years old versus the Peds Infectious Disease Doctor who may have to work a little harder. The next thing you probably don't think about when picking a medical specialty is location. You're like, what are you talking about? I'm a physician and I can work anywhere in the world. Well, that's partly true, but the location of your work depends on what specialty you are in. And let's dive a little further. Some people may be so subspecialized that they can only work in certain hospitals. So say for instance, you wanna be a pediatric cardiothoracic surgeon. You can't really practice Peds' cardiothoracic surgeon in the community hospital setting because they don't really have the capabilities of handling those kind of patients and the staff may not be trained enough to take care of these patients. I'm really talking about a lot of Peds today, but so a pediatric cardiothoracic surgeon may only be able to practice at certain large academic hospitals or big tertiary care centers, usually in larger cities. So say for example, if you wanted to live somewhere in like South Georgia, away from everything, you can't really do that if you're a Peds' cardiothoracic surgeon because you wouldn't find any work down there. Contrary to that, if you, contrary to that, if you wanted to be a primary care provider, you could pretty much go anywhere you want. You would not be limited. You can work in a big city. You can work in a small rural town. Doesn't really matter. But super subspecialized physicians can only work in usually large cities or big tertiary care centers. So this is why picking your specialty may limit some locations you to live. Another thing you have to consider when picking a medical specialty is the time in training. Keep going back to the neurosurgery versus pediatrics comparison because that's what we already talked about, but a neurosurgeon is in training for at least six or seven years and usually do a fellowship afterwards, lasting about a year or so versus a pediatrician who finishes med school and goes to residency for about three years, plus or minus fellowship, and they can start practicing immediately. So the neurosurgeon obviously has a prolonged gratification compared to a practicing pediatrician. For someone who is in a long specialty training, they will miss out on many years more of vacation, seeing friends, time off at work, work-life balance, not being in the hospital when compared to someone who has a shorter training period like a pediatrician. Seven years in training doesn't sound that bad when you think about it. Well, it actually does. I just did six years and it was pretty terrible, but during residency I saw a lot of my friends who were emergency medicine physicians, pediatricians, internal medicine doctors, et cetera, who were done when I was halfway through residency and they were done on these massive vacations, buying cars, enjoying their life, and I was still stuck in the hospital taking call. So the length of your training is definitely something to consider. Another thing you may not consider is that each specialty works different hours in the hospital and each specialty takes different amount of call or no call at all. If you have a family, if you have children, or if you are even an older non-traditional med student, doing a specialty where you are working in the hospital all day, all night, on your feet all the time, when you have all these extracurricular requirements, may not be a good decision for you. Would you rather spend time in the hospital because you love your specialty or would you rather be at home with your family? Would you like to get called in in the middle of the night or would you not like to get called in the middle of the night? Every specialty is very different. Again, a pediatric infectious disease doctor probably doesn't get called in in the middle of the night, hardly ever, if at all, versus a neurosurgeon who makes almost four times as much as a pediatric infectious disease doctor and compare that to a neurosurgeon who may get called in every time they're on call. I promise you, no matter how much you like your specialty, getting called in in the middle of the night gets old very fast. It seems cool when you're in school, but there's a reason why the older partners of any practice try to sell their call to the younger folks, it gets old after a while. And by a while, I mean like a couple of months. The final thing you probably don't think of when choosing a medical specialty is something I tell pretty much every single med student I talk to about this topic. And that is, what do you see yourself doing at 50 years old? The reason I say that is because my specialty, interventional radiology and other surgical specialties may require you to be in the OR when you're 50 plus years old, standing up all day long, taking call, going in in the middle of the night, wearing the lead for a long period of time, having your back hurt forever. Those are things that you may not want to do as you get older. And you have to consider the long term here because you're not going to be practicing in your 20s and 30s forever. Eventually, you're going to be older, your body is going to break down, you're going to need more sleep than you would when you're 26 years old. And these are all things you should take into account when choosing a specialty. What do you want to be doing at 50 years old? I personally would like to be retired or at least part-time at 50 years old. The reason I chose interventional and I do a lot of diagnostic radiology is because eventually as I get older, I'll transition more into the diagnostic space because wearing lead all day for hours and hours and hours gets old after a while and takes a toll on the back. That officially concludes this video and hopefully this may help somebody who's trying to pitch a specialty or change a specialty. So make sure you gently press that subscribe button, become a member of the channel if you so please. I would appreciate it. Follow me on Instagram and TikTok if you don't already and of course I'll see you all on the next video. Bye.