MD Choosing specialties?

[DrRiker]

---

Members do not see this ad.

I'm a current applicant fortunate enough to have a small handful of acceptances to choose from. A priority of mine when choosing a school is to find a curriculum that gives me enough time to explore my broad range of clinical interests. In this sense, condensed pre-clinical curricula are enticing, but most of my options (so far) feature more traditional curricula, with clinical rotations starting in M3. So I'm curious to learn from current students, what is the typical timeframe like for choosing a specialty? When do residency applications really fit into the med school timeline? My understanding is that residency applications occur during M4, often before having the opportunity to participate in interesting electives. Is this true? For those of you in traditional curricula, have you had time to explore more obscure clinical interests (subspecialty IM, ophthy, gas, EM, IR, etc) before making a decision?

I also have the opportunity to participate in a more research-focused program, which would require a couple of electives to be dedicated to research. For those of you who have taken research electives, have you found these valuable? Did you feel as if they came at the expense of clinical learning?

 

[DrDwayneJohnson]

Hi #1 (hope you get this reference based on your username).

Even though it doesn't seem like it at first, you really have a ton of extra time as an M1. Especially with non-mandatory classes and/or P/F curriculum. There will be interest groups and shadowing opportunities galore no matter where you go. I would just spend a ton of time shadowing M1 to try and get lucky and find something you like early on. However, it's hard to judge if you really enjoy CT surg, psych, etc. until you're on the wards third year.

As for applying to residencies: you do that at the beginning of 4th year in September. Depending on your specialty of choice, you might do away rotations but you'll almost certainly do a "sub-I" in the field. Depends on your curriculum but you'll probably have time to do at least one before submitting your app in Sept to get some sweet letters.

TL;DR: shadow your tail off during M1 and hope that you find your way. You'll have plenty of time

 

[mrbreakfast]

1) Most people decide in the spring or summer of M3. Some decide later, and some dual-apply (like, peds and surgery) so they can make their decision much later. I decided "late," in like June, and still had plenty of time to get into/complete a sub-I and line up my letters before September. I know people who got their letters in September itself.

2) For M3, keep in mind you'll get a lot of exposure to various fields on the wards, including ones you aren't directly working with. I spent hours in the ED on IM, OBGYN, surgery, neuro, etc, enough to know what it was about. I spent time in the reading room on a number of rotations too. Anesthesia? You'll spend many boring hours in the OR while not scrubbed in, so you might as well peek your head around the drapes. Ultimately, you'll get one of two electives, maybe a few more, to try things you wouldn't otherwise get early exposure to. But keep in mind, condensed curricula often entail you taking an elective or two as "study time."

3) An important consideration is how much time you have to study overall, particularly for step 1. A ton of students will delay step and end up taking a clinical rotation as an elective later, so make sure things aren't too rushed.

4) In terms of what to explore: just keep and open mind and shadow during M1/M2 when you have free time. There are a few fields (all the surgical subspecialties but in particular uro, ENT, and especially ophtho, as well as derm, rad onc, maybe IR) in which if you are considering them you will want to get early exposure. The joke at my program is that people interested in ophtho should have a publication and a letter lined up before their first ophtho rotation...

Ultimately, your goals for the first two years are to put yourself in a position academics-wise to match into as many things as possible, and to get a broad enough basic exposure to have a few ideas of what you find interesting (e.g., you think you might like rheum, OBGYN, surgery, or peds, but not path, rads, family, etc). But the answers will come.

 

[ciestar]

I was part of a traditional curriculum and my fourth year starts in May, so I have plenty of time to explore and tie up the indecisions i already have.

 

[ed*26]

You'll definitely have time to shadow during your first year, and on top of that there'll be a ton of interest group events to attend if you want a sneak peak into the specialty. Your interest in different subjects can also point you in a direction. Many students go into third year with a short list of specialties they're most interested in.

I also have the opportunity to participate in a more research-focused program, which would require a couple of electives to be dedicated to research. For those of you who have taken research electives, have you found these valuable? Did you feel as if they came at the expense of clinical learning?

I'm in a research-based program. How valuable it is really depends on whether you want to do research. Research is typically helpful if you want to match into an academic program, and absolutely necessary for some fields (e.g. derm, ortho). Most medical students also do clinical research in their field of interest, so research can be a great way to get close to a mentor in your field, and you become something of an expert on your particular subject. If you don't want to dedicate your extra time to research, though, then you won't find it as valuable. One of my friends at another school spent two months doing a kick-ass primary care fellowship that I wouldn't have been able to do because I was required to do research.