Sunday, December 28, 2008

Most Stressful Medical Specialty?

Stress is hard thing to judge within a medical specialty. Various factors play a role in creating stress, from the patients and procedures themselves, to one's work environment and career path. I'm not sure how to weight all these factors, but here's the sense I've gotten from the specialties I've been exposed to. 

5 Most Stressful Medical Specialties

1. General Surgery - perhaps I'm biased by the training, but I think given the career, it seems like a lot of stress, considering the income and hours down the road.
2. OB/Gyn - the training is hard, the hours are long, the liability high, and there's relatively less 'control' / predictability over how patients will do from what I've seen. 
3. Internal Medicine - again, just biased by what I see the residents go through. 
4. Surgical Subspecialties - stressful to train, but I think it gets easier in the career itself.
5. Emergency Medicine - while the career is good, I think the fact that these are 'emergencies' is stress inducing on its own, plus who wants to do overnight shifts when they're 60?

As for the least stressful medical specialty, I don't think you can wrong with the old "ROAD" mnemonic (radiology, ophthalmology, anesthesia, and dermatology). Some people would also throw pathology (heh, PATH / ROAD, get it?) and emergency medicine in there as well. While all are competitive to train for, I think the lifestyle down the road more than makes up for it, leading to less stress overall.

What do you think? Perhaps there are stressful specialties that I just haven't been exposed to?  


  1. Anesthesiology is very stressful. Your schedule is better outside the hospital, but the stress when you are working is high.

    1. I was just going to comment and correct that Anaesthesia can be very scary and stressful, its like aviation.
      I agree with all the stressful specialties except for internal medicine, its so chill, but I suppose u are based in USA. we are in Australia. I would replace internal med with Emerg Medicine, and put anaesthesia in top 5 stressful ICU should be there. Surgery isn't really stressful in the same way critical care is. Its extremely demanding but there are down times and moments where you are doing low stress surgery.

  2. It's true that anesthesia can be stressful. I remember being in a CABG case on the anesthesia side. The patient was coming off bypass and the resident pushed something that he was used to pushing, but the CT surgeon wanted it done differently and chewed the resident out because the patient's BP fell. The tension in the OR was definitely palpable.

    However, my list was more about a person's entire week. Even specialties like derm or path have stressful moments, but I think on the whole, their practitioners lead less stressful lives relative to their peers in the fields mentioned above.

  3. I hope to combine Family and Psych or Internal and Psych. Don't ask me how but thats what I would really like!

  4. I beg to differ. I'm a radiologist, and I take ER call and outpatient call. We work 7A to 6P and have to read from home. Almost like 11 hour days. The ER call is brutal. We have to cover 2 busy ER at night by ourselves. Rad isn't what it used to be!

  5. True, but perhaps I should clarify: specialties that are "less" stressful are not stress-free. I just have the impression that the total amount of stress (if you could calculate such a thing) is relatively less in them.

    As much stress as there is in radiology, I'm still willing to bet you wouldn't want to trade spots with an OB/GYN doc, right?

  6. I would never trade spots with OBGYN, ER docs, or any surgical specialties. My respects to them. By the way, my cousin is an opthalmologist, and he suffers quite a bit too. Despite former beliefs, "rad is not a cush job." High pay, but not easy pay. Declining medicare reimbursements is making it tough for everyone. Work more for less pay.

    I only think only derm and occupational medicine are relatively stressless nowadays.

  7. I think you underestimate the stress in performing anesthesia. It looks easy when everything is going smoothly, but the patient's life is completely in your hands, there is so much potential for disaster, and bad things happen regularly. Internal medcine and many of its subspecialties would be much better: office hours are rarely life and death situations. The residency can be difficult, but it's short compared to many others, and the internship is the worst.
    That's all from a surgery resident's perspective.
    Oh, and you forgot to mention neurosurgery as absolutely the most stressful and demanding at all times.

  8. As for difficult specialties, how about interventional cardiology? The training is insane, the hours after training remain's like being a general surgeon, lifestyle-wise.

    Any specialty can be relatively low-stress if you're willing to find the right practice environment. Even in fields like internal medicine, you can choose to work less, or in less stressful environments, for less pay.

    Several IM subspecialties are quite low-stress.

    Your classmate

  9. Speaking of stress, personally, I find it less and less rewarding being a physician. People are more demanding, lawyers more litiginous, insurance less willing to pay. No matter how much you love helping people, to some there comes a breaking point. I know many of my collegues and myself included who will work full time for 10-20 years, save, and then move to part time or quit. Anyone else feel the same way?

  10. I'd have to agree with you, and I'm not even out practicing yet! Speaking with some of my friends who are also about to enter residency, it's hard to see ourselves doing this for another 50 years. I hope I find a nice practice environment where I'll be happy to come into work and this won't be an issue, but it seems like such places are harder and harder to find.

  11. it si not only the anesthesia but also intensive my opinion this is the most stressful and most difficult specialty,because anesthesiologists are those who should make decisions in a very short time that is critical almost always.Besides,the intensivists are those MDs who MDs from any other specialty call when their patients become unstable.All in all,anesthesiologists and especially intensivists (this is one specialty) are the last and final instance in medical care and specialists from any other specialty call them for advice when they have problems they cannot solve by themselves!

  12. Hands down pediatric or congenital heart surgeon by miles! There is no other specialty that requires a minimum of a nine year training process for good reason. The decision making is complex, the technical demands immense, and care of the infant challenging. The stress of getting a child through a major operation is unparalleled. Although it is definitely a team effort, the 900 pound gorilla is on the shoulders of the surgeon.

  13. Anesthesiology is least stressful?! Only a surgeon could say that! Let me tell you something about Anesthesiology... It is an ugly specialty, and it one of the most stressful specialties... If you're lucky enough, your day would be boring;on the other hand, having action during surgery/anesthesia means the patient is unstable and needs constant supervision and intervention! While the surgeon operates on certain hole/organ, the anesthesiologist must take care of the patint as a whole... When the surgery is over, the patient has to be able to know his name... If he doesn't, it means he's a vegetable... For most patients, the process of keeping them alive is very simple... But for some, it is mind aching and stomach "ulcering"! Of course there are many other specialties that have the stress level as high as anesthesia, although few do! But in Anesthesia problems need immediate solutions... And while the surgeons keep pushing for time and relaxation, the anesthesiologists oscillate between stomach ulcer, heart attacks, strokes and last but not least, a career change... I chose the latter!



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