What Premeds Should Know About Types of Doctors | Education

With the abundance of job types in health care, premed students should not feel forced onto one career path. Duties can vary widely among medical specialties, and salary and work-life balance should also be considered.

Besides clinical care, doctors also have great opportunities in research and education, says Dr. Jeffrey SooHoo, assistant dean of admissions and assistant dean of student affairs at the University of Colorado School of Medicine.

“They might do hospital administration, they might do policy or advocacy for political groups, lobbying, pharmaceutical work, industry, etc.” he says, “so there’s a lot of different ways to use your medical degree.”

It’s a bit tough to categorize because the specialty a medical school student initially chooses to go into, their residency, has a lot of offshoots, he says.

“You could go into pediatrics and become a general pediatrician, probably like most kids have when growing up, someone that you saw annually for a well child check,” he says. “You could also go down a rabbit hole of pediatrics and do one or more fellowships, and they can be super specialized, like pediatric endocrinology, pediatric cardiology, pediatric ICU care. And those actually look very different despite starting out in the same residency.”

Specializes in and administers anesthesia care, pain management and critical care medicine.

Focuses on the immediate decision-making and action necessary to prevent death or further disability both in the pre-hospital setting – by directing emergency medical technicians – and in the hospital emergency department.

Trained to care for the whole patient in every way necessary, including surgery, and diagnoses and manages medical conditions before, during and after surgery.

Specializes in diagnosing and treating diseases of the female reproductive system, as well as pregnancy care and menstruation issues.

Diagnoses, treats and manages brain and nervous system disorders, including the spinal cord and nerves.

Treats cancer and provides medical care for a person diagnosed with cancer.

Diagnoses and treats eye and vision conditions.

Treats children, providing check-ups, preventive health maintenance and ongoing monitoring, as well as medical care for those acutely or chronically ill.

Treats medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons, helping to restore function for someone disabled by disease, disorder or injury.

Specializes in mental health, including substance use disorders, and assesses the mental and physical aspects of psychological problems. This medical specialist also can prescribe medicine to treat mental disorders.

Diagnoses and treats injuries and diseases using medical imaging procedures, such as X-rays, magnetic resonance imaging, nuclear medicine and ultrasound.

Specializes in diagnosing and treating diseases of the prostate, kidney and urinary system, including the bladder, ureters and urethra.

Students should also consider the job market.

“Things like family medicine, internal medicine and pediatrics just have more spots because of the way training is in the United States and the way residencies are funded, versus something like what I do,” SooHoo says. “I’m an ophthalmologist, and there’s fewer spots for ophthalmology residency in any given year.”

Emergency medicine, historically highly competitive, has become oversaturated in recent years, so the job market may have changed, he says. Psychiatry recently has become much more popular, especially since mental health is getting more attention, he says.

Getting doctors into the primary care specialties has been challenging because med students are graduating with huge amounts of debt, says Anastasia Rowland-Seymour, medical director of the Physician Assistant Program at Case Western Reserve University School of Medicine in Ohio.

“They don’t feel free to necessarily make a decision based upon simply what they love or what they feel will be kind of the highest order of their service,” she says, “but they are thinking carefully about having $300,000 or something of debt, how they are going to pay that, which is a very practical approach, so I can’t fault them on that.”

Balancing work and time off “looks different for everybody, and I think balance suggests actually that there’s a right answer, like, if you think of a scale, balance means that things are correct,” SooHoo says. “I actually don’t think that’s possible, at least not all the time.”

He says he tells students and others that work is a part of his life, and he doesn’t try to necessarily separate the two.

“Sometimes I go to the dentist during the day, and sometimes I answer emails or see a patient at night,” he says. “Are those my work? Are those my life? Those are the same thing to me, and while I don’t recommend doing email at the family dinner table, it all is interwoven.”

Rather than a burden, work should be a source of meaningful passion, SooHoo says.

“Actually find work that you enjoy; I don’t mean that you should work 24/7, but if you find work that’s meaningful and fulfilling, then it becomes less of an issue to try and decide what’s happening at any given moment. What I talk to students about is to understand what’s non-negotiable in a specialty versus what’s negotiable.”

For example, experts say, someone who wants to avoid working nights or weekends should not be an emergency room doctor. Or, someone who never wants to be on call overnight would likely want to avoid becoming a transplant surgeon.

By contrast, someone who wants to work four or five days a week from 9 a.m. to 5 p.m. may find that being an outpatient pediatrician is a good fit.

For work-life balance, SooHoo says it’s important for students to evaluate the wants versus needs of a job.

Jobs with procedural specialties tend to pay better, SooHoo says.

“We as a society have valued procedures in a different way than we have more cognitive specialties, even though the value to society is not necessarily appropriately understood,” he says, using a hypothetical situation to make the point.

“For instance, I’m an eye surgeon, I can take out someone’s cataract in 15 minutes, and that’ll pay a certain amount depending on their insurance. If my internal medicine colleague spends an hour with a patient and gets them to quit smoking, that actually reimburses less. Spending an hour with a patient and getting them to quit smoking reimburses less than a 15-minute cataract surgery, but which one do you think actually has more value to the health care system?”

Rowland-Seymour says it’s less about work-life balance and more about how to be financially responsible while choosing a job that a student still feels is his or her calling and passion.

Jobs that are shift work tend to have a better work-life balance in the traditional sense, she says. “You could do radiology sitting in your house, in your pajamas, so it kind of depends how much patient interaction they want and whether that’s super important to them.”

Primary care physicians usually start out with a salary similar to a physician assistant, which can be disheartening after years of medical school and hundreds of thousands of dollars in debt, which can push people away from primary care, Rowland-Seymour says.

“It’s much more attractive to start a residency and finish residency and come out with a $400,000 or $500,000 job in surgical specialties. That’s much nicer. Or even a $200,000 or $300,000 (salary) in emergency medicine,” she says.