Medical Specialty Outlook: What does the future hold?

Given the current and expected physician shortage in the United States, any newly minted doctor will have no problems finding a job. “Doctors coming out of school are no different than a Heisman Trophy winners,” said Kurt Mosley, VP of business development at Merritt, Hawkins & Associates, a nationwide physician recruitment and staffing firm. “They are wooed and wooed. There’s no such thing as an unemployed physician.”

That’s the good news. And even better news is that, depending on what specialty you choose, you can expect a plethora of job offers and highly lucrative deals that include six-digit salaries, bonuses and vacation packages.

So which medical specialties are “hot?” In the past couple of years cardiologists have been most in demand, commanding annual salaries ranging roughly from $230,000 to $520,000. Other high-income specialties include ophthalmology, anesthesiology, dermatology, and plastic surgery.

And the “hot“ specialties are expected to keep sizzling well into the future decades. As the population grows older and the risk of age-related conditions rises, there will be an increased demand for specialists to treat these diseases. For example, experts say the baby boomers may be the most vulnerable generation ever to heart disease, hence the need for cardiologists. And according to the American Academy of Ophthalmology, the demand for cataract surgery within that age group is expected to increase by 47 percent, and the need for general ophthalmic surgery is predicted to rise by 88 percent.

Plastic surgery is another cutting edge specialty that will cater to affluent baby boomers, ready to pay out of the pocket for rejuvenating but costly nips and tucks. The American Society of Plastic Surgeons reported that in 2004 more than 8.7 million Americans spent $9.4 billion on elective cosmetic procedures that required cash up front. The trend is expected to continue, helping plastic surgeons to rake in an average of $320,000 a year.

Another area where demand for specialists is steadily growing is hospice and palliative medicine. With longer life expectancies and millions more of baby boomers boosting the ranks of the general population every year, “this is an area that is very important to all of the specialties involved,” said Stephen H. Miller, president and CEO of the American Board of Medical Specialties.

Starting in 2008 the Board will certify 10 specialties – family medicine, internal medicine, gynecology, pediatrics, physical medicine and rehabilitation, anesthesiology, psychiatry, neurology, radiology and surgery – to care for patients with chronic or terminal diseases.
“Each of the co-sponsoring boards recognizes the growing importance of this area of medicine,” said James C. Puffer, MD, president and CEO of the American Board of Family Medicine.

Just as some specialties gain in popularity, lower paying, time demanding, on-call fields such as family medicine, internal medicine and general surgery are shunned. According to the American Academy of Family Physicians, osteopathic family practice residency programs fill just over half of their open positions. And general surgery experiences a painful cut in its ranks as well, as “students are more interested in being with their family and having free time,” said Susan Brundage, MD, who conducted a study on the career choices of University of Texas-Houston medical students, and subsequently published the findings in the Journal of Surgical Research. “If they can work in a less-demanding specialty to economically support the lifestyle they want, maybe the attractiveness of surgery doesn’t compensate for the lost time and money.”

So how do med students decide what specialties to pursue amid the myriad of fields available to them? It is a toss-up between the quality of life and financial obligations. On one hand, high-income specialties will help offset undergraduate and medical schools loans, amounting, on average, to a hefty $120,000 per student.

On the other hand, “lifestyle issues have been significant in the choice of specialty,” says David Kennedy, Vice Dean for Professional Services of the University of Pennsylvania School of Medicine. “It’s a big reason more medical students choose specialties that offer high salaries and normal work hours.”

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46 Responses to “Medical Specialty Outlook: What does the future hold?”

  1. Ahmed Sherief says:

    This an awesome article that helped me alot for my future plan as i’m a final med student in Egypt…. Thnax

  2. Anonymous says:

    It is disappointing that the FP and IM docs are so undervalued.

  3. M.Li says:

    I think it’s a huge problem that PCPs/IM/FP are so undervalued… From a public health standpoint they are probably the most important yet they essentially have to know the most, work the hardest and longest hours, get paid the least, and get the least respect/recognition.

  4. amanda berg says:

    I disagee with this article, today primary care field options are opening up allowing one to take a position as a hospitalist, 1 week on 1 week off, and start at salaries upward around $180,000, that’s about 6 months of work. General medicine is awesome, 3 years of residency and you start with a nice salary working half the year. I DO NOT SEE THE DOWNFALL. Specializing is great, but I think if you like general medicine, and you are good at it you will be in high demand. GOOD INTERNISTS ARE HARD TO FIND THESE DAYS, AND YOU WILL BE NOTICED!

  5. Monica L says:

    No matter what the demands are and the salary is it is ultimately the satisfaction of doing what you want.

  6. Anonymous says:

    “So how do med students decide what specialties to pursue amid the myriad of fields available to them? It is a toss-up between the quality of life and financial obligations.”

    These issues do play a role in the decision-making process, but I don’t know anyone who has chosen a specialty ONLY for these reasons. All of us care very much about whether we’ll enjoy actually doing the job every day for the next few decades.

  7. Radwa A.Harris says:

    This is one great article really, but the thing thats missed here is that what makes anyone choose to enter a medical school? i see its because of their love to practice medicine, i mean its not a lifestyle or salary kinda thing…u can get that easily in other majors without wasting 7 years studing medicine. That’s why when u specialize u’ll choose something u like too, just like u chose medical studies at first.

  8. Karim says:

    How can you have “a love to practice medicine” when you’ve never practiced medicine before? Anyway, there are many considerations one must make when considering to pursue a career, and a desire to pratice medicine is just one of them.

  9. Pedro F Moreno says:

    Ecxelent article. Very true that we need more doctors in public health because there is more demand, in this case to take care patients with cronic and terminal diseases. Also this aricle helped me for my future plans, im pre-med in Puerto Rico

  10. Pedro F Moreno says:

    Ecxelent article. Very true that we need more doctors in public health because there is more demand, in this case to take care patients with cronic and terminal diseases. Also this aricle helped me for my future plans, im pre-med in Puerto Rico

  11. Yasmine says:

    i think this article is a great article and it has giving me top specialties in the U.S which i am going to consider for my future… good luck to you all…

  12. will says:

    Wow! Internal medicine docs are getting paid to work half the year (week-on/week-off) as hospitalists? I’ve never heard of that? Do you mind me asking how you know this or in what part of the country offers like this are sprouting up?

  13. annoynmous says:

    this article blows!

  14. Anonymous says:

    cool

  15. Anonymous says:

    I Want to be a Cardiologist yeahhhhhhhhhhhhhh mariiaaaaaaaa morenooooooooooooo was here :]

  16. anonymous says:

    is medicine really about the money? because then I am going into the wrong field…
    this makes me sick.

  17. future doc says:

    oh yes baby, its all about the money

  18. Anonymous says:

    No, its what you make of it.

  19. Reality Check says:

    Medicine is obviously not “about” only one thing. I personally first asked myself where i could be happy working, then i considered if there was a point to my efforts, lastly i considered what field would best financially compensate my efforts.
    To be fair, no doctor i work with has mentioned an inspirational story from their childhood of healing injured animals or siblings as catalyst for their interest in medicine. Interest often comes from proximal illness or financial attractiveness, not to mention a healthy dose of megalomania. In spite of the common failings of some aspiring medical students, they are still human, and almost always become more tolerable to be around after graduation;)

    Like the awkwardness of when you first attended public school, med-school is no different. You will learn to play the games as you go. If you ask relevant questions and have the ability to retain key points of information, coupled with personality traits which include commitment and diligence, med-school will not be daunting in the least. In fact the days i recall most fondly are ones when i was being constantly challenged, and was filled with an undercurrent of excitement about my future.

    Life as a doctor of any specialty can be quite alien. Often one finds oneself put on a pedestal, at times far from the familiar social setting they are reared with. Your cohort is predetermined and at times unwelcome. Such a small selection gives way to the inevitability of conflict and, for some, eventual cynicism.

    Much like other life pursuits, time will be the chief measure of your own satisfaction with medicine as a career. The unique posturing medicine will offer you is the ability to feel good about your impact on the world, even if your actual work is incongruent with your preference.

    Give yourself some breathing room, meditate, sleep in on sunday, drink a latte or whatever makes you happy, because at the end of the day no one enjoys the company of a grumpy cliche.

    Best wishes, and no worries. Life is short.
    Dr. K

  20. challenging says:

    i think it’s difficult to choose because by the time you graduate, lots of time invested already, need more time to study again to specialize and less time for you to live life. no time!

  21. Harbringer says:

    Clear sunny skies in the forecast?

    Not so much when you consider the proposed 10% cut on Medicare reimbursement (who knows what congress will do next), an increasingly bureaucratic work environment (thank you very much HMOs, you sons of bitches), and the ever looming threat of malpractice lawsuits.

    I

  22. Anonymous says:

    im a plastics reg and its all about the $$$$$ baby

  23. Anonymous says:

    Its not just about the money it is about doing somthing you want to do and what makes you fell good inside.

  24. Marc says:

    Med student from Sweden checking in.

    Nice article, and good feedback. Well written from Dr. K. Some of you are a bit too keen to play the saint or greed angle. I don’t believe that’s the only thing triggering you. The money whores has to see a point in doing important things, and get something out in helping the while the saints obviously don’t work for free and there’s a reason they became docs instead of nurses.

    Despite reading all this, I still can’t make up my mind. In Sweden what we make in salary in one year, you guys almost make in a month. On top of that low level, we still have rather big differences in salary. The best salary are the most unpopular specialties like general practicians and psychiatry where the demand are the biggest. Here taxes pay our salaries, that’s why we have fallen behind you guys, and that’s why we get more paid in where there’s a bigger public demand.

    Right now, here’s what I think matters the most.

    1. You like working or being with family?
    2. What’s speciality makes you tick? You like to build stuff, or to sit down and think about complex stuff?
    3. Aiming for a PHD?
    4. What kind of atmosphere does the place offer. Are they on their knees in shit, or working fine?

    I like being with GF, and play with cars and motorcycles. I would like to work half time with something interesting that makes me feel important (bye buy surgery), and I want to see some results (see ya psychiatry) and maybe do some reasearch (not general practician in Sweden)?

    So what the hell should I do?

  25. Anonymous says:

    As much as I’d like to believe that I’m becoming a doctor to “help people”, I know there is more to it, and money certainly plays a part. Can you honestly tell me, that if doctors were payed as teachers are, you would still consider this field? The reality is that most people know that they will lead a comfortable life (in terms of being financially free) when they choose this profession. I certainly have a passion for medicine and science in general, but the money helps satisfy our basic human need for survival, which includes having the ability to help our parents when they age, and give an amazing life to our children. Some may find this ridiculous, but I see it as taking something I know I will love and benefiting financially from it. There is nothing wrong with accepting this fact. I find it immodest to pretend that money has nothing to do with it. There are many ways to “help people” that reap only moderate financial rewards.

  26. Chinekwu says:

    Thanks for this quite enlightening piece…… you’ve aided my future plans a great deal……keep up the good work!

  27. haniffa says:

    i went through all the stuff, i still do not figure out, what i should specialise in- surgery out for me – anything else, give me one field

  28. Anonymous says:

    “Its not just about the money it is about doing somthing you want to do and what makes you fell good inside.”

    If you could spell I might take you seriously. Money is a huge aspect of medicine when you are $120,000 in the hole on graduation. Stop lying to yourself. Feeling good inside doesn’t pay off student loans. If I’m going to commit myself to being an excellent physician I expect to be compensated generously for it.

  29. Dr Bones says:

    In this day in age, I find it very fascinating that this debate of money vs job satisfaction still rages like a bull. When YOU all DECIDED to be doctors (operative words there being YOU & DECIDED), no-one held a gun to your head in making that decision. Therefore, you knew what you were getting yourself into i.e long hours working, implications on social life or should I say lack-there-of, the financial benefits (in the long run) being a dr brings. So stop whinging like little kids who lost their toys in the playground & put in the effort into whatever field you choose, or alternatively quit medicine & come clean my garden, its looking rather dense lately….

    Dr Bones

  30. Ceejay Kayode says:

    My vision of the Utopia is slightly different.I am a newly qualified Doctor in Nigeria,with my primaries in Psychiatry.i had wanted to be a Psychiatrist but during my National Service in a Psychiatric hospital,i discovered that Psychiatrists are terribly Stigmatized,i also developed some doubts about the Scientific basis of the specialty . I need advice on what specialty that will enable me have time for my family and be fulfilled

  31. Dr. Gyn says:

    Dear Ceejay,

    A good one would be gynecology. I have practiced gynecology for over 20 years. Your patients come to know you and vice versa. You can help them with through a myriad of problems. They also have a tremendous amount of stress with family and life changes. So, you can help them through the use of surgery, medicine and psychological support. And, no stigma.

    Dr. Gyn

  32. gk gen says:

    will interventional cardiology continus to be lucrative int the future considering the fact that gene therapy could cure atherosclerosis?

  33. Andres says:

    guys, I’ve read you all and it doesn’t surprise me, that for so many of you money is the issue, and let me tell you that even when money is the motor that moves the world, so is love, please don’t laugh just yet, yes love for what you do, for your family and the people around you (that’s the least but still is) I’ve seeing myself doing many things for a living (metaphorically) but nothing compare with the thrill and heart filling sensation that medicine has given me, alone with the respectives disappointments and hard times that comes with it. Medicine is not only a mean to make a living, it’s a way of live that gives you certain status and economically support a “high end” lifestyle. But guys now seriously don’t disrespect medicine, to be a doctor, or at least a good one, you must care more for what you do than for what you perceive economically out of it. imagine yourselves doing something without economical reward, even more something you have to pay for in order to do it, would you practice medicine under that circumstances? because I would! and then you find out that you can get paid instead of paying for that, isn’t that great? you can do what you love most (just like your dream hobby, but a serious one)and get paid for doing it! it doesn’t matter how much, there are more important things than that, as long as your live spends are covered or maybe a “little bit” more, you’ll be the happiest person in the world knowing that you are doing what you love most (besides your family) regardless of how much are you getting out of it! and by doing it this way, believe me, you are going to get much more that what you think!!!

    PS. my wife says that i love medicine more than i love her, and of course this is not true, well the truth is that this is not ENTIRELY false!

  34. Dave says:

    The reason why primary care docs get payed so little is because they do so little. I mean, their job could be done by a social worker or a nurse. And the thing is that most people who go into it are not the magical / super motivated kind. They’re the average students with an average future to come. What they should do, if they want to get payed more, is make them do more. Instead of a super easy 3 year residency, inlcude a 2 year MBA degree paid for by the residency program. So that these average students can learn how to manage a large number of social workers and nurses in order to meet the healthcare need. At this stage, primary care docs do not deserve more compensation.

  35. dalia says:

    sorry Dave you are wrong! Primary care docs do a lot more than a lot of specialties. I work closely with physicians of all kinds day in and day out. Most primary care physicians are very bright and have to be on top of it with many disease states. A lot of times they are also the endocrinologist, dermatologist, allergist and psychiatrist in one. There are definitely other specialties such as anthesiology that deserve pay cuts. It seems to be like most of them just sit around and read a book while the patients are under. Primary care docs actually help more sick people day in and day out than most other specialties. People are starting to see that. I think their pay will go up in the next few years and a lot of the other “specialists” will see a pay cut.

  36. doctobe says:

    dave, you are an idiot and clearly have not medical background.

  37. Dr. Nick says:

    For those who are saying people shouldn’t be going into medicine for the money – you’re absolutely right. But you can’t be naive either… Eventually we all must make decisions about what kind of life we want for ourselves. If you want a family and/or any kind of meaningful life outside of the hospital, specialties like general surgery start looking less and less attractive.

  38. MD one day soon says:

    “The reason why primary care docs get payed so little is because they do so little”

    Dave, I laughed out loud when I read that. You are a moron.

  39. Rick says:

    Ok, I’ll give everyone a big roaring laugh, I just turned 60 and I also just got accepted to Medical School; I have a Business/Pharmacy Degree, Engineering Technology Degree, Masters in International Management and a Doctorate in International Business; my dissertation was on Sales Behaviors using Empathy as the independent variable and Giving, Getting and Using Infomration as the modifiers and dependent variables.

    Why did I at 60 choose to do what I’m doing, well, it wasn’t all about money, but yes, that had a role in my decision, it was basically the fact that with all my educational background, I couldn’t find a decent job after I sold my own company of 12 years.

    Anyway, I’ve always had the desire to become a physician, and I even know what I want to specialize in; Internal Medicine; because there will be so many older people to take care of in the next 10-15 years.

    Thanks for allowing me to post this response.

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  41. christne says:

    Only for those who are not doctors or even in any medical field can say that doctors are there only for the money. Its not as if ANYONE can be a doctor–there is so much competition and high expectations for this field. And going in to a career knowing that after 4 years undergrad there is still 4 more years of medical school and then at least 2-5 years more of residency…would certainly deter anyone who wasn’t truly in love with the profession running for the hills. So being a doctor is so much more than the money. Those who end up being ones know all the sacrifices that go along with it. Money is like the very tip of the iceberg, but honestly you’re way below water most of the time.

  42. James says:

    Rick,

    Congratulations. I think I’ll laugh, too. You’ve proved to the SDN world that you’re a professional student. With all 4 of your degrees, one would hope that by now you would have figured out that the phrase “medical school” contains no proper nouns and requires no capitalization. But I suppose a “doctor” in international business doesn’t have much need for English. Also, will you please post a link to your dissertation? “Giving, Getting and Using Infomration as the modifiers and dependent variables.” I love it already and am dying to read it as soon as possible.

    James, MSII

  43. Dr. Epione says:

    I don’t know how it is in the US, but in Argentina’s main public university it’s very, very hard to become an MD. The career is long (6 years + internship + residency) the teachers terribly demanding, not to mention the gruelling bureaucracy. Also, there’s a meager budget so we’ve got no central heating and struggle to obtain even the most basic supplies (not to mention high-tech equipment).
    Once you finally do manage to graduate, the healthcare system is oversaturated, the hospitals falling to pieces, with only some acceptable exceptions.
    There’s a horrible asymmetry in the attention the patients get according to their social status. It’s no coincidence either that the students who actually complete their studies and earn a title are mostly those better off financially.

    Even highly respected physicians don’t make the six digit sums that any ordinary doctor gets in the US. I would estimate their yearly earnings in a third of that figure.

    And before you say that’s because we’re underqualified, let me tell you we’ve got several Nobel prizes, and world-wide acclaimed physicians.

    I doubt people get into med school here merely because of greed.

  44. Dave B says:

    James,
    I am 39 YO, with an Engineering degree and an MBA in Information Systems and I am in pretty much the same boat as Rick. I have a job but had to take a 20% pay-cut after I got laid off from one of the big financials in 2009.
    Technology is ever-changing and continuous education (read hard core studying) is required to be competitive and you are competing with people anywhere from 18 to 65. And most importantly, in my profession we do not have an AMA which was lobbying until 2006 saying there are too many Doctors in America, effectively keeping the supply LOW (capitalized on purpose) and demand HIGH.
    I will start Medical School (we from Technology background tend to capitalize, unnecessarily) in 2012 with scholarship, based on my MCAT score and GPA of pre-med courses. Yes, I had to take them as after high school I did not take any Physics, Chemistry (Gen and Org), and Bio. Anyone looking for a career change from a similar background, please go ahead and Just Do It. If you can make various communication protocols talk to each other, or develop custom software using multiple languages, you can certainly do THIS.
    Rick – Good Luck to you.
    James – Stop being a condescending A’Hole.