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deleted1139416
Don’t take this the wrong way but - why did you go into medicine in the first place? I just think that if you are having these feelings right now then 1) you either didn’t know what medicine was really like or didn’t want to go into med school in the first place or 2) you have some sort of depression that makes everything seem dull and intolerable. Please don’t be offended - I know that text communication comes off as harsh but I don’t have any intention of being a jerk.
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deleted1139416
I’m very sorry for your loss. At this point I would just say to go to the field that you hate the least.
I’m not sure who would be a good resource to talk to about these things (maybe your career advisor?), but there are a ton of non-medicine things you can do with an MD. You can do consulting, research, teaching, biotech, etc. Not sure if you’re serious about giving up medicine altogether, but there are definitely other ways to make fantastic money with a medical degree. A lot of the business-MDs end up making more than they would as physicians
Ophtho. It’ll give you the high ground.
If you're considering rads then consider path. It has colors.
as a pathology applicant who is in love with my field - please do not go into path by "default"? hahahah. its an amazing field with a fantastic job market, but give yourself to get to get to know it and to love it. i hate when ppl go into path by default.
so true, so true hahahha
One of the top students in my class applied path this year. His rationale at the time of his decision, despite outstanding academic performance, was that he hated everything (else). But since deciding to go into path he has gone full nerd about it and loves it to bits. He is also mentoring students in my school who are in a similar predicament as you describe regarding a career in path, and from the sidelines, it seems, from his pitch, like a career I would at least consider. I say look into path
Sorry you're in this situation, I'm sure it's stressful given how deep in the career path you've gotten. I'm assuming you mean you didn't like any of the core rotations overall. Were there any individual parts you liked? Certain procedures, certain pathologies, certain clinical settings, etc? MS3 is not a complete picture of medicine by any means. Moreover, the experiences as a resident, fellow, and attending are all different among each other, and very different than that of a student. There may be some flavor of clinical medicine that you'd like once you're actually a doctor. If you don't want to consider clinical medicine at all, rads and path are viable options. But you have to like that kind of work. Are you visually detail oriented? Did you like anatomy and/or histology in pre-clinical? These are things to consider in regards to those specialties.
EDIT: Also consider preventive medicine. It's a lesser-known specialty that does have dedicated residency programs. After intern year, the remaining two years are split with half of your time being outpatient clinic-type stuff, and the other being pursuit of a degree such as an MPH. It can set you up for public health jobs, and if you want, you can still do outpatient clinical medicine.
EDIT: Also consider preventive medicine. It's a lesser-known specialty that does have dedicated residency programs. After intern year, the remaining two years are split with half of your time being outpatient clinic-type stuff, and the other being pursuit of a degree such as an MPH. It can set you up for public health jobs, and if you want, you can still do outpatient clinical medicine.
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Yes. Pathology is a field you can practice for a a long time in and can get easier with experience and age. COVID has finally pushed out the numerous 80+ year olds who have been in the field since the 70s. Probably 3-5x more jobs posted now than there were in 2019. It’s an intellectually demanding speciality with great pay for hours worked and stress level. We need more passionate quality medical students and less autism spectrum disorder misfits who couldn’t cut it in clinical medicine.
yeah i am obsessed with pathology. i have been wanting to do it for a long time, and for me it's a dream come true pretty much, as nerdy as it sounds. i truly believe that it is the best specialty out there hahahha. i am in love. i honestly hope more people like me go into the field. definitely planning to mentor med students from my school.
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deleted1139416
Was it about glomerular diseases??
Yeah...
Ah interesting. What about places like quest and labcorp though? Would that worry you at all or are they alright places to work too
Is it really possible to understand what clinical medicine is like before ever doing it? I feel like I got glimpses of what medicine is like shadowing/working as a scribe, but now, just as a 3rd year, I realize how incomplete my impression of the field was.
Don't try it!
Pathology was the first medical field to go corporate, largely because the high cost of lab equipment, relatively non-emergent nature of the specialty and ability to ship materials allowed places like quest and labcorp to move in. Everything in medicine is becoming corporate now, you can really only escape it with niche cash only type stuff like cosmetic derm. Am I worried? No. They still need us to slap glass and by the time AI comes in and gets FDA approved, we will all be long retired and we won’t be the only ones replaced. As a matter of fact, no one wants this turf and we’re likely the least of all specialties susceptible to midlevel encroachment.
As far as work conditions, quest and labcorp have a certain culture that some people love. Sit in a cubicle or small office 9-5 with coffee, biopsy slides, one line of medical history and no interaction with whoever sent the case. May not even be from the same state. Relatively high pay (350-400k+) with big incentives to move the meat. Some of us don’t feel enough like doctors and prefer a hospital gig where you know the surgeon and oncologists. Others like it- no call, no lab crap, no autopsies, no tumor boards, no resection cases or grossing, etc.
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yeah thats what i love in pathology - there are SO many options to mold your career and change it depending on personal life goals and on what your life is looking like at the moment. I personally think i want to do academics/practice in a big academic hospital for a few years after fellowship (hopefully in one of big places like CO or UT where i'll do some teaching, some practicing), and then we will see. This way i will be able to forgive my student loan (because residency counts as well), and i love teaching. But then - we shall see. pathology is so diverse.
I'll say to you what was said to me many years ago by a mentor/supervisor: "Everyone has to chose a specialty track and become fully qualified in something. If you don't, you get stuck in limbo as a non-specialist/non-board certified physician. If you don't know what you want to do, pick a generalist specialty, such as Internal Medicine or Family Medicine, which gives you the most flexibility in terms of future specialisation choice and reasonable work-life balance. And get the training done as soon as practically possible; your work and personal life gets somewhat better after you're an Attending in whatever specialty."
Since you appear to have no intrinsic interest in the field, I would suggest a non-clinical career.
Another good thing about path is no mid-level creep…nobody else would ever be allowed to diagnose cancer from a path specimen (despite their taking a weekend seminar on the subject and then receiving a document of certification after completion, from ABOMiNation (the American Board of Midlevels in our Nation).
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Anesthesia don't do clinic... anesthesia don't round... anesthesia barely chart... 😆🤣🤣🤣
specialties aside, what things did you like, and what did you like about them. then what things didn’t you like and what didn’t you like about them?
what was it about clinic that you didn’t like it?
as noted above it’s important to think about whether things you don’t like are things unique to being a med student or trainee vs what it’ll be like as an attending and in vs out of academic settings. endless rounding in IM seems to be an example mentioned a lot as something not reflective of what it’s like out in community practice.
would you like clinic more with full ownership of the patient and full responsibility for accurately dxing their problem and coming up with a plan?
what was it about clinic that you didn’t like it?
as noted above it’s important to think about whether things you don’t like are things unique to being a med student or trainee vs what it’ll be like as an attending and in vs out of academic settings. endless rounding in IM seems to be an example mentioned a lot as something not reflective of what it’s like out in community practice.
would you like clinic more with full ownership of the patient and full responsibility for accurately dxing their problem and coming up with a plan?
Clinicians tend to better listen and respect Medical Administrators if they have qualified and worked at the coalface as an Attending Physician themselves. I say this as a clinician who has worked in hospitals and health services with naive Medical Administrators who come in with new ideas without evidently having the clinical knowledge and experience of working the wards and clinics to inform their decisions at the executive level, which can have harmful outcomes on patient care and the medical workforce.
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Every admin I’ve ever met makes plenty of money regardless of my or anyone else’s lack of respect for them.
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deleted1095841
How does one become one of these admins?
Don’t know exactly but some universities offer “hospital admin” programs. Notably, all the people I know who attend them are somewhat delusional…
Probably top med school top residency. Top undergrad probably wouldn’t hurt either
Get a MHA or MBA with healthcare concentration.
Seems like a nice gig from the outside, but the higher you go the more time you spend looking over your shoulder. Someone always has a knife out for you.
Some of the people that go into it seem to thrive off that kind of environment lol
Indeed, and they often turn out to be the worst.
Would strongly consider gas, rads, path as others have noted above. Ophtho is very clinic heavy, though hours tend to be very solid.
Gas seems like it would hit a lot of the high points - high salaries, great lifestyle. There are also some subspecialty fellowship options that can expand your practice options. If maximizing salary is the goal, things like pain fellowships can be very lucrative. Highest paid doc in my hospital is a pain guy and he usually makes $1.3-1.5m in an employed position.
Non clinical positions are also a great option. You don’t need to do a residency for these but you’re often more appealing and have more options if you are licensed and board certified. It’s also hard to go back to clinical medicine if you never did a residency and it’s some time since Med school graduation. Doing some kind of residency would at least give you a fallback option if you found the non clinical world unappealing.
The final consideration is that you don’t have to love everything about a field. I definitely didn’t like clinic much as a Med student or even as a resident. I always found the OR much more enjoyable, but then I also didn’t like the OR so much that I wanted to just live in there. Now as an ENT I find I like the balance in my schedule. I’ll do a day of clinic and it’s actually somewhat interesting because I’m not shadowing, I’m actually making the big decisions. But after a day I’m usually glad my next day is more an outpatient procedure day, so I get to come to work and do something different. Then the next clinic day isn’t so much of a drag, and then I have an OR day after that, etc. I find the variety helps the week fly by and I’ve arranged my schedule such that I have a decent amount of free time outside of work. I could see Ophtho being very similar, so if clinic is at least tolerable, you might be able to make something like that workable too.
Gas seems like it would hit a lot of the high points - high salaries, great lifestyle. There are also some subspecialty fellowship options that can expand your practice options. If maximizing salary is the goal, things like pain fellowships can be very lucrative. Highest paid doc in my hospital is a pain guy and he usually makes $1.3-1.5m in an employed position.
Non clinical positions are also a great option. You don’t need to do a residency for these but you’re often more appealing and have more options if you are licensed and board certified. It’s also hard to go back to clinical medicine if you never did a residency and it’s some time since Med school graduation. Doing some kind of residency would at least give you a fallback option if you found the non clinical world unappealing.
The final consideration is that you don’t have to love everything about a field. I definitely didn’t like clinic much as a Med student or even as a resident. I always found the OR much more enjoyable, but then I also didn’t like the OR so much that I wanted to just live in there. Now as an ENT I find I like the balance in my schedule. I’ll do a day of clinic and it’s actually somewhat interesting because I’m not shadowing, I’m actually making the big decisions. But after a day I’m usually glad my next day is more an outpatient procedure day, so I get to come to work and do something different. Then the next clinic day isn’t so much of a drag, and then I have an OR day after that, etc. I find the variety helps the week fly by and I’ve arranged my schedule such that I have a decent amount of free time outside of work. I could see Ophtho being very similar, so if clinic is at least tolerable, you might be able to make something like that workable too.
Directors and Administrators tend to attract two types: people who are genuinely good leaders; and, people who like the power and position.
I have met some brilliant medical directors and administrators and they’re typically clinicians who haven’t forgotten where they can from in terms of their clinical background, and they genuinely work hard to influence executive and implement projects that improve a health service.
However this is far outweighed by the vast majority who just enjoy climbing the corporate ladder and playing office politics to push their agenda, usually at the detriment of the staff and patients.
There is a smaller subset of administrators who just do nothing but keep a warm seat and collect a pay check, which are equally hopeless.
There are tons of people with MHA degrees making decisions w/o MDs. No cares if doctors respect them (unfortunately).
Perhaps in pharmaceuticals?
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deleted1095841
If they get an MD and an MBA, do they need to do residency?
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deleted1095841
Is this true for admin positions at academic medical centers only? Or also private? Asking because I don't have these.
I feel like psych should be the absolute last specialty to choose if you want to avoid patient interaction
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I would like to give my 2 cents.
What about each rotation did you dislike? What about each rotation in each field did you not get to experience that may have changed your outlook?
For example, if you did not get to see GI scopes, cath labs, pleural taps, code strokes, ICU management, TEEs, emergent procedures in the ED, etc then you may not be informed enough to say you dislike all fields wholly
What about each rotation did you dislike? What about each rotation in each field did you not get to experience that may have changed your outlook?
For example, if you did not get to see GI scopes, cath labs, pleural taps, code strokes, ICU management, TEEs, emergent procedures in the ED, etc then you may not be informed enough to say you dislike all fields wholly
Do Anesthesia, Rads, or Path
I feel like rotations aren't the best way to gauge how much you like a certain field. How much I enjoyed a rotation was more dependent on the people I worked with and the culture of the hospital (multiple hospitals in my city, some better than others). For instance, I enjoyed obgyn and peds but it wasn't the content but rather the preceptors that I enjoyed.
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Depends on what they're aiming for. If the goal is to be top dog at a powerhouse medical center then they'll probably need to be a department chair, which means they'll do a residency and then rise through the academic ranks.
If the goal is more like a mid-level administrator or perhaps CEO of a public hospital then they don't need all the academic cred.
