Health careers

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This wiki is in very early stages and is a work in progress.

This page contains all notes on health careers over and above what we put in our career profile. Read the profile first, here.

Profile type

Exploratory

Best resources including income

The Bureau of Labour Statistics for the US and Prospects for the UK both produce useful guides for both understanding the profession and knowing their salaries. You should start there to get an idea of how well they pay in the UK and US. Elsewhere, you can easily check Payscale for salaries, or (better) find a reliable government source such as the ABS for Australia.

Some of the professions have had more in depth guides written about them which you could look for using this. It's worthwhile looking for 'day in the life' resources for whichever profession you're interested in, such as this for physical therapy.

More information on individual options

This section is a work in progress and has claims which we have varying levels of confidence about. It will mainly be useful for preliminary thoughts as well as sources.

Dentist

High job satisfaction and autonomy. ONET data shows 77% state they have ‘a lot of freedom’. Helping people through uncomfortable procedures is probably emotionally draining. A dentist we interviewed made this point: Dentistry is very expensive - this leads ethical quandaries around giving people the ideal care given their priorities + feeling like you’re doing a bad job if they can’t pay + dealing with people who feel like you’ve ripped them off. ONET data states dentists Deal With Unpleasant or Angry People — 48% responded “Once a week or more but not every day.”

We don’t know how useful a degree in dentistry is for health policy. Fluoridation is a clear win, but there are interest groups opposing it. Possibly relevant to how much you can optimise policy is the interesting fact that no countries have implemented a truly universal, free dental scheme which covers all dental procedures due to the high cost of dentistry. http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BN/2011-2012/DentalSchemes

Regarding specialisation (info from BLS):

Around 1/10th of dentists are specialised. Orthodontists mean - $221,390, prosthodontists mean $161,020, all other is $171,040.

Dental public health specialists promote good dental health and the prevention of dental diseases in specific communities.

Endodontists perform root-canal therapy, by which they remove the nerves and blood supply from injured or infected teeth.

Oral and maxillofacial radiologists diagnose diseases in the head and neck through the use of imaging technologies.

Oral and maxillofacial surgeons operate on the mouth, jaws, teeth, gums, neck, and head, performing procedures such as surgically repairing a cleft lip and palate or removing impacted teeth.

Oral pathologists diagnose conditions in the mouth, such as bumps or ulcers, and oral diseases, such as cancer.

Orthodontists straighten teeth by applying pressure to the teeth with braces or other appliances.

Pediatric dentists focus on dentistry for children and special-needs patients.

Periodontists treat the gums and bone supporting the teeth.

Prosthodontists replace missing teeth with permanent fixtures, such as crowns and bridges, or with removable fixtures, such as dentures.

Pharmacist

Seems to have pretty high job satisfaction and pay. In the UK and Australia it's not too competitive. Hospital pharmacists are unusually part of the hospital team, so it seems like a better option if you want to work in a team.

How much room for career advancement? Forum post - https://forums.studentdoctor.net/threads/can-pharmacist-specialize.680896/ discusses ways to narrow scope of practice (renal, cardiovascular etc), not really ways to expand it https://pharmacyschool.usc.edu/programs/pharmd/pharmdprogram/career/ also goes over some specialisations

There are 3000 pharmacists working in academia, around 1% of pharmacists; in research or teaching - http://work.chron.com/kind-research-pharmacist-do-20986.html. Industry has similar or higher pay to clinical work, but higher variance. PhDs do the work on the drugs, but people with some post grad training, or just straight out of uni can do marketing, regulatory stuff, drug safety etc. Seems useful to have people who want to do good in this industry. http://www.pharmaceutical-journal.com/career/career-feature/how-pharmacists-can-start-a-career-in-the-pharmaceutical-industry/20068025.article https://www.monster.com/career-advice/article/pharma-industry-jobs-for-pharmacists

Podiatrist

? worse for job satisfaction given prestige. Podiatrists do have lots of autonomy though. 66% on payscale for job satisfaction which is 303rd out of 512, but is 83% for meaningfulness, which is 60th. This is odd. There are 1/20th as many podiatrists as there are physical therapists, so we might just be missing sample size here.

There’s a high degree of autonomy, diagnosis, treatment, career progression, pay, even surgery. Is that actually a really excellent career which people are missing out on because they don't want to work with feet all the time.

Useful resources: https://www.careersinpodiatry.com/ http://www.scpod.org/

Optometrist

In terms of further education to expand scope of practice or specialise, there's relatively little. Certainly some, but not compared to physical therapy or dentistry. This forum post says it's hard to expand your scope of practice - https://forums.studentdoctor.net/threads/do-optometrists-have-the-option-to-specialize.160546/ This college of optometry page lists that you can do optometry in community, in hospital, in people's houses who can't get to a clinic and research. https://www.college-optometrists.org/qualifying/a-career-in-optometry.html http://www.provision.com.au/page/opticalspecialties says you can specialise in contact lenses, low vision, kids/behavioural, sports vision, and therapeutic (who prescribe) forum of discussion about whether it's repetitive - http://forums.whirlpool.net.au/archive/2361872 and https://www.indeed.com/forum/job/Optometrist/do-you-enjoy-most-about-your-optometrist-career/t23910 and https://www.quora.com/What-are-the-disadvantages-of-being-an-optometrist Latter claims that in community practice weekend and evening work is common, particularly in the larger chains.

Global cost of refractive errors >200 billion/annum - http://www.who.int/bulletin/volumes/90/10/12-104034/en/

Fixing refractive errors: https://www.ncbi.nlm.nih.gov/pubmed/18621429

"In all regions, screening of 5-15 years old children yields most health effects, followed by screening of 11-15 years old, 5-10 years old, and screening of 8 and 13 years old. Screening of broad-age intervals is always more costly than screening of single-age intervals, and there are important economies of scale for simultaneous screening of both 5-10 and 11-15-year-old children. In all regions, screening of 11-15 years old is the most cost-effective intervention, with the cost per DALY averted ranging from I$67 per DALY averted in the Asian sub-region to I$458 per DALY averted in the European sub-region. The incremental cost per DALY averted of screening 5-15 years old ranges between I$111 in the Asian sub-region to I$672 in the European sub-region."

Physician assistant

Very new in the UK. Unclear where this profession will go. Normally need a couple of years working as a health professional before you can apply to the program.

Physical therapist

This seems pretty competitive given that it's not paid that highly. Very high job satisfaction. A guess; this is from their high autonomy, the number of conditions they treat/could specialise in, and how interesting and complicated musculoskeletal medicine is.

Occupational therapist

Surprisingly low job satisfaction in our BBC job satisfaction source (153rd from 274). 77% satisfaction on payscale though.

Speech pathologist

From Prospects: "Competition for entry-level posts is fierce and it's important to be geographically flexible if possible" "Competition for places on training programmes is strong and you'll need to show that you have an understanding of the work of a speech and language therapist."

Dental hygienist

Frey and Osborne paper say it's 0.68 on 0-1 scale, which means quite automatable. This doesn't square with my understanding of automation risk and I suspect it's a weakness of their methodology rather than a real danger. It requires patient interaction and precise procedural work which could hurt patients if you made an error in.

Diagnostic radiographer

http://www.sor.org/learning/document-library/improving-student-retention-guidelines-and-good-practice/3-retention-nhs-funded-courses We haven’t fully looked into this, but it’s possible an unusually large fraction of people studying radiography drop out. The SCoR Approval and Accreditation Board Annual Report for academic year 2006- 2007 outputs showed student attrition rates for diagnostic students as 31.7%. Sonography is unusually automatable for a health career at 0.35 according to Frey and Osborne, but this is still quite low.

Profiles in the several professions we included in this profile: https://www.bls.gov/ooh/healthcare/radiologic-technologists.htm#tab-1 https://www.bls.gov/ooh/healthcare/diagnostic-medical-sonographers.htm#tab-1 https://www.bls.gov/ooh/healthcare/nuclear-medicine-technologists.htm#tab-1 https://www.bls.gov/ooh/healthcare/radiation-therapists.htm#tab-1 payscale, https://www.prospects.ac.uk/job-profiles/therapeutic-radiographer https://www.prospects.ac.uk/job-profiles/diagnostic-radiographer

Forum discussing whether it's repetitive - https://www.boards.ie/b/thread/2055986446

Dietitian/nutritionist

Pros: Relatively short training period, with 3-4 years of undergraduate study for both the UK and the US. The field has a very complicated evidence base and there’s disagreement over what the ideal diet is. Producing research which makes real progress on this question could be very high impact.

Cons: Low salary relative to entry requirements, with a median pay of $58 000 and the top 10% earning above $81 000 Low direct impact

Our impression is that the field of nutrition currently has a very complicated evidence base which is difficult to draw firm conclusions from. http://www.nature.com/ejcn/journal/v59/n1s/full/1602189a.html It often relying on observational evidence due to the difficulty of obtaining randomised controlled trials. Some conclusions are well agreed upon - vegetables and fibre are good, obesity is bad etc. But there are disagreements over fairly basic questions - what is the best ratio of carbohydrates to fats to protein? How bad are saturated fat, sugar and dairy? If getting the best answers to these questions gives a substantial health benefit to the average person, it could be very high impact to find those answers. To add another level of difficulty, we’re not sure whether becoming a nutritionist/dietitian is the best way to accomplish get into this research. In addition, there’s a lot of research in this space and the area probably isn’t very neglected. This suggests that you should think that you can become a very motivated and skilled researcher before you go into nutrition for this reason.

People’s diets are important to their health. But helping people change their behaviour is notoriously difficult. It is possible, to improve people’s diets with regular advice. http://www.cochrane.org/CD002128/VASC_dietary-advice-for-reducing-cardiovascular-risk http://www.aafp.org/afp/2006/0501/p1551.html https://www.ncbi.nlm.nih.gov/pubmed/18254000

This isn't a huge effect on cardiovascular disease. Compare it to statins (the best cholesterol lowering drugs) for example. http://www.cochrane.org/CD004816/VASC_statins-primary-prevention-cardiovascular-disease

Respiratory therapist

Relatively non-competitive and low paid. Doesn't exist in Australia or the UK (where physio's or OT's or nurses specialise to do these tasks, or doctors just do them).

Ex phys/sports science

Tried to thoroughly answer this question about whether it's just a really difficult job market. Seems robustly true, even though there are individual sources which dispute it.

From Prospect: "Although more career opportunities are becoming available, competition for jobs is fierce." - "As competition for jobs is strong, it can be useful to have a postgraduate qualification specialising in sport and exercise physiology or a relevant PhD." "Although job opportunities in sport and exercise science are increasing, the number of sport and exercise science graduates is also growing, making competition for jobs intense."

This forum makes it seem hard to get a job - https://www.indeed.com/forum/job/Exercise-Physiologist/exercise-physiologist-job-opportunities-growing-declining/t40938

There's this blogger arguing against it - http://ecressey.wpengine.com/is-an-exercise-science-degree-1

On the other hand, the article from the guardian was quite positive - "Of 2009 graduates, over 60% went straight into full-time or part-time employment, with around a third in sports-related industries. Careers in education (11.1%), the public sector (7.6%), health (2.8%) and business (2.7%) were also popular choices. The relatively low proportion immediately employed in stop-gap retail or catering work implies there is a higher than average demand for sports science graduates." https://www.theguardian.com/money/2010/dec/11/sports-science-degree

The guardian article linked to in the piece settles this question; it is harder to get a job in this than the other courses.

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