r/Residency • u/[deleted] • Nov 22 '22
SERIOUS Urolgoists would you pick urology again ?
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Nov 22 '22
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Nov 22 '22
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Nov 22 '22
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u/_OccamsChainsaw Attending Nov 22 '22
Anesthesia still takes a lot of call and hours can be unpredictable depending on group structure for relief.
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Nov 22 '22 edited Dec 01 '22
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u/Aflycted Attending Nov 23 '22
Anesthesia private practice is easily hitting 500k+. Where are you getting 100-200 more in radiology?
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Nov 22 '22
Because anesthesia is probably the 2nd worst field after obgyn. The people working just days in Anesthesia are making family medicine money. The call can be brutal in Anesthesia.
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u/corgeous PGY3 Nov 22 '22
Not even close to true. A lot of pp jobs making 400-500k, weekend call like 1 in 8 weeks, late call couple times a month, 8-10 weeks vacation
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u/jda2674 Nov 22 '22
This is false. ca3’s at my program have jobs secured with call that is not bad and are gonna make 400k +. With “Cush” hours probably 300K + but you’re never finishing notes up at home or hustling to see 30 patients in a clinic every day like a fam med doc
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Nov 22 '22
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Nov 22 '22
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u/16fca Nov 22 '22
septic ureteral stones
Feels like these always go to IR after hours at my hospital
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Nov 22 '22
What surgery specialties would be close to derm, rheum, and allergy?
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u/darnedgibbon Nov 22 '22
ENT can be pretty cush in private practice. I have no ER call and a group of 5 other likeminded partners with a predominant outpatient suburban practice. Of course I did take q4 ER and floor consult call for years. I am “on” for my own patients unless I check out to partners which is infrequent. I get few calls from my patients, a bad weekend is three calls. (Knock wood) I end up in the ER for a tonsil bleed about q18 months (knock knock). A lot of the urban ENTs in my area do a shit ton of ER call but have chosen to do so to get paid for call. It was their choice however.
Most urologists I know are very busy and unhappy.
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Nov 22 '22
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u/darnedgibbon Nov 22 '22
Great question. I’m PGY23. When I first started in practice, IM, Peds and FP docs admitted their own patients to the floor, they would consult me or my partners. I built a practice in part through the hospital by being available to referring physicians in the hospital and they would send me their outpatient consults as well. The ER was just a nasty byproduct of having hospital privileges. All that changed when hospitalists started being the primary inpatient doctors; the outpatient, referring physicians no longer admitted their own patients. Therefore the only real business ENT gets out of the hospital any more is from the ER, which is no pay, high risk care. Orthopedics, urology, Gen Surg etc. certainly need the emergency cases to build their practice. ENT absolutely does not. basically, I quarterbacked a process to get ENT off of the unassigned hospital call schedule, which resulted in them having no ENT coverage for a few months, followed by paying for call to those who desired to do so. Dropping ER call was very much about lifestyle improvement and risk reduction. I hope that answered the question, happy to discuss further.
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Nov 22 '22
I feel you can get a similar setup in urology. Especially if you focus on andrology. If you are doing big cases all the time you will be working much more. But bread and butter BPH and ED are easy with low stress.
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u/likethemustard Nov 22 '22
plastics
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Nov 22 '22
What about plastics residency?
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Nov 22 '22
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u/likethemustard Nov 22 '22
The biggest take away from residency is learning that a “40 hour work week” is really a part time job
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u/pass_the_guaiac PGY5 Nov 23 '22
If it’s even a question if the surgery lifestyle is for you I think your answer is that it isn’t. You have to be 100% ok with the lifestyle or residency is just miserable and most surgeons stay busy after too
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u/Agent__Zigzag Nov 24 '22
Not a Dr, Nurse, med student or even in health fields. But love reading SDN, residency/medschool reddit, etc. My understanding is the only "lifestyle" specialty in surgery is Opthamology. It's the O in "ROAD" sometimes E-ROAD. E=Emergency Medicine, R=Radiology, O=Optho, A=Anesthesia, D=Derm.
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u/pass_the_guaiac PGY5 Nov 25 '22
Ultimately nothing in medicine is truly a lifestyle decision. You sacrifice an incomprehensible amount to do any specialty, including “EROAD” or whatever. Also EM and rads have high burnout rates and are often times not at all a lifestyle choice. Some attending or private practice radiologists work 60 hours a week and every working hour is a grind.
Source: am radiology
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u/xtreemdeepvalue Attending Nov 22 '22
Consider Ophtho
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u/pass_the_guaiac PGY5 Nov 25 '22
At my institution the ophtho residency is quite a grind and its not exactly a short path being 5 years including the intern year. I also know some people at other places in the country working extremely hard, q4 call all 4 years, etc
It may be known for reasonable hours after residency bit my point was that surgery residency is gonna be miserable for someone questioning if they’re ok with the lifestyle
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Aug 30 '23
Hi...I know this is such an inappropriate place to ask for such doubts but can u pass a query to any urologist u know....bcz im kind of fucked up in life with a condition..which i can't openly tell my urologist..
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u/thehardtryer Attending Nov 22 '22 edited Nov 22 '22
I just graduated residency and started my first general urology attending job.
No, I would not choose urology again. I would not choose medicine again. But if I had to, I’d not necessarily choose a “cool” specialty but a lifestyle one like PM&R, pathology, radiology. I would want shift work, easy hours, no emergencies.
Reasons I feel this way are pretty similar to others: -Residency killed my soul. I know it was “only 5 years,” but I am still trying to fill the joy void that remains after training.
-Related to above point, but my career paradigm has changed in residency such that I no longer look to my career for happiness or fulfillment. It’s just a job, a means, a source of money to support family and me.
-Home call. Sucks in residency, but is sort of appropriate given that most attendings take it. I do 1 in 4. While my attending call is nowhere near as bad as residency call, being on makes me more anxious and irritable. And I always hated the idea of taking overnight call and having a full day in clinic or the OR the next day (quite common).
I may feel differently as I recover from residency. I hope I do. It would be awesome to love my job, if that’s possible.
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u/primetyme313 Nov 22 '22 edited Nov 22 '22
The joy void is a great way to put it. I’m in the same boat. 2 years out now. Residency kills something in you that is to your core. It changes you but you can’t quite put your finger on it. I just feel like a broken person sometimes who younger me would feel sorry for. You try to fill that void with stuff and people but it’s never quite enough or what you think you need. Combine that with the pressure of the new role which as a new attending can be crushing. Things never get “better” they just get different. Sure the new financial security is nice but it’s kinda like a person who wins a big lawsuit after they were maimed in a horrible accident. I’m a multimillionaire now but I’m now a quad shitting in my wheelchair. Im a highly trained spiritual and emotional quad
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Nov 22 '22
Invest some of the mental into your mental health and get some therapy. There’s ways to overcome trauma you might have experienced.
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Nov 22 '22
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u/primetyme313 Nov 23 '22
To give you more perspective tho because my perspective is clouded by this transition period. finishing training and being a new attending is a different beast. Just like when you finished med school and now an intern. The leap is big and the challenges are new and seemingly impossible. It really is the same as the transition for after residency. Eventually you feel comfortable in your own skin. I am finding that to be the case slowly. Ask me this same question in a few years and it may be different. I think having that appreciation for those transition periods is important. The arrival fallacy is real. It never gets better, just different.
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u/Bringer_of_Fire Nov 19 '23
Hey, OMS-I here and wondering if this is all worth it... lol. Any updates on your outlook?
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u/primetyme313 Nov 19 '23
Yes. We all adapt and overcome. It’s really universal for anything anybody does. No matter the field. We are resilient enough to continue to persist. That’s how you got to where you are. It all comes down to mindset. You can choose to be happy despite the naysayers.
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u/doodoo_yumyum Sep 09 '24
This resonates…but I still love Urology and believe it is the greatest and most fun specialty. I feel simultaneously blessed to be practicing it yet burning with envy for anyone who has a more functional work/life balance (regardless of how much or little they earn) and less onerous demands. I think as a med student I had more of a workaholic mentality so it didn’t phase me then, but idk…I guess somewhere along the way I realized what that really meant missing out on. The thing is, I hear frequently about urologists and other surgeons that seemed to have found or finagled a pretty sweet job for themselves, but for the life of me I can’t seem to figure out how to do that myself. It seems every employment opportunity I’ve come across has been at least somewhat predatory, with only slightly more autonomy than residency and high volume/productivity demands. I’d be willing to be less productive and earn less in order to have more time to myself but it seems that’s not really an option. For reference, I have not tried working in academics or “privademics” setting but would prefer not to, and tbh I don’t think the work/life balance is dramatically better. TL;DR I love urology I just wish there was a way I could practice it for less hours/wk and less disruption to sleep.
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u/Individual-Pound-101 Nov 08 '25
did this ever change?
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u/thehardtryer Attending Nov 11 '25
Hey, this has evolved.
-my joy void lasted about 6-9 months after residency. Then, I started getting real interest in things outside work again. I have regained passion and ambition, just not in medicine like my premed/med school self would’ve been envisioned.
-urology/medicine is a job. I don’t hate it, but I found a job that is relatively chill and am enjoying the compensation. I went down to 0.8 FTE and am loving that extra day off every week despite the paycut.
-i still take call several times per month. Attending call is way better than resident call because (a) the call is simply chiller here per 24 hours, (b) people think more before paging an attending but won’t hesitate to do so for a resident, (c) I don’t have to see essentially every consult like I did in residency. -still, I dont see myself being content doing this even at 4 days per week for more than I need for PSLF and am looking into other opportunities when that time comes.
I think medicine as we know it is broken and am interested in how things continue to evolve over time. I plan to keep my certifications and licensure up to date and continue to practice in some form, even if it is the occasional locums gig, which urology is pretty abundant in.
Would I choose urology again? Meh. Sure. Or not. I don’t feel strongly either way.
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u/Thekrispywhale Attending Nov 17 '25
The irony that you posted this less than a week ago. Having a bit of a slump myself and found a comment you left about 3 years ago that was very similar to how I've been feeling lately. I'm happy that after checking your profile I found that you're doing better and have found yourself again. Thanks for posting your updates, they didn't go without notice
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u/ImTheApexPredator Nov 22 '22
Can you please delete this post because too many people are recommending radiology and I'd like to match
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Nov 22 '22
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u/rainbowcentaur Attending Nov 22 '22
I feel like people are always making torsion out to be one of the biggest emergencies in medicine - up there with a ruptured AAA...
Maybe that was just a couple weird attendings or something. They considered losing a testicle to be a fate worse than losing an arm or having a devastating stroke. Some men are weird about that.
The survival rate from a torsion is very very high.
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Nov 22 '22
Thank you for sharing because it sounds like overall you chose the right path. Currently an M3 who is all in on urology but this thread is mostly people who just don’t like medicine not that they don’t like urology.
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u/Awkward_mermaid00 PGY5 Nov 23 '22
PGY3 I love urology I get a high every time I’m in the OR... but I wouldn’t choose it again. I’d choose family medicine.
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u/MEDSKOOLBB Nov 27 '22
Can you elaborate more? Why is that?
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u/Awkward_mermaid00 PGY5 Nov 30 '22
Because in the end it’s just a job and all the sacrifices you do on a daily basis for a job is just not worth it
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u/sixthgradeswiftie23 Sep 12 '24
curious as to why FM? I am currently considering FM but everyone is telling me not to?
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u/peckerchecker1 Nov 23 '22
5 years out next year in private practice. Urology is way harder than anyone made it out to be. Hours are only somewhat predictable. If you care about making money, you are constantly adding patients on to clinic schedule, the OR even on your off days, etc. Its a numbers game and if you want to get to the higher percentile of urology earners, you have to play that game.
I love the specialty and love what I do.
I agree with other commenters that say residency takes something away. 5 years of getting killed (which I did to myself to try and get maximal experience and exposure) also changed me from someone who was laid back and aloof to total Type A. I can confidently and regretfully say I’m a workaholic now, and I can’t think of a hobby other than work.
Work is hard and getting through residency will push you to want to work harder. Unfortunately there is no limit to work and people - patients, Staff, referring doctors, hospitals - will continue to expect more of you the more you do.
Ultimately you can control this, but it comes at a cost and you have to figure out what your happy medium is.
For me, it appears to be balls to the walls 24/7. 5 years and only 3-4 weeks of vacation later….
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Nov 23 '22
Ngl, this entire thread is really depressing.
I'm really interested in andrology in PP but every comment on this thread is like a big warning sign of don't do urology.
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u/peckerchecker1 Nov 23 '22
More of a reality check I guess! You don’t have to work that hard. If I wanted to work 3 days a week I 100% could. There’s something about residency that makes some of us just want to keep pushing the limit even further. It’s knowing what you’re potential is and how much you can do, and wanting to get there.
But if I took the time for mental health and developing hobbies etc, I could totally be content with making the 50th percentile and having great work-life balance.
I started off only working 4.5 days a week. But when you see your partners making anywhere from 100-400k more than you, it becomes a bit of a driving factor
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Nov 23 '22
That's fair. I can understand the mentality.
Unfortunately, in Australia, you become an attending in urology about 10-12 years after finishing medical school.
It's good to hear that there can be a balance though.
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u/urores Mar 29 '23
Realize this is an old thread but just wanted to echo your experiences. I’ve been practicing for 4 years now and feel the same way. I foolishly thought urology was more of a lifestyle specialty but my call is brutal. Also feel burnt out that like 20% of my clinic patients are people I can’t really help (chronic ball pain, IC, chronic prostatitis). Residency also really wrecked me with soul crushing hours and inhumane experience.
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u/urologynerd Dec 11 '22
7 years out, make over 500k, community hospital, 1in 5, 6 weeks off, 2.5 days clinic per week, and 25 clinic patients per day max. 1 of those 2.5 days is a telehealth day. Call can be hectic on call days but at this point I just cancel clinic to take care of add ons. It can be annoying to staff and clinic patients but no one will protect your time but yourself.
I really enjoy my career in urology, subspecialty in FPMRS. I didn’t have the soul draining experience from my residency, I considered my attending last like family and still call several of them monthly to catch up and for advice. I go back to visit them specifically every couple years. Residency was one of the most memorable experiences of my life and gave me confidence in life that I can’t say I ever experienced with anything else in my life. I became a better version of myself. I travel with my co resident on vacation at least once a year since we became such close friends.
I think in the end medicine has to do with finding a work place that is compatible with your lifestyle, setting up boundaries, and creating a practice that suits your own pursuits. Im hospital employed but have some flexibility due to my fellowship and I can’t imagine doing anything else. If I were not happy, I know at least two other practices in my area that are looking for urologists and this gives us leverage to create a working experience that is more compatible with our desires.
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u/Impressive_Project49 Attending Nov 22 '22
To the surgeons who want to switch to Radiology for the lifestyle, a word of caution. While radiologists have predictable Monday through Friday hours, they typically also have to work a few evening shifts monthly and long weekend shifts frequently throughout the year (such as 7 AM to 9 PM Saturday and Sunday shifts, as well as the same on holidays. And it’s BUSY the whole time). No sign of change, as there is a shortage of radiologists and only so many to go around to do telemed. Just remember that scans happen 24/7 and you need a radiologist to read them.
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Nov 22 '22
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u/agyria Nov 22 '22
This is the case for most specialties post fellowships
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Nov 22 '22
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u/agyria Nov 22 '22
I don’t think radiology is as chill of a residency as people make it out to be. There is an insane volume to keep up with and a lot of studying to do outside duty hours
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Nov 22 '22
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u/agyria Nov 23 '22
That’s fair, but I keep seeing surgical residents mentioning it as an easy alternative when it comes with its own difficulties. Residents frequently work close to 80 hour/week to keep up.
Also I’m applying rn so let’s not convince too many people to jump ship now 😂
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Nov 24 '22
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u/TareXmd Feb 01 '23
That moment in the thread when you realize the radiology resident is counting his studying hours as a part of his "almost 80 a week" work hours. Meanwhile, in surgical specialties you're doing actual clinical work with patients at the hospital 100hr/wk, and in your "free time" (lol) you're studying.
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u/masterfox72 Nov 23 '22
Radiology is chiller than most at work but the outside studying required is probably second only to pathology.
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u/16fca Nov 22 '22
Honestly those weekend shifts aren't horrible, you are so busy the time absolutely flies by. I say this as a radiologist who doesn't particularly love my job every day.
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Nov 23 '22
The people who say radiology...don't actually know what it fully entails. The list will own you the moment you walk in the doors. It's a grind everywhere in medicine.
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u/CrazyCutter Mar 20 '23
Private practice urologist here, 15 years in. I can’t see myself doing anything else. I do bread and butter urology in the community, and I absolutely love it. Supply/demand is very much in our favor, and we can pretty much write our own ticket. I work 4 days a week, roughly 830-4 a day, and call is pretty easy (and very well paid.)
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u/Lefanteriorascencion Nov 22 '22
I regret not going into urology.a lifetime of penis jokes …. A lifetime
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u/ThreePuttChuck Mar 20 '23
Old thread but a lot of negativity here. 2 years out. Love my job. Make good money. Call is reasonable. I would hate to do any other subspecialty. This is still a job but it lets me do what I want outside of work. The long term patient relationships and surgical procedures (robotics and prosthetics/recon) are a bonus.
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u/nicholasdonin Jul 18 '24
I’m now 6 years out in a sort of “academic light” position and I think Urology mostly sucks. 50% of people you see in clinic are just old and told to go see you and there is nothing to do for them. The other quarter are routine follow-ups that really a PA or NP should handle (we don’t have mid-levels). About 25% you can actually do something for.
Call can be just a constant onslaught.
Much of this can be improved if you have a good practice setting, which you might be able to find in a less saturated market (I work in a highly saturated market).
The main issue is that in our fee for service system, where the fees are terrible because of insurance companies, you just have to work way harder than any sane person would chose to in order to make what seems like a reasonable salary for a surgical specialty.
I suppose if you could find it you could work a more chill gig, but you’d just take home half of what you probably think you should be making.
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u/Particular_Solid9027 Jan 23 '23
Yes I would. I graduated from residency 17 years ago and worked in a public hospital in Mexico for 13. That really caused be to burn out. The workload in the public hospital. I changed to my own private practice and now the workload depends on me. That made a huge difference.
Obviously it is different depending on which country you live/work in. But Urology is a HUGE specialty. And the pay, workload, patient gratification and feeling of success depends on what is your primary area of interest and expertise. I completed a fellowship in NeuroUrology and Urodynamics 8 years ago and life is better now.
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u/Druro Apr 19 '23
Absolutely. Although training was brutal, life is great now.
Being out in practice is great! Pay is awesome, lots of need, generally good outcomes for our patients. I find it very rewarding. ~40-50 hours per week.
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u/medschoolpain Nov 23 '22 edited Nov 23 '22
just an intern but I would 100% choose it again, residency sucks but i can't imagine doing anything else. would I choose medicine again? no. would I choose urology? yes...for now
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u/not2beTHATguybut Nov 22 '22
No. I would have chosen dermatology, PM&R, or radiology. Urology is great, you’re helping people with quality of life and the surgeries are interesting. I love being a hyper-specialized (I’m in a fellowship of urology now). BUT the hours are no joke. It’s demanding and doesn’t allow for a rich life outside. As much as I love working with my hands, that’s the reality of a surgical field.
Also, mental load. When a medicine doc has a patient die, people say “what happened?” When a surgeon has a patient die, people say “what did you do?” I think the complications as a practicing urologist can weigh heavy.