Doctors make some pretty serious money, but they pay a big price for it. First, there's the training, which usually lasts for 12 to 16 years and costs a ton of money. Then there are the hours to think about, and the workload, and the on-call time. For a lot of medical students, the so-called "controllable lifestyle" specialties look pretty good. Training still takes a long time, but doctors in fields including anesthesiology and physical medicine enjoy more stable hours and a less stressful lifestyle away from work.
If you decide to go into physical medicine, or physiatry, you can expect to spend a lot of time explaining it to people. Physiatrists are doctors who perform physical therapy and rehabilitation for patients with chronic diseases, injuries or the lingering effects of major surgery. You'd work with neurologists, orthopedic surgeons, trauma surgeons and other physicians, helping their patients recover their mobility and improve their quality of life. Physiatrists also draw up plans of treatment or therapy, which are usually carried out by a licensed physical therapist. Your patients might be athletes rehabbing after an injury, children with multiple sclerosis or seniors recovering from a stroke.
A lot more people will know what you do when you tell them you're an anesthesiologist. The biggest part of the job is keeping patients unconscious during surgery, but there's a lot more to it. Anesthesiologists also provide respiratory support for patients with impaired breathing ability and pain management for patients during their post-operative recovery or for ongoing chronic pain. Anesthesiologists sometimes work in emergency or trauma environments, keeping patients breathing or putting them under anesthesia while other doctors address their injuries.
Both of these specialties are considered to be "controllable lifestyle" disciplines within medicine. Physiatrists typically keep office hours during the day, and the likelihood of being called out after hours is just about nil. Not many patients show up in the emergency room at 2 a.m. demanding an exercise routine. Shifts are a bit more variable for anesthesiologists. You may work in outpatient clinics or anesthesiology services, where your hours are stable and predictable. In hospitals, there's a greater likelihood of being called for an after-hours emergency, but one anesthesiologist can supervise several anesthesiology assistants or nurse anesthetists, if necessary. The Association of American Medical Colleges reports a median salary of $248,000 a year for physiatrists and $424,000 a year for anesthesiologists.
Both anesthesiologists and physiatrists begin their careers with four years of undergraduate education, followed by four years of medical school. After graduation, they spend one year in a general internship, then three more in an anesthesiology or physical medicine residency. Physiatry is a relatively small specialty, with 367 residencies available in 2012. In comparison, there were 1,476 residencies available for anesthesiologists. The Bureau of Labor Statistics projects 24 percent employment growth for all physicians by 2020, well above the average for all occupations.
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