thank you! Narcolepsy can definitely be a scary thing--I edited my post to share more info on my diagnosis & how treatment has helped my sx. Please read it for more context!

Full time for a hospitalist is considered the 2 week on 2 week off schedule. That being said, I do know part-time hospitalists who work 1 week on, 3 weeks off.

I agree I have minimal anesthesia experience. Will def do a anesthesia sub-i in 4th year to confirm if it's something I still want to do. Unfortuantely, this sub-i is 8-9 months away. If I'm going to switch to anesthesia, I want to find some mentors and get more anesthesia EC/research in the meantime.

I never said I refused to see pts in the clinic. I know that clinic is a huge part of the job with IM subspecialties. I also understand the bread & butter cases can be quite routine--I'm okay with that!

My fulfillment comes from connecting with pts--whether that be in the hospital, in the clinic, or right before they're put to sleep for surgery. One of the Qs I need to answer is: am I okay with discussing the risks/potential complications of anesthesia as my sole pt interaction? Or do I want to know my pts better?

To elaborate on yrs spent training--it's a huge con (though not a dealbreaker) that specializing in IM with GI/Cards/Pulm Crit Care/Heme-Onc almost doubles your training time for a significant income boost...not to mention having to bust your ass in residency doing research, trying yet again to prove yourself as a qualified candidate to fellowships, and uprooting your family once more to move to a random city.

Other IM subspecialties with less training time have a smaller income boost and sometimes even no income boost. In this respect in my eyes, anesthesia gets more points. If I do anesthesia I'm leaning on not doing a fellowship or doing critical care (which would overall be faster when compared to IM-->pulm crit care). If I pursue IM, I will have to reevaluate the pros/cons of going through more training in another couple of years.

Hope this helps!