This whole argument comes down to a matter of personality. Some people really enjoy the high-adrenaline, quick-fix type of solution, while others like the long-term relationships and slow, positive change physicians (especially those in primary care) can provide. It's very interesting talking to people in my class now that most have decided which area they want to go into--most people you could tell from early on what they would be good at. Each specialty truly does have its own personality; once you do third year rotations, this will become very obvious.
I personally like the idea of getting to help deliver a baby and then follow that individual through his or her life and helping him or her with all problems, big or small, medical or non-medical. But others hate this kind of thing and would rather do a quick surgery. Does this mean either of us have more or less of an impact? No, because if you need your appendix out, you need it out now, and the person who can do that makes a huge difference in the patient's life, albeit short-term--but if they don't play a role, the patient can die. Just as important, as one other person posting said, is getting someone to quit smoking by constantly asking him about it and trying to support him through the difficulties of trying to quit. An ER doctor can give a quick fix to someone who is badly hurt or can give relief to a parent who is scared because her baby has a fever. The point of this long post is to say that, although it sounds like one of those things you're just supposed to say during interviews, the "team" aspect to medicine is crucial. During rotations, you start to see how many physicians criticize other specialties and insist that theirs is better--but the truth is that the world needs all of them. Just as there are so many different types of personalities among us all, so too are there in medicine. The key is to not get into the habit of thinking one is superior over another. And I guess that's what has bothered me about this message thread--even if I have no interest in being a radiologist, I sure as heck am glad they exist, because they see things on scans that I certainly don't. Being able to diagnose a small tumor on a CT is certainly not an "inconsequential impact" on someone's life. It's not a matter of "liking" or "not liking" patients (as someone put it)--it's all about what part of the team you see yourself doing, based on your own personality, the best. If you like long-term care, join us in family medicine, pediatrics, or internal medicine. If you like the quick fix, go into surgery or ER.
Now it's certainly true that "lifestyle specialties" (as one poster put it) are becoming more popular--but this is nothing new. The proverbial pendulum swings in medicine; at the beginning of the 90s, there was a huge shortage of people going into primary care. When I entered medical school three years ago, they were talking about how there was suddenly a shortage of specialists. Now we're almost back to the primary care shortage. Each year, the percentage of people entering different specialties changes, as does how competitive each is. General surgery, for example, has become much less competitive just over the past few years. Anesthesiology, on the other hand, which used to be basically the easiest specialty to enter just a few years ago, is now becoming quite competitive. But in a few years, the job market will become saturated, and fewer people will go into it. A classmate of mine freely admits that he wants to be an anesthesiologist because of the amount of compensation and the hours since he's 33 and has two children. He's not the first person in history to have that thought, and it certainly doesn't mean he doesn't enjoy being with patients. You'll find that every specialty, with the exception of pathology and a few othes, deal with patients directly more than you might think. Diagnostic radiologists, for example, now do many procedures and don't just sit around in a dark room all day.
It's all about your personality and what you value the most. Don't let anyone tell you that your reasons for wanting to do something in medicine are wrong; just make sure you are clear about what your reasons are and why.
Congratulations to anyone who made it all the way through this--feel free to PM, IM, or email me 🙂
--Brendan--
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