When did you decide on specialty?

[wannabeOBGYN]

I had a list of top 3 when I started med school. The list changed quite a bit during the first 2 years but one specialty was always in top 3 (surgery). Halfway through 3rd year and I've rotated through most core specialties and know enough about most specialties to know that I can only do surgery and nothing else.

I've noticed with my group of friends that their specialty of choice now as 3rd years was always present in their list of top 3/5/10 specialties when we all started med school.

What I'm saying is that if you make a list of top 3 or top 5 specialty of choice when you start med school, you will most likely end up in one of those by the end. No surprises!

I guess I was one of the weirdos, then. I started med school sure I would do IM, peds, or something else nonsurgical. OB/GYN was so far outside my realm of possibilities that I never thought I'd even consider it. However, during my second year, I realized that my women's health class was the only systems course for which I read way beyond the requirements. Who knew? OB/GYN was my first rotation as a third year, and I was sure within 5 minutes of my first day that that's what I wanted. It just took one delivery to know.

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[wannabeOBGYN]

Voice of reason, finally. Now, can we please do away with 3-4 months or more of Family Medicine (PCOM, I'm looking at you).

Agreed! I'm at Nova and between 3rd and 4th year we have 11 months of primary care (3rd year: 3 months IM, 2 months family, 2 months peds, 1 month geriatrics. 4th year: 3 months rural medicine [aka IM or FM]). We get 2 months of surgery and it's usually both general surgery. I wish we had 3 months so one could include subspecialties and anesthesia, it'd be nice to experience more than appendectomies, cholecystectomies, and hernia repairs.

 

[SB100]

At the end of my peds rotation is when I knew that's what I want to do. Problem is that was way back at the beginning of the year and I had to do all these other rotations since then

 

[olemissbabydoc]

At the end of my peds rotation is when I knew that's what I want to do. Problem is that was way back at the beginning of the year and I had to do all these other rotations since then

I'm grateful I didn't have peds til halfway through. The next 16 weeks are going to be the bane of my existence.

 

[MilkmanAl]

I actually know quite a few people who were "set" on peds before they did the rotation and ended up hating it. It was a little weird, actually.

 

[olemissbabydoc]

I actually know quite a few people who were "set" on peds before they did the rotation and ended up hating it. It was a little weird, actually.

I was TERRIFIED that was going to happen to me, so I tried to like everything. In the end though, the only thing I could've done if peds wouldn't have been "it" was OB. Had to be close to the babies somehow.

 

[MossPoh]

Some of it depends on your exposure or knowledge of the field before hand. Most people have minimal exposure to the fields going in, so they are in love with their idea of that specialty. I always had a strong idea of what I would end up going for, but mostly because my entire viewpoint of medicine growing up centered around that and I saw the pros/cons for quite sometime.

 

[jcu]

Hate adults. Like kids. Boom.

 

[olemissbabydoc]

Couldn't agree more with jcu.

 

[AlexMorph]

I hate obgyn more than T cells must hate HIV

 

[jcu]

Thanks olemiss. Many usually play devil's advocate with such reasoning. Because parents are adults too don'tcha know! But they're not MY old, gross, infantile diva patients

 

[MilkmanAl]

Liking kids+liking medicine =/= liking pediatrics. True story from a future anesthesiologist who loved working in a daycare but hated peds.

 

[jcu]

Liking kids+liking medicine =/= liking pediatrics. True story from a future anesthesiologist who loved working in a daycare but hated peds.

I actually almost never play the "I LOVE kids!" card because it's so trite. This one applicant really emphasized it during a group interview a few months ago and the Chair, not missing a beat, shot back "Well then why didn't open a daycare?" and was totally serious

 

[SlickNickMD]

Liking kids+liking medicine =/= liking pediatrics. True story from a future anesthesiologist who loved working in a daycare but hated peds.

I worked in a preschool 3 years in college and loved it, doesn't mean I want to become a pediatrician--I keep stressing this to people

 

[ArcGurren]

Some of it depends on your exposure or knowledge of the field before hand. Most people have minimal exposure to the fields going in, so they are in love with their idea of that specialty. I always had a strong idea of what I would end up going for, but mostly because my entire viewpoint of medicine growing up centered around that and I saw the pros/cons for quite sometime.

I'm not 100% sure if this is the case for everyone. I had some "exposure" to surgery in my preclinical and undergrad years that made it a very attractive option for me but when it actually came to working on the rotation, working with other surgeons and surgical residents, it made me want to vomit. I literally had such a vehemently bad experience (including in one rotation that's supposed to be a "good" site) that it really changed my mind.

I think an important thing is to go into third year with a fairly open mind. I really was surprised at how much I enjoyed Medicine considering how I thought it would go beforehand. I know people who've made 180 degree about-faces in their choice of field (one guy switched from Ortho to Medicine, one person switched from Peds Neuro to OB, etc).

 

[Depakote]

Liking kids+liking medicine =/= liking pediatrics. True story from a future anesthesiologist who loved working in a daycare but hated peds.

Had that same "love kids"/hated the type of medicine that pediatrics is realization... couldn't stand wards, couldn't stand clinic. Wound up going into Anesthesiology as well. I plan to give Pediatric Anesthesiology a good solid look when I'm doing my rotations in that. It's definitely on the table for fellowship consideration.

 

[VenusinFurs]

I actually didn't really like surgery very much, but at my school we do 3.5 months of medicine, and I really think if you're going to do that then having at least TWO months of surgery is not asking too much. We get two specialties and a month of general.

Or maybe it would be nice to let us choose if we want more surgery time or more medicine time. It just doesn't seem fair to the kids who know they want some type of surgery but don't get to see a wide variety of types.

 

[Dr Lyss]

If I knew the answer to this question, planning 4th year wouldn't be so frustrating

I came into 3rd year open, but having a top 3 I guess of things I knew I was more drawn to. Now, I've done everything except surgery and I'm still confused but kind of surprised with what I liked and didn't like. Ob-gyn was first and I was shocked that I really really liked it... but then I met ob-gyns in NY and saw they were miserable so... yea (you know if people in the profession are telling you to run far far away there is something going on). Thought I would love EM and critical care/IM... still liked EM but really didn't like IM. Over and over again I prefer younger patients and I LOVED peds. So here I am deciding between pediatrics and EM. I think I might check out peds critical care and see if that fits... because I really can't deal with any more 70+ patients with all these comorbidities. UHHHH I need another year haha

 

[ArcGurren]

I actually didn't really like surgery very much, but at my school we do 3.5 months of medicine, and I really think if you're going to do that then having at least TWO months of surgery is not asking too much. We get two specialties and a month of general.

Or maybe it would be nice to let us choose if we want more surgery time or more medicine time. It just doesn't seem fair to the kids who know they want some type of surgery but don't get to see a wide variety of types.

It's interesting how some peoples' schedules for surgery seem to work. At my school, we have 12 weeks of internal medicine and 8 weeks of surgery - in the 8 weeks, it's split between two sites, which can be completely random (I know someone who didn't get any exposure to actual general surgery during his rotation and ended up with one vascular, one trauma rotation).

I think ideally surgery would work fine if we had 2 weeks of subspecialty/anesthesia, 3 weeks of one site, and 3 weeks of another site.

 

[2012mdc]

If I knew the answer to this question, planning 4th year wouldn't be so frustrating

I came into 3rd year open, but having a top 3 I guess of things I knew I was more drawn to. Now, I've done everything except surgery and I'm still confused but kind of surprised with what I liked and didn't like. Ob-gyn was first and I was shocked that I really really liked it... but then I met ob-gyns in NY and saw they were miserable so... yea (you know if people in the profession are telling you to run far far away there is something going on). Thought I would love EM and critical care/IM... still liked EM but really didn't like IM. Over and over again I prefer younger patients and I LOVED peds. So here I am deciding between pediatrics and EM. I think I might check out peds critical care and see if that fits... because I really can't deal with any more 70+ patients with all these comorbidities. UHHHH I need another year haha

Peds EM was one of my favorite experiences durring 3rd year (and this was after I already decided on rads) and everyone seemed happy

 

[olemissbabydoc]

Lyss- my best friend is doing Peds EM. The beauty is you can go either route - Peds or EM to get there. She likes EM enough that she's going that route. Peds critical care is <3. I'm still Minorly torn between nicu/picu/both but at least ive got a few years to figure that part out.

 

[Dr Lyss]

ya know I only got to do one week of Peds EM but I wasn't too thrilled with it. If I fall in love with my peds sub-i I'm going to do a subi in either PICU or NICU

From what I heard most people won't go the EM -> Peds EM route because it's a pretty big pay cut. Sigh

 

[dozitgetchahi]

It's a DO school. Need I say more?

Granted, these 3-4 months are over the course of 3rd and 4th year but still.

UMDNJ-SOM does 3 months 3rd year and another month of "FP SPEC" 4th year. Annoying.

 

[DrVanNostran]

I actually decided on my specialty on the day my Rank List was due. I interviewed at IM programs and did another 6 in a competitive field. I did away rotations in both and couldn't decided what I wanted until rank day. When I took the mask off my eyes, I realized that my main motivations for the competitive field were more lifestyle, whereas my hopes for Internal Medicine (and H/O later on) were driven by a motivation to learn the field and learn medicine. I may not have even matched into the other speciality if ranked them 1-6, but I am confident that I am happy with my decision.


I think 3rd and 4th year is a really confusing time, yet so exciting. When you just step back and think of what you REALLY liked, the decision is pretty easy. It's just difficult to admit it to yourself sometimes.

 

[SlickNickMD]

Down to 2: Orthopedics and radiology (interventional)---would have liked urology but that early match is unreasonable and I don't think I'll have my aways in or even application in on time

I should be deciding by the end of my current rotation (Surgery), it's looking like ortho has a leg up

 

[gooze]

Down to 2: Orthopedics and radiology (interventional)---would have liked urology but that early match is unreasonable and I don't think I'll have my aways in or even application in on time

I should be deciding by the end of my current rotation (Surgery), it's looking like ortho has a leg up

why are you giving up on urology?? i know it's an early match but it's more than doable...don't let the early match deter you from applying to a great field esp. if you really like it.

 

[SlickNickMD]

why are you giving up on urology?? i know it's an early match but it's more than doable...don't let the early match deter you from applying to a great field esp. if you really like it.

I like Uro and Ortho somewhat equally, I just thought I'd go with ortho by default and the fact that uro was early match made the decision a little easier. Either way I'm choosing between 3 very good specialties and I would be happy doing any of them

 

[gooze]

I like Uro and Ortho somewhat equally, I just thought I'd go with ortho by default and the fact that uro was early match made the decision a little easier. Either way I'm choosing between 3 very good specialties and I would be happy doing any of them

hey, makes sense. i actually am kinda torn between uro and ortho myself...just wondering what you liked about both and what has swayed the decision for you towards ortho (at least for now). thanks. but yes, i agree, both are great fields. can't really go wrong with either.

 

[SlickNickMD]

hey, makes sense. i actually am kinda torn between uro and ortho myself...just wondering what you liked about both and what has swayed the decision for you towards ortho (at least for now). thanks. but yes, i agree, both are great fields. can't really go wrong with either.

Ortho: From a technical stand point I've always loved orthopedic surgery. What attracts me to it happens to be what others find off-putting about the specialty. I love the fact that the tools are akin to those used by a common mechanic or carpenter. There is also something for everyone, I'd love to eventually get a fellowship in ortho onc or trauma in the distant future if I go the ortho route.

Uro: A perfect union of highly technical and technology driven procedures and medical management. The urologists I've shadowed are also the most outgoing and hilarious doctors I've ever met-Penis jokes for days

Interventional: A growing field with an seemingly infinite potential to grow. Very few specialties do procedures that span every single organ system. The manage pathologies from other specialties in a less "invasive", safer, more efficient and in some cases more efficacious manner


I'm swayed toward ortho for the reasons I gave earlier, that early match and interventional is an increasingly competitive fellowship and not guaranteed. I love reading images, but I'd like to keep my time in the reading room to under 40% of my time

 

[gooze]

Ortho: From a technical stand point I've always loved orthopedic surgery. What attracts me to it happens to be what others find off-putting about the specialty. I love the fact that the tools are akin to those used by a common mechanic or carpenter. There is also something for everyone, I'd love to eventually get a fellowship in ortho onc or trauma in the distant future if I go the ortho route.

Uro: A perfect union of highly technical and technology driven procedures and medical management. The urologists I've shadowed are also the most outgoing and hilarious doctors I've ever met-Penis jokes for days

Interventional: A growing field with an seemingly infinite potential to grow. Very few specialties do procedures that span every single organ system. The manage pathologies from other specialties in a less "invasive", safer, more efficient and in some cases more efficacious manner


I'm swayed toward ortho for the reasons I gave earlier, that early match and interventional is an increasingly competitive fellowship and not guaranteed. I love reading images, but I'd like to keep my time in the reading room to under 40% of my time

i agree with all that you say....for me personally, i'm leaning towards uro mainly because of the fact that there is a little more flexibility in your career where you can decide to not do as many big surgeries later in your career and focus more on smaller surgeries/office procedures. this just isn't too possible in ortho in my opinion as you really need to operate your entire career in ortho....but again, i still have no idea what to do, haha.

 

[SlickNickMD]

^^career longevity is always a concern for surgeons, how long do do you see yourself operating? There are quite a few "smaller" procedures in ortho, I can see myself doing nothing but hand or scoping knees all day when I'm in my 70s

 

[gooze]

^^career longevity is always a concern for surgeons, how long do do you see yourself operating? There are quite a few "smaller" procedures in ortho, I can see myself doing nothing but hand or scoping knees all day when I'm in my 70s

you're right. there are "easier" procedures in ortho, however most, if not all, of those will still require OR time...in uro, there is a possibility of doing a bunch of procedures in the office including cystoscopies, prostate biopsies, vasectomies, urodynamics, prostate ablations, etc...and to be honest, if i were to do ortho, i'd prob. would want to do either spine or trauma and both of these really will not lend themselves to a career past 60ish years old. For me, hand and scoping knees is mind-numbingly boring and just don't think I would do it (but who knows). but again, i think it comes down to the fact that there is really no such thing as an orthopod that does not operate whereas there are plenty of urologists that decide not to operate. I just don't know how big/important of an issue I should make this aspect as i try to decide what field to go into.

 

[bestcoast]

finally decided mine 3 weeks before ranklist dead =P

 

[ManBroDude]

As an MS-0 with 4 months until I start school, would you guys suggest I go and spend some time shadowing different specialists while I have the time? I work in the ED as a scribe in a 400-bed hospital and with access to everything from med-surg to IR with a strategic phone call from my doc. I plan on getting married next summer between M1 and M2. What do you think?

 

[partydoc]

As an MS-0 with 4 months until I start school, would you guys suggest I go and spend some time shadowing different specialists while I have the time? I work in the ED as a scribe in a 400-bed hospital and with access to everything from med-surg to IR with a strategic phone call from my doc. I plan on getting married next summer between M1 and M2. What do you think?

I think you should enjoy your last bit of freedom.

As you find things that interest you in 1st/2nd yr, that might be a better time to shadow, cuz you will have more of an idea of what is going on.
I tried shadowing during my first year in the ED- it was a complete waste of time.

 

[MossPoh]

It is fun to go and hangout and see stuff, but I don't think it is tremendously high yield until you establish some baseline level of medical school.

 

[ArcGurren]

As an MS-0 with 4 months until I start school, would you guys suggest I go and spend some time shadowing different specialists while I have the time? I work in the ED as a scribe in a 400-bed hospital and with access to everything from med-surg to IR with a strategic phone call from my doc. I plan on getting married next summer between M1 and M2. What do you think?

Go on vacation or play video games all day and stop going crazy before you start medical school.

 

[dienekes88]

I thought I knew half-way through first year. I was absolutely sure at the end of first year.

 

[officedepot]

.

 

[username456789]

lol... what year are you now?

first year med students can be pretty naive.

Pretty sure he's a 4th year, but I could be mistaken.

 

[dienekes88]

lol... what year are you now?

first year med students can be pretty naive.

Matched already, boss.

 

[ArcGurren]

Matched already, boss.

Into... what?

I always found it weird when people were like "oh yeah man I totally knew I loved xyz specialty" and spend their entire four years trying to live and breathe it...

 

[officedepot]

.

 

[dienekes88]

Into... what?

Doesn't matter.

I always found it weird when people were like "oh yeah man I totally knew I loved xyz specialty" and spend their entire four years trying to live and breathe it...

If you have a passion for something, then you want to immerse yourself in the field.

out of more than 1500 posts you don't feel the need to elaborate?

No.

such as what field and how you knew so early in med school what you wanted to do?

Very generally, I chose my field because:
1) I love reading about it, so I study in my free time.
2) The physiology and pathophysiology are fascinating to me.
3) It appeals to my detail-oriented nature.
4) It's very technically demanding.
5) The patients have a compelling narrative.

I don't care if you already matched. I still think it's naive to be so close-minded as a 1st year med student even if you already think you love something. I often see this stuff with people who want to do very competitive fields like neurosurgery.

This is the mindset that leads me to tell most medical students to lie about their specialty preferences.

Having a passion for something does not necessarily mean that you are closed-minded. There is a lot to learn on every rotation and from every patient. Most residents and attendings respected the fact that I had a passion for a certain field and more importantly respected my work ethic and fund of knowledge. Some took on your mindset and viewed me through the "future-specialist uninterested in my field"-lens, though.

 

[officedepot]

.

 

[username456789]

lol probably the most douchebag posts I've read

Odd, considering there is really no douchebaggery whatsoever to his post. His refusal to acquiesce to your request to divulge his chosen field is his choice, and he handled the other points pretty calmly and without resorting to name calling or other cheap shots.

 

[ArcGurren]

Doesn't matter.

If you have a passion for something, then you want to immerse yourself in the field.



No.

Very generally, I chose my field because:
1) I love reading about it, so I study in my free time.
2) The physiology and pathophysiology are fascinating to me.
3) It appeals to my detail-oriented nature.
4) It's very technically demanding.
5) The patients have a compelling narrative.

This is the mindset that leads me to tell most medical students to lie about their specialty preferences.

Having a passion for something does not necessarily mean that you are closed-minded. There is a lot to learn on every rotation and from every patient. Most residents and attendings respected the fact that I had a passion for a certain field and more importantly respected my work ethic and fund of knowledge. Some took on your mindset and viewed me through the "future-specialist uninterested in my field"-lens, though.

I still don't understand why you don't want to say what field you're in. And everything you've said about your reasons for picking it could be the generic reasons for any field. And you've matched, so it's not like someone's going to track you down and prevent you from becoming whatever doctor you want to be. That's so unnecessarily silly.

 

[dienekes88]

I still don't understand why you don't want to say what field you're in. And everything you've said about your reasons for picking it could be the generic reasons for any field.

Absolutely, and that's why listing those reasons is better than enumerating the very specific things that drew me to a particular field. The specifics wouldn't apply to anyone else. What you see listed is my best advice for future generations in the general process of specialty selection. If you can find a field that you enjoy reading about; a field with pathophys that whets your appetite for intellectual stimulation; one that is in line with your work-style; one in which you like the bread and butter cases... well, then I will assert that you have found your field independent of what my field did for me.

And you've matched, so it's not like someone's going to track you down and prevent you from becoming whatever doctor you want to be. That's so unnecessarily silly.

I prefer to maintain some semblance of anonymity. The field of medicine is very small.

 

[235009]

Very generally, I chose my field because:
1) I love reading about it, so I study in my free time.
2) The physiology and pathophysiology are fascinating to me.
3) It appeals to my detail-oriented nature.
4) It's very technically demanding.
5) The patients have a compelling narrative.

My guess is he's talking about anesthesia. Future anesthesiologists are the only ones I've seen who list fascinating physiology as a reason.

 

[ArcGurren]

Absolutely, and that's why listing those reasons is better than enumerating the very specific things that drew me to a particular field. The specifics wouldn't apply to anyone else. What you see listed is my best advice for future generations in the general process of specialty selection. If you can find a field that you enjoy reading about; a field with pathophys that whets your appetite for intellectual stimulation; one that is in line with your work-style; one in which you like the bread and butter cases... well, then I will assert that you have found your field independent of what my field did for me.

I prefer to maintain some semblance of anonymity. The field of medicine is very small.

I suppose, but the field of medicine is not THAT small...