Best field for intermittently disabled person? Least physical specialty

[RA resident]

What field do you guys think is the least physical? I got RA in med school & I am A-OK 95% of the time, but every so often the stress / sleep deprivation puts me in a flare. Let's say 1% of the time it's hard for me to even dress myself. Hasn't been a big deal through MS3, but no one is counting on me to put in a chest tube.

I know disability accommodations are a thing, but I think I'd like to try for a field where I wouldn't need it. Especially as I am unlikely to be able to get disability insurance. And I'd like not to be a burden on the other residents. And I'd like to not second-guess myself if something happened to go south for a patient I treated while not physically 100%. Like if I am the only doctor on the service & **** hits the fan & it just so happens my arms are not working. There are a ton of attending positions that would work great, but getting through the residency first is key.

Due to a glitch in scheduling (had to take time off when first diagnosed) I am done with all MS-3 rotations. I really liked almost everything! But even in something like IM or Peds I could see areas that I wouldn't be able to do in a bad flare. I loved OBGyn but it's totally off the table. I did a couple of weeks in Surg Path that were quite nice.

Basically I am looking for ideas! Non-residency ideas are also welcome. I feel pretty limited in options. If I could predict this I would not go to med school again. Fortunately my loans are sub 100K so I don't need a high paying specialty.

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[primadonna22274]

Psych and path seem like good options.


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[witzelsucht]

psych
pmr
no one is gonna have a peds resident solo doing intubations or chest tubes. you'll be fine

 

[RA resident]

Psych and path seem like good options.


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Psych would be good except it makes me soooo depressed, I get so sad for the patients. That one's off my list for sure.

I do think path would be good, thanks for the reply!

 

[RA resident]

psych
pmr
no one is gonna have a peds resident solo doing intubations or chest tubes. you'll be fine

PMR is one I hadn't thought of. Doesn't it have really hands-on work & examinations? Like you'd have to do a lot of MSK exams and lift heavy limbs and such. I could find a way to do a short rotation & see for myself

 

[Bonferroni Correction]

Ahem... how about rheumatology? I've seen a few examples of personal medical history leading to increased interest and ultimately a love for a particular field (1 friend with crohn's ->GI, another was set on ortho since undergoing an ACL repair in college). In those cases, passion for the field plus a unique ability to empathize with patients makes for a perfect fit. And your patients will love you.

But don't be so quick to dismiss your options - even if trauma surgery and EM are bad fits due to physiologic stress, the vast majority of fields would be fine, especially once you are an attending. When interviewing for residency, make sure you find a program and PD that will genuinely care about your health and allow some flexibility when needed.

 

[RA resident]

Ahem... how about rheumatology? I've seen a few examples of personal medical history leading to increased interest and ultimately a love for a particular field (1 friend with crohn's ->GI, another was set on ortho since undergoing an ACL repair in college). In those cases, passion for the field plus a unique ability to empathize with patients makes for a perfect fit. And your patients will love you.

But don't be so quick to dismiss your options - even if trauma surgery and EM are bad fits due to physiologic stress, the vast majority of fields would be fine, especially once you are an attending. When interviewing for residency, make sure you find a program and PD that will genuinely care about your health and allow some flexibility when needed.

I appreciate the motivational speech, it's kind of you. Honestly, I could possibly even get through a surgical residency if I needed to. I'm not that badly off usually. However, I am trying to consider the worst case scenario. I don't want to link my health to my income, especially as I cannot get disability insurance. If I could find a specialty that allows me to work even if I get totally disabled I will have better peace of mind.

 

[ThoracicGuy]

I appreciate the motivational speech, it's kind of you. Honestly, I could possibly even get through a surgical residency if I needed to. I'm not that badly off usually. However, I am trying to consider the worst case scenario. I don't want to link my health to my income, especially as I cannot get disability insurance. If I could find a specialty that allows me to work even if I get totally disabled I will have better peace of mind.

Radiology?

 

[bashwell]

Basically you're looking for specialties with no or minimal procedures.

Or which have procedures but where you aren't fully dependent on procedures and can wean yourself off of doing procedures if can't do them any longer.

 

[mvenus929]

Peds would be reasonable... there are months that are more procedure heavy, but there's always someone to back you up at those times, and most of the time, there is someone who is willing enough to take procedures if you give them up. The only place it might get bad is when you have to attend deliveries, but how much of that you have to do will depend on the program you go to.

 

[n618ft]

I'm so very sorry that this is going on. Have you ever thought about academia and teaching?

 

[DrBowtie]

Radiology?

I'm already getting OA in my scrolling finger.

 

[kchan99]

Dermatology (if excellent USMLE scores and no geographic restrictions) with path or psych as backup for applications. Derm procedures seem to be smaller procedures without need to hold heavy limbs often. If manual dexterity is an issue, then avoid path (grossing during residency, FNAs) and derm.
I think PM&R could be too procedural. Think MSK exams, EMGs, injections, ultrasound, etc. with need to hold limbs.
Diagnostic radiology if call isn't often

Avoid rheum because of sleep deprivation during frequent call during internal medicine residency ward months

 

[J ROD]

I would say Psych but since you do not care for it. Rads. Just get through the first year.

 

[gutonc]

Honestly, anything that's not heavily procedural is going to be fine for you. Decide what you want to be when you grow up.

 

[rokshana]

and disability insurance isn't off the table per se...during residency you will have disability insurance (its group so no underwriting) and many places it will be portable, again with no underwriting...ask about it when you interview.

 

[northernpsy]

It's too bad that you don't like Psych. In my job, I do a bit of telepsychiatry (psychiatric evals over the computer with something equivalent to Skype) which I think would be perfect for someone with physical limitations who still wants to see patients.
If you're basing your opinion of psych just on seeing the inpatient side of things, do keep in mind that there is a lot more to psychiatry than inpatient work and it might be worth seeing if you can get an outpatient elective. I think many people find inpatient psych to be depressing or even scary as a medical student. In the real world, most psychiatrists do outpatient work, and in an outpatient office practice you would see (generally) much higher functioning patients who are doing much better than the folks who end up in a psych hospital are.

 

[RA resident]

I'm so very sorry that this is going on. Have you ever thought about academia and teaching?

yes, academia/research/teaching is something I'm looking at. And don't feel too bad for me, I actually have it pretty good, especially with all the new drugs in the past 20 yrs!

 

[RA resident]

I would say Psych but since you do not care for it. Rads. Just get through the first year.

Is there a way to just do diagnostic in rads residency? I noticed there were a lot of guided interventions during my rotation

 

[RA resident]

It's too bad that you don't like Psych. In my job, I do a bit of telepsychiatry (psychiatric evals over the computer with something equivalent to Skype) which I think would be perfect for someone with physical limitations who still wants to see patients.
If you're basing your opinion of psych just on seeing the inpatient side of things, do keep in mind that there is a lot more to psychiatry than inpatient work and it might be worth seeing if you can get an outpatient elective. I think many people find inpatient psych to be depressing or even scary as a medical student. In the real world, most psychiatrists do outpatient work, and in an outpatient office practice you would see (generally) much higher functioning patients who are doing much better than the folks who end up in a psych hospital are.

Something to think about, for sure. On my first week of the rotation I did intake on 4 suicide attempts in elderly people in impossible socioeconomic conditions. I was half suicidal myself at the end of it.

I have had depression myself before. I guess I worry about exacerbation in a psych setting.

 

[meister]

Is there a way to just do diagnostic in rads residency? I noticed there were a lot of guided interventions during my rotation

No, not really. Image guided procedures are part and parcel of diagnostic radiology and I have a hard time imagining someone completing residency while avoiding IR.

 

[primadonna22274]

I think most emotionally healthy physicians, psychiatrists included, learn to separate their empathy toward their patient from their sympathy of their awful situations. No matter which specialty you choose, this is a vital part of resilience that any physician has to learn to not get so wrapped up in the day to day struggles that our patients face. Life is hard. Life is pain. My job is to help alleviate suffering where I can but a huge part of that requires that I maintain some emotional distance myself. There's only so much of me that I can give away for free every day.
Good luck


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[Goro]

Palliative care?

Take a look at this guy:
http://www.nytimes.com/2017/01/03/magazine/one-mans-quest-to-change-the-way-we-die.html

What field do you guys think is the least physical? I got RA in med school & I am A-OK 95% of the time, but every so often the stress / sleep deprivation puts me in a flare. Let's say 1% of the time it's hard for me to even dress myself. Hasn't been a big deal through MS3, but no one is counting on me to put in a chest tube.

I know disability accommodations are a thing, but I think I'd like to try for a field where I wouldn't need it. Especially as I am unlikely to be able to get disability insurance. And I'd like not to be a burden on the other residents. And I'd like to not second-guess myself if something happened to go south for a patient I treated while not physically 100%. Like if I am the only doctor on the service & **** hits the fan & it just so happens my arms are not working. There are a ton of attending positions that would work great, but getting through the residency first is key.

Due to a glitch in scheduling (had to take time off when first diagnosed) I am done with all MS-3 rotations. I really liked almost everything! But even in something like IM or Peds I could see areas that I wouldn't be able to do in a bad flare. I loved OBGyn but it's totally off the table. I did a couple of weeks in Surg Path that were quite nice.

Basically I am looking for ideas! Non-residency ideas are also welcome. I feel pretty limited in options. If I could predict this I would not go to med school again. Fortunately my loans are sub 100K so I don't need a high paying specialty.

 

[primadonna22274]

Palliative is great but you would have to get through medicine residency first, most likely, although I understand there is now a new dedicated palliative residency. But that's likely to involve a lot of long medicine months.
Honestly anything even psych is going to involve at least one long and intense PGY1 year. Pick what you like best and get good support. Good luck.


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[meister]

Occupational medicine?