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What are you supposed to say when not interested in their specialty

Discussion in 'Clinical Rotations' started by Guillemot, Apr 1, 2012.

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  1. Guillemot

    Guillemot

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    SDN Members don't see this ad. (About Ads)
    So on a couple rotations Ive had doctors and residents try to convince me to do their specialty and give me crap about doing another specialty etc etc.

    What is the best way to tell them you dont want to do their specialty without seeming lazy by choosing a better lifestyle or telling them that what they do is boring?
  2. mmmcdowe

    mmmcdowe Duke of minimal vowels Moderator Gold Donor

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    I try to keep it light, make some self deprecating jokes, and acknowledge the things about their specialties that I like.
  3. partydoc

    partydoc

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    I usually stick to something like "I'm still not sure what I want to do, but I find the pathophysiology of [insert specialty here] really fascinating".

    You can usually gauge who is going to give you crap for saying you want to do something else.
  4. Chakrabs

    Chakrabs

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    I always told people honestly that I was interested in neurosurgery. Most of the time it bought respect because I was honest and upfront about what I wanted to do. There were, of course, a few snide comments, but I largely agreed with those who said I was crazy for working the tough hours and years, and argued with those who bitched about the patient outcomes. Never seemed to affect my grades any.
  5. HalladayWeekend

    HalladayWeekend

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    I very much don't like when asked on 3rd year rotations "what are you going into?" I really don't think it should matter on a required 3rd year rotation what a student is going into. Sure, there are attendings/residents that will "tailor" the rotation to the student's interests, but I have not seen much of this. Sure, if you want to go into peds and are on a peds rotation, let all your attendings/residents know. Otherwise, everyone else should be on an equal playing field.
  6. bleeker10

    bleeker10

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    I always tell people that I'm going into surgery and if they ask which subspecialty I tell them ortho. But I never hide it or try to fake interest. I also tell them I learn useful things from every rotation, whether it be how to communicate with patients or ways to diagnose/treat. I may have no need to do a pap smear again but I learned from ob that drawing things on paper (such as the normal 28 day cycle and hormonal effects on the body) can help them understand their situation much easier.

    I have had rotations where the physician offered me the opportunity to do more ortho related things even though I was on a completely unrelated rotation. I thanked them but politely declined, saying I was there to learn about their specialty and I will get to experience the ortho stuff on other rotations.
  7. mmmcdowe

    mmmcdowe Duke of minimal vowels Moderator Gold Donor

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    I agree. I personally am going to try to avoid asking and instead ask "what about my specialty interests you?" I wouldn't accept nothing or everything as answers, because I think that knowing what a student likes could actually help their experience.
  8. KeratinPearls

    KeratinPearls

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    tell them you what you like and that's that. Who cares what they want you to do. No need to tell them what they do is boring. You live your life not them. There is nothing wrong with going home at 5 pm while they are there until 10 pm. Really if you can go home at 5 pm and get paid well for it, the joke is on them.
  9. jace's mom

    jace's mom Member

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    I didn't worry about it too much. I just told the truth, took any teasing in stride, and showed with my work ethic that I was fully involved in their field for the time being. I never had any problems.
  10. ArcGurren

    ArcGurren only one will survive

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    In peds, psychiatry, neuro, and family med so far i have had no issue with telling them I want to go into medicine; in fact many were quite happy with the decision because they thought I was very competent.

    In surgery I actually got somewhat shafted for it grade-wise (the attending readily admitted it to me) so I would advise lying through your teeth about it if you have a surgery (or otherwise) rotation known for being somewhat malignant about it.
  11. Top Gun

    Top Gun

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    I used to tell them that I was still deciding, but that I was learning a lot of things from the rotation that would be useful in the future, whatever specialty I decided to go into.
  12. Tic

    Tic

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    I always appreciate when students are honest about this question. It's mostly just a get-to-know-you question anyway, but sometimes the answer helps me direct certain cases or teaching points your way that are more in-line with your interests.

    It's been my experience that most other 'normal' residents think this way. If you've got a weirdo or an asshole then it might be better to be cagey.
  13. BigRedBeta

    BigRedBeta Why am I in a handbasket?

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    As a resident who always asks this, I want you to be honest.

    As others have mentioned, there are some out there who will try to nudge you towards cases that are likely to be interesting to you. I try when I can, but it doesn't always work out and some fields just don't work out. But if I don't know, I can't help you.

    The other major thing is, that as a 3rd year, no matter what specialty you're going into, EVERY patient has something you can learn from. I know that not everyone is going to be a pediatrician - hell, I don't want everyone to be a pediatrician. But what upsets me most are the students who think that taking care of pediatric patients is somehow beneath them, boring, or worthless. As a 3rd year, your inexperience is overwhelming and so to throw away an opportunity to get better is ridiculous - especially when you see how many people complain how they don't learn enough on clerkships. Even if the only thing you focus on is doing your perfect H&P in 30 minutes instead of 35, that's going to beneficial for you as an intern.

    Lastly as far as choosing lifestyle specialties...I'm going to respect you far more if you can show me how much the medicine actually matters to you. If you go on and on about your salary, the hours you're going to work and the boat you're going to buy, don't expect me to congratulate you. But if you can tell me how much you love Moh's surgery and getting to positively impact the life of a cancer patient, that's far more interesting. But just as you have biases about my specialty, I'm entitled to biases about yours. Sorry but I'm not sorry that as a pediatric intensivist, I feel like saving the lives of dying children is more important than making sure some Junior Leaguer got her Botox and liposuction or that dictating "clinical correlation is advised" on the report for a chest X-ray is somehow the most fulfilling use of your time.
  14. MilkmanAl

    MilkmanAl Al the Ass Mod Moderator

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    That's the best approach. I think you'll find that, more often than not, residents and attendings are willing to cater to your interests fairly often. During every rotation except OB, I had at least one person go out of his way to teach me something important to a budding anesthesiologist.
  15. dienekes88

    dienekes88

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    After a number of missteps (and getting a lot of crap from a lot of people), I think the safest way to go is, "I'm not sure, I think *blank* is an aspect of *insert field here* that is very interesting/useful no matter what field."

    I wouldn't say, "oh my, I would love to be a surgical oncologist" or "it has been a dream of mine since having a great pediatrician to become a pediatrician" if it isn't true. However, you can say, "I'm not sure yet, but I think that learning about delirium/major depressive disorder/the difficult interview/etc. will be very important no matter what field I go into." If you're particularly bold, you might say "I'm not sure yet, but I'm thinking about peds. Learning about prenatal care, development, and general ob will be critical in my education, so I'm really excited for L&D."
  16. MilkmanAl

    MilkmanAl Al the Ass Mod Moderator

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    Yikes, that'd get an eye roll from me, for sure. I understand that some people can be judgmental regarding specialty choice, but damn...
  17. Bacchus

    Bacchus PGY-Uh Oh Moderator

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    I don't get much resistance when I tell people I've chosen family medicine. Maybe they feel sorry for me? After I got halfway through 3rd year and did my FM core, I knew that's what I wanted to do. I told everyone after the rotation I encountered I will be doing FM when asked. It's helped a bit, actually, because things have been more tailored to my interests. One example was my psych attending talking to me about treating depression and anxiety in the office and then supplying me with other primary care/FM articles regarding common psych issues.

    Everyone likes something different. There's no reason to hate one another for it.
  18. davidjones

    davidjones

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    When I started 3rd year I used to say I liked whatever specialty I was on, which was true, plus what I ultimately went into,IR. This wasn't a huge deal where I was, since both IR and DR were highly respected and IRs were also surgical faculty, and I worked my butt off, when I was on Peds I worked like I was going into Peds, When on OB I worked like I wanted to be an OB, even when I was a medicine intern I worked as hard and read as much IM stuff as the categorical residents.

    Now as a resident I always ask that question, I ask so that I can tailor what I teach, if there is a student with me on ultrasound and they like OB I send them to do pelvic scans and we read them together, if they tell me they want to do neuro, I send them to the angio suite or to neuro rads.

    Most residents, fellows, attendings who ask this question are 1) genuinely interested and trying to relive that feeling of getting to choose a specialty, which is a great feeling and 2) want to teach to your interests

    There will be those who will give you crap for choosing a particular area of medicine, but so what? And if they give you a bad grade for it, and otherwise you performed well, then talk to the dean or clerkship director.
  19. Substance

    Substance

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    ...and this right here is why if you are asked, say you're not sure, or answer one of the core uncompetitive scut fields. Going into a core rotation saying you want derm or something else that's plainly just a better job(in the pay/hour and controllable lifestyle sense, not in the importance sense) is a wonderful way to put a target on your back.
  20. Mace1370

    Mace1370

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    I think it is great you are willing to go out of your way to find cases that suit a particular student's interest. Not every resident is willing to do that.

    I don't think it is acceptable, or professional, to judge a student based on his motivations for going into a specialty.
  21. McGillGrad

    McGillGrad Building Mind and Body

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    I will definitely give them more responsibility if they are interested in my speciality, but above all else, I am going to teach all students what they need to know for their shelf exam and for their CK and Step 3 exams. If they want more speciality-specific teaching, then I am game. If not, then cool. In my mind, my job is to teach the fundamentals of my speciality that adds to your general medical knowledge.
  22. dienekes88

    dienekes88

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    This comment doesn't make sense to me.

    So you (assuming you were a psychiatry resident) would roll your eyes if a student said, "I think learning about delirium is important no matter what field I go into?"

    The analog to your field (anesthesia?) would be: "I'm not sure yet, but I think that learning about vasoactive medications, basic airway management, and cardiovascular/pulmonary physiology will be important no matter what field I go into." You would roll your eyes to that? Really? That doesn't seem reasonable. The person has actively sought out a reason to be interested in your field.

    I don't think you understand the full extent of how judgmental people can be.
  23. Mace1370

    Mace1370

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    He is rolling his eyes because it sounds like brown nosing (whether or not it actually is).
  24. MilkmanAl

    MilkmanAl Al the Ass Mod Moderator

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    Correct. It's mostly the wording, not the concept.
  25. ArcGurren

    ArcGurren only one will survive

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    In all fairness it's kinda tough to gauge initially how a resident will react to your response so that's probably one of the most "safe" ones on an average. I'll probably also ask that question as a resident, but mostly so I can gear the teaching towards their interests. I really hate when people use it as a metric to somehow judge another person.

    As I've said repeatedly before and in other threads, I've usually been pretty honest about what I want to do for a career, and the only time it's ever screwed me is during my surgery clerkship.
  26. Phyozo

    Phyozo

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    I'm another one of those folks who went through being honest and having it work everywhere except surgery.
  27. exi

    exi EM, home of the cool kids

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    +1.
  28. AlexMorph

    AlexMorph

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    me too. but those ppl are buttholes, so i dont care
  29. dienekes88

    dienekes88

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    Interesting. I was always honest, and I've gotten some really interesting comments on ~1/2 of my rotations in 3rd and 4th year. It wasn't that I was graded negatively as a result of being interested in another field. The primary issue with honesty was that it framed the rest of the rotation. If I ever made a mistake, it was assumed to be a result of disinterest and laziness.

    Eh. I think it's one of the safest answers possible, and in retrospect I probably should have used it.
  30. ArcGurren

    ArcGurren only one will survive

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    This, exactly. I have a friend who I've rotated with who's a quiet person but otherwise very competent and speaks up at rounds. However, he isn't a boisterous or flattering person, so when it came time for evals he always got shafted because the surgery residents thought his quietness was a self-esteem issue (and so did some of the medicine residents, unfortunately). People have very bizarre biases that come through during these evaluations.
  31. Mace1370

    Mace1370

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    Absolutely. I've found the only way to prevent this to any degree is to get serious "mid-rotation" feedback if you can. A lot of people will recognize that you are making an effort if you ask them what you can do better and then visibly attempt to correct any errors they point at. That said, sometimes you just can't win.
  32. peppy

    peppy Senior Member

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    I feel the same way. I'm a psych resident, and I usually ask med students what they're interested in just to get an idea of who they are and to think of ways to apply things about psych to their area of interest. I DO NOT hold a grudge against those who say something other than psych. It wouldn't be realistic to expect everyone who rotates on psych to want to do psych.

    While some odd characters will indeed grade you down for not professing an interest in their specialty, the flip side of pretending you're interested in a certain specialty is that in some cases you might be graded more harshly because you're being held to a higher standard. You really do have to try to get a feel for the person you're dealing with.

    In psych, most of us are pretty easygoing and won't take it personally if someone admits they want to be a surgeon or internist. In fact, there was one med student who did not seem to have the right personality for psych, though he was clearly quite bright. We were happy that he wanted to go into surgery because he did seem well suited for that. :) It kind of amuses me when I can tell that someone is totally just saying they're considering psych because they're on psych. I want to tell them "It's okay, I really don't care. I'm just making conversation". :)
  33. Mace1370

    Mace1370

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    I told the truth on general surgery. It was generally a mistake. I don't think I was graded down for being honest, but if I lied I would have avoided all their stupid comments.
  34. group_theory

    group_theory EX-TER-MIN-ATE!' Moderator

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    When I ask students what field they are interested in, I usually do it to get to know the students more, to know what they like and dislike, and also to try to tailor their rotations to stuff that they might need to know that is related to their fields (ie, if interested in ortho surgery, then discussing how medicine docs risk stratify patients, or treat common complaints that everyone will field such as chest pain, shortness of breath, etc)

    Every field is interesting and every field is important, so I try not to demean anyone. I usually say "good for you" and "that's a tough field, I know I can't make it in that field" ... and "we need more people like you to go into that field" ... which is true. We need good dermatologist, good histopathologist, good interventional radiologist or even pediatric neuroradiologist (who can tell the difference between a normal MRI of a premie brain vs diffuse atrophy with loss of gray white matter differentiation concerning for possible stroke, cerebral edema, or encephalopathy, clinical correlation highly recommended)

    Making fun of other fields or insulting other fields (in front of the students who are interested in those fields) is unprofessional and makes you and your profession look bad and immature.

    The student is rotating on my service (whether by choice or not) - my job is to make the most out of the student's time and have him/her learn the basics of my field ... even if the student only remembers 1 or 2 aspect from the rotation (and carries with him/her throughout his training), my job was successful. If I convince the student to go into my field, even better :D
  35. Bacchus

    Bacchus PGY-Uh Oh Moderator

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    Stop trying to be reasonable, G_T.
  36. Day man

    Day man

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    I don't get why anyone would lie. I've said Ortho from the get go and never had any issues. It'd more the attitude you hold and how you carry yourself. E.g. Act like a third year who knows jack in the scheme of things and needs to absorb as much of the basic compitencies as possible during third year, not a [x specialty] resident/attending who disrespects other fields. I always cringe when I hear students talking in a semi-entitled manner...sure fire way to look like am ass and get bad marks come evaluation time.

    Edit: and my residents have done what some of the fellows/residents mentioned here with the tailoring of cases for me. For IM, during consults I was responsible for all Ortho consults...definitely helped prep for intern type decisions.

    Double edit: and as far as comments...need to learn to let things slide. I can't count the number of times I got my balls busted on surgery and IM. Can I bench my body weight? The Ortho vs anesthesia paper. The YouTube video. What sport did I play? Blah blah...in the end it's all in good fun. And if it isn't...who cares? What's 2 weeks or 2 months anyway?
    Last edited: Apr 21, 2012
  37. ArcGurren

    ArcGurren only one will survive

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    Why can't more fellows/residents think like you, then? Good man.
  38. MossPoh

    MossPoh Textures intrigue me

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    My school has minimal exposure to working with residents, so I can't testify much to that. When asked, I just tell them now and explain my reasoning. I work my butt off during the rotation and emphasize that I still want to learn all that I can since it may be my last opportunity to see that stuff. I get good spirited harassment from my attendings at times while others cater discussions to my interests a little more.

    The other day I was taking just a little too long in the OR to close and my doc said something along the lines of, "Yeesh, performing major surgery in there? I guess I should expect that from a future radiologist!" I simply laughed and replied, "Well, the lights are way too bright in here. I'd be faster if you turned them off!"....everyone had a chuckle and we moved on.
  39. exi

    exi EM, home of the cool kids

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    :thumbup:
  40. MilkmanAl

    MilkmanAl Al the Ass Mod Moderator

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    It's amazing how far a little social grace can go.
  41. Roguelyn

    Roguelyn

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    It never occurred to me to judge a student on their specialty interest. I usually ask just to get to know the student more and to try to pick topics and cases that might be of more interest to them.
  42. cpants

    cpants Member

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    If a resident is asking you this question it is most of the time just to make small talk and some of the time to teach you points that might be interesting to you throughout the rotation. Almost never is it to pass some judgment on you or talk you out of your choice. The impression you make will be based on your motivation and performance. There have been many times I have said "man, I wish that student was going into surgery". On the other hand, there have been many times I have said the opposite, "thank god he's doing xyz...or...I can't believe he wants to be a surgeon."

    Own your choice and have good justification for it, because the natural follow up question will be "Why?". It's good practice for interviews to be able to articulate the reasons you are choosing your specialty (and the right answer is never related to lifestyle even if that is the real reason).
  43. babdoc

    babdoc

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    I'd say tell them the truth. The docs I've been with, and I'm guessing nearly every doc overall, wanted to get to know me by asking this. It's just small talk. I doubt they're really going to mark you down simply for wanting to do something else. I have had an internist (my specialty of interest, btw) say that he's had other students that were interested in other specialties (peds in the example he gave) nearly fail bc they didn't put forth the effort. It's not that the doc was prejudiced against this peds leaning girl, she simply made it obvious that she doesn't care about IM. Residents and attendings are looking for hard work and the attitude that as a student, you're there to get experience in it all. You specialize after med school, not during.
  44. HooahDOc

    HooahDOc

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    I ask out of curiosity and to share whatever knowledge I have of the field they're interested in. If they say psych, then I will make a point to talk to them more in-depth about the field.

    Sometimes I will harass students about their specialty, but it's all in jest. I have never let it influence their evaluation.

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