How Hard Is It to Specialise in Medicine?

Mikey88 on 24/08/2019 - 17:37
Last edited 25/08/2019 - 10:47

Hi all,

My nephew is studying medicine at the moment (3rd year out of 4 year degree) and he is hearing a lot from his peers that specialising nowadays is just ridiculously competitive, needing PhD's etc to enter some training programs. There is also so much in the news about the surplus of junior doctors due to too many medical schools, with there being a massive bottleneck as a result.

He's worried about how potentially bleak his career will be. With no one else in the family coming from a medical background we are all a little uncertain of how things will work out. One of the reasons we were happy when he was originally accepted into medical school was the traditionally good job security and benefits, but we're not sure how realistic this is looking now.

I know there some doctors on here, from previous forums, would anyone be able to shed some light on what the current situation is like for newly graduating medical students in terms of job prospects etc. Also if anyone has any experiences with competing for selection into speciality training? Are there 'easier' specialities to get into? What are the drawbacks of the easier ones?

He says he is interested in Ophthalmology if that makes a difference but from how things look, we think as long as he can get into a stable job we'll take it.

EDIT: Thanks for the responses so far. Out of curiosity I've decided to add a poll for those who are in or finished speciality training - How many years did it take you to enter your speciality training program after finishing medical school?

Poll Options

  • 8
    <2 years
  • 24
    3-5 years
  • 7
    6-8 years
  • 55
    >9 years
Education & Work

Comments

  • [Deactivated] on 24/08/2019 - 17:41
    +1

    You don't get a phd to enter a training program, that's a different educational direction. It is extremely competitive though. You're competing with the best of the best, especially for the desired specialisms. Many of those professions lead to 7 figure pay days, the colleges want people who are exemplary.

    • Deridas on 25/08/2019 - 13:30

      "Many" lead to 7 figures a year as a specialist?

      Please enlighten me on which speciality is that, how much hours per week, and how many % of doctors ACTUALLY earn 7 figures. I should change my day job.

      • [Deactivated] on 25/08/2019 - 14:19
        +13

        Yeah, its not that easy.

        Many experienced specialist doctors in private practice make 7 figure incomes, Obgyn, plastic surgeons, orthos, the list is long. ATO figures don't tell the true story. When you're on 7 figures, there are many ways to minimise your tax bill.

        • AAAB on 25/08/2019 - 18:40
          +1

          The 7 figures are almost exclusively in private I'd say

          • [Deactivated] on 25/08/2019 - 19:12
            +8

            @AAAB: Well yes, that's why I said it.

    • KevinL on 25/08/2019 - 19:37
      +2

      In the last 5-10 years there has been a bit of a arms race and it is not inaccurate that many people are doing higher degrees (including masters and PhDs) in order to differentiate themselves from the crowd and make themselves more competitive for training - ophthalmology is a fairly good example.

      • TheCutter on 27/08/2019 - 09:02

        This is true.
        But its a bad show to have this thread on a site like this.
        It just gets chumps who know nothing about hard work getting jealous about the money docs make.
        FYI the party is over for medicine for many reasons and its a grinding hard job where your family does suffer.

        But if I run into OP's relative I'll make sure they suffer for this ozb outrage.
        /s

  • paraneoplastic on 24/08/2019 - 17:53
    +10

    Depends on which speciality,

    There are still areas of need, like psychiatry and anesthetics

    I can give some info about surgical pathways. Depending on the sub spec, getting a PHO role (i.e. unaccredited registrar) is not very difficult, as there is usually a large amount, however, getting accreddited is the challenge, and that's were research and CV stuff matters.

    'Easier' specs: GP, psychiatry, anesthetics, gen surg, gen med, rehab med, ortho (unaccredited role), radiol

    'harder': neurosurg, urology, rheum, derm, opthalm, interven radiol,

    BPT (basic physician pathway) is not as competitive or difficult to get onto, and there is usually more job security.

    Opthalm, is a special one, as i'm sad to say, it does really help if you 'know someone' or have connections. It's similar to the other highly specialized specs like neurosurgery, urology, rheumatology and dermatology. Connections matter, as getting a unaccredited role is extremely difficult, even if you are above the rest, as the competition is immense.

    However in saying that, with hard work and dedication, anything is possible. For whatever, he decides, getting into research early is always advisable, no matter how trivial (i.e. even if a 4th, 5th, 6th author). I wouldn't get too worried about the whole too many jnr dr's thing, as the new med schools that have opened are yet to see any graduates for at least another 5 years, as such he will be in the clear by that stage.

    • solidweiner on 24/08/2019 - 18:52
      +12

      I'd probably remove anaesthetics/general surgery/radiology from the 'easy' category. In today's market they are by no means easy to get in. The ones who get in are usually excellent or have fought tooth and nail to gain entry. And BPT can be competitive depending on the network.

      • paraneoplastic on 24/08/2019 - 19:12
        +3

        I put them as easy since to my understanding there is no nationwide ‘limit’ on adv trainees compared to surgical which there is a college mandated limit and is done centrally (I.e irrespective of caliber of applicants only 3 got chosen for urology last year)

      • gleason50 on 26/08/2019 - 21:25

        The College of Surgeons report on the number of offers they give in. The number of applicants vary. Paed Surg I guess could we be the most competitive since they have only taken 1 candidate in the last 2 years (2018 and 2019)

    • Mikey88 on 24/08/2019 - 19:35

      My understanding of unaccredited positions is quite vague. Do they increase your chance of getting into an accredited position compared with people applying having not done an unaccredited?

      • paraneoplastic on 25/08/2019 - 01:33
        +2

        It only applies to surgery. You need to get an unaccredited role prior to exams/interviews to get onto the Surgical education and training (SET) program (as most require 1 - 2 years worth of experience in the field). So to answer your question, yes it does by 100%, as if you cannot get into the SET program without being a unaccredited trainee first.

        • sjtem3 on 25/08/2019 - 09:05
          +3

          Unaccredited positions apply across the board, not just surgical training. I have many colleagues who have completed several years of unaccredited work in order to apply successfully for anaesthetics training positions. Yes they increase your likelihood of successful registrar application.

          Your nephew's perspective is very important in determining whether medicine has the security he wants. I would argue that the job/career security in medicine is top notch, because as a junior doctor I am routinely bombarded with offers for locum work and simple HMO positions. There are options everywhere. What becomes difficult is if he is 100% set on ophthalmology, in which case there are no guarantees. Any training position will be challenging to get into (though not impossible) and the careers with better lifestyles (typically derm, opthal, radiology, anaesthetics) are to my knowledge more difficult to successfully gain entrance to.

          If he is happy with a fulfilling career in a well paid job then there's no worries with medicine. If he's 100% set on ophthal it'll still probably work out, but with a lot more time/effort, and if he's wanting even more job security and remarkably high income without being flexible then medicine is likely not for him.

          • Mikey88 on 25/08/2019 - 09:30

            @sjtem3: How does locum work work? From my understanding you go somewhere for a short period of time, kind of like a relief teacher example? But I mean this would probably have to mean that you are currently unemployed right? Is it tough to get full-time permanent positions even as a junior doctor?

            • sjtem3 on 25/08/2019 - 10:18
              +2

              @Mikey88: Locum work is short-term contracting to fill in available positions wherever needed. Relief teching is a good example, though medical locuming comes with financial incentives.

              I'm currently employed full time as an anaesthetics registrar, and am able to locum wherever/whenever I want provided it fits with my roster. I know a few colleagues who decided that they wanted a year off and proceeded to locum on and off for a year travelling in between shifts, because the income from locuming could support their lifestyle.

              In Victoria all medical graduates who are citizens are guaranteed full time positions at least for the first year (or at least that was the case when I graduated). I have never felt that I was at risk of not having a full time job. Junior doctors are a sought resource, particularly for rural hospitals.

              • Mikey88 on 25/08/2019 - 12:49

                @sjtem3: Ahh that makes sense, thanks for the info. The guaranteed year you're talking about is that the intern year or the year after that?

    • MessyG on 24/08/2019 - 22:31
      +10

      Not sure I agree with this one. Anaesthetics is super competitive and even if you get on, those exams are career changing. GP becoming increasingly so. I wouldn't include unaccredited anything in that list because it's not a training programme and not a guarantee they'd get one the way things are going. And while BPT isn't too hard to get onto, getting the subspecialty you want post-exam can be. Cardiology and geriatrics have the two biggest intakes and both now are oversubscribed, to say nothing of the lower-intake ones.

      Psychiatry (sadly) still easy to get onto, ditto rehab med.

      That said I wouldn't go for a specialty based on how easy it was to get on. The undersubscribed specialties don't need anymore disillusioned and disinterested doctors going through them!!

      • paraneoplastic on 25/08/2019 - 00:44
        +1

        Fair points,

        though, i was doing all relative to each other spec - as in GP is easier than psych which is easier than rehab which is easier than so on and so forth

        agreed on not going to a spec based on ease or pay.

      • unelectric on 29/08/2019 - 21:21

        I gotta ask, are you the MissG whose section 2 essay writing advice I occasionally refer to?

    • Jcww on 25/08/2019 - 09:07
      +1

      Ahaha hahahaha. Anaesthetics is easy. Ok. It’s probably one of the damned hardest!!!! Maybe not to get into, but to stay in. Jeesus, you need to know your sh!t. Let’s keep in mind, these people are in control of the abc (airway breathing circulation). Not an easy job to get into and pass all the assessments and training

      • paraneoplastic on 25/08/2019 - 18:06
        +5

        Calm down mate, i never said it wasn't a vitally important job. I was doing it relative to opthalmology…

        Yes i agree, like with most specs, certification is the difficult part, however there are some which are even hard to get a PHO/unacreddited role in.

      • Save Medicare on 25/08/2019 - 20:57
        +6

        Just do ED instead

        Airway
        Breathing
        CT Scan

        • solidweiner on 25/08/2019 - 23:20

          I seriously need to consider retraining now…

        • paraneoplastic on 26/08/2019 - 14:30

          and

          Dont
          Eever
          Forget
          Glucose

    • blackorange on 25/08/2019 - 17:24
      +1

      Anaesthetics is not an easy specialty to get into, neither is radiology

  • whooah1979 on 24/08/2019 - 18:00
    +2

    I’m probably wrong, but my understanding is GPs are specialist medical practitioners and may treat a wide range of illnesses.

    • serpserpserp on 24/08/2019 - 22:17
      +5

      They do a training program just like any other specialty. I think many years ago this wasn't the case though and thus the stigma of them being "lesser" which is really unfounded these days.

      • Deridas on 25/08/2019 - 13:35
        +2

        GPs now have their own college and have their own training program, but in terms of the amount of training, assessments, study, it is significantly lower of a hurdle compared with "other" speciality colleges.

      • BestofOZB on 25/08/2019 - 19:33
        +1

        Hence the speciality "family medicine" elsewhere is recongised better, I think the term "General" practicioner does not do them justice.

  • profar on 24/08/2019 - 18:14
    +2

    Reports everywhere that huge supplies of Uni students are going to end up in their life time worst than tradies .
    Blame it on the culture of parents believing the best education leads to the best jobs .
    Don’t worry with shortages of tradies they can do a course of 1 yr to outperform many doing 4- 8 yrs at Uni lol.

    Simply supply and demand .

    • whooah1979 on 24/08/2019 - 18:26
      +2

      tradies they can do a course of 1 yr

      Which trade in Australia requires only one year of Tafe?

      • profar on 25/08/2019 - 09:15
        +2

        100's of courses under a year .

        But I believe the stats are more important :

        https://www.tafecourses.com.au/resources/what-are-the-highes…

        Nice one there for 33 weeks :

        Certificate IV in Work Health and Safety

        33 wks
        Average Course Length
        $90700
        Average starting salary
        Job Outcomes
        Work Health and Safety Systems Officer
        Career Path
        Business Services

        employed or in further study
        95%
        1 year after training

        • whooah1979 on 25/08/2019 - 09:18
          +1

          100,s of courses under a year

          Please name one trade that may be completed after one year by attending TAFE.

        • whooah1979 on 25/08/2019 - 09:23
          +2

          Certificate IV in Work Health and Safety

          This is not a trade .
          https://training.nsca.org.au/training-courses/whs-qualificat…

          $90700
          Average starting salary
          Job Outcomes
          Work Health and Safety Systems Officer

          The starting salary for green safety supervisors are no where near $90k p/a. It's closer to $200 p/d + super.

        • SupeNintendoChalmers on 26/08/2019 - 13:22

          employed or in further study 95%

          lol, doesn't say that 95% are not flipping burgers

        • brad1-8tsi on 28/08/2019 - 08:51
          +1

          100's of courses under a year .
          But I believe the stats are more important :
          https://www.tafecourses.com.au/resources/what-are-the-highes…
          Nice one there for 33 weeks :
          Certificate IV in Work Health and Safety

          I have a Cert IV in WHS. It's not a trade. I took 4 classroom days and a significant amount of "show knowledge and competancy" to get mine.

          My trade took me over 1000 hours of classroom training and 3500hrs of on the job training. Even then there are only certain trades where you walk straight into "big money". I made all mine working 50-60 hour weeks for the first 15 years. The green was all in the overtime/extra hours. My back hurts just thinking about it.

          And then I did another 2000 hours of classroom work to get a job where I earnt good money without the overtime.

    • [Deactivated] on 25/08/2019 - 09:14
      +4

      Simply supply and demand.

      It's not.

      Tradies are protected. You can choose to see a chiropractor for problems. I can't get a random person to change my light fittings.

      If you think tradies would be earning anywhere near their current rate if anyone can attend short courses to do basic work for themselves, you're dreaming.

      And what a load of croc the apprenticeship system is. Why should aspiring tradies be limited by their ability to find a mentor. Remove the selection process and make the qualification process a hurdle system and we would have so many tradies the market becomes true supply and demand.

      • brad1-8tsi on 28/08/2019 - 08:53

        Plumbing and sparky are both highly protected.

        Carpenters, motor mechs, autoelecs and all the rest, not so much. There are plenty of journeyman (unqualified) "tradies" out there.

    • Thenarrator on 26/08/2019 - 22:52

      FU*K TRADIES UNION.

      • brad1-8tsi on 28/08/2019 - 08:54

        What is a tradies union?

  • raun on 24/08/2019 - 18:27
    +7

    He has plenty of time: he hasn't even graduated yet. He should be resume building if he can, and when he graduates (or even as a final year medical student) he should be trying to network with people in the specialty he is interested in.

    As mentioned above, some specialties are more competitive to get into than others. Some people who don't know what they want (or have some inkling) often rotate around as residents for a a year to a few years to get an idea (i.e. PGY 1 is intern year and mandatory, PGY 2-4 to get a feel of things). Some people who know exactly what they want, try to get a job in their specialty of preference in second year (or in rotations that lead towards building a better application for subsequent years), so not getting in right away isn't necessarily an issue. More time doing different things will never go to waste, because a well rounded doctor is always a better doctor.

    As a doctor, there will always be jobs. The only problem is whether or not they are acceptable to the candidate. Non-training posts or rural posts are always available; they just might not be where you want to be. I usually get a few emails each week from agencies offering shifts or jobs outside of capital cities.

    Easier specialties to get into doesn't imply that they are bad. They're just specialties that aren't popular. Specialties that are often associated with good financial remuneration or have good lifestyles (i.e. minimal to no on-call) are often competitive (i.e. ophthalmology, dermatology). These days, every branch of medicine is considered a specialty, as there can be so many subtleties, and this includes general practice medicine. Some "easier" specialties have poor quality of life (i.e. physician training), high burnout rates (i.e. emergency medicine), or worse financial remuneration (i.e. GP).

    At the end of the day, it's going to be something he's going to have to do for the rest of his life (should he choose to stay in medicine). A somewhat idealistic view of the situation would be that he shouldn't worry about jobs, but rather try to find something he enjoys. This is particularly true AFTER he graduates and gets a feel for how specialties are as a team member rather than an observer. With time and effort (and luck or connections), almost everything is possible. He shouldn't settle for something he doesn't enjoy, as most specialties have some sort of significant problem (whether that's shift work, long on-call hours, or high work load), and having to deal with that every day until he reaches consultancy (and where life arguably becomes better) can be a long and painful road if he hates it.

    • Mikey88 on 24/08/2019 - 19:32

      Do you have any recommendations for resume building? From what I know, research seems to be highly valued. Is there anything else that would give an applicant a better chance?

      • MessyG on 24/08/2019 - 22:36
        +2

        The way resumes are ranked (in physician training (medical specialties) anyway, not sure about surgical or other specialties like opthal is that teaching is most highly valued, followed by committees and representation, quality assurance, awards, professional development, and lastly research.

        My advice would be to seek out extra teaching opportunities, get on some sort of quality control or governance committee or do an audit, don't worry about awards (they just happen), and do a course or go to a conference. Not all at once! Also just be friendly and keen to learn and help out colleagues.

        If I could give myself one piece of advice for my intern self, it would be to build relationships with everyone. Not just with other doctors - get to know the nurse consultants, the GP liaisons, all the allied health. I did this to some extent but knowing know that many consultants grew up in these hospitals and have long term relationships with everyone all the way to the cleaners, means that everyone talks about you to them. And you want the general chatter to be positive.

        • Mikey88 on 25/08/2019 - 09:25

          Thanks for that info! I will pass it on.

      • Save Medicare on 25/08/2019 - 20:57

        Do AMSA / medsoc

  • dcep on 24/08/2019 - 19:29

    the money is on marijuanalogy

    • MessyG on 24/08/2019 - 22:37
      +1

      Bane of our existence!!! Cannabis oil messes with the pharmacology of so. many. drugs. Not against it per se but when a sick person is on multiple essential medicines, cannabis oil changes their levels making the ineffective or poisonous.

  • screensaver on 24/08/2019 - 19:56
    +1

    What about oncology, new treatments are coming in like immunotherapy or I met a doctor doing general clinical trials, that is popular now. I went for screening for one. Or cardiology, my mum had a heart valve issue they wouldnt fix because too old for surgery and she died from heart failure. She would have lived with the valve, and wanted to go on. Or paediatrician or geriatric nedicine. Thre is a trial going on with dementia where they sniff something, cant remember what it is but I wrote it down, and it relieves something. I found it, they sniff insulin and it relieves some kind of demented hysteria, I didnt write down the exact condition. The cause of it is actually a lack off insuln to the brain. My mum had those episodes

  • fossilfuel on 24/08/2019 - 20:48

    He says he is interested in Ophthalmology

    My dad went to an opthalmologistat his private clinic a few times. Whilst the opthamologist booked patients up to 5PM, dad was seen at 9:30PM and there were still a few patients to go. This happened every day and the clinic would open at 9AMish and close at 10PM, 5 days a week. They'd make a killing tho but the hours are horrendous.

    Also if anyone has any experiences with competing for selection into speciality training? Are there 'easier' specialities to get into? What are the drawbacks of the easier ones?

    GP is much easier to get into. I think once you're done with your internship (1st year out) or a year or so in residency (2nd year out), you can apply for GP training (3 years total). Very flexible hours, good pay and flexible workplaces.

    • fantombloo on 24/08/2019 - 21:30
      +2

      Grossing tens of thousands of dollars in one day makes a 13hour workday somewhat forgivable.

    • serpserpserp on 24/08/2019 - 22:15
      +1

      GP is much easier to get into. I think once you're done with your internship

      Or do pathology and make even more cash.

  • serpserpserp on 24/08/2019 - 22:13
    +2

    He says he is interested in Ophthalmology

    Yeah and so are most of the medical students that want to be rich beyond their wildest dreams. They don't take many into the training programs and yes, they do prefer PhD's. Just tell him to be REALLY GOOD at his rotations and get to know people because PhD or not, unless you are brilliant at the job, they still might take family over you if their qualifications are just as good.

    Most people go into medicine thinking they are going to get into plastics/opthal/derm/surgery because its prestigious (to other doctors and thus medical students) but they are hard places to crack and not a lot of opportunities so you really have to work your guts out and network like crazy to get in.

    Other specialties still pay great once you become a consultant, even a GP can earn excellent money if you get into the right stuff or as the theme in this post has been, are really good at what you do.

    • Mikey88 on 25/08/2019 - 12:47

      unless you are brilliant at the job, they still might take family over you if their qualifications are just as good

      The sad reality of nepotism (for those without the family connections) :(

      • serpserpserp on 25/08/2019 - 13:21
        +1

        The sad reality of nepotism

        So be better than them.

        It happens in all jobs. Sometimes a workplace might need gender balance so they'll take a man/woman over the other similarly qualified person, sometimes it might be based on the way they look, dress, friendlier disposition, or even what football team they go for. The only way to overcome these things is to be truly exceptional.

  • MessyG on 24/08/2019 - 22:26
    +5

    It really depends on the specialty - ENT is ridiculous, there were 6 training positions Australia-wide this year in spite of the years long public waiting lists.

    Opthal is very hard to get onto but it is a matter of playing the game. Doing opthal releated research in med school, trying to get rotations in clinics so you can get known is a good start, as is being willing to go anywhere in Australia to get the job. A good friend of mine did a PhD first and still didn't get on, ended up going interstate and getting a job there, then transferred back here under the same training program. Neurosurgery is quite ridiculous too but again if you're willing to play the game and be willing to go anywhere and do the unaccredited job somewhere regional but with bosses on the interview panel/connections back in the city, you can jump the queue so to speak.
    GP training is getting competitive now too - the entry process has become a lot more stringent, I believe it's now a multiple choice plus a multiple mini interview situation, and once you're on, it's 3 exams to get through.

    It's really really important not to get demoralised though because someone has to get these jobs and being keen, willing to learn and easy to get along with takes you a really long way. That whole idea of having to be a super impressive font-of-all-knowledge sort is really outdated. Everyone getting through these days is good, their knowledge is good - it's how they treat their colleagues and patients that is the big separator now.

    (Tell your nephew to do physician training though - it's the best!)

    • Bozman on 25/08/2019 - 08:18
      +2

      This is what I find interesting. As a non-medico (who actually works in finance), why would they only take 6 ENT if there’s huge need? I’m presuming there’s more than 6 applicants of sufficient skill, but seems crazy to arbitrarily limit intake like that. That just keeps pricing high, and limits the effectiveness of the system. Although that may be their intention.

      • [Deactivated] on 25/08/2019 - 09:27
        +4

        It is partially true that it is to keep the market controlled.

        It is also true that there is a limit to how many can be trained.

        Many specialist do not want to teach and factually, in medicine, you cannot (or really should not) learn through trial and error. If there simply aren't enough facilities, ie hospitals and patients, to train more ENTs, simply increasing the number of specialists in training is just diluting the quality beyond what is usable.

        I'd rather have six good ENTs than 7 and some of them never having completed certain procedures.

        Having said that, a lot if protectionism is the result of Medicare. Most patients do not see the real cost of medicine hence many do not complain. Most complaints are made out of envy. "my surgeon earns too much". When people cannot afford to seek treatment and doctors have empty books, the costs will be adjusted to meet in the middle.

    • Mikey88 on 25/08/2019 - 09:23

      I will pass it on. What makes you say physician training is the best? :)

      • MessyG on 25/08/2019 - 10:28
        +2

        We're all highly biased towards our own choices hah! In my highly biased opinion, physicians are excellent advocates for their patients.

        • paraneoplastic on 25/08/2019 - 18:09
          +1

          This is really true, it saddens me how callous most surgical consultants are towards patients, particularly in the public system. Not the same story with physicians, most actually have bed side manner and people skills lol

        • kiitos on 25/08/2019 - 20:49

          What is a physician?

  • poboy on 24/08/2019 - 22:49
    +3

    Reminds me of my favourite comedy skit:
    https://youtu.be/THNPmhBl-8I

  • Eeples on 24/08/2019 - 23:12
    +1

    He says he is interested in Ophthalmology if that makes a difference but from how things look, we think as long as he can get into a stable job we'll take it.

    Unintentional pun.

  • profar on 25/08/2019 - 09:32
    +1

    A small % will get that great paying job its just the large behind them that will suffer with decent qualifications and no job unless down grading to something that's in demand .

    Ultimately wasting all the time and $$$$ that could have been better invested by some simply figuring out jobs that are going to be in demand in the future .

    • whooah1979 on 25/08/2019 - 10:00
      +1

      Having a Dr. in a title opens doors that other titles can’t.

      • Ozpit on 25/08/2019 - 11:00

        This ^. Literally. And it doesn't need to be a medical doctor. A mate of mine has a PhD (i.e. doctorate) in Information Technology and when he travels he always whacks the Dr in front of his name. He says hotels can always find a room for him, and ditto for other bookings, e.g. tables at restaurants, etc. He says hotel desk clerks and concierges often refer to him as 'Doctor'. He thinks it's a laugh. What's more, he doesn't even work in the IT industry anymore. Yeah, being a 'doc' has its perks.

        • KSMLJ on 25/08/2019 - 19:16
          +7

          Its all fun and games until someone collapses, someone screaming for a doctor in the house, and everyone else looks at you.

          • Ozpit on 26/08/2019 - 09:18
            +1

            @KSMLJ: Yeah, I know. I keep telling him to stop walking around in a white lab coat with a stethoscope around his neck. It gives the wrong impression.

  • Deridas on 25/08/2019 - 14:35
    +1

    I'm not sure why as an uncle/parental figure you're worried. As with all other careers in life everything is competitive, and generally regulated by supply and demand.

    If your nephew is already worried about are potentially bleak future in medicine/speciality, then speciality training really isn't for him.

    There are very few other careers out there which guarantee a year of employment after University, the most transparent recruitment process (dates, numbers, rates of pay, criteria) are publically announced).

    Tell your nephew to be thankful for where he's at, and enjoy the training process.

    • Mikey88 on 25/08/2019 - 15:57

      As with all other careers in life everything is competitive, and generally regulated by supply and demand.

      I agree with your statement and appreciate your thoughts. He is thankful that he is in medical school given it took a fair few tries to get to this stage! I didn't say that we as the family were overly worried at this stage - more just unsure of how the profession will be going forward for new graduates given the increasing competition.

  • Baebs on 25/08/2019 - 17:02
    +3

    Word of the mouth: on average only 1 person a year gets the chance at Ophthalmology in AU and that's with the right "connections". It's not surprising to see family clans for specialties as well (Ophthalm esp)

    • Save Medicare on 25/08/2019 - 21:14
      +4

      Certainly know a father and son in VIC and a mother and daughter in NSW. Same goes for any competitive specialty though. Having a dad who is an orthopod is much better for getting onto ortho than having a PhD and 10 papers.

  • blackorange on 25/08/2019 - 17:23

    It always has been and always will be extremely hard to get into high earning specialties, of which ophthalmology is high on the list if not top of the list. If your nephew is serious about it he will be facing a significant amount of pre training work to outshine the other candidates. It helps if he starts getting to know as many people in the specialty as possible and start doing research in ophthal. If he's interested in one particular aspect of ophthal, doing a PhD in that is one of showing commitment to the field. There are for sure a lot of graduates now as a result of the government's knee jerk bandaid increase in med student places. Most graduates will find jobs, just a question of what & where & degree of desirability. Ophthal is in a different basket to "getting a job as a doctor" though.

  • [Deactivated] on 25/08/2019 - 18:52

    First, there is so only so much govt funding available to open new registrar training roles in certain specialties.

    Second, this is a reality for the above:
    "specialising nowadays is just ridiculously competitive".

    Third, getting accepted is one thing, passing the exams is another. Only 60% pass their final exams for a specialty I personally know about.

    Fourth, nepotism is real, but those who really stand out from the rest and make a lot lot lot years of sacrifices and hard work, even without any Doctor family members worldwide, they can still get into the training and pass all exams.

  • [Deactivated] on 25/08/2019 - 19:04
    +5

    Life real example:
    2005 finished uni.
    2006 intership
    2007-2008 rmo 1 & 2
    2009-2011 phd
    2012 accepted to training plus finishing thesis
    2016 finally passed final exams and started to live a normal life.

    • Adoses on 25/08/2019 - 19:24
      +2

      My god thats over 15 years of life to get to the normal life. And those are most people's best years of life.

      • [Deactivated] on 25/08/2019 - 19:33

        And oh, she spent 8 years (1998-2005) at uni doing 3 degrees too.

        • BestofOZB on 25/08/2019 - 19:42
          +1

          But why does she charge so much? And not offer a refund if the back pain doesn't get better???

          • [Deactivated] on 25/08/2019 - 19:44

            @BestofOZB: Sorry, she doesnt do back pain. It is actually as low as $230 for new consult but you get $72 medicare rebate with a new gp referral.

            And 3 months wait.

            • BestofOZB on 26/08/2019 - 08:23

              @[Deactivated]: Now that you live a normal life, you need to spend more time on OZB lol. It is a common meme now that people here complain about how much doctors fees are, one even suggested on another forum that doctors should offer a no-fix no-fee service (back pain forum), hence the sarcasm 😅

              • [Deactivated] on 26/08/2019 - 08:34

                @BestofOZB: And what they (usually non business owners) dont understand is, there are admin and nurse wages to pay, super guarantee to pay, premise rent, huge indemnity insurances, and many other things.

                Whats left for the doctors is actually less that what people tend to believe.

      • Blitzfx on 25/08/2019 - 19:37
        +3

        Yes, and that is why they get big money too.

        Sometimes I hear people complaining about paying $300 for 15-30minutes of a doc's time for irrational reasons.

        • Adoses on 25/08/2019 - 20:14

          Oh I understand they deserve big money. I have many doctors in my immediate family. But none spent 18 years to finally start getting a normal life. Thats just insane.

          • [Deactivated] on 25/08/2019 - 21:04

            @Adoses: They must have better priviledged life and support :)

            She has no family members worldwide who is a medical doctor.

          • HighAndDry on 26/08/2019 - 10:26

            @Adoses: It's a bit of how you look at it. If you think your "normal life" starts only after you get your specialty, you're going to suffer. But people live normal lives during these years too.

            It's no different from say, aiming for partner at an accounting or law firm. You're still living while you get there.

            • [Deactivated] on 26/08/2019 - 10:45
              +1

              @HighAndDry: Biggest difference is, to become an accounting firm partner if any sizes (small to Big 4) you dont have to sit for 8 hours of written exam and 2 days of practical exams.

              • HighAndDry on 26/08/2019 - 10:46

                @[Deactivated]: True - it's not a perfect analogy. Just a comment as to the perspective of "normal life" only starting after obtaining the specialty.

      • aliam on 27/08/2019 - 14:43

        I missed my high school 20 year reunion because I was doing my final specialist exam that weekend. I will never do another exam for the rest of my life.

    • solidweiner on 25/08/2019 - 23:29

      This is a bit more of a realistic view. For those who enter medicine purely for financial reasons, they need to read basic economic theory and consider the opportunity cost of all those years. And then decide if it's still worth it.

      Interestingly enough, most of the medical students I have been involved with think it's a lot easier than it actually is.

  • Save Medicare on 25/08/2019 - 20:46

    A colleague got onto ophthal pgy3 for Pgy4 this year. Highly atypical. You'd be looking at getting on pgy8+, that is if you ever get on

    • bs0 on 26/08/2019 - 02:15
      +2

      I know someone who is PGY2, who got on for next year. Extremely extremely atypical. She's been gunning for it since end of med school
      - masters, research, volunteering every year overseas multiple times, committees
      Another guy I know PGY2 this year, has finished his PhD this year, whilst working through internship/residency year. Going for SRMO next year, and program the year after.
      They're pretty damn dedicated.

      Then I have another mate who wants to do opthalmology…. but also radiology… but maybe anaesthetists. Good luck to him, if he hasn't even committed, he's way too far behind.

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