What is the ideal specialty?

[miamiheatfan]

I know that every specialty has their pros and cons, and for some specialties you have to like doing certain things or not. I also get that everyone will do what is in their best interests. I'm pretty much open to any specialty right now, and while I know I'll get a better idea of what I want to do once I'm in medical school, I just wanted to get opinions on what people think is the best specialty to do and why, not including fellowships (or include them in your explanation). Appreciate the responses!

PS: I tried to group them as well as I could only put 10 options so sorry. If you pick a response where I put multiple specialties feel free to explain which one you meant in particular.

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[deleted577188]

more money less work, whichever one that may be

 

[Ismet]

Peds. Because babies.

 

[Cyberdyne 101]

I picked pm&r because it doesn't get the recognition it deserves (it's lifestyle friendly and not very competitive) Also, there are various fellowships available for physiatrists including sports medicine, spine intervention, peds, spinal cord injury, and pain management.

 

[referee3]

more money less work, whichever one that may be

That would be derm.

 

[miamiheatfan]

Thanks for all the responses so far!

 

[miamiheatfan]

LOL just noticed that someone posted a thread about specialties that are good for jokesters about 15 minutes before I did. Promise I didn't see that, I was in the process of making this thread when he posted that so it's ironic that a similar post was made at almost the same time

 

[gyngyn]

The best specialty is the one that most magnifies your ability to be of service.
Thus, it will vary by personal strengths and weaknesses and your community's needs.

 

[pandahunter]

it's derm. it's always been derm. And i say that despite the fact that i hate derm. if you have a chance to do derm, do it. There's a reason they have the highest job satisfaction rate out of all specialities by a significant margin.

 

[pandadawn]

it's derm. it's always been derm. And i say that despite the fact that i hate derm. if you have a chance to do derm, do it. There's a reason they have the highest job satisfaction rate out of all specialities by a significant margin.

I do not care what you have to say, and I completely disagree, and your username is offensive.

That said, I'm going to have to say that derm is where it's at.

 

[amazing tekkers]

Internal medicine

 

[miamiheatfan]

Internal medicine

Can you expand on why by any chance?

 

[Goro]

Jeeze, heat...ask this of 100 med students and you're going to get at least 200 hundred answers!

I know that every specialty has their pros and cons, and for some specialties you have to like doing certain things or not. I also get that everyone will do what is in their best interests. I'm pretty much open to any specialty right now, and while I know I'll get a better idea of what I want to do once I'm in medical school, I just wanted to get opinions on what people think is the best specialty to do and why, not including fellowships (or include them in your explanation). Appreciate the responses!

PS: I tried to group them as well as I could only put 10 options so sorry. If you pick a response where I put multiple specialties feel free to explain which one you meant in particular.

 

[gamrag]

Do what you love. Do something that you can see yourself getting up every morning for the rest of your life and not say "OMG I have to go to work again." Money is important, but you'll make enough in any field in medicine if you are smart with your finances. There is no ideal specialty that fits everyone. Ask yourself the question: If every specialty had the same pay and same prestige, what would you do?

 

[miamiheatfan]

Jeeze, heat...ask this of 100 med students and you're going to get at least 200 hundred answers!

Haha I know you're shaking your head at me Goro! I had to ask haha!

Do what you love. Do something that you can see yourself getting up every morning for the rest of your life and not say "OMG I have to go to work again." Money is important, but you'll make enough in any field in medicine if you are smart with your finances. There is no ideal specialty that fits everyone. Ask yourself the question: If every specialty had the same pay and same prestige, what would you do?

Definitely will keep this in mind!

 

[Ace Khalifa]

Ortho is the specialty I'm most interested at the moment. After shadowing my ortho friend who works in a community hospital doing mostly elective surgeries, I can say that he's always happy and joking around with everyone while doing amazing work that really helps the people in our community. Oh, he makes bank too, so can't go wrong with that. I liked that you grouped all the surgical fields together (except urology and ENT, you should have included them too) because I think it would be extremely satisfying to be a surgeon - you connect with your patients, get immediate results after doing surgery, and help patients feel better right away especially if you fixed their problem completely (ortho is really good in this regard) and not just treated it.

I'm a sucker for anything that allows me to fix things. I'm not a fan of chronic issue management - I've had to do this with non-medical issues before, and believe me, it's not fun at all.

 

[miamiheatfan]

Ortho is the specialty I'm most interested at the moment. After shadowing my ortho friend who works in a community hospital doing mostly elective surgeries, I can say that he's always happy and joking around with everyone while doing amazing work that really helps the people in our community. Oh, he makes bank too, so can't go wrong with that. I liked that you grouped all the surgical fields together (except urology and ENT, you should have included them too) because I think it would be extremely satisfying to be a surgeon - you connect with your patients, get immediate results after doing surgery, and help patients feel better right away especially if you fixed their problem completely (ortho is really good in this regard) and not just treated it.

I'm a sucker for anything that allows me to fix things. I'm not a fan of chronic issue management - I've had to do this with non-medical issues before, and believe me, it's not fun at all.

Haha yeah I should've! I felt weird grouping so many things together lol! Thanks for the response Ace

 

[Lucca]

Heme/Onc. I have not seen such an attentive, responsive, involved, patient population like I did in oncology. Cancer patients are a privilege and there's plenty of interesting research to do.

 

[NickNaylor]

There is no "best." It depends on your interests, priorities, and goals. For some people, "satisfaction" is working 100+ hours a week while that would make me want to jump off a bridge. For some, improving lives means being in the OR or in an office.

There is no best. Even taking into account money and lifestyle considerations, getting paid well for something you hate doing is certainly not going to be "the best."

 

[JPA178]

There's no such thing as an "ideal" specialty, or even the "best" specialty. It varies from person to person. What might be ideal for me could be terrible for someone else. Different people have different priorities and interests.

That being said, I think one of the most important questions that students need to answer first is: medicine vs. surgery, or more broadly, procedural vs. non-procedural. How do you see yourself spending your day? Mostly performing procedures with a mix of seeing patients admitted/in clinic? Or do you see yourself as someone who primarily examines, diagnoses, and treats medically? Each has a different mindset and a different type of workday. Once you figure this out, then I think it's easier to narrow down the direction you want to go.

 

[deleted577188]

Heme/Onc. I have not seen such an attentive, responsive, involved, patient population like I did in oncology. Cancer patients are a privilege and there's plenty of interesting research to do.

Cancer patients are a privilege or working with them is?

 

[Lucca]

Cancer patients are a privilege or working with them is?

As in working with them is

 

[Hospitalized]

Peds has gotta be pretty high. Nothing like touching a patient's nose while making a "beep" noise to make them laugh. Doesn't really work on adults.

 

[Omppu27]

Peds has gotta be pretty high. Nothing like touching a patient's nose while making a "beep" noise to make them laugh. Doesn't really work on adults.

Never know until you try...

 

[JPA178]

If you like surgery, urology is pretty darn awesome. Lots of cool toys to use in the OR like robots and lasers, good mix of procedures/inpatient/clinic, minimal call compared to other surgical specialties, opportunity to make a big difference for the patients you see... oh, and making serious bank doesn't hurt either

 

[WingedOx]

As someone who has only a few months of residency left, I'm glad I didn't spend the last few years of my life inside an OR.

 

[Frazier]

There is no "best." It depends on your interests, priorities, and goals. For some people, "satisfaction" is working 100+ hours a week while that would make me want to jump off a bridge. For some, improving lives means being in the OR or in an office.

There is no best. Even taking into account money and lifestyle considerations, getting paid well for something you hate doing is certainly not going to be "the best."

Don't be so coy. We both know the answer is psych.

 

[Mad Jack]

Peds. Because babies.

Kids come with parents. Parents are terrible.

 

[Mad Jack]

Heme/Onc. I have not seen such an attentive, responsive, involved, patient population like I did in oncology. Cancer patients are a privilege and there's plenty of interesting research to do.

This is a perfect example of how people see fields drastically different and one man's dream field is another's nightmare. Cancer depresses the hell out of me, and the treatments we have are so comparatively ineffective when compared to other areas of medicine that I just could never find it satisfying and would be horribly depressed in practice.

 

[jl lin]

This is a perfect example of how people see fields drastically different and one man's dream field is another's nightmare. Cancer depresses the hell out of me, and the treatments we have are so comparatively ineffective when compared to other areas of medicine that I just could never find it satisfying and would be horribly depressed in practice.

Yea, I think I have often felt this way. But there have been big changes in treatments and outcomes. Sure, a lot of it still sucks, but there has been improvement. Some of it, say for AML, has gone through some changes. There has been improvement in tx that may have helped my dad. Instead, he died relatively young, especially compared to his parents and grandparents. Freaking early retirement and working with a bunch of chemicals for decades. Thing is, he was working away from exposure for some time before he retired. I think they were pressuring him to retire. Work decades for a company and exposure yourself to God know what all, and then you get the bum's rush when you can't be abused anymore.

I don't know if I would want to work with it day in and out though. Plus I like a mix of things.

 

[I'm No Superman]

Emergency Medicine: No call

 

[toutou]

I'm biased because of my experience as a nurse. I'm shooting for OBGYN mainly because I want to do Gyn Onc. If I can't land Gyn Onc, I would still be very happy as an OBGYN.

 

[bc65]

Get the book on choosing a medical specialty from the SDN store. It's very complete and has a lot of useful information. Read it, and you will find the specialty that will seem best for you.

Then you'll go to med school and change your mind.

But do read the book once you get to med school anyway.

 

[Ismet]

Emergency Medicine: No call

Ah yes, never mind the high burnout rate. Just as long as I don't have call.

 

[miamiheatfan]

I appreciate all the responses! Definitely looking forward to the next four years and beyond

 

[armybound]

I'm offended by your lumping of urology with ob/gyn.

 

[Psai]

Best specialties: Allergy/immuno, ENT, derm, PM&R, ophtho

Worst: EM, anesthesiology, general surgery, peds, obgyn

 

[miamiheatfan]

I'm offended by your lumping of urology with ob/gyn.

Haha sorry!

 

[miamiheatfan]

Best specialties: Allergy/immuno, ENT, derm, PM&R, ophtho

Worst: EM, anesthesiology, general surgery, peds, obgyn

Thank you! Can you expand on why? Specifically for PM&R, allergy, anesthesiology, and General surgery?

 

[NickNaylor]

Thank you! Can you expand on why? Specifically for PM&R, allergy, anesthesiology, and General surgery?

PM&R pays pretty well and has a good lifestyle in both practice and during residency. The main drawback for most people is the patient population that you'll be dealing with - chronic problems that often don't respond well to treatment. Allergy is much the same sans issues about the patient population.

General surgery is rough because of the hours - both during training and in practice. The training culture, to speak in generalities, can be brutal, though this isn't a true rule.

Not sure why anesthesiology is put on the bad list. It's a great field for those willing to go into it; the pay is excellent and, depending upon practice environment, the hours can be decent. Perhaps the main reason for Psai is the encroachment of CRNAs into routine anesthesia management. In many places, this shifts the attending physician into more of a management role than as a pure clinician.

 

[miamiheatfan]

PM&R pays pretty well and has a good lifestyle in both practice and during residency. The main drawback for most people is the patient population that you'll be dealing with - chronic problems that often don't respond well to treatment. Allergy is much the same sans issues about the patient population.

General surgery is rough because of the hours - both during training and in practice. The training culture, to speak in generalities, can be brutal, though this isn't a true rule.

Not sure why anesthesiology is put on the bad list. It's a great field for those willing to go into it; the pay is excellent and, depending upon practice environment, the hours can be decent. Perhaps the main reason for Psai is the encroachment of CRNAs into routine anesthesia management. In many places, this shifts the attending physician into more of a management role than as a pure clinician.

Great insight, thank you Nick!

 

[PatsyStone]

Best specialties: Allergy/immuno, ENT, derm, PM&R, ophtho

Worst: EM, anesthesiology, general surgery, peds, obgyn

I'm going to assume you've never done an allergy rotation

 

[Psai]

I'm going to assume you've never done an allergy rotation

I've done an outpatient rotation with an allergy/immunology physician who trained at the NIH, thanks for asking.

 

[PatsyStone]

Allergy is like the "derm" of Internal Medicine right now. Very good reimbursement and insurance mix, no inpatient, cush.

I want to ask the same question above (thanks for responding, @Psai !). When you were a medical student, did you rotate in derm and allergy? I mention this because before I rotated in allergy, I totally bought into the "allergy is just like derm: if you can't match into derm and you have to do IM, you should totally do an allergy/immunology fellowship." In reality, allergy is boring, like really f*cking boring. I cannot image a worse career than having to see patient-after-patient where you do a 45-60 minute H&Ps about how eating carrots makes their mouth itch. Or spending 20 minutes describing to someone the correct way to use nasal spray. Granted the immunology cases are more interesting, but the bread and butter is managing asthma and discussing food allergies. I just get the sense that someone compared allergy to derm in the past, and then people on SDN repeated it over-and-over as a matter of fact

IMHO, rheum is more like the derm of IM: their hours are great, call is minimal, more complex diseases, you get to Rx biologics/immunosuppressive agents, clinic runs fast-ish, there's a shortage of rheumatologists everywhere, patients tend to be very compliant with meds, patients are grateful for the help you can give them, you can do small procedures (joint injections), more female than male patients, and like in derm, there is a mix of crazy patients.

 

[PatsyStone]

I haven't, but I have several good friends who matched in it last year and are quite happy, and my SO strongly considered it.

Yeah, differn' strokes for differin' folks. I find cardiology and neurology boring, but I can appreciate why other people find them interesting. I just cannot understand why someone would do allergy, even with the easy hours and decent salary.

 

[miamiheatfan]

For the medical students and residents specifically on this thread, which specialties if any can you match into without having to do research?

 

[NickNaylor]

For the medical students and residents specifically on this thread, which specialties if any can you match into without having to do research?

With the exception of probably the most competitive specialties (derm, plastics, optho, etc.), you could probably match somewhere - perhaps not a great program or a large university program - with little or no research. I think most programs would expect some kind of research experience, though.

The NRMP actually tracks this. Google "NRMP Charting Outcomes 2014" and look at the report for yourself. They report "research experiences" - which could include anything from a first author pub to a poster presentation - by both specialty and by whether or not applicants matched. Keep in mind those figures are means, but that might give you a better answer.

 

[Ace Khalifa]

For the medical students and residents specifically on this thread, which specialties if any can you match into without having to do research?

+1, follow up question: Is it possible to match into excellent residency programs (the ones that will provide you the best clinical training and best chance for fellowships) for the surgical specialties with zero or minimal research experience?

 

[NickNaylor]

+1, follow up question: Is it possible to match into excellent residency programs (the ones that will provide you the best clinical training and best chance for fellowships) for the surgical specialties with zero or minimal research experience?

Highly doubtful, but perhaps someone with more specialty-specific knowledge can chime in. I would again refer you to the NRMP Charting Outcomes document mentioned above. The one exception I can think of is if you have a clear non-research interest that you've actively developed and will continue to develop in training. Perhaps that's public health work, perhaps that's international work, or any myriad of other things. But the key point is that if you're trying to get into an academic program - where most but not all good programs are - without any real or imagined interest in academics, then you need to have something else going for you.

 

[Ace Khalifa]

Highly doubtful, but perhaps someone with more specialty-specific knowledge can chime in. I would again refer you to the NRMP Charting Outcomes document mentioned above. The one exception I can think of is if you have a clear non-research interest that you've actively developed and will continue to develop in training. Perhaps that's public health work, perhaps that's international work, or any myriad of other things. But the key point is that if you're trying to get into an academic program - where most but not all good programs are - without any real or imagined interest in academics, then you need to have something else going for you.

Does that something else have to be more than just, "I only care about becoming a strong clinician"?