腎臟科出路

[wcfgg]

各位大大好 拿到內專後 前一陣子有問過meta/rheuma相關訊息
腎臟科在R期間也接觸不少 臨床方面有興趣
考量個性 興趣目前也考慮腎臟科
但是對於出路還很陌生...
不過風聲傳說腎臟科不若以往 大多是洗腎市場已經飽和 被壟斷 給付被大砍 ...
還有就是考照率頗低
我比較想請問各位的是
目前洗腎發生率下降中 一年大概還有3000新洗腎病人
1. 所以學會用考照率來控管專科人數 是因為腎臟科醫師/洗腎市場 的需求已經不多了嗎?
不談醫學中心 區域醫院/地區醫院 是否也一位難求了?(翻開台灣醫界 徵腎臟科醫師真的很少 反觀GI...)
2. 要是出去的話 洗腎診所
不是被當地的大醫院割據 就是被商業團體壟斷 還有洗腎室醫師不再限專科醫師
所以似乎也很難找位置?
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主要有經濟上的考量 所以才會把nephro排進考慮選項
畢竟meta/rheuma平均上pay少一點
這幾年很夯的GI 缺很多 開業容易 pay也多
整體上好像都贏nephro 也反映出fellow的消長
只是實在對GI沒興趣...
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多謝各位指點!!!

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