My thoughts:
1. Yes surgery requires special talent but actually most medical specialties do. Some can be learned, some can't. A ton of doctors would make awful pediatricians, for example.
2. I'm not a big fan of the notion that if you start medicine late you are obligated to do a shorter residency path. If you are changing careers imho it had better be into what you really want. If the goal is just to get back into the workforce ASAP, don't make the jump. You can already earn a living doing something that isn't your calling without incurring postbac and med school debt. I mean you only live once so spend it doing or striving to do what you want/enjoy. It's the journey that matters, not the destination. Don't look back regretfully and say, if I only started sooner I could have done neurosurgery, but instead I became an allergist because the residency was really short. That's just a silly way to live life. Be a NS if that's your dream. Or at least go down swinging for the fences.
3. Instead of "medical examiner" you probably mean pathologist. There's a difference.
4. I agree that people need to do research and have a Pretty good idea of their own goals and dreams. I don't see a downside to asking experienced people their advice on how to get there once you do that. Pretty much daily on SDN some misimpression will be debunked. There's a lot of stuff you need to filter out on here but if you do it right a lot of the advice, particularly from those further down the rabbit hole who have seen how things play out, is often pretty darn good. Lots of doctors on here giving back to the community for all the free advice they themselves got early on. Milk it for all it's worth. You won't get this kind of experienced candor elsewhere.
LOL OMG Law, this is what I meant:
[Overview
The University of Maryland Medical System/Hospital and its affiliated hospitals, Veterans Administration Medical Center/Baltimore, Mercy Medical Center, and Medical Examiner's Office/State of Maryland, offer a four year, ACGME accredited residency program in Anatomic and Clinical Pathology. An Anatomic Pathology only pathway is also available on an individual basis.
Residents are provided a mandatory two-year core program in the basic principals of anatomic and clinical pathology. Rotations also include hematopathology, neuropathology and molecular diagnostics. Individuals with an interest in academic pathology will be encouraged to begin their research activities in the second and/or third year of training.
Third and Fourth year residents are provided ample opportunity for elective time in order to encourage individual subspecialty interests. The residency requirements are adapted to meet the educational and career objectives of each resident, while meeting the requirements of the American Board of Pathology and the ACGME. Senior training (yr. 3-4) includes rotations at the
Medical Examiner, Electron Microscopy and in Cytogenetics in the Department of Pathology.
]
Clearly there are different paths w/i pathology. For the love of God, it was an example, which I related to myself. At this point in my life, I had better have some idea of what would be a better fit for me and what would not. I have had an advantage in terms of having a closer perspective than others.
Point: Actually ME or other paths in that re: would be interesting; but that is NOT what I feel called to do. I am destined to deal with people and their disorders and txs. I actually would get a huge kick out of studying under a ME; but again, I totally don't feel called to do that, and my life thus far as not prepared me for that IMHO. Someone has to work with the living, talking, sometimes raging and annoyed masses of people. My top choice would be ED; but honestly, there is no way of getting around night rotations. I could do them for another 5-7 years, I'd say, but not much more than that w/o resentment. My Lord, I have done more than my share of long, nightshifts over the years. I'd have to pay that price all over again--ongoing; and I don't think that would be the best use of my education and experience. I love the ED. As much as I found/find it interesting and exciting at times, I was drawn more to intensive care--more in-depth evaluation of what's going on. I have always been drawn to that in my field. That is the patho side of me, but for the living people--or not limited to cytology reports and the like. And now, at this point in my life, no. I do not see the point of working a lot more years of off-shift. I will do what I must for school, as I have in my current job and then some. Fine. But I will get the best run and use out of this education and so forth, by working in primary care.
I personally don't see why people hold their noses at primary care. I have had the wild ride of critical care--given, as a RN--but it was still a long, cool ride, which has been great in many ways--hard, frustrating at times, but great. That's life. I spent the last year working more in a primary care role with high risk, very fragile peds pts. I have found it very rewarding. I don't feel like primary care is settling at all!
For many, it makes no sense to do a seven year residency/fellowship if they start later in life. It doesn't make good financial sense, and in general, it defies just plain ole good sense IMHO.
Sure not everyone would make a good pediatrician. Ah, and so what . . .does that have to do with the rice of beans in Mexico? I think I would make a great pathologist; but it's not my calling. Pathology, being a ME, any of these roles that limit a lot of interaction minute by minute interaction with various patients--these are important roles. It's not a role I feel called to do. I like dealing with kids--yes, even sick kids. I like dealing with adults. Primary care is a perfect role for me--as much as anything perfect can be in this imperfect world
It's nice for people to say, "Hey, on interviews tell the interviewees to tell the adcom members that you have an open mind." That's great for the 22 year olds, or perhaps even the 30 year olds. 40+ and up, well, the reality is that with perhaps a very few exceptions, people this age and up are limiting their selection-choices in medicine. I'm not looking at the odd exceptions. I would think for most, a 5 year residency would be the max for those 40 and UP. I mean you do have to have some sense of pragmatics here.
I am NOT going to tell ANYONE what to do one way or another. I have, however, a better idea of how I work and what fits for me than you do. You don't know anything substantial about me. By now you know I'm not 22. God I would hope you would value older applicants that
do have a reasonable sense of fit--especially if they have already been working directly in acute healthcare for a substantial period of time.
As I said, I know darn well how difficult people can be when working with them on a daily basis. And I like people, and they tend to like me; but some folks can zap a lot out of you, if you let them. You just have to focus on their needs and do what you can and not let them get to you. That factor was there when I was 20 and working in healthcare and it remains today.
And you want to talk about pediatrics? Funny thing is some folks have this mistaken feeling that they will be dealing primarily with children. No, you will be evaluating/txing children medically, but you must know and care about interacting w/ parents and guardians. There is no free pass on that by going into pediatrics. So you are dealing with both kids and adults--and there are some times when it is hard to tell the difference.
So people that don't like dealing with all kinds of people with all kinds of various issues should re-think primary care IMHO or ED or Critical Care, but I am not one of those people. In fact, I highly respect the physician's ability to compassionately relate with patients and families in internal medicine, anesthesia, ED, intensive care medicine, and just about any other area of medicine where you will be spending most of your day talking and interacting with people.
And I am sorry, but there are a few too many nurses and docs that totally suck in dealing with people; b/c they expect reverence and respect from them. No
. People under stress and in need can be a major pain in the butt, and some people are more gracious and grateful than others. Many an addict could not give two craps if they show you respect or suck up the time you give them, which you could better be using helping others many times--or at the very least, getting some well-needed nourishment. Regardless, they are damaged by the abuse/addiction, and you just can't expect a lot of love from them, if you know what I mean.
"Know thyself" is not simply an aphorism for the ancient Greeks.
I've done the work of a fair amount of that. So I don't feel stupid or naïve in anything I have learned about me through my journey of life and my work in healthcare over the years. Why indeed wouldn't I apply these experiences to m perspective in looking at what is more of a fit for me in medicine? It would be illogical for me not too do so.
As far as point no. 4 is concerned, I never said or implied otherwise. In fact I said people should do their homework and then ask more specific questions. Otherwise, a lot of these generalized questions are a waste of time, with people going back and forth and no one really getting anywhere.
IDK, I am not sure, but it feels like you are just being argumentative, and I don't really care about being argumentative. But why else would you make an issue about specific paths that come out of pathology--like trying to make me look stupid re: becoming a medical examiner? I know some folks that determined this path for themselves, even before the start of medical school, and they are happy in the role. I know a number of people that actually got enough clinical exposure, and in spite of their M3-M4 rotations, they knew what they wanted to pursue, and they are happy in their choices--choices they made before rotations. Although it may be a good, general admonition to tell pre-meds and med students to keep an open mind about medical area selection, it doesn't work that way for everyone.
And do you know how many folks tell the adcoms and others the standard line of "I am going to keep an opinion mind?" Nice idea but it doesn't apply to everyone. I am certainly not going to be bogus and make such a statement to an adcom, b/c I am realistic. I am not the kind of person that generally tells people what I think they want to hear. I won't cross certain lines, but I am not going to be disingenuous about my aspirations.
Also, learning and performing basic surgical procedures is one thing,
as I said. Making general surgery and then moving into a subspecialty of surgery, however, is a HUGE COMMITMENT. After having worked with surgeons, I'd say, you had better have a strong idea that you are fit for it and it is a fit for you, b/c it is a ball buster and then some.
Again, I am not talking about learning the very basics. I will get all that I can out of these rotations in school; but no, I will not get a fire in my belly for it. I've been exposed to enough of it to know it's true. It can be interesting, and I respect 99.9% of all the surgeons I have been fortunate enough to work around. But really I know straightaway from experience, it's not for me. I have no problem, however, taking care of the patient pre-op or postop.
What's up Law? Darn, it's like the whole MBA thing. The reality is people keep asking general questions without doing their homework, and I just can't see them getting the kind of answers they need, so long as they don't do the work. I am also not a fan of generalizations.
You could always skim over the first and last paragraphs of her posts and skip the rest. That will give you the general gist.
