Choosing specialties

[advn1]

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Just a curious pre-med here. I guess this question would be more for M4's:
What field did you end up specializing in? What made you choose that (if it wasn't what you planned on when first entering medical school)?

 

[JP2740]

Just a curious pre-med here. I guess this question would be more for M4's:
What field did you end up specializing in? What made you choose that (if it wasn't what you planned on when first entering medical school)?

Yawn

 

[CrimsonKing]

I'm not an MS4, but I can already tell that specialty choice is probably highly related to Step 1. Step 1 gives you a range of specialties for which you are competitive and you choose from within that list.

Moral of the story is that you can't choose to be a neurosurgeon or orthopod with a 220, so some of the choice is already made for you.

While Step 1 helps to gauge your competitiveness for certain fields, it by no means rules them out if you have the passion, strong application otherwise, and wisdom to apply broadly. Higher step 1 does correlate to greater chance of matching, of course, and students should know the risks of not matching if they apply to competitive fields with a sub-optimal score.

From NRMP data (cited at bottom): 9 US MD students matched into Neurosurgery in 2014 with <220 Step 1, 14 did not. Out of those with a score 221-230, 20 matched and 4 did not. For Ortho, 25 US MD students matched with <220 Step 1.

Source: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

 

[J ROD]

Sometimes you get what you want and sometimes you get what you can.......

 

[643320]

Can't you apply to multiple specialties in the match (allowing you to do your super-competitive "reach" but also a less-competitive alternative if you don't get into the more-competitive field)? But please correct me if I'm wrong...

 

[ksmi117]

I'm a fourth year going into Ob/Gyn because I like the OR, clinic, continuity of care, obstetrics, and the mix of primary and specialty care in the field.

I'm not an MS4, but I can already tell that specialty choice is probably highly related to Step 1. Step 1 gives you a range of specialties for which you are competitive and you choose from within that list.

Moral of the story is that you can't choose to be a neurosurgeon or orthopod with a 220, so some of the choice is already made for you.

While Step 1 scores do matter, I think it's important to consider what fields would make you happiest first. For instance, I had a classmate with a 260 who almost went into Derm but realized that it bored her and she matched into Peds instead and is very happy. I had a competitive score as well and picked Ob/Gyn because that's what I found most interesting. That's not to say that score can play a much bigger role when the score is lower, unfortunately.

So my thoughts: you pick what you find most interesting regardless of the score, and then adjust if it's really competitive and maybe apply to a second-choice but still desirable specialty as a back-up. I think it's a big problem that people with really good scores get coerced into not doing what they really want because their scores are "too good" for that specialty.

 

[Winged Scapula]

Just a curious pre-med here. I guess this question would be more for M4's:
What field did you end up specializing in? What made you choose that (if it wasn't what you planned on when first entering medical school)?

Please post in the Pre-Med forums as per SDN policy. Interested medical students will come there to post.

 

[ksmi117]

You are talking about situations in which people get a high Step 1 and choose a less competitive specialty. Thats a completely different scenario from what I was talking about. Its not like getting a high score forces you to do derm haha! Of course, I agree with what you wrote, but I don't see how what you write applies to my original post about being limited (in an upward direction) by Step 1.

You have one sentence at the end of that paragraph relating to my post, but I wish people would be more honest and direct about it. You can't just do whatever specialty you want... Step 1 dictates it.

I did acknowledge that Step 1 can play a factor in how competitive a specialty you can feasibly aim for, but I also wanted to point out that there are other very important aspects that play a role in what people choose to do since that is what the OP's question was. Step 1 is important but shouldn't trump people's inherent interests. I honestly think the biggest determining factor in starting to narrow down specialties is "medicine v. surgery".

 

[tiedyeddog]

I knew what specialty I wanted to do before medical school. I have a strong personal history with the field with one of my parents. Additionally, one of my relatives is a surgeon so I had some perspective on lifestyle.

As you go through third/fourth year you'll see a variety of styles of medical practice. You'll really figure out at that point what you like and what you don't throughout the day. You should have some idea what you like before that, however. Do you like working with your hands? Are you more cerebral or are you more goal oriented through your day? Do you enjoy seeing primarily well people or primarily sick people? Do you like kids more than any other patient population? do you want to be in clinic all day, everyday?

For me, I love the OR. If I couldn't be in the OR I would rather not practice medicine, tbh. I also enjoy the ICU, bedside procedures, and very sick patients. I like fast-paced, focused clinic visits, and being a specialist is something very appealing to me.

 

[tiedyeddog]

I honestly think the biggest determining factor in starting to narrow down specialties is "medicine v. surgery".

I agree this a great place to start.

 

[caffeinemia]

I honestly think the biggest determining factor in starting to narrow down specialties is "medicine v. surgery".

I would revise that to:

Medicine v. surgery v. I never want to touch another human being in a hospital ever again.

Don't forget the radiologists, radiation oncs, nuclear medicin-alists? and psychiatrists.

 

[MMADoc]

Competitiveness helps to guide expectations but there are always statistical outliers on either side. Below are some of the broad points that I considered while choosing my future specialty.

1) Medicine to lead to a better life vs a life of medicine
2) Procedural (i.e. working with your hands) vs Patient management/thinking
3) Level of desired patient interaction
4) Level of desired continuation of care
5) Limitations (Physical vs Social skills vs Commitments outside of specialty vs Family vs minimum number hours of sleep at night I need not to be a SOB)
6) Interest in the specialty
7) Financial goals
8) Desired residency location (more competitive the specialty, the increased likelihood you will take whatever you can get)

 

[J ROD]

Just as a side........you do use a PE sometimes in Psychiatry. To rule out Medical causes. Esp Neuro exam.