By Joe Dyton, WCI Contributor
Most jobs in the medical field come with some level of stress. Regardless of the specialty, a physician has someone’s health—or even life—in their hands at any given time. That thought alone can make the job stressful. Throw in the long hours and the fact that, at times, there aren’t enough physicians to treat a growing number of patients, and it’s no wonder that people consider leaving the profession altogether.
While medical specialties aren’t without stress, there are some fields that are a little more easygoing than others. If you’re considering a medical career and its high-earning potential and you need to pick a specialty or you're a current physician who wants to switch fields, Medscape has released its 2023 Physician Burnout & Depression Report. In the report, 53% of doctors said they were burned out. Compare that to the 2018 Medscape survey when only 42% said they were feeling that way.
Here’s a look at some of the most and least stressful medical specialties, according to that survey.
Least Stressful Medical Specialties
Again, a profession where someone’s health is at the mercy of another person’s job performance won’t be 100% stressless. Fortunately, the medical field offers an array of specialties that range all across the stress level meter. Here are some of the less stressful medical specialties.
Psychiatry
The psychiatry field often pays well, and the hours are not as abundant as in other medical specialties. As more focus is being put on mental health, psychiatrists are in an in-demand profession, minimizing worries about job security. Additionally, this field is one of the few in the medical field that can be done virtually. With that in mind, a psychiatrist has the flexibility to treat patients from their own home, their practice, or a combination of the two. All of it offers the opportunity for a strong work-life balance.
Dermatology
Similar to psychiatry, the dermatology field typically offers a set number of office hours to treat patients. The less emergency-based atmosphere provides dermatologists an opportunity to form a stronger connection with their patients. Additionally, dermatologists also have high earning potential (an average of $438,000 per year in Medscape's latest survey), and if you combine that with good work-life balance, dermatology is one of the happiest medical specialties.
Plastic Surgery
The plastic surgery field is constantly evolving, allowing physicians to adapt to new strategies and to keep their work fresh. Many plastic surgeons can also set up their practices around their schedule and lifestyle. Their work also helps patients feel either safer, better about themselves, or sometimes both. According to Medscape, plastic surgeons also make the most of any medical specialty, and that surely helps the stress level for many.
Ophthalmology
An eye specialist’s work is wide-ranging—often split between seeing patients in their office and performing surgery. The diversity in their work helps create work-life balance. Additionally, a lot of ophthalmologists work in a practice with other physicians, so they aren’t on their own to deal with eye-related emergencies. Meanwhile, according to the Medscape data, an ophthalmologist earns an average salary of $417,000, which is in the top half of all specialties.
Orthopedics
The low burnout rate among orthopedic surgeons is likely due to the interesting challenges their profession presents. They see their share of trauma-related care while also treating patients who seek elective reconstructive procedures. The fact that a lot of work for orthopedic surgeons involves helping patients regain their mobility instead of life-and-death situations makes it easy to understand why this is one of the happiest medical specialties.
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Most Stressful Medical Specialties
It’s understandable why there are a number of incredibly stressful medical specialties. In some cases, physicians have minutes to make life-saving decisions for their patients. Meanwhile, some specialties require a lot of a physician’s time, making it nearly impossible to have any semblance of a work-life balance. The ongoing pressure that comes from working in the following specialties is also part of what makes them among the most stressful.
Emergency Medicine
Any profession with the word “emergency” in it is bound to come with stress, and emergency medicine, at a 65% burnout rate, is no exception. Stress comes from a number of different angles for physicians—not knowing what ailments they will treat on a given day; long hours that come on nights, weekends, and holidays; and needing to move along from patient to patient in a hurry. Patients expect to be seen and treated quickly, but being short on staff often makes that impossible. That makes emergency medicine an even more stressful medical specialty.
Obstetrics and Gynecology (OB/GYN)
Working in obstetrics and gynecology can bring physicians plenty of joy as they bring new lives into the world. Stressful medical situations can quickly overshadow that joy, however. Similar to emergency medicine, no day in obstetrics and gynecology is the same. A physician could spend a good portion of their week treating patients in their office before being on call for 24 hours. They’re also responsible for delivering babies, which they might have to do at a moment’s notice. There’s also the pressure that comes from having to perform life-saving procedures—for the baby, mother, or sometimes both. Plus, there's the constant worry of potentially being sued for malpractice. “Bad baby cases” have some of the highest payouts in medicine.
Internal Medicine
Second only to Emergency Medicine, the physicians who practice Internal Medicine reported a burnout rate of 60% for 2023. That's a huge difference from the 2022 survey when only 48% of docs in this specialty reported feeling that way.
Urology
Urologists’ burnout rate has also fallen a bit from Medscape’s 2020 report where it led all medical specialties at 54%—compare that to 2024 where the 47% figure was in the middle of the pack. Urology remains one of the more stressful medical specialties, however. In fact, the Occupational Information Network, a part of the Department of Labor, ranked urology as the most stressful job in the US. The shortage of physicians combined with the care delays the pandemic caused has created greater demand for appointments and, in turn, longer wait times. As urologists retire, the physician shortage will only get worse—the decrease in the urology workforce is expected to continue to decrease in the US through 2060, according to the National Library of Medicine.
Critical Care
The critical care physician burnout rate was 55% in Medscape’s 2023 report. Anytime a patient is admitted to the Intensive Care Unit (ICU), it’s stressful for physicians as well as the patient and their loved ones. ICU physicians are under immense pressure to save their patients in an environment where they see people die almost every day. Being around death so often can weigh on even the strongest and most focused medical minds. Additionally, ICU physicians were under tremendous stress prior to the COVID-19 pandemic, but the aftermath has left critical care units with fewer physicians on hand, creating even more pressure.
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My Solution to Overcoming Burnout: Diversify My Income
The medical profession is one of the few where stress is all but guaranteed. If you're thinking of becoming a physician or changing specialties, ponder how much stress you’re willing to endure on a daily basis. You’ll also have to weigh the potential stress against other factors. If you want to pursue a high-paying medical specialty that’s stressful, which is more important to you: the high salary or maintaining a reasonable amount of peace of mind? The same goes for your professional interest—if your dream field is one of the most stressful ones listed here, are you willing to endure high-stress levels to work in your desired specialty?
Stress levels are just one factor to keep in mind when deciding on a medical specialty. Be sure to weigh it along with others, such as salary, work-life balance, demand for physicians, and career growth potential as you make your choice.
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Do you agree with these rankings? If you had to do it over again, would you choose your specialty based on the stress (or lack thereof) that comes with the job? Is making more money worth more stress? Comment below.
There is going to be a lot of scrutiny with this post…..
I think the comments section of this post will be as interesting as the post.
I did my internship in OB/GYN, but left the program after a year of every other and every third night call. My off service rotation in Emergency Medicine halfway through the internship sealed the deal as it was “five 12 hour shifts a week” or 60 hours, versus the 120-130 hours I was doing on OB. It turned a light on in my brain. Life was much better than work.
I delivered about 500 of the 10,000 babies born in the county from 6/90 to 6/91. My all-time record hours topped 130 per week. I lost 10-15 pounds and was turned into a different person. I hated it.
I liked ER medicine in med school so I applied for a 2nd year opening, but did not get it. It was very competitive. I used my last five days (of ten allowed) to interview for a second year position in Psychiatry in SC, Virginia, or Ohio…three programs in one five day trip.
All three offered me the second year positions. I chose the one near a beach, with 14 residents per level, and a free gym membership. With so many residents, the call was twice a month. In the 3rd and 4th years, it was once a month! The Dean of the Medical school was a Psychiatrist. I had seen the light. Life was much better than work.
I never looked back. I was able to double my resident salary by moonlighting all three years as the program was about 50 hours a week at most, and I was used to over 100. The year of OB/GYN gave me nightmares of moms and babies dying. It also gave me the upper limit on human work hours, such that I was always able to work whatever Psychiatry three my way.
I think the prior experience of being able to work over 100 hours a week made my 12-20 “extra side gig weekends” from 2011 to 2022 seem easy. They paid for my early semi-retirement.
I clearly prefer Psychiatry. My usual work week without moonlighting was about 38-45 hours. I sold some of my free weekends while holding full time jobs with no weekends and no call. To keep it challenging, I was always the “Medical Director” if possible. It’s better to lead than to follow. Xxxx rolls downhill.
I’m going to subscribe to the comments on this post. It’s going to be entertaining. For me, the move to a “lifestyle specialty” was the best decision I ever made.
To paraphrase a WCI mantra…. I think the intra specialty stress levels may vary as much or more as the inter specialty stress levels.
Growing up shadowing my father who practiced ortho trauma (vs more elective ortho) and seeing that lifestyle I wouldn’t say Ortho is necessarily low stress. Similarly, practicing retina myself there are very high stress moments. Treating advanced pathology in functionally monocular patients with a very real threat of blindness looming (and occasionally coming to fruition) has led to some sleepless nights.
Ultimately though I wouldn’t change and maybe that is the whole point of the article?
Writing assignment: Write about the different medical specialties, contrasting which ones you think are more or less stressful, using examples from at least one article you found on the Internet.
great post and review. I agree with you guys above that intraspecialty stress levels can be just as varied as interspecialty differences. I find with myself in neurology I don’t feel burnt out anymore, but my burnout was more financial related losing money to whole life insurance rather than anything related to the field of neurology. also as a neurologist I can give tPA remotely so don’t have to run to the ER during a stroke code while on call, so I think that should help. also luckily many drugs have come out to help neurological disease so the diagnose and adios adage if slowly fading from neurology.
Not a psychiatrist, but I personally don’t think psychiatry would be low stress, particularly inpatient. They need to deal with suicidal patients, some of who will end up killing themselves despite treatment and are young adults. Perhaps psychiatrists need to be more detached from their work than other specialists to remain low stress.
I think the most stressful specialty is Cardiothoracic surgery.
And unlike in generations past where most CT surgeons worked for themselves in a group, the majority now work for hospitals and healthcare systems. This dramatically influences how these docs practice and the resulting stress.
I agree that there is a range in all these fields. I practice at a tertiary referral center and our ophthalmologists, dermatologists, plastic surgeons and orthopods are in house all the time doing urgent and emergent work on critically ill patients. Much of it is life saving. Having too much of your skin slough off can be fatal. Not only burn patients, but keeping post RT surgical flaps alive is literally vital. The ophthalmological part of care for even the most severe eye injuries may not be life saving, but most people would consider avoiding blindness to be critical. Same for emergency spine surgery to avoid quadriplegia. Or even non urgent surgery to resect some horrible tumor and restore spine stability. Being able to use your hands is about as important a function as their is.
My take on people who end up in these jobs is that the acuity and importance of their role in healthcare is fundamental to why they entered the field. Just yesterday we were going over a patient in which the surgeon had done a masterful job of a massive tumor resection. I do not know how long it took but I doubt it could have been done in under 8 hours. If it had not been an all day horror show that most surgeons would not have touched, the person who did it probably would not have been interested. “This is easy. Let one of the junior people have at it.” Which Is what this person says a lot, largely reserving themselves for the “run for the hills” cases.
As it was, the patient did great and now has a large hole where an “unresectable” tumor used to be. The surgeon would not have had it any other way.
Thank you for this discussion! I’m EM, and in the in the past few months finished transitioning to all-locums, all-FSED practice to address the stress factor. It’s my coast-FIRE gift to myself – and will hopefully provide longevity.
Like POF says, I want to think “Heck, yes!” every time I see my shift assignments.
Palliative care is a real field now and has better QOL than the vast majority of specialties. (For the right kind of person)
I used to volunteer to visit palliative care patients many moons ago, and it is much more draining than I had anticipated. The patients are dying right in front of your eyes and there’s nothing anyone can do except to provide comfort. It is really really depressing
The stress comes from horrible management. I was in Sleep Medicine which should be low stress but the CEO, COO, and HR were bullies and thugs and created a toxic, racist, environment.
I would add Pathology to the low stress list.
As a small town psychiatrist for over 30 years, I did psychotherapy and managed medications for the adults I treated with crippling anxiety, profound depression, bipolar disorder and psychotic illnesses. Things may be different now with shorter med management appointments but my work was incredibly stressful with the concern for suicide in my patients often looming. And yet it was also incredibly gratifying and humbling to have done such meaningful work.
Ditto on Pathology. I wanted to do OB, but it became clear that the market didn’t want Male OB’s as generalists anymore. Then I wanted to be an IM Hospitalist, but the residencies disagreed. Then I stumbled into Pathology and it was happiest accident ever. Become a Pathologist at a small community hospital. I know some that pull 400k a year and take call 7 weeks a year. Emergency is not really in our vocabulary. You sit down most of the day. As a rule we are taught not to look at a new case after 2pm for safety reasons. The biggest problem, is that its so low stress that people can do it into their 80s, so if you want a job in a desirable location, you will have to wait for the current placeholder to die.
You left out Trauma Surgeons
Unfortunately, there is a MAJOR omission in the article on the list of least stressful medical specialties. I am speaking of the most neglected and misunderstood specialty in medicine: Physical Medicine & Rehabilitation
Physical Medicine & Rehabilitation (PM&R) is a specialty that some physician don’t even know about despite it being one of the 24 certifying boards or Member Boards of ABMS. I would argue that PM&R is one of the least, if not THE least, stressful specialty.
I was dead set on becoming a plastic surgeon when I started med school, but after one rotation of general surgery, I realized that the training was going to be grueling and not conducive to a balanced family life. After searching for different options, I decided on PM&R because it was a good mix of non-operative ortho/MSK medicine, neurology, and had multiple subspecialty options:
Brain Injury Medicine
Neuromuscular Medicine
Pain Medicine
Pediatric Rehabilitation Medicine
Spinal Cord Injury Medicine
Sports Medicine
PM&R is a specialty that allows you to live a balanced life. It takes 3 years to complete PM&R residency (after your intern year). I worked 40-60 hours per week on average during residency. There was not in house “call” during training. I was able to spend quality time with my family and loved that period of my life. I opted to sub-specialize in Pain Medicine and completed an accredited ABMS fellowship after residency (1 additional year).
I now work about 35 hours per week (8am-5pm). I spend 3 days doing procedures and 2 days in clinic. I have no after hour or weekend call or duties. PM&R has been the best career choice in my particular situation (married with 4 kids) and may be an option for those looking for a “low stress” specialty.
I know lots of happy rehab docs so I suspect you’re on to something. I don’t know why PM&R gets left off of many surveys.
I’ve always been very interested in orthopedics and PM&R. I feel like there isn’t much info on PM&R, the things those specialists do and opportunities and possibilities in that field. I’m a non trad student and planning on going to med school next year. I’m an older student and hope I won’t have too many problems to keep up with the younger ones, and would love to do some shadowing in the PM&R field, but it’s hard to find doctors who practice that in my area.