What specialty is best for me?

[Skarl]

I’ve published a lot of research in a surgical subspecialty (double digit no. of peer-reviewed papers), but want to make sure I’m not anchoring.

In my rotations, I’ve enjoyed being in the OR and feel motivated to hone my technical skills (closing incisions, suturing, assisting). When permitted, I find it very satisfying to assist in surgeries (using the bovie, closing incisions, suturing). I like that surgeon prowess and successful treatment can be tangibly seen during an operation. The workflow of surgery, focusing on one patient at a time, also appeals to me. I especially like being able to offer definitive treatments to patients and cure pathologies. Personality-wise, I feel I fit in as I’m somewhat impatient, task-oriented, and more decisive than comprehensive. In general through my rotations, I’ve found that time passes more quickly when I am actively DOING things rather than idling.

However, I’ve heard you should only do surgery if you can’t see yourself doing anything else. I think this is an extreme statement and am unsure if it’s true because my medicine rotation was enjoyable. My residents and attendings gave me positive feedback and let me do more. I led H&Ps/bedside conversations, performed minor procedures, pended orders, and had autonomy over care of patients I followed. The hours were better and I was usually home earlier and up later.

Miscellaneous things are I like gathering info by talking to patients over chart-reading, especially if I have to sift through numerous notes to gather a thorough history. I prefer concrete labs/imaging and definitive diagnoses → treatments. I like offering patients tangible solutions; I don’t enjoy talking to patients for prolonged visits or convincing them to do something they are against (e.g. motivational interviewing). Some med students interested in surgery say that they “have always liked working with [their] hands,” but honestly I’m not sure what that means. Until medical school, the only work I’d done with my hands was bubbling in Scantrons and pipetting.

I value being well compensated and lifestyle to an extent (I believe that if you genuinely love your work the hours don't feel as long). I am considering a career in academics but am undecided. What would be the best specialty for me given the above?

Tl;dr- enjoy being in the OR, but didn't hate medicine either. Like DOING things. Dislike charting and longer visits. Love definitive diagnoses and treatments.

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[voxveritatisetlucis]

Anesthesiology

 

[Kardio]

I value being well compensated and lifestyle to an extent

enjoy being in the OR, but didn't hate medicine either. Like DOING things. Dislike charting and longer visits. Love definitive diagnoses and treatments.

Ophtho - money, lifestyle, procedures, definitive treatments
interventional cardiology - money, procedures, definitive treatments, option to ‘drop down’ to general cards if the OR/cath lab gets to be too much for you

 

[operaman]

ENT here. I’ve always thought the whole “do anything else if you can” mantra was bunk. Yes I love the OR, but if I did that 4 days a week I think I’d hate it. I love a nice variety personally and ent allows me that. I do some clinic, some OR, some awake procedures - it’s a nice variety that makes it easier to get through the week.

It’s hard as a student to separate a good rotation from a good career fit. Just remember that eventually you get all of the autonomy and also that nobody else cares anymore. All your attending friends will have the same autonomy and you’re basically free to do whatever you want. Try to focus on the day to day stuff and whether you actually like it or not. Try to picture if you’ll enjoy it when you’re all by yourself doing it.

Academic medicine, which every student practices by definition while they’re a student, also gives a warped view of things. For example, in my field you can rotate with sub specialists doing all kinds of crazy stuff, but no one attending in practice is doing all of it. Try and focus on individual attendings and their practice and see if it sounds interesting. Everything is interesting when you bounce between amazing unique cases every day, but the individual attendings each did their one unique case that week and then went back to clinic or to more mundane stuff.

I often advise students to spend a lot of time picturing their day to day work week in the future, what they want their life to look like overall. Work backwards from that.

Your post suggests a surgical sub may be perfect for you. Anesthesia is also a great option.

 

[anbuitachi]

Anesthesiology here.

Disagree with anesthesia being a good choice , but also disagree with only apply to surgery if you cant see yourself doing anything else.

With anesthesiology, the lifestyle is one of the worst because you have very little control over how many cases are booked by the surgeon and how long the surgeon takes to operate. There are often also a lot of calls and nights if you are in a big hospital because they cover 24/7 emergencies. Anesthesia starts before surgery starts and ends after surgery ends. Sometimes you may get relief from call team but thats again unpredictable. Also salary is much lower than surgical colleagues per hour

Also if you are impatient, anesthesiology is also not a good fit. because over half the time will be waiting for the surgeon to finish the procedure while you look at the vitals.

 

[voxveritatisetlucis]

Anesthesiology here.

Disagree with anesthesia being a good choice , but also disagree with only apply to surgery if you cant see yourself doing anything else.

With anesthesiology, the lifestyle is one of the worst because you have very little control over how many cases are booked by the surgeon and how long the surgeon takes to operate. There are often also a lot of calls and nights if you are in a big hospital because they cover 24/7 emergencies. Anesthesia starts before surgery starts and ends after surgery ends. Sometimes you may get relief from call team but thats again unpredictable. Also salary is much lower than surgical colleagues per hour

Also if you are inpatient, anesthesiology is also not a good fit. because over half the time will be waiting for the surgeon to finish the procedure while you look at the vitals.

Is academic anesthesiology usually more laid back? One of my friends who went to HMS told me that she matched into anesthesiology for lifestyle purposes, but I’m pretty sure she wants to do academic medicine. Would it have been better for her to do ophthalmology, ent, urology from a lifestyle point of view. Given that she came from HMS, I’m sure she could’ve done anything

 

[anbuitachi]

Is academic anesthesiology usually more laid back? One of my friends who went to HMS told me that she matched into anesthesiology for lifestyle purposes, but I’m pretty sure she wants to do academic medicine. Would it have been better for her to do ophthalmology, ent, urology from a lifestyle point of view. Given that she came from HMS, I’m sure she could’ve done anything

lets just say, medical school is 4 years, with a few months at best of exposure to anesthesiology. residency has 3 year exposure to anesthesiology. attending is entire career. so any resident you ask, will have zero years of attending experience to talk about. at most they tell you about lifestyle in residency.

now with that said, every academic institution is different, every job is different. if you are very research heavy and want to do research, some places will hire you just for your research, +/- with a different salary. other places wont care at all. everything got its own niche. but IMO, you shouldn't be limiting yourself. but hey if you are confident in exactly what you want, go for it

And disagree with coming from HMS, couldve done anything. Med school is just med school. you can be a rockstar medical student and be a terrible anesthesiologist. not exactly the same skill sets

 

[Dr G Oogle]

The “do anything” thing probably refers to general surgery where the schedule can be brutal in residency, but in private practice could be pretty Cush. I dont think it refers to the subspecialties or even gen surgery subspecialties. If you like doing things then figure what procedural specialty you like. Surgeons are the end all be all; other specialties (cards, GI, IR) can treat a lot of conditions and are usually fine, but it’s the surgeon who is the back up and who is the final stop on the treatment train and can fix the complications the other folks may encounter/cause

 

[DOVinciRobot]

Welcome to surgery.

Many of us could have done other things, we didn't because only in surgery can you play in the OR (anesthesia isn't the same type of playing, unless you are talking about candy crush). Yeah residency is rough, but you can control your life a lot more afterwards.

 

[Tenk]

Welcome to surgery.

Many of us could have done other things, we didn't because only in surgery can you play in the OR (anesthesia isn't the same type of playing, unless you are talking about candy crush). Yeah residency is rough, but you can control your life a lot more afterwards.

That’s residents and CRNAs. Real attending anesthesiologists play Vanguard, TD Ameritrade and Fidelity during cases.