Anyone else narrowing down the career possibilities?

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So I was pretty set on EM, but I am currently out of the city (that's NYC) and doing a FP rotation in Concord, NH and having the time of my life. I love that I get to do Peds, and Gyn, and Psych... and everything. And the small-town feel. And preventative medicine... it meshes well with my plan-ahead Type A personality.

So it looks like it's going to come down to EM and FP. Our school doesn't have EM as a core 3rd year rotation, so I'll do sub-I's in both... and go from there!

It's hard to justify the significant pay cut and the longer hours as a FP vs. an ER doc... but as I'm told, I should do what I love, and the money will come.

Thoughts?


They are vastly different fields united only by the fact that both specialties produce generalist physicians.

Enjoying other rotations doesn't mean EM isn't for you. I freaking loved Ob/Gyn...

Then again, if you are way into preventative care, that might speak strongly against a career in emergency medicine.

Pay difference between EM and FP is not enough to force someone away from FP. If you do office procedures, maybe have a PA or two, you can probably make more money as an FP.

Hours... Well I'm in the camp that the "lifestyle" of EM is over-hyped. Most of your days as an FP won't be starting at 11pm.

Do you want to have your own patients?

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Not really: IM, OB/GYN, Radiology, FP,

Possible: EM, Peds, Anesthesia, Derm, General Surgery/Surgical Subspecialty

Thats pretty much as far as i have got. I think i need to do a surgical internship to spend more time deciding....
 
when i started med school i wanted to be a pediatrician or a family practitioner. i loved the idea of preventative medicine, clinic, having a private practice, out in the community. now after ive finished 3 years, ive COMPLETELY changed my mind!! pardon the severe splitting thats about to follow.....

here is what ive learned on every rotation
internal medicine- LOVE: adult medicine, making a differential, interpreting radiology, ekgs, labs. HATE prerounding/rounding. HATE call.

ob-gyn- LOVE: the cute babies, the new mothers. HATE: the lifestyle, the crabby residents/attendings, the unpredictable hours. also got pretty sick of vaginas all day long

pediatrics- LOVE: cute kids. HATE: pediatric medicine. realizing i love adult medicine much more. ooh, yeah, and i realized how much i despise outpatient medicine

surgery- LOVE: acute patients, concise rounding, revisiting adult medicine. HATE: lifestyle, hours, being in the OR freezing my butt off and getting pushed around by scrub nurses with inferiority complexes

psych- LOVE: seeing the really crazy people off their rockers, personality disorders. HATE: nonstop rounding, spending hours talking about farfetched theories. manipulative patients who just want to stay at the hospital for food/shelter. uugh

soooo, ive come to the conclusion. im 99% emergency medicine. i love being the first one to see the patient, coming up with a differential, ordering tests, interpreting them, etc. i love acute problems (i'll take an acute MI over high cholesterol any day). i realized i dont want continuity of care. i want medicine to be my job, not my life. i love the idea of shift work. and its awesome to walk into work not knowing whats coming my way and having a blank slate every day.

or maybe i'll be a radiologist. hehehe
 
Probably: IM (love EVERYTHING about this!), Neurology (loved it, just wished there could be more diabetes and thyroid issues)

Maybe: Psychiatry (really liked psych, but need more medicine), FP (URI's get old after a while), ENT (doing an intramural this summer), Derm (might get boring)

Definetly NOT: OB/GYN (i hate vaginas, not enough medicine for me), Gen Surgery (life style is atrocious!), ER (not enough continuity)

Just started my IM and love it... but am cautiously optimistic b/c its my first week.... and I felt the same way about surgery at this time! so we'll see.... prob know next month for sure! made a mistake doing IM last... oh well..
 
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