@jack.jaret, choosing a specialty is not easy. You have to take a really good look at your naked true self, without wishful thinking, and check what fits and what doesn't with the chosen specialty (personality, skills, lifestyle, pay etc.). Even if you have all the data (which you don't, as a student, or even as a resident), it's a tough choice.
For example, I am average at anesthesia, but probably above average at critical care (something that my attendings noticed even as a CA-1, but it took me a long time to realize). On paper in the top 25% at both, knowledge-wise. (Knowledge doesn't really matter
that much in anesthesia, whatever wiseguys like to say, hence the difference.) Also, to me, procedures are a means to an end, not the epitome of the specialty; if you want to be happy in anesthesiology, you must be orgasmic from doing procedures, not from fixing patients (the latter is much rarer and you usually get zero credit for it, or for practicing evidence-based medicine, and you are judged by your procedural skills). And I don't really like being told what to do, especially by people who don't know what they don't know, who practice yesterday's medicine (i.e. surgeons); I like being treated as a consultant, not as a nurse. Some people just don't care about that, as long as they get their paycheck. And I am generally a nice person, way too nice for the surgical environment, which is more akin to swimming with sharks; you really need a thick skin with certain dinguses. You also have to enjoy endless worthless chats with OR people, who are generally not particularly bright (it takes a special IQ to mess with the hand with the pulse ox during induction, or to chat loudly during emergence etc.), especially if you are stool-sitting. It can be like having clinic with and listening to the same patients every day; it can be beyond boring. Of course, this is all stuff I didn't know when I chose the specialty, not even about myself.
Accordingly, I enjoy practicing critical care way more than anesthesia. Except that there are much fewer critical care jobs for anesthesiologists in my area (and most areas of the country). Also, anesthesia tends to pay better than critical care (especially when adjusted to the stress level). And it
can have a better lifestyle, especially in a no-call setting. I can't even stand the idea of ICU jobs where I see 20 patients/day, and busy 12 hour shifts are not my favorite pastime (I am beyond the happy puppy age of 20-35). Let's not mention working every 2nd weekend. There are even people who try to sell 7x24 hours in-house/2 weeks off combined intensivist/community hospital
nanny resource jobs as a "lifestyle" job. So what do you choose?
My advice is to choose the specialty that gives you the most time off (especially if it allows you to practice independently). Nothing heals the soul better than being rested and spending time doing what you like (especially if you work for yourself, not the man). You work to live, not live to work. The rest will come. You will be much happier at work, unless you really hate the job. If you aren't a workaholic (which is basically a psych disorder, because you have a huge chance of ****ing up your family relationships long-term), you
will should never enjoy your work more than spending time with your family. Don't chase the money, except if it's soooo good that for every year worked you gain 3-4 years of early retirement. Which rarely applies for employed docs nowadays. Btw, you and your family should be living on $100K or less regardless how much you make.
There is much-much more to think about. I only wanted to show you how little you know as a student, and I only scratched the surface. If you follow my basic advice, you'll thank me when you're in your forties.
😉
