Completely lost about figuring out what specialty I might be interested in [M1]

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manohman

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Im an M1 and seeing a lot of people get involved in different specialties but i have no idea what specialty interests me. But I also do not want to waste time.

How did you narrow it down? Any good resources for seeing what different specialties are like?

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Im an M1 and seeing a lot of people get involved in different specialties but i have no idea what specialty interests me.
But I also do not want to waste time.

I will probably end up doing a non surgical specialty but i have no idea where to start. Nothing seems that interesting/everything seems boring.

How did you narrow it down? Any good resources for seeing what different specialties are like?

Most of those people will change their minds. It’s easy to say you want to be something when you’re a preclinical student.
 
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Shadowing and interest groups are chill, flexible, and non-committal ways to explore a couple fields of interest. If you then find a field you really like you can get involved in some research and start networking a bit, especially if it’s a competitive specialty.

If no fields are particularly interesting (but you still like medicine in general) then you can just focus on doing well in school which will help keep doors open.

If you have zero interest in any fields...
well then you need to think about why you’re even there
 
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What the hell got you into medicine in the first place?
I think it is all interesting but. I have no idea what I want to do. i guess i should have phrased it better as "i cant see myself dedicating the rest of my life to any specialty" yet but in the end everyone seems to. And so I am wondering how people have gone about doing that, those who have decided.

I like every class, from metabolism to genetics and every specialty seems cool but for a lifelong thing, given my limited experience, which is almost none in most specialties, I have no idea.
 
At your stage, most people made up their minds based on George Clooney's hair in the ER and pa$$ion. You'll have a better idea as you go through the motions and reach M3.
 
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OP: don’t stress about this until third year. Everyone is different: for me, I didn’t find out until over halfway into my third year, but when I knew, I knew. There’s no way to tell exactly what working in a specialty is like during preclinical years. Just focus on getting the best grades you can, doing research, and doing some volunteer work, so that when you do find your specialty you already have a decent CV ready to go.
 
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3rd year will give you better idea. As long as you aren’t dead-set on a surgical subspecialty or derm you can pretty much make it into anything without having a large body of proof of your dedication to the specialty.

You’ll still give yourself a hard time for not having any idea about which one to pick, that’s okay though - it is part of the process.
 
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I think it is all interesting but. I have no idea what I want to do. i guess i should have phrased it better as "i cant see myself dedicating the rest of my life to any specialty" yet but in the end everyone seems to. And so I am wondering how people have gone about doing that, those who have decided.

I like every class, from metabolism to genetics and every specialty seems cool but for a lifelong thing, given my limited experience, which is almost none in most specialties, I have no idea.

You don’t need to be worrying about this yet. You won’t really know until third year. Preclinical classes are an okay place to start by saying you like this or that, but that’s about it.
 
No worries...I went in set on Neuro (or maybe IM). I did neuro club/fundraiser and everything.

Third year Neuro rotation made me say...um, no. I didn't know what I was doing then. I started to gravitate toward path during third year. My first rotations 4th year in April were path and derm. I latched onto derm day one of my rotation.

You have the time. If you have no idea, try to get some shadowing experience in during first year (if your school allows it).
 
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When you get to clinicals, see what assigned articles you find interesting . Later, notice what journal articles you find yourself reading on your own. I liked physio and pharm in pre clinical, cardio, pulm, and critical care during clinicals as examples.
 
My advice will be a bit different from previous comments: if you think you want to do any competitive specialties such as surgical sub specialties...try to shadow and decide it now...especially those place heavy emphasis on research and 1. if you come from program where you don’t get a good support or research is terrible and 2. Match at a solid/top program from a “low” program. Research can take a long time to build especially if you have a terrible home program. Also finding a good mentor who really takes the time to guide you is not always straight forward. As someone who is applying to a surgical sub specialty, these are the things I wish I would have done differently.
 
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Even if you don't know now, make sure to do some research and volunteering in case you decide you want to do a competitive specialty down the road. Just to keep your options open for now.
 
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Im an M1 and seeing a lot of people get involved in different specialties but i have no idea what specialty interests me. But I also do not want to waste time.

How did you narrow it down? Any good resources for seeing what different specialties are like?

Knowing early has its advantages.

1.) Identify someone you have shadowed. Do you want their life in 30 years? What things of their life do you like/not like?
2.) What are your plans for the future and how long can you feasibly invest into training?
3.) How well do you handle stress? If not well but you're someone willing to work hard and make genuine connections every day maybe you'll be better in a less acute setting (outpatient).
4.) Do you want to be doing things with your hands/value quick results, etc. Then maybe something surgical is right for you.

Once you're done with this exercise there's tons of flow-sheets and charts online as well as MCQ tests but the first thing to decide on is medicine or surgery.

1.) Surgery or Medicine? Do you like to work with your hands, be certain of things, work long hours vs. do you like to talk to patients, be cerebral, etc. Don't worry that these are extremes but it's important to have an idea of which line of thought you identify with. There are also fields that do a bit of both like OB/GYN (ex.)

Surgery Pathway:
-What are your particular interests? Do you like bones, angles, and physics or cauterizing, snipping, and colons. How much do you value your income? How much do you value your time? Do you want to develop relationships with patients and see them in clinic regularly or just fix remove their appendix, follow up in a few weeks, and be done with it?

Medicine Pathway:
-What are your particular interests? Do you like the brain and thinking about pathways, figuring out where the lesion is, and are meticulous with your physical exam? How much do you value your income? Speaking of that, do you like procedures because GI/Cards offers both. Do you handle stress well? If not, maybe outpatient is a better setting for you. Do you like to be a generalist or specialist? Do you like to triage and stabilize? etc, etc.
 
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Im an M1 and seeing a lot of people get involved in different specialties but i have no idea what specialty interests me. But I also do not want to waste time.

How did you narrow it down? Any good resources for seeing what different specialties are like?
Chill. You have plenty of time to figure this out.
 
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I think it's important to consider options early - shadowing ideally, but given that my school and I imagine others aren't letting preclinical students shadow during covid, I would at least try to attend some interest group events/reach out to faculty members or resident who might be willing to talk with you about their specialty. You absolutely don't need to decide anything right away, but it's good to know what's out there and what you might be leaning towards, especially if it might be something competitive that you need to build a resume for. I've found people to be very generous with their time as long as you approach them with the appropriate polite enthusiasm.

That said, as others have mentioned you should be open to new interests during clinical rotations, when you really get to see what the day to day is like. I'm currently having my own little existential crisis as a 3rd year because I loved a rotation I didn't expect, and am now reconsidering the specialties I thought I had settled towards
 
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You don't have to think about it as devoting your life to it. I think you can think about it as a job if nothing is clicking as a passion, and that's fine as long as you do right by your patients no matter what. If I didn't have a passion for medicine, I could at least ask "what would I rather do than a desk job somewhere?" If a desk job starts to sound nice compared to crazy hours in surgery or rounding as a hospitalist, consider a clinic-based specialty (ophtho, derm, outpatient ent, outpatient IM/FM/etc) or something more removed from patients like path or rads.

Also, if you came into med school interested in the anatomy or the science and just don't click well with clinical duties, that's another good reason to think about path or rads. Both are fields you won't get a lot of exposure to post M2, and I will say, as someone going into a clinical field, that if it hadn't clicked, rads had a ton of appeal.

Overall, though, I wouldn't worry. There's a good chance that something will really click in M3, and if not, you can always fall back on the ways of thinking I mentioned above. Most people don't choose a career saying "what do I want to devote my life to?" As a med student, you already chose to answer that question with "medicine," but the specialty choice doesn't have to be taken as a life-or-death thing. I think I would have been happy choosing a lot of different specialties, in the end.
 
I knew from the womb I wanted to specialize in PM&R.

Actually, I made that decision about a month before submitting residency applications. I’d been set on psych most of med school.

Before med school I wanted to be an architect, structural engineer, photographer, professor of religious studies, high school teacher, and of course, an astronaut. I really wanted to be one too—I was going to go to the Air Force academy, learn to fly, become a test pilot (after getting at least one PhD) and then pilot the space shuttle.

Explore everything now while you have time. M1 and 2 seem busy, but there’s not much time to explore non-core specialties once you start M3.
 
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I knew from the womb I wanted to specialize in PM&R.

Actually, I made that decision about a month before submitting residency applications. I’d been set on psych most of med school.

Before med school I wanted to be an architect, structural engineer, photographer, professor of religious studies, high school teacher, and of course, an astronaut. I really wanted to be one too—I was going to go to the Air Force academy, learn to fly, become a test pilot (after getting at least one PhD) and then pilot the space shuttle.

Explore everything now while you have time. M1 and 2 seem busy, but there’s not much time to explore non-core specialties once you start M3.

Me when people ask me what specialty I want to go into:
DAFED3C3-DE93-4600-AF9B-08C64E55925B.gif
 
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I'm halfway through 3rd year and still don't know, talk about stress!
 
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Relax, you have time. That being said a lot of people go about picking specialties the wrong way. As you rotate and learn more about each, ask yourselves these questions:

1. Call or no call.
2. Weekends/holidays or no weekends/holidays.
3. Nights or no nights.
4. Inpatient, outpatient, or both.
5. Procedures or no procedures.
6. Patient contact or no patient contact.

1-3 will affect your life and well being far more than 4-6 btw, you just don’t know it yet.
 
Relax, you have time. That being said a lot of people go about picking specialties the wrong way. As you rotate and learn more about each, ask yourselves these questions:

1. Call or no call.
2. Weekends/holidays or no weekends/holidays.
3. Nights or no nights.
4. Inpatient, outpatient, or both.
5. Procedures or no procedures.
6. Patient contact or no patient contact.

1-3 will affect your life and well being far more than 4-6 btw, you just don’t know it yet.
1-3 are not really that helpful to ask because the answers are always no. The question students should ask is how much of 1-3 can they put up with to do what they're interested in.

4-6 are much more helpful for actually figuring out which specialties you're interested in because reasonable people will answer them differently.
 
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1-3 are not really that helpful to ask because the answers are always no. The question students should ask is how much of 1-3 can they put up with to do what they're interested in.

4-6 are much more helpful for actually figuring out which specialties you're interested in because reasonable people will answer them differently.
It's more a question of willingness
 
1-3 are not really that helpful to ask because the answers are always no. The question students should ask is how much of 1-3 can they put up with to do what they're interested in.

4-6 are much more helpful for actually figuring out which specialties you're interested in because reasonable people will answer them differently.
Umm. No it’s not. I don’t mind working weekends/holidays. I don’t mind working nights. I absolutely would never want a pager. I enjoy having weekdays off because I can go do whatever I want while other people are working.

These three things affect your life outside the hospital far, far, far greater than 4-6 that it’s really no contest. When you’re an actual attending you’ll understand that this is just a job, not a fairy tale.
 
Med school roadmap:

If you turn out to be a great test-taker, do derm or ophtho.

If not, do anesthesiology if you like procedures, psych if you like talking.
 
Umm. No it’s not. I don’t mind working weekends/holidays. I don’t mind working nights. I absolutely would never want a pager. I enjoy having weekdays off because I can go do whatever I want while other people are working.

These three things affect your life outside the hospital far, far, far greater than 4-6 that it’s really no contest. When you’re an actual attending you’ll understand that this is just a job, not a fairy tale.
This is my point. The question is how many calls, nights, weekends, holidays etc. do you mind working in order to have the career you want?

If you ask random med students "hey do you want to work holidays or no? do you want to be on call all the time or no?" you're going to get the same answers from all of them. If you tell them that's how to pick a career, everyone would pick FM or EM; really, how many specialties are there where you're never on call? I appreciate your perspective as an attending but you have the bias of being in EM if I recall correctly, which ticks most of those boxes. I'd bet the percentage of EM attendings who agree with the "just a job, not a fairy tale" line is disproportionately high compared to the average MD. Isn't the rate of burnout highest in EM?

Nobody chooses my specialty because they want to be on call and work weekends, nights, and holidays all the time. They choose it because it's what they want to do, and they accept the lifestyle burden. There's no amount of holidays off or pager-free days that I would accept in exchange for having to do the work of EM or FM physician. Believe it or not, many surgeons are happy with the path they chose.
 
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This is my point. The question is how many calls, nights, weekends, holidays etc. do you mind working in order to have the career you want?

If you ask random med students "hey do you want to work holidays or no? do you want to be on call all the time or no?" you're going to get the same answers from all of them. If you tell them that's how to pick a career, everyone would pick FM or EM; really, how many specialties are there where you're never on call? I appreciate your perspective as an attending but you have the bias of being in EM if I recall correctly, which ticks most of those boxes. I'd bet the percentage of EM attendings who agree with the "just a job, not a fairy tale" line is disproportionately high compared to the average MD. Isn't the rate of burnout highest in EM?

Nobody chooses my specialty because they want to be on call and work weekends, nights, and holidays all the time. They choose it because it's what they want to do, and they accept the lifestyle burden. There's no amount of holidays off or pager-free days that I would accept in exchange for having to do the work of EM or FM physician. Believe it or not, many surgeons are happy with the path they chose.
EM has two out of those three negatives btw. Nights and weekends/holidays. For some people that’s a deal breaker. I’ve seen med students who have fallen asleep in the break room trying to work nights. I’ve always been kind of a night owl personally so it’s nbd for me although as I age they are definitely harder than in my 20s.

You are correct though. People don’t choose specialties to do more call, holidays or nights (well some do) but these are the things that affect your life outside of work. 4-6 really don’t, they are just where you work and what you do which is still very important, it’s on this list after all. It’s just 1-3 follow you home. It affects your sleep schedule, your ability to spend time with your kids, your freedom to have hobbies, how often you can travel, and even when you will die as night shifts are linked to higher mortality in multiple studies. That’s why they are so important.

To put this another way: figure out what kind of life you want to live as an attending and then find the specialty you either like the most or hate the least that lets you live that life. You should always work to live not live to work. Nobody wishes they had worked more on their deathbed.
 
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