choosing a specialty-help!

[jen628]

6 and a half months into third year and i still don't love anything. people keep saying i have a lot of time to figure something out but that's really not true considering i've been working on this for how long now and i still am not closer. gyn, general surg, fp, and er are all up there. i don't want to do a transitional year and i don't want to switch residencies after internship because i made the wrong decision.

soooooo, besides reading the choosing a medical specialty book by taylor, which i've done, any good ideas out there? i tried some site which is supposed to have an mmpi to determine which specialty your personality type is like at virginia or something but of course you have to have a password to get in- does anyone know it?

and please don't recommend talking to the folks here at school. that experience yielded this (true story) stellar advice, "think about the kind of things you like and the kind of things you don't like."

thanks

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[AnnK]

Im a third year too and equally confused. I dont have any great recommendations. Im thinking about things as diverse as RadOnc and FP. Do you have the galaxo welcome seminar at your school? I did that and it helped a little bit. Ill be interested in thoughts from other people on this subject too. I think that it is really hard to make this decision with so little clinical experience. We have to pick 4th year rotations in just a couple of monthes!
Good luck.
Ann

 

[SUNYboy]

The first thing you have to decide is whether you want to be a diagnostic Doc (IM, neurology, etc) or a procedural Doc (ortho, ophtho, ENT, etc). There are of course, some combo of both. Also, do you want to be responsible for diagnosing and intervening, by meds or surgery (ENT, ortho, ophtho), or do you want to diagnose and pass the buck (FP, IM, EM(the biggest turfers))? If you decide on surgery, do you want to do major surgery, or meticulous surgery? Once you are able to answer those basic questions, then you can add in more factors such as lifestyle, pay, etc... Hope this helps...

 

[edmadison]

Something that has helped me a bit decide what I want to choose is a gross overgeneralization, but it works. I like to catagorize the specialties as relationship oriented or outcome oriented. Many people gain job satisfaction from the long term interactions that they have with people. Big results aren't as important to them. These people would probably be happier in primary care specialties: Medicine, Family Practice, Peds. Others (myself included) need to conquer problems. I love working with people but I want big successes and am willing to give up some patient interaction for this. Outcome people might be happier in surgery, radiation onc, or cardiology. If you want a little of both, try OB/GYN.

Finally, unless you can't live doing anything but surgery, don't go into general surg. Five years of hell is no worth it otherwise.

Ed

 

[GoatBoy]

Does anyone know the password for that virginia site that jen is speaking of?

 

[e2k]

When you look at a broken radio, do you want to?

Fix it: surgeon
Find out what's wrong: IM
REALLY find out what's wrong: Pathology
Investigate the problem to make sure it never happens again: research
Find out if it's actually broken or just doesn't feel like playing: Psychiatry
Patch it together and send it on to someone else: EM
Play with it until it feels better: Peds
Toss it out the window, buy a better one: HMO Administration

No, seriously. What do you want to do with your days? If you like talking to people, primary care. If you like interacting with data, radiology or pathology. If you like fixing things and playing with new toys, Surgery.

Many people do IM if they really don't know what they want to do. This allows you a lot of leeway with many fellowships that allow you do to many different things.

Listen to Ed. DON'T DO SURGERY UNLESS YOU ARE 100% COMMITTED TO IT!

ERIC

 

[deleted4401]

Choosing a specialty is some scary stuff ... I'm just a first year and I change my mind every week.

That's all I have to add to this ... good luck.

Simul
Tulane Med '05

 

[godfather]

i was in the same position as you guys last year and here's my advice. The only decision you really have to make right now is whether you want to or are keeping the option of going into a competitive field open. Your application is going to go out like as soon as your third year ends so you have to keep this in mind if your thinking about going into Derm,Orthopedics,Radiology, combined plastic surgery and possibly ent and Er,(ent and radiology change in competitiveness year to year but radiology has been extremely competitive over the last couple of years). The reason you need to know if your interested in these fields is because your going to need to do an elective early (either in your 3rd year if your school allows you an elective in this year or EARLY in your 4th(like by Sept)year) so that you can get a letter of reccommendation and you can get your application out early. As a matter of fact if you want to go into a supercompetitive field you might need to decide by your 2nd year so that you can aim for a good board score. For most of the other fields there are either lots of spots,eg Ob-gyn, IM or not many people going into the field that even if you decide later on or send your application out later it won't be totally detrimental as you can still secure a spot(although it might not be at Hopkins). However if it's ortho, derm, or Rad that you wan't to go into you'd better decide quick because then grades,class ranks, letters, research, and getting out an early application all start mattering. ie you have to decide like by the first or second month of your 4th year if you want to go into a competitive field or a noncompetitive field.

 

[jen628]

heh, when i read the clock radio piece i immediately thought, 'throw the damn thing out.' uh oh.

so i'm not so concerned about money since i think no doc is hurting in that respect. if i *do* choose g surg i've already decided to shoot for non academic residencies and programs <100 hrs/wk. hopefully it's not a myth that they exist.

i guess i kind of do know what i want-the variety and breadth of fp with the prestige and fix-it-ness of surgery, the excitement and 'real medicine' of er and the ability to help folks when others won't of gyn. anyone know where i can find that package?

thanks

 

[AnnK]

Thanks for the great replies. I like the diagnostic vs interventional approach. I have also heard the "pick your favorite/least favorite" patient population and choose from that theory.

I seem to have different answers to these questions on different days. I sort of feel like there is a difference between what I might really like the most on an hour by hour basis and what I think is a smart choice. For example, I like FP and Ob/gyn for the diversity and pt relationship potencial but the lifestyle is tougher than something like rad onc. Plus, I have a PhD so I feel like I ought to do something with a more academic bent. Its so tough! Seems like there is something I like about every field and something I dont.

Also, I have the virginia web site. Ive done the quiz multiple times in the past without being asked for a password but the site seems to requred one right now. If anyone can figure it out let me know. I got some strange choices last time. I got 1. occupational medicine and 2. Thoracic surgery!!

<a href="http://med-ed.med.virginia.edu/med-ed/specialties/Home.html" target="_blank">http://med-ed.med.virginia.edu/med-ed/specialties/Home.html</a>

Thanks again for the great thoughts.
Ann

<a href="http://med-ed.med.virginia.edu/med-ed/specialties/Home.html" target="_blank">http://med-ed.med.virginia.edu/med-ed/specialties/Home.html</a>

 

[PainMan]

here is the virgina link that works without a password....<a href="http://www.med-ed.virginia.edu/specialties/" target="_blank">med specialties</a>

 

[jwpelley]

The following link should help with concerns about specialty choice. I think this is more than an advising issue in medical schools - it is an important area of professional development.

You will find that Myers-Briggs intuitive types (big picture types) tend to take longer to decide on their specialty and tend to go into diagnostic areas as SUNYboy so wisely points out. Myers-Briggs sensing types (specifics oriented types) prefer more certainty and tend to make up their minds sooner, sometimes even before arriving at medical school. The sensing types tend to go into procedural areas of medicine, which includes many primary care specialties.

The most important single advice you can get is to not let a test or a person tell you what to go into. Investigate and know yourself. I know of many students who went against their personality because of other factors and are doing fine. What personality instruments tell you is not what to go into, but what will come easy and what will require effort.

my best,

jwpelley

<a href="http://www.ttuhsc.edu/success/career.htm" target="_blank">TTUHSC AMSA presentation on specialty choice</a>