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Did any one actually not changed their mind while in med school?

Discussion in 'General Residency Issues' started by biogirl215, Jun 15, 2008.

  1. biogirl215

    biogirl215 2+ Year Member

    May 1, 2007
    I always hear that people almost never end up going into the specialities that they plan to go into as an MS-0/MS1/MS2. Did any of you actually end up in your "planned" specialities? If not, what made you change your mind?

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  3. colbgw02

    colbgw02 Delightfully Tacky 10+ Year Member

    I would say, in general, there is a pretty strong tendency to gravitate toward lifestyle specialties (and not just the well-paying ones) as you progress through medical school. It's easy to want to be a hotshot trauma surgeon when you're young, fresh out of college, and have no family. By the time you make it through the clinical years, you're older, more likely to be married or in a long-term relationship, and you realize that working 80+ hours a week just isn't worth it irrespective of how much you'll make or how much you love the thrill of doing emergent ex-laps on GSW victims. That 40 hour a week psychiatry or family medicine practice all of a sudden looks a lot more attractive.
  4. Winged Scapula

    Winged Scapula Cougariffic! Staff Member Administrator Physician Faculty Lifetime Donor Classifieds Approved 15+ Year Member

    Apr 9, 2000
    hSDN Member
    I started out wanting to do either a medicine specialty or FP. Surgery briefly crossed my mind only to be immediately deleted as a consideration.

    I am now a surgeon.:laugh:
  5. elwademd

    elwademd 2+ Year Member

    Jun 24, 2007
    i started out thinking i wanted to ortho, until i realized i didn't have an innate love for anatomy or wielding a scalpel!

    i'm now an internist, 2 weeks from being done with hell, i mean residency. :D
  6. fuzzyerin

    fuzzyerin Senior Member 10+ Year Member

    Apr 23, 2004
    I wanted to be a forensic pathologist (and this was BEFORE Crossing Jordan, CSI, and all those other glamorous tv shows that make it seem cooler than it is - I acutally worked at the medical examiner's office as an undergrad.)

    I'm now an obstetrician. Sorta different...:laugh:
  7. I'm probably one of those rare residents who didn't change their mind during med school. CT surgery attracted me back in college (has to do with my work and research on artificial hearts as a Bioengineering major), and though I kept an open mind and liked many other fields during my MS-III rotations, in the end I knew it was still G Surg --> CT Surg for me.

    I should note that during residency other fields - e.g. Surg Onc, Vascular and Minimally Invasive - also appealed to me but in the end nothing beat the thrill of operating in the chest. Give me a CABG, AVR, Heller, Nissen, VATS lobe or bilateral lung transplant over anything else any day of the week!
  8. DeLaughterDO

    DeLaughterDO Ghost in the Machine 10+ Year Member

    Jun 26, 2004
    State of Being
    I went into medical school planning on becoming an Emergency physician... I am now an EM resident.

    I guess we all don't change our minds.
  9. docB

    docB Chronically painful Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Nov 27, 2002
    Las Vegas, NV
    I went to med school to do EM. I had been an EMT, an ED tech and a firefighter. Am now an EM doc.
  10. DrDre311

    DrDre311 Makaveli 2+ Year Member

    Apr 14, 2008
    When I was an MS2 my dad told me to consider plastic surgery, because of my artistic talent and ability to work with my hands--I told him no way, as I was dead set on becoming a pediatric oncologist.

    Guess what I do now?
  11. tr

    tr inert protoplasm Physician PhD Faculty 10+ Year Member

    Nov 17, 1999
    I was pretty sure it would be neuro but it ended up being psych.
  12. buckley

    buckley 7+ Year Member

    Jul 30, 2007
    I hated 1st year medical school and I felt my saving grace was neurosciences. I think I made my commitment to neurology then and there. It was the subject I found that I didn't have to drag myself to study. I didn't get stellar grades, got stellar grades in other fields, but I just enjoyed it more. Weiiiiiiiiiiiiiiird. Hahaha!
    I did consider the other fields as I rotated through them...but it was always a question of--"Neuro or this?"

    Hopefully, I'm on my way to being a neurologist after my prelim year :D

    We'll see....
  13. Tiki

    Tiki Girl named after a Giant 10+ Year Member

    Jan 6, 2004
    East Coast
    I went into medical school wanting to do path and I'm starting my path residency in a week.

    I did change my mind a few times during third year. I thought about peds, neurosurgery and radiology but after I did my fourth year elective in pathology I realized that my initial choice was the right one for me.
  14. Neuronix

    Neuronix Total nerd Administrator Physician PhD Faculty SDN Advisor 10+ Year Member

    Mar 14, 2002
    the beach
    That's what happened to me. I still see my 6 year old posts sometimes where I talk about wanting to go into neurosurgery. Now I'm applying for Radiology. The truth is I liked a lot of medical specialties. The clincher for me was getting my PhD in Radiology, but I could still easily see myself in several different specialties. Still, that's not to say I'm not strongly interested in Radiology, my computer/nerd background draws me like a fly to the bug zapper!

    But yeah, spending all that time in the hospital... It's just not for me. I have too many other interests in life.
  15. AmoryBlaine

    AmoryBlaine the last tycoon 7+ Year Member

    May 1, 2006
    It's an interesting question. You'll find people on both sides of the fence obviously. The thing is that for each individual person the reality is the same -- pre-med specialty selections are tenuous at best.

    I probably saw the most people who said they wanted to do EM and then peeled off for something else.
  16. The common ones I see are:

    *Pediatric heme/onc
    *Trauma surgery
  17. docB

    docB Chronically painful Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Nov 27, 2002
    Las Vegas, NV
    So it was gonna be dysfuntional brains one way or the other?:D
  18. At the end of second year I thought that I would go into either Neurology or an Internal medicine sub-specialty. I had completely "ruled out" going into peds, OB, or surgery...

    I will be starting my peds residency in a few days. OB was a close second. In the end I enjoyed working with the kids way more than the adults, that's what changed my mind.
  19. smq123

    smq123 John William Waterhouse Administrator Physician SDN Advisor 10+ Year Member

    Jan 9, 2006
    What I've found over the course of third year is that I actually a) didn't know a lot about the nuts-and-bolts of the different specialties, and, more surprisingly, b) didn't know myself very well.

    I think that everyone knows that surgeons cut people and operate, but I didn't really know very much about the post-op management in the SICU...which is equally important, and pretty interesting. I didn't really know before MS3 how surgical ENT and urology were. Everyone knows that OB/gyns deliver babies and do pap smears, but there's a lot more to the field than that. Etc.

    Before third year, I somehow had this weird idea that the only way that I'd be happy in medicine is if I were in a specialty that was very cerebral...and that I'd hate doing procedures. Oops. I hated internal medicine, and I'm pretty much only happy if I'm doing a work-heavy specialty.
  20. NPR

    NPR 2+ Year Member

    Jun 14, 2008
    I was one of those freaks who liked derm going into med school. If anything, finishing 3rd year should really push all students in that direction. Still praying for that residency spot.
  21. madisonrose

    madisonrose 2+ Year Member

    Mar 31, 2008
    For better or worse, I ALWAYS knew I wanted to be an ob/gyn. I tried to do everything in medical school to talk myself out of it -- including doing an elective called "ob psych" thinking I could do psych.

    And here I am living my "unfortunate calling."

    I love OB but BOY IS IT TOUGH.
  22. gutonc

    gutonc No Meat, No Treat Administrator Physician PhD 10+ Year Member

    Mar 6, 2005
    A fibrotic stroma
    Seems redundant.
    (If I was one of those dorks who used smilies, it'd be here for the humor impaired.)
  23. BabyPsychDoc

    BabyPsychDoc 2+ Year Member

    I went into medschool planning on becoming a surgeon.

    As a MSIV, I decided I wanted to be a trauma/ortho surgeon.

    I did two years of training in surgery, and basic science research related to surgery - only to find out that I was not really happy in my professional life.

    Several years (and multiple nights oncall in various specialties) down the line, I think I finally know what I want to do with my life.

    Now, that is changing my mind.:D
  24. BlondeDocteur

    BlondeDocteur 10+ Year Member

    I went to med school on a clear and straight trajectory: to do infectious disease. I had three years of basic science research in infectious disease. I had two Master's degrees in infectious disease. I worked on infectious disease epidemics in 5 countries.

    Honestly, most of me thought I probably wouldn't do a residency at all-- I thought I just needed the "MD" after my name to jump into higher-level jobs in global health.

    I'm applying for residencies in general surgery in the fall-- which is, absolutely, without a doubt, the last thing I ever thought I'd do.

    Also analyzing it a bit, there are strong overlaps between surgery and ID-- both are very "curative," and interventionally-oriented, and expect to see dramatic results. But American ID simply didn't have what I had so loved about tropical medicine-- it's mainly the chronic management of AIDS patients here (which is now a stable life-long condition), and I thought the practice of it was little different from being a pulmonologist. And I loved, loved, loved every second of all three of my surgical blocks.

    The bottom line, I suppose, is that you can know yourself as well as possible, but you can't predict how things will strike you until you live them. And you have so little information before getting on the wards that would be actually useful in making the decision.

    In choosing a specialty, I'd say three things are of critical importance:

    1) intellectual attraction to its content;
    2) you can tolerate the bread & butter;
    3) everyone likes every field's positives-- you have to be able to deal with the negatives of yours

    And besides #1, you can't know any of that till at least third year.
    Last edited: Jun 17, 2008
  25. Fantastic post above. :thumbup:
  26. biogirl215

    biogirl215 2+ Year Member

    May 1, 2007
    Thanks for all the responses--they're very much appreciated! It seems like going to med school knowing you only have two or three specialities to choose from would be unwise...?
  27. BlondeDocteur

    BlondeDocteur 10+ Year Member

    I'm not sure what this means, BioGirl. As an MS-1 you'd have every specialty open to you (barring physical disability, I suppose). Feel free to talk passionately in your med school interviews about your interests-- they're taken with a grain of salt anyway. :)
  28. Are you asking if being interested in 2-3 specialties is a bad thing? (It isn't.)

    Or are you saying that it's better to keep an open mind? (Yes.)
  29. biogirl215

    biogirl215 2+ Year Member

    May 1, 2007
    Yeah, that. If I could get into med school, I'd be pretty much limited to psych and PM&R due to physical disability...
  30. AJSmith


    May 28, 2008
    I went to med school to be a cardiac surgeon. Everyone will tell you about the benefits of having an open mind, but let me tell you a couple of benefits of having a trajectory:

    1. You'll figure out faster if it's really for you.
    a. you'll spend more time getting early exposure to the field (scrubbing in, shadowing office hours, recreational reading, whatever)
    b. you'll probably do research or other activities (e.g. free clinic) in the field you're interested in
    c. you'll get mentors in the field you want to go into
    d. Because of a, b, and c, people will let you do things they don't usually let other people do, or get you involved in things other med students aren't usually involved in

    2. If it is what you want to do, you'll be better prepared to do it
    a. because you've been doing research in the field, you'll probably have publications; or, if you're volunteering in the free clinic as a first year, you might be running it later on.
    b. because you have mentors in the field, you'll be directed towards things those people find important (e.g., are publications important, should you do a year out, what rotations should you sign up for, etc.)
    c. because you hung out a lot as an MS1 and MS2, you'll shine as an MS3 when you do your rotations

    3. If it turns out to be not what you want to do (happens) no biggie -- a lot of the stuff you built up in 2 is transferable.

    4. You might find options are open to you that aren't open to people who decide in the usual timeframe (e.g., cardiology fast track at Mayo, cardiac surgery integrated program at Penn or Stanford, etc.)

    5. When you go through your clerkships, you'll get more out of them -- if you tell the psych people "I'm going to be a neurosurgeon" they're going to try to teach you what they want every neurosurgeon to know; if you tell the surgeons, "I'm going into emergency medicine" they'll teach you what they think an ED physician should know.

    A couple of pieces of advice if you taking this path (e.g., "I'm going to do surgery until proven otherwise", rather than "I think surgery might be for me, but I'm keeping my options open") is to take the rotation you think you want to do FIRST. That way, you aren't all the way at the end of your clerkships in a bind if you find out you don't want to do it -- you have another nine months to figure out what you want to do. As far as the idea that you might perform better if you do it later, realize (1) you're going to be really gung ho at the beginning of the year, and that will make up for a lot; and, (2) you should have been hanging out a lot during years 1 and 2, so that you're going to look like a star on that clerkship even if you do it first. Second piece of advice -- DO NOT blow off ANYTHING because "I'm not going to need that. Approach it with "this is the last time I'm going to see this or get a chance to learn this, because I'm never doing peds/psych/surgery/whatever again". First, you aren't wise enough yet to decide what you do and don't need to know; second, you might change you're mind; third, it's more fun that way for both you and your resident.

    Anyway, I realize it's not the common opinion on this matter, but wanted to offer another perspective.

    Last edited: Dec 22, 2011
  31. BlondeDocteur

    BlondeDocteur 10+ Year Member

    I read your responses in this thread:

    The point was well-made that there's just as much physical work in physiatry as there is in medicine, pediatrics, neurology, etc. If PM&R is open to you, so are these things! And there are other fields you've probably not thought of, such as pediatric neurology, where having a physician with a disability would be very warmly received by the patient population.

    Many people become interested in a particular medical field due to an illness experience they've had. In your case, I'm going to assume that your experience was very traumatic and influenced your life profoundly. This can be a wonderful reason to feel drawn to PM&R, and of course would be compelling in an interview. But as posts above have pointed out, you might well find yourself interested in a completely different field of medicine once you start rotating through the specialties.

    You appear quite concerned about a lack of fine motor skill and seem to feel that this will limit your choice of specialties to psychiatry. This is fine too. Medical schools are not interested in choosing students they feel could become "anything" (in fact, there probably is no such person-- it's unlikely the same person would be just as happy in plastic surgery as in primary care, or in pathology as in general surgery). They're interested in competent, compassionate people, and it doesn't matter that your specialty choice is somewhat constricted when you're being considered for admission.
  32. lowbudget

    lowbudget Senior Member 7+ Year Member

    Aug 4, 2003
    Damn. Numbered points... with subpoints? Yea, you're a surgeon in the making.

    Here's my fortune cookie for y'all for the day: All those who wander are not lost.

    Enjoy med school.
  33. MSHell

    MSHell Deranged User 10+ Year Member

    Nov 29, 2004
    I entered med school knowing I couldn't do surgery because of a disablity. At the time I thought it wouldn't matter, but it turns out I really like surgery, especially ENT. What a bummer. (Don't have the marks or the research for it, so not a total loss!)

    But, there is more to medicine than just a few specialties. I've found pathology, neuro and FM to be to my liking as well.

    My point is that you may enjoy more than you initially thought and you may be able to do more than you initially thought. Ask your doctor which specialties are completely off limits so you can start to look realistically at specialties you can do, what you can bring to them, what lifestyle they offer and if they can be tailored to your needs, especially if things go downhill (The tailoring part is mostly post-residency).
  34. sunlioness

    sunlioness Fierce. Proud. Strong Physician 10+ Year Member

    Feb 23, 2007
    I came to med school thinking I wanted to be a pediatrician. I actually co-coordinated the peds interest group as an MS-2. That changed when I did my peds rotation and I realized that 1) parents suck and 2) I don't like causing pain in children who are too young to understand what I am doing.

    So then I drifted for a while. I did my psych rotation right after my peds rotation. Psych was always something I recognized an intellectual interest in and was the only class I honored during the first two years of med school. But I never seriously thought about doing it. It was much too overwhelming and I had the belief at that point (from my family of origin) that mental health professionals never actually help anybody.

    I did my internal medicine rotation in late fall of MS-III and really loved it. I think the reason I loved it was because I was fortunate enough to be on a great team, with an awesome attending devoted to teaching and really good residents and interns. So I decided at that point to become an internist and that's what I matched into.

    Except I didn't like it. People kept telling me early in my intern year that the reason I didn't enjoy was because I was an intern for pity's sake and no one in their right mind loves that. But it was more. Yes, I was overwhelmed being an intern, but it was more than just that. I wasn't really interested in learning more. And I hated procedures like nobody's business. I enjoyed my continuity clinic, but I found I most enjoyed seeing the patients that I ultimately had to refer to psychiatrists. And that started cheesing me off. By this time, through my own therapy (which I had started due to really bad anxiety on my inpatient heme-onc rotation) I had revised my opinion that mental health professionals don't help anyone. So it was at that point that I made the switch from internal medicine to psychiatry, which I do truly love.
  35. GoodMonkey

    GoodMonkey sproutmobile 7+ Year Member

    in 10th grade i thought i might like to be a general surgeon. in college, i was pre-med but then thought i wanted to be an ecologist. or teach french. i went to grad school. in med school i thought i'd be a primary care doctor, or do EM or maybe infectious diseases (i did ID research in college.) i was very active in the EM interest group. as an M3, i taught their suture workshop for M1/M2s. things commonly heard by my friends when asked about my career plans: "oh, i don't know. anything but surgery, psych or neuro;" "yeah, i just want to hit a national average step 1; it's not like i want to do ortho or anything;" "something where i can have a life outside of medicine;" "as long as i don't have to deal with open wounds."

    i'm now finishing up my pgy-1 year in orthopaedic surgery. :D
  36. Ludicolo

    Ludicolo Fib Hunter Physician 7+ Year Member

    Mar 26, 2008
    Conjunction Junction

    We meet again biogirl. (I was looking for an appropriate context to use the ninja smiley...Thanks)

    BlondeDocteur and MSHell are spot on with their advice. As said before, there are many doctors with different types of disabilities in a wide range of specialties. You should do what you like. You know yourself best, but - if you get in - you will learn a lot in med school. Not just in terms of medical knowledge but you will learn much more about yourself along the way. With more experience and insight, you gain a better understanding of what you like/dislike. Where you fit in. What you can/cannot overcome. This development of insight, I think, is why some people change specialties.

    Curious, do you like PM&R or psych? If you didn’t have impaired hand function, what specialty would be most attractive to you? it too soon to tell? :D
  37. TxMed

    TxMed SpottieOttieDopalicious 5+ Year Member

    Jan 31, 2006
    decided ortho december of MS1 year and applying ortho this fall.
  38. biogirl215

    biogirl215 2+ Year Member

    May 1, 2007

    Thank you for all your responses! I'll answer briefly, as I'm moving across the country tommorrow and will be be without personal internet access for a couple of months (if I can buy food after paying the rent, I'll be happy!:laugh:)

    Nope. I was born this way (Cerebral palsy, quadrapalegic, no idea as the subtype), so for me, it's just how life is (I'm a writer by useless hobby--nothing I would want to by professionally-- and I've written on this topic... If anyone wants to see my writing, shoot me a PM, by all means! :)) My interest in medicine, etc. is mostly academic and not very personally motivated (or at least no more than most).

    I've talked to physicians with similar disabilities who had a lot of specialities "ruled out" by their disabilities (a doctor with very similar functional limitations ended up not matching in peds for two years and eventually going into psych; another with much fewer functional limitations ended up not going the developmental peds route due to concerns about being strong enough to do neurodevelopmental exams). So, I guess I'm cautious. That, and I wouldn't want to be a danger to patients in terms of procedures...

    PM&R doesn't really interest me at this point (no offense!;)), but if I don't go into medicine, I'd probably go into clinical psych, so psych's an interest. Other than that, i'm interested in path and neuro, but to soon to tell as you say! :)

    Thank you SO much for your posts, by the way!!!
  39. ineedsleep

    ineedsleep 5+ Year Member

    I'm EM and started out that way from MS0. I'd worked in an ER during college as a scribe and realized that was what I wanted to do. There was a brief fling with trauma surgery during third year, but I liked it for all the wrong reasons. During fourth year, I got back into the ER and realized that's really what I wanted. I just started orientation for my ER residency. :)
  40. cool c

    cool c 2+ Year Member

    Jul 2, 2007
    Wow what a thread. My story's a bit diff I guess, but b4 i started med school i wanted to go into either neurosurg, CT surg, or Cardiology.

    3 full years of med school and I had thrown out the above 3 mentioned. As an MS3, I had thought bt things as unrelated and different as gastro, neurology, ob/gyn, IR, and heme onc. And then 4th year started, and a couple rotations and shadowing opportunities later, I think I am down to Ophtho, cardio, and neurosurg.

    Nothing much in common between these three, but who says I have to like just one thing. Sure i'll have to pick one, but i don't have like just one. Anywayz, feel like they all have their drawbacks. I may end up choosing on the side of lifestyle and going towards ophtho, but then I think that I will someday regret my choice and wonder if I had not been a pansy, and not minded working crazy hours, I may have been a better fit and happier in cardio or neurosurg.

    Anywayz, sorry for the long post. I guess the irony is after driving myself crazy tryin to pick a specialty for a year, 2 of my pre-med interests are still on the list (could it be fate?), but I may pick ophtho...................

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