Committment issues...

[Taciturngosamer]

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Ok, so I realize that this is probably something that I should just whole myself up in a room for a few days and ruminate over my options rather than blabber to complete strangers....but there's comfort in random outside opinions.

So: how did you make your decision to enter into x specialty? Its the middle of third year and I feel like I should be a grown up and pick something. Problem is that I feel like my early rotations merely confirmed what I DON'T want to do rather than help me narrow things down. Don't get me wrong, I love the field of medicine, but I feel more clueless now about where I fit than when I started third year.

So how do you do it?

 

[BigNavyPedsGuy]

I know this isn't what you're looking for, but just relax, you'll find something. And if you feel the same way toward the end of the year, I reccomend the ol' list of pros and cons.

 

[Samoa]

OK, start thinking to yourself about what particular things you like and dislike about the fields you've seen so far. If your school allows you any say in the order and timing of your core rotations, try and do a rotation in a field that combines a lot of what you like.

For example, if you like clinic, take family med or ambulatory medicine. If you like the OR, but hate the atmosphere on gen surg, try another surgical specialty. If you only like certain kinds of medicine patients, take an elective in that subspecialty. If you like lots of technology and procedures but hate the OR, maybe cardiology is more your style. If you love the OR, but also love clinic, try ENT or urology or OB/GYN. If it pisses you off that your patients never do what they're supposed to in order to stay healthy, try peds-- parents are extremely anal about making their kids do what the doctor says.

If you hate dealing with patients at all, but like interacting with your colleagues, try an elective in pathology or radiology.

There's a niche for just about everybody. The one thing that trips most people up is that subspecialties can have a completely different feel than the overall specialty they're a part of, so don't cross something off just because you hated the core for that field.

As an example, I'm going into a subspecialty field where I hated the core rotation. Well, it turns out that many other people in my field can't stand the core specialty either. And yet we all truly enjoy the subspecialty. I mean, who would have guessed?

So just give some thought to what you liked and disliked, and find somebody knowledgeable to guide you in exploring different areas.

 

[Taciturngosamer]

Thanks,
I guess I'm just looking for that epiphany moment when everything is clear. Which of course is completely unrealisitc.

But somehow making a list of pros and cons for deciding which specialtiy of medicine to enter into seems like making a pros and cons list for deciding which person you should marry (maybe even moreso as most people actually stay in the medical field they originally choose). I'll give it a go though. Thanks again...

 

[Samoa]

Well, there are too many specialties to go about it by trial and error, so the key is figuring out which one is most likely to give you that epiphany, and then do that elective and see.

p.s. I would probably make a pro and con list about marrying someone, as well. Epiphanies are all well and good, but life decisions like that deserve all the practical thought you can muster under the circumstances. Which is not always a lot, I concede.

 

[Taciturngosamer]

True, it does deserve clear, logical, and precise thought. But there just seems to be something coldblooded about it.

I mean I strapped myself with an unfathomable amount of loans, sacrificed my youth, and trashed the golden years of my social life (ok so it really wasn't that bad)....for something that I was and am passionate about.

I just can't seem to muster a clear passion (heck even preference) for a specific area.

And no passion isn't a substitute for reality or logic, but it would sure help to have just a teeny tiny amount of excitement/something for an area of medicine that makes me think: this is it (heck, even this could be it).

Ah well, I still have the two big ones left to get through: Medicine/Surgery.I probably should hold off my whining till I've at least rummaged through the two of them.

I just was fielding how others have made this crazy decision: I mean divorce might be messy but it seems a heck of a lot easier than switching specialties once committed (which probably says something negative about society/my own views on marriage).

Thanks again and have a happy new year!

 

[Igor]

Look at the people you know in each specialty and ask yourself:

"Is this what I want to turn in to?"

Because you will.

 

[Taciturngosamer]

Look at the people you know in each specialty and ask yourself:

"Is this what I want to turn in to?"

Because you will.

Now that is not a reassuring thought....

 

[Samoa]

I don't know about that. There are all kinds of people in every specialty, and if your school happens to have jackasses in yours, you can always train somewhere else.

You have to think about whether it's the field you dislike, or just the people at your institution?

In fact, I think one of the biggest reasons people choose specialties they end up hating is that their school happens to have a particularly charismatic faculty member in that field. And it's even more likely if that person has a lot of student contact, and obviously enjoys their work. Their excitement is infectious.

But is it the field you enjoy being around, or is it the person?

Consider this also: the people you work with have a far bigger impact on how much you enjoy your work than does the work itself. So you could actually make a very strong argument for the idea that your specialty matters less than does the particular program you choose for residency.

 

[Dr JPH]

I guess I'm just looking for that epiphany moment when everything is clear. Which of course is completely unrealisitc.

This is what happened to me.

A bit more than 50% through my 3rd year and it hit me, 3 days into my surgery rotation.

I think the advice above is correct...you need to try to view specialties that fit your personality, career goals, personal goals and even financial goals.

Like a professor once told me "You need to figure out if you're a DOIN' doc or a THINKIN' doc." Broad categories, but a good place to start I guess!

 

[nutcancer]

DOIN' doc or THINKIN' doc..that's real clever but not fully applicable in today's age

a lot of people are interested in DOIN' (procedures) as an internal medicine subspecialist as opposed to surgery. i don't know about the original OP but a problem i'm having is if i think i'll be able to tolerate an IM residency enough to achieve those subspeciality goals, many of which are strictly procedural.

i kind of wish surgeons got all the procedures so i wouldn't have to contemplate this!

 

[Hard24Get]

Ah well, I still have the two big ones left to get through: Medicine/Surgery.I probably should hold off my whining till I've at least rummaged through the two of them.

Med/Surg will be key. You have NO IDEA whether you will like rounding/meetings versus quick rounds and procedures until you get there, and then the world becomes crystal clear.

In the meantime, use:
AAMC Careers in Medicine, a great resource with medical specialty info and the ability to complete multiple tests to choose a specialty, as well as tips for residency application
Iserson's guide to getting into residency, a classic medical school bible with some limited specialty-choosing help but excellent advice and tips
How to Choose a Medical Specialty A really fun book with great specialty descriptions

Myers Briggs Personality and Medical Specialties, to be used with the
Myers-Briggs personality test

And then there are the SDN favorites, The U of Virginia test, and the infamous chart.



Hopefully we can sticky these links???? 😀

 

[aggernodi]

Here is another way of looking at answering your committment question... I originally posted this advice somewhere else, but I can't remember where, so I have rehashed it here....

Back when I was a medical student (1990s), a very wise surgical resident gave me this advice on choosing a specialty. Do NOT choose a specialty based on how miserable or long a residency is. Residency is NOT reflective of what life is like after you finish. Keep the end goal in mind, but not the process. 5 years (+/- a few years) is a small price to pay for a lifelong career decision.

With that in mind, think about what you want your call to be like once you are done with residency. Do not answer these questions as a medical student or even as a resident, but answer these questions by imagining yourself being 45 years old with a family and kids. Of course, I'm assuming you all are in your 20's.

1) Do you like (or don't mind) emergencies?
2) Do you like (or don't mind) call?
3) Do you like a regular, planned schedule?

These questions determine what the rest of your life will be like and its quality regardless of the specialty.

If you answer yes to 3, and no to 1 & 2, pathology, dermatology, radiology are for you.

If you answer yes to 1, no to 2, yes to 3, than ER.

If you are ambivalent to 1 & 2, and yes to 3, than ENT, ophtho is for you.

etc etc etc.

 

[edmadison]

There has been some great advice. Start by picking big picture things.

Do I want long term patient relationships?

Do I want patients at all?

Do I like doing procedures?

Do I like talking to people?

Am I a work-a-holic?

This should help you narrow your list somewhat. Next thing about things like outcome. If you like seeing immediate changes in your patient's based on your intervention, Medicine and Psych are not for you.

Ed

 

[quideam]

Here are a few more to help you narrow down your options...

Have you always wanted to be in a sorority and discuss your sex life with all the other giggling women during morning report?...... OBGYN, my friend.

When you see a baby, do you have an uncontrollable urge to go over and play with it? Do you think it's cute when that baby pees all over your white coat?...... Peds.

Do you love standing around for hours discussing the intricate pattern of a patient's magnesium and how that may or may not be related to an obscure infection that an obnoxius intern read about in the NEJM?...... Medicine at some stuffy Ivy hospital.

Are you obnoxious? Do you steal patients, yell at your classmates, and demand that you get whatever you want?...... well, you're probably just a jackass, but consider Surgery (I know several people that are *just* like this!).

Always wanted to live in the "Batcave"? Don't mind losing your vision by the time you're 50?...... Radiology all the way.

Do you think you're god's gift to women, patients, and basically anyone you come in contact with? Do you spend more than two hours per day at the gym? Is most of that time spent lifting unnecessarily large weights while grunting incomprehensibly?...... Think about ortho or plastics.

Do you value your free time? Are you content to go home at the end of a busy shift and not have to worry about Mrs. Smith's erratic potassium? Would you prefer to wear cargo pants and a scrub top rather than a suit and tie to work?..... ER!!! (my baby....)

.... and so on.

 

[kito]

above is too funny.

 

[tiredmom]

Also consider specialties that you don't get exposure to during 3rd year. I had a friend who was in the same situation, only it was now June and she'd finished 3rd year, and disliked everything! She did rots in Anesthesia and in Path for her first two 4th year rots and found out she really liked pathology.

 

[GregsAnatomy]

 

[Taciturngosamer]

Thanks for all the comments.

I think its just going to come down to either an odd alignment of the planets or getting half a clue after surg/med.

Although I have to say that the chart is more amusing than not 😀

 

[ericdamiansean]

Follow your heart my friend...😎

Whether you are anal retentive is also an issue

 

[m1234d]

I feel like the decisions I make are based more on:
1. inpatient vs outpatient vs no patients. I HATE outpatient and office staff
2. kids vs adults

surgery vs medicine just doesnt seem to be as important because there are so many specialties with procedures.

how appropriate are my criteria? so far, its inpatient (or at least limited outpt) and kids