Which Specialty?

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Khaos05

RN going MD
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Hope you guys don't get annoyed with me, but I'm the type of person that has to have a lot of things planned (but somehow likes spontaneity).

Here are my top choices. What I want to know is the difficulty (time, on-call, etc.) of the residency, how/why you think one is more enjoyable, and what each is like post-residency. I've been married for two years and by the time I graduate medical school we will be looking to have kids. That's where my concern and planning comes in.

1. Surgery
2. Emergency
3. Cardiology
4. Internal Medicine
5. Family Practice

Those are probably in the order from favorite to "least" favorite. I have a feeling that even though I have a real interest in GS, my family could not handle that and I would therefore drop it for my second choice if need be.

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Well, here's my question to you: what interests you in each specialty and have you spent time in each field? I'm emergency, but I don't think anyone should be trying to convince you of any field, particularly if you have not spent time in the OR, the floors, the clinics, or the ER (or maybe the darkened reading rooms for rads). I think ultimately, you have to figure out which one of those settings feels like home to you before you decide what you want to go into.
 
Here are my top choices. What I want to know is the difficulty (time, on-call, etc.) of the residency, how/why you think one is more enjoyable, and what each is like post-residency. I've been married for two years and by the time I graduate medical school we will be looking to have kids. That's where my concern and planning comes in.

1. Surgery
2. Emergency
3. Cardiology
4. Internal Medicine
5. Family Practice

Not really the best way to select a career. All fields have their own areas of "difficulty" and what I may find enjoyable, you may find detestable. Asking re: post-residency life is equally tricky because often, it's what each individual makes of it.

I will say that if you are hesitant about pursuing a career in surgery prior to even starting residency, it's probably not the field for you. But I wouldn't say a career in EM, cards, IM would necessarily result in a significantly cushier lifestyle.

The best advice would probably be to do as well as possible early on in med school and then keep an open mind during the clinical years as to what you may want to do. (The doing-well early on will leave a lot of doors open)

I'm sure you must have heard of the ROAD mnemonic as well for fields that have traditionally been viewed as cushy: radiology, ophtho, anesthesia, derm. You may want to consider those as well if lifestyle concerns are paramount. Family medicine, as you mentioned earlier, is another field that often provides a lot of flexibility with regards to lifestyle. (Obviously, that shouldn't be the sole driving factor in pursuing a career in one of those fields)
 
Those are probably in the order from favorite to "least" favorite. I have a feeling that even though I have a real interest in GS, my family could not handle that and I would therefore drop it for my second choice if need be.

Here's the thing...why does it matter right now? It's not like you need to sign a contract saying what field you are going into before you start medical school.

Step 1 is getting into medical school; Step 2 is succeeding in first year. Choosing a residency is somewhere down the line at about Step 25 - why are you trying to decide now? Especially when (no offense) your questions indicate you don't really have a clear concept of what any of these fields are like?

Do you know that you want to be a doctor? If so, take your list of 1-5 with you and figure it out during medical school.
 
Hope you guys don't get annoyed with me, but I'm the type of person that has to have a lot of things planned (but somehow likes spontaneity).

I would definitely wait to assess this until 2nd year, preferably until the end of 3rd year. Many things change over the course of med school - your interests, your priorities, residency hour requirements, even the strength of your marriage :)scared: :().

I think that you'll also get a lot more exposure to ALL the different medical fields, even as an MS1 or an MS2, a lot more than you can get now as a pre-med. For instance, some people translate their love of surgery into ophtho, which is significantly more lifestyle friendly. Other people go into their MS3 rotation sure that they'll love surgery, and then spend 3 hours in the OR and vow never to set foot in the OR again. It's hard to tell this early in advance...even for the planners.
 
Well, part of me feels like I have a small idea of what each of those is like due to clinicals in nursing school and from working as a nurse aid at the local hospital, but I plan on shadowing a few MDs in the near future.

I was just hoping that you may be able to bring something to my attention about those specialties that would either make me love it or hate it.
 
Well, part of me feels like I have a small idea of what each of those is like due to clinicals in nursing school and from working as a nurse aid at the local hospital, but I plan on shadowing a few MDs in the near future.
I am a firm believer in the idea that you cannot know what a specialty is like until you rotate on it...and even then, it's only a glimpse. As a pre-med and a shadowing MS1/2, you have no idea what it's like to come in at 4:30am for weeks to months at a time, come up with daily plans, read after spending 12 hours in the OR, etc. And even as an MS3, you won't understand what it's like to spend your entire day off writing discharge notes, to have to stay late simply to wait on one lab result/one procedure/resolution of a social issue, etc.

So thinking about your potential future fields as a pre-med is fine. But planning your life in detail now is kind of pointless, as I can almost guarantee you your choice will change in just a few years.
 
Here's the thing...why does it matter right now? It's not like you need to sign a contract saying what field you are going into before you start medical school.

Step 1 is getting into medical school; Step 2 is succeeding in first year. Choosing a residency is somewhere down the line at about Step 25 - why are you trying to decide now? Especially when (no offense) your questions indicate you don't really have a clear concept of what any of these fields are like?

Do you know that you want to be a doctor? If so, take your list of 1-5 with you and figure it out during medical school.

This post is true to an extent. There are some exceptions. For the following fields, you absolutely need to know you're interested in them at the very start, almost to the exclusion of all other fields: Radiation oncology, dermatology, plastic surgery, and possibly otolaryngology.

OP, decide now whether you might want to pursue one of the fields I've listed above. Either that, or be willing to take a full year off (following third-year, once you've come to your decision) to do enough research to make yourself a competitive applicant. I bought the whole "you don't need to decide anytime soon," and later discovered that applicants with all Honors and Step scores of 250+ are routinely denied Rad Onc interviews for lack of 6+ peer-reviewed articles in the field.

Of those you've listed, I'd suggest already ruling-out surgery. Why? Because the mere fact that you've listed other fields means that you're willing to go into something OTHER than surgery. Do that. Problem solved.

Cardiology is a subspecialty of internal medicine, so the choice you've got to make is whether you want, first and foremost, to be an internist. Even cardiologists, minus interventionalists (perhaps), practice a ton of internal medicine each and every day of their careers, making this a horrible choice for someone who doesn't like IM.

Emergency medicine, I agree, you will need to experience for yourself. As opposed to surgery, which you know beforehand will run you into the ground, and to IM which is, well, MEDICINE, you'll actually need to experience EM to understand what it is. Some people choose it for the shiftwork...and I'd caution you about this. Those people burn out, since the hours spent in the ED are hectic, brutal, hard-worked hours potentially full of frustration for someone who hasn't gathered adequate experience before committing to it.
 
I only read the OP, but with regards to getting annoyed. 1. this is not a "General Residency Issue", and should be posted in some other thread. 2. Cardiology is a branch of Internal Medicine, so I'd exclude it from your list, since youve posted both. (If you said Cardio or bust, thats different)

OK, something more constructive to follow.
 
K.

Now, one thing you shouldnt do is decide on a career based on how time consuming the training is. Residency is temporary, the career will last for the rest of your life. Just because the residency is busy doesn't mean that your career will be, or has to be, or vice versa.

If the issue is having kids while in residency, think about how to make that work.

And as others have said, you have to DO these to find out what theyre really like. You really need to give yourself some time to figure things out, since youve selected everything (medicine, surgery...), you'll narrow things down on your own.

Surgery - tough life, 80hrs/week during residency, if not more. Thats for 5 years. After youre an attending with some experience, you can start setting your own hours.

EM - youve really gotta check it out for yourself. residency is decent hours, swing shift might drain you.

Medicine - the hours depend on what service you're on in a particular block. 3 years. Flexibility as an attending. A subsequent Cardiology fellowship is very competitive to get into (read - great scores, lots of time in resesrch). Once youre in, the hours are long, and the work is difficult. Also think about how old you'll be when you are in fellowship. But, this is WAY off in the future.

Family Practice - probably the most stable and flexible field - in terms of work hours (probably <80/week everywhere), creating any sort of a schedule, and for fitting your practice to your life.
 
So if I were to choose cardiology, I would have to do a 3 yr residency and then do fellowship?

I wish there was a specialty that interested me that was also flexible. It seems like the fields I consider "cool" are also the ones with long hours, long residencies, and lots of on-call.

I love GS right now and I wish I could do it, but I'm afraid it would put too much strain on my family during residency and then probably still afterward.

FatPigeon - none of those specialties interest me (or at least at the moment).
 
So if I were to choose cardiology, I would have to do a 3 yr residency and then do fellowship?

I wish there was a specialty that interested me that was also flexible. It seems like the fields I consider "cool" are also the ones with long hours, long residencies, and lots of on-call.

I love GS right now and I wish I could do it, but I'm afraid it would put too much strain on my family during residency and then probably still afterward.

FatPigeon - none of those specialties interest me (or at least at the moment).

Yup, any specialist (cardiologist, pulmonologist, gastroenterologist, endocrinologist...), is a general Internist first, and a specialist second.

Maybe the fields that you think are "cool" are the glamorous ones with long hours and lots of emergencies... i.e. the ones with the most public exposure. So, give yourself time to get exposed to the field.

If you want flexibility, think about going into PM&R (pun intended), Family Practice, Pathology, Psychiatry, EM, IM, Pediatrics, to name a few.
 
Yup, any specialist (cardiologist, pulmonologist, gastroenterologist, endocrinologist...), is a general Internist first, and a specialist second.

Maybe the fields that you think are "cool" are the glamorous ones with long hours and lots of emergencies... i.e. the ones with the most public exposure. So, give yourself time to get exposed to the field.

If you want flexibility, think about going into PM&R (pun intended), Family Practice, Pathology, Psychiatry, EM, IM, Pediatrics, to name a few.

And also consider fields that work in multiple settings such as ENT, Ob/Gyn. Honestly, don't plan on anything at this point unless you've worked in the field in some way extensively for awhile. I knew what I wanted going into med school, but only because I had like a year and a half of it going in.
 
Few more questions:

What does a fellowship actually consist of?

Also, do you consider EM, Cardiology, Hospitalist, and FP are flexible? I want something that I can enjoy working at, but still have time to spend with my wife and future kids.
 
Few more questions:

What does a fellowship actually consist of?

Also, do you consider EM, Cardiology, Hospitalist, and FP are flexible? I want something that I can enjoy working at, but still have time to spend with my wife and future kids.

EM and hospitalist can do shift work. EM ~250k, but depends how many shifts you do. IM hospitalist ~150-200k starting, 7 days on 7 days off.

Cardiology has intense hours and high compensation. Interventional has better compensation than many surgeons. Hours are bad and hard to control.

FP flexible but lower pay.
 
As a general rule, I like to think of 3 different categories of specialties:

1. "Medicine" Specialties: IM and subspecialties, FP, Psych, Neurology, Derm

-On average, tend to spend more time thinking about problems, formulating differential diagnosis, etc. Tend to treat problems with medications, etc rather than procedures. Patients usually with more chronic and multiple problems.

2. "Surgery" Specialties: Gen Surg and subspecialties, Ortho, Neurosurg, Urology, ENT, Plastics, Ophtho

-Tend to be more decisive, to the point. No long hours of rounding/discussing patients. Patient problems treated with surgery/procedures more so than medications. Patients usually have more acute or single problem that (sometimes) can be fixed by a surgery.

3. "Other" Specialties: Anesthesia, EM, Path, Radiology, Rad Oncology

Don't fit well into the other 2 categories. Some have less direct patient contact (Rads, Path) or long-term followup (Rads, Path, EM, Anesthesia). Tend to have better lifestyle b/c don't have inpatient services, do shift work, etc.

Obviously there are exceptions to these general categories. My advice would be to keep an open mind during 3rd year of med school. An important thing to figure out is if you are more of a surgical person or a medicine person (or neither!). Almost everyone figures out the right specialty eventually.
 
Thanks mercaptovizadeh & Forbin! That clears it up a lot. Where are those salary #'s from? I'm from AR so I tend to think it would be lower than other places.

I think I would enjoy either. Right now I want to do a little of both: medicine and procedures. Do you think EM or IM would allow that?
 
Thanks mercaptovizadeh & Forbin! That clears it up a lot. Where are those salary #'s from? I'm from AR so I tend to think it would be lower than other places.

I think I would enjoy either. Right now I want to do a little of both: medicine and procedures. Do you think EM or IM would allow that?

EM has procedures and medicine. The level of medicine is shallower than in IM but is broader, covering kids and pregnant women, and of course the focus is on emergent situations (there is a lot of primary care, though, too).

IM can be procedural, depending on the subspecialty: cardiology (esp. interventional), gastroenterology, critical care, pulmonology, heme/onc to some degree. Nephrology, rheumatology, allergy/immunology, endocrinology, infectious diseases have few procedures.

Btw, I agree with forbin. There's the "medical" specialties (although I would not include psychiatry there since it is quite different from the rest), the surgical specialties, and the "support" specialties - keep the patient asleep during surgery, stabilize emergent situations, read images, etc.
 
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Yeah - I was thinking of cardiology too, but I don't particularly want to do a fellowship. I think 2 more years of school, 4 of med school, and then 3 of residency will drain me enough. And i'll be 31 by then so I'll be ready to actually work and do.

I kind of like the idea of hospitalist since you get to continually test & treat until they are d/c'd, but I like the idea of fast-paced emergent care.

Plus, unless i'm thinking wrong, EM shouldn't have on-call right? I mean once you stabalize them and admit them or d/c them they aren't your pt anymore.
 
Plus, unless i'm thinking wrong, EM shouldn't have on-call right? I mean once you stabalize them and admit them or d/c them they aren't your pt anymore.

No, there's no call, but you will often have to work nights and/or weekends, which can be fairly draining too.
 
Once they're d/c'd or admitted, they're technically not your patient, but if they're in the ED still waiting for a bed or waiting for the discharge papers and something happens, you're still on. You don't have call, but you have widely varying shifts, you will work weekends, nights, holidays because you work X shifts / mo, the particular day of the week doesn't matter. You don't necessarily leave when your shift's over, you leave when your work is over, which basically means getting everyone squared away for sign-out (you have a simple set disposition plan, all needed tests and procedures are done, you know what results you're waiting on and what each scenario will be so the person taking over for you doesn' t have to think).

You sound like you should look into a mixed field such as ob/gyn, urology, ent, or some such thing. procedures =/= surgery. But in all honestly, you need to not even think about planning this stuff out until you're beginning medical school or until you've spent at least 150-200 hours in a field.
 
No, there's no call, but you will often have to work nights and/or weekends, which can be fairly draining too.

Forever, plus holidays, it is the emergency department after all. Unless you find partners who somehow enjoy taking your evening/weekend/holiday call from you.
 
I just need to find a specialty that maximizes what I would enjoy with flexibility.

Areas that I have no interest in: OB/GYN, Psych, ENT, GI, Uro, Optho, Onconlogy, Derm, and Peds. Those areas would by among my last choices.

Maybe I'll just have to deal with have some call and varrying shifts? I know that pretty much any specialty has some, but I just don't want to work 90hrs/wk and never see my wife & kids.
 
I just need to find a specialty that maximizes what I would enjoy with flexibility.
I think that is what everyone seeks; everyone has to define his/her own enjoyment:flexibility ratio and that is how people end up choosing their respective specialties.

Maybe I'll just have to deal with have some call and (or) varrying shifts?
Unless you do radiology or rad onc, this is most definitely true.
 
Something I've been meaning to ask:

Is radiology really that flexible? One of my FAVORITE professors at my college is an MD. He graduated from LSU and then started his residency as a radiologist. Part of the way through, his family began to suffer because of the time he had to commit to residency and he decided his family was more important so he dropped out.

As of now, he is happily married with kids and grand kids. He teaches most of the med school prereqs and is on my colleges pre-med board.

I said all of that to say this: he tells stories all the time about being called in at odd hours to read an xray, ct, etc. and that's why his family couldn't handle it. Am I missing something?
 
Basically, my fields of interest at the present are:
1. General Surgery
2. Cardiology
3. General IM (hospitalist)
4. Emergency
5. FP

My top concerns are:
1. Length of Residency/Fellowship
2. Time Commitment (I want to see my wife and kids)
3. Pay (Not doing medicine for money, but I still have to provide for my family)
 
Basically, my fields of interest at the present are:
1. General Surgery
2. Cardiology
3. General IM (hospitalist)
4. Emergency
5. FP

My top concerns are:
1. Length of Residency/Fellowship
2. Time Commitment (I want to see my wife and kids)
3. Pay (Not doing medicine for money, but I still have to provide for my family)

1.) GS (5), cardiology non-interventional (6), cardiology interventional (7), general IM (3), EM (3-4), FP (3).

2.) GS (call; very heavy), cardiology non-interventional (call; heavy), cardiology interventional (call; heavy), IM hospitalist (shift based; shifts are not easy), EM (shift based; shifts are intense), FP (lighter call, less heavy).

3.) Cardiology interventional/GS > cardiology non-interventional/EM > IM (hospitalist) > FP.
 
1.) GS (5), cardiology non-interventional (6), cardiology interventional (7), general IM (3), EM (3-4), FP (3).

2.) GS (call; very heavy), cardiology non-interventional (call; heavy), cardiology interventional (call; heavy), IM hospitalist (shift based; shifts are not easy), EM (shift based; shifts are intense), FP (lighter call, less heavy).

3.) Cardiology interventional/GS > cardiology non-interventional/EM > IM (hospitalist) > FP.

Thanks a ton!

Phew! I don't know if I can handle 5-7yrs of residency/fellowship! Here is the review (although 7yrs old) of the school/hospital I would want to do my GS residency at:
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3785&d=1

Does call q3 or q5-6 mean every 3 or 5-6 days? That doesn't sound that bad? If that's true q5-6days is like one night of call a week. 80hr/wk over 7 days is like 11hrs/day (if it was spread dead even) which isn't too bad either I guess.
 
Although I would REALLY prefer to stay in AR (and would have a better chance of being accepted to residency here), here are GS residencies I would be interested in:

University of AR for Medical Sciences
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3785&d=1

University of MS Medical Center
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=952&d=1

University of TX SW Medical School
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=976&d=1

University of TN-Knoxville
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=955&d=1

University of TN-Memphis
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3164&d=1

St. Louis University School of Medicine
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=902&d=1

One of those reviews said "call is optional" - what?!? Someone must be full of bologna.

Also, some of those sounded "cush" because of 3-4wks vacation, one weekend a month off, and very strict 80hr/wk rule. Plus being considerate that your taking post-call so you get done around noon if you're on call.
 
Something I've been meaning to ask:

Is radiology really that flexible? One of my FAVORITE professors at my college is an MD. He graduated from LSU and then started his residency as a radiologist. Part of the way through, his family began to suffer because of the time he had to commit to residency and he decided his family was more important so he dropped out.

As of now, he is happily married with kids and grand kids. He teaches most of the med school prereqs and is on my colleges pre-med board.

I said all of that to say this: he tells stories all the time about being called in at odd hours to read an xray, ct, etc. and that's why his family couldn't handle it. Am I missing something?

Yes, you are. He trained back in the day when one would need to physically be in the hospital to read a study. With all radiology going electronic, it doesn't much matter if you're in the hospital or at home, you're going to be seeing the same images.

Also, DO NOT make a decision based on the length of residency. You'll be in training from 3-9 years depending on what you decide you want to do. You'll be in practice the rest of your life. If you can only imaging being a neurosurgeon and you'd otherwise be miserable in medicine, then do neurosurgery. Sure...it'll suck for 7 years but after that, you get to do what you want for the rest of your life. Don't choose IM, EM, Peds or FM just b/c you can get out of it in 3 years. You'll be miserable for the rest of your working life.
 
Well, those 5 I listed are there because I'm interested in them. Sure, the length of residency kind of stinks, but I didn't choose FP, EM, or IM because of short residency.
 
Make sure to keep your mind open. Don't start ruling out specialties before you've even started medical school. Although some med students do come in with a very concrete plan, very few actually keep that plan. You don't want to come into third year rotations with your mind made up and miss out on a field you might truly enjoy because it's not on your list.
 
Areas that I have no interest in: OB/GYN, Psych, ENT, GI, Uro, Optho, Onconlogy, Derm, and Peds. Those areas would by among my last choices.

You know, I still havent' seen you say what you like and don't like about different areas of medicine. I see a lot of talk about lifestyle and flexibility, but I see very little about what aspects of medicine and patient care you find interesting and abysmally boring. What aspects you find frustrating and what aspects you don't really give a crap about.
 
My top concerns are:
1. Length of Residency/Fellowship
2. Time Commitment (I want to see my wife and kids)
3. Pay (Not doing medicine for money, but I still have to provide for my family)

prolly should've quoted this. See this is my concern. None of your concerns, important as they may be, have anything to do with medicine itself. What disease processes do you like to deal with, what sort of patient care do you want to do, what kind of patients you like to see, what you like to do for patients, if you want to deal with a broad broad broad spectrum of disease or you want to focus on a few specific disease entities.

This would be akin to me asking someone what computer game to buy, and saying that my concerns are cost, if it runs better on a PC or a Mac, and how long it takes to beat.
 
prolly should've quoted this. See this is my concern. None of your concerns, important as they may be, have anything to do with medicine itself. What disease processes do you like to deal with, what sort of patient care do you want to do, what kind of patients you like to see, what you like to do for patients, if you want to deal with a broad broad broad spectrum of disease or you want to focus on a few specific disease entities.

This would be akin to me asking someone what computer game to buy, and saying that my concerns are cost, if it runs better on a PC or a Mac, and how long it takes to beat.

I understand.

EM - I like emergent, fast-paced, on your toes type situations. Keeps me interested and the day moving.

OR - I can't quite nail what it is, but I love it. Maybe because I like working with my hands and I would be fixing people quite literally with my hands. Just love procedures (and surgery is pretty procedural i'd say:D)

Hospitalist - I would like to track patients and see what works and what doesn't and try new/different things to treat them. I would like to make rounds and see how they are all doing as compared to yesterday.

Cardiology - I just love cardiac stuff. The heart itself and the way heart dz and acute cardiac problems present is interesting. It seems very straightforward yet very intriguing.

That help?:oops:

P.S. Anyone know anything about post #29?
 
I understand.

EM - I like emergent, fast-paced, on your toes type situations. Keeps me interested and the day moving.

OR - I can't quite nail what it is, but I love it. Maybe because I like working with my hands and I would be fixing people quite literally with my hands. Just love procedures (and surgery is pretty procedural i'd say:D)

Hospitalist - I would like to track patients and see what works and what doesn't and try new/different things to treat them. I would like to make rounds and see how they are all doing as compared to yesterday.

Cardiology - I just love cardiac stuff. The heart itself and the way heart dz and acute cardiac problems present is interesting. It seems very straightforward yet very intriguing.

That help?:oops:

P.S. Anyone know anything about post #29?

It does help a bit. But it doesn't sound like you've spent much time in the ER or the OR? Most emergency stuff is not fast-paced, although you do have one crazy thing happen every couple days. And as for surgery, you either love the OR or you don't. procedures are not surgeries, and most fields with a high number of procedures are not surgical fields.

Based on what you're telling me, I would look closely at critical care medicine, PM&R, ENT, and derm early on in med school. And keep an open mind regarding ob/gyn, in addition to the fields already mentioned. The reason I'm not telling you to go out of your way in regard tothe 5 you list is that it doesn't matter when you decide on those since you will have plenty of exposure to all of them by the time you need to pick a residency. However, critical care, PM&R, ENT, optho, and derm, you will not have exposure to unless you seek it out. Now if rashes and skin surgeries aren't your thing, forget derm, and likewise for ENT and Optho.
 
I understand.
P.S. Anyone know anything about post #29?

Don't compare residencies until you know exactly what one you're applying to and are closer to the date. The setup of residency programs changes from year to year and what may be bad now might be great when you apply, and vice versa.
 
Although I would REALLY prefer to stay in AR (and would have a better chance of being accepted to residency here), here are GS residencies I would be interested in:

University of AR for Medical Sciences
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3785&d=1

University of MS Medical Center
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=952&d=1

University of TX SW Medical School
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=976&d=1

University of TN-Knoxville
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=955&d=1

University of TN-Memphis
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3164&d=1

St. Louis University School of Medicine
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=902&d=1

One of those reviews said "call is optional" - what?!? Someone must be full of bologna.

Also, some of those sounded "cush" because of 3-4wks vacation, one weekend a month off, and very strict 80hr/wk rule. Plus being considerate that your taking post-call so you get done around noon if you're on call.
whoa cowboy, slow down there.
 
whoa cowboy, slow down there.

Agreed.

Wait till 3rd year to decide. The core curriculum will help you decide somewhat general IM, GS, EM, and FP. You just need to schedule an early cardio elective as well.

Looking at specific program policies and benefits makes no sense unless you are sure of the residency you want and in the process of applying.
 
I understand.

EM - I like emergent, fast-paced, on your toes type situations. Keeps me interested and the day moving.

OR - I can't quite nail what it is, but I love it. Maybe because I like working with my hands and I would be fixing people quite literally with my hands. Just love procedures (and surgery is pretty procedural i'd say:D)

Hospitalist - I would like to track patients and see what works and what doesn't and try new/different things to treat them. I would like to make rounds and see how they are all doing as compared to yesterday.

Cardiology - I just love cardiac stuff. The heart itself and the way heart dz and acute cardiac problems present is interesting. It seems very straightforward yet very intriguing.

That help?:oops:

P.S. Anyone know anything about post #29?

Not really. You're talking generics and gleaning what you want to out of the name of the specialty.

"I just love cardiac stuff" isn't going to get you through 4 years of medical school, 3 years of residency, and then 3 years of fellowship.

I would echo everyone else in saying slow down, do well, and then decide what you want to do. There's no point in looking so far ahead. Particularly when all the fields you've mentioned are not the ubercompetitive type that require early research.

Re: scutwork, that site is outdated and open to any anonymous poster, which makes it very to completely useless. This would be another case where I'd recommend waiting, doing away electives as a 3rd/4th year, and definitely doing your research IN-PERSON when you go to interview. The type of things you're inquiring about are likely to change and the best people to ask are the residents who are most recently in the system.
 
Although I would REALLY prefer to stay in AR (and would have a better chance of being accepted to residency here), here are GS residencies I would be interested in:

University of AR for Medical Sciences
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3785&d=1

University of MS Medical Center
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=952&d=1

University of TX SW Medical School
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=976&d=1

University of TN-Knoxville
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=955&d=1

University of TN-Memphis
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3164&d=1

St. Louis University School of Medicine
http://www.scutwork.com/cgi-bin/links/review.cgi?ID=902&d=1

One of those reviews said "call is optional" - what?!? Someone must be full of bologna.

Also, some of those sounded "cush" because of 3-4wks vacation, one weekend a month off, and very strict 80hr/wk rule. Plus being considerate that your taking post-call so you get done around noon if you're on call.

I'll echo the advice above (i.e. slow down cowboy).

But also, how on earth did you pick these? It kind of seems like you just picked southern GS residencies out of a hat. You've also listed at least 2-3 that are known for being old-school/harda** programs which don't fit with your desire for cushiness/flexibility. You are also not in any place to know which of these programs are better than others - like any other premed. Their websites and their 2-7 year old scutwork reviews don't really indicate much of anything about the quality of the programs.
 
Sorry guys. I guess I would like to have a set track of pre-med, med school, GS residency (or whatever specialty) and done. And in a perfect world that might happen, but I guess I'll have to keep an open mind.

I'm a very laid back person overall, but this is a pretty important decision and it's just about the one thing that I can't seem to get off my mind. I keep thinking "what am I going to do and where?"

I guess I'm afraid to have an open mind and not really decide until 3/4th year and then have to make a quick decision and then decide to change residencies later.

Thanks for all the advice!
 
I'm a very laid back person overall, but this is a pretty important decision and it's just about the one thing that I can't seem to get off my mind. I keep thinking "what am I going to do and where?"

It's only an important decision if you...

a) get into medical school,
b) pass Step 1, and
c) successfully finish MS3.

None of these things are guaranteed. I cannot tell you how many med students, both in real life and on SDN, have had serious difficulties with each of the 3 steps.

It's like when girls stress out about which wedding dress they ought to get when they don't even have a boyfriend yet. One step at a time. :)

I guess I'm afraid to have an open mind and not really decide until 3/4th year and then have to make a quick decision and then decide to change residencies later.

Even if this WERE to happen, it's not the end of the world. It happens to tons of people every year, and they manage to muddle through it somehow.
 
So, through some odd "research" (i.e. looking at doctors education, residency, etc. at the hospital I work at) and then through reading on this board, I found out some interesting information.

If you read this thread, you will see that my top specialties of choice are IM, FM, EM, and GS.

Well, another one of my concerns in lifestyle. Given that, wouldn't it be smart to go into FM? I know that FM can stick to FM or do hospitalist and/or EM doc. One of the hospitalists at my hospital did her residency in FM, went to work in ER and then moved to be a hospitalist (all in AR so I'm sure its allowed).
 
So, through some odd "research" (i.e. looking at doctors education, residency, etc. at the hospital I work at) and then through reading on this board, I found out some interesting information.

If you read this thread, you will see that my top specialties of choice are IM, FM, EM, and GS.

Well, another one of my concerns in lifestyle. Given that, wouldn't it be smart to go into FM? I know that FM can stick to FM or do hospitalist and/or EM doc. One of the hospitalists at my hospital did her residency in FM, went to work in ER and then moved to be a hospitalist (all in AR so I'm sure its allowed).

I'd actually put both IM (hospitalist) and definitely EM above FM in terms of lifestyle. In family medicine you'll be trying to pack about 30 patients per day into 9 hours (gotta make those 6 dollar government reimbursements add up to keep the lights on!), and then until 8 or 9pm you'll have tons of paperwork and notes to write. The guy I worked with on FM was way overworked and miserable.

While you may be able to work effectively as a hospitalist-type physician or grab a position in the ER (though I'm unfamiliar with this), the easiest way to each is definitely through their respective courses. FM residency is not particularly lifestyle friendly (months of labor and delivery call?!), and in fact is likely just as bad or worse than IM.
 
Do not go into FM if your plan is to work in a ED.

While many rural or understaffed EDs may currently hire FMs to work, this is getting tighter and tighter. Many will hire only EM trained physicians. Your contact is a product of a different time/different era.

Finally, as noted above, in terms of lifestyle, EM >>>> FM.
 
So, through some odd "research" (i.e. looking at doctors education, residency, etc. at the hospital I work at) and then through reading on this board, I found out some interesting information.

If you read this thread, you will see that my top specialties of choice are IM, FM, EM, and GS.

Well, another one of my concerns in lifestyle. Given that, wouldn't it be smart to go into FM? I know that FM can stick to FM or do hospitalist and/or EM doc. One of the hospitalists at my hospital did her residency in FM, went to work in ER and then moved to be a hospitalist (all in AR so I'm sure its allowed).

If lifestyle is in the top 1000 things you want in a job, Gen Surg is not the way to go. FM will allow you to do clinic, hospitalist (in some places, not all) and some urgent care/fast track type of gigs. Working in the ED as a non EM trained physician is going the way of the Dodo. If you want to do EM, do an EM residency.

IM is (IMHO) the most flexible of your stated interests b/c it allows you to do primary care (adults only obvs), hospitalist work (just about everywhere) and multiple sub-specialties if it turns out that's what you want to do.
 
An argument for FM over EM, and in passing over general IM or Peds, from the incomparable full-scope FM advocate Wm. MacMillan Rodney: Part 1, Part 2.
 
An argument for FM over EM, and in passing over general IM or Peds, from the incomparable full-scope FM advocate Wm. MacMillan Rodney: Part 1, Part 2.

I'll be honest - I have no idea what 90% of that means.

The FM residency doesn't sound too bad. I read (on this board) that it's 3yr and averages 60hr a week. Maybe it stinks at times, but when compared to a 5yr, 80hr week surgical residency its looks like gold.

The FM FAQs also hinted that if you did outpatient only FM it was very 8-5 and no call. And if you wanted you could throw in a few shifts on fast-track ER.

Here's something - I'm getting conflicting ideas/opinions (which I expected) about which one (FM, IM (hospitalist), or EM) makes for the easiest lifestyle.
 
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