Do you know what you want to specialize in?

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Do you know what you want to specialize in?

  • Yes, something outside the realm of primary care (specify below)

    Votes: 140 58.8%

  • Yes, something within the realm of primary care (specify below)

    Votes: 32 13.4%

  • No, I'm still not sure.

    Votes: 66 27.7%
  • Total voters
    238
The same field we all got into pre-med for; Colorectal Surgery.
 
As far away from primary medicine as possible.
 
doinmybest5840 said:
Any reason in particular?
Click to expand...

I'm willing to guess at least a couple of common reasons would be:

1) Compensation

and

2) Having the "jack of all trades, master of none," feeling
 
Zolar Czakl said:
I'm willing to guess at least a couple of common reasons would be:

1) Compensation

and

2) Having the "jack of all trades, master of none," feeling
Click to expand...

3) Reduced prestige.
 
Infectious disease, or Emergency Medicine. I like bugs, and I need lots of stuff to keep me busy! Someone either here or somewhere else said that EM was like Internal Medicine for people with ADD. That defines me totally!
 
Something in the field of primary care. I would hope for an IM residency, since that allows you to practice general medicine, but also provides more possibilities in case you would like to subspecialize in the future by doing a fellowship, etc. So I'd imagine myself doing a good decade of primary care and then possibly advancing my education if I feel like it.
 
Zolar Czakl said:
The same field we all got into pre-med for; Colorectal Surgery.
Click to expand...
my girlfriend's dad is a colorectal surgeon.. 😉 it's not as bad as one might joke.

I have an idea I'd like to do surgery, but I'm not narrowing my choices down just yet. I haven't met a field I haven't enjoyed yet.
 
oncology all the way. here's to a life of gloom but hopefully i'll cure cancer....:luck:
 
Something in Primary Care most likely. I like the long term contact with patients. I like the idea of FM in particular because I get to work with kids and adults (I would love to do OB/gyn and FM so I could follow women from conception and as their kids grow up - I know a few doctors who do this - but I don't want to spend that much time in residency).

My other thought right now is MAYBE EM. I like a lot of variety of stuff and staying really busy for short periods. Which is basically EM. But I'll miss getting to know the patients so I doubt I'll do it. Hours would be ideal for having a family though.
 
little pebble said:
Infectious disease, or Emergency Medicine. I like bugs, and I need lots of stuff to keep me busy! Someone either here or somewhere else said that EM was like Internal Medicine for people with ADD. That defines me totally!
Click to expand...

You will change your mind about ID after you've been in school long enough to know what they do (or more importantly, what they don't do, like bill out for procedures). EM is like gas and rads. It's one of those that people "discover" and gravitate toward once they've had a taste for the system.

Also any US grad who wants to do internal medicine can do internal medicine. It's not something that you are going to have to compete for unless you are deadset on going to a top program. Ditto for family medicine, and people are running away from family med kicking and screaming because not only do they not deliver babies anymore, but the number of procedures that they can do is limited (which in turn slashes pay). Behold the emergence of emergency medicine. Lots of procedures, good scheduling, excellent pay, decent prestige, manageable lifestyle.
 
Maybe cardio or neurosurgery. Anything where you get to use your hands and cut stuff. Human body is 1000x more interesting looking at the inside than out. 😀
 
You know, I'm really early in the game here... I'm starting medical school this fall, so there is plenty of time to figure it all out. However, that said, I am considering a dual residency in IM/Peds. Maybe in 3 years, I'll laugh at what I wrote here, having discovered that I want to do something else, but maybe I'll be even more convinced. We'll see how things pan out.
 
Coming from a teaching background Peds was one area, or Family practice - im thinking it will give me the best chance to spend time with my family (is it true?)
 
Heavily leaning towards primary care right now. How about you, OP?
 
Critical Mass said:
You will change your mind about ID after you've been in school long enough to know what they do (or more importantly, what they don't do, like bill out for procedures). EM is like gas and rads. It's one of those that people "discover" and gravitate toward once they've had a taste for the system.

Also any US grad who wants to do internal medicine can do internal medicine. It's not something that you are going to have to compete for unless you are deadset on going to a top program. Ditto for family medicine, and people are running away from family med kicking and screaming because not only do they not deliver babies anymore, but the number of procedures that they can do is limited (which in turn slashes pay). Behold the emergence of emergency medicine. Lots of procedures, good scheduling, excellent pay, decent prestige, manageable lifestyle.
Click to expand...

Good points. Do you feel that a lot of FPs in more rural areas, though, are treating a lot of derm disorders? Supposedly derms oversaturate big cities, and are almost nonexistant in rural areas, so FPs are making doing all the derm procedures (within their rights).
 
mongrel said:
Heavily leaning towards primary care right now. How about you, OP?
Click to expand...

Thanks for asking! 🙂 I'm not sure yet, but I kind of feel like I want to do something where I see patients long-term. Maybe IM, peds, etc. Some specialties see patients long-term too, though, ya know? Like maybe derm or allergist. There's always something in the back of my mind that is thinking ob/gyn, because I think it would be amazing to deliver babies. But then I think, do I really want to be looking at vaginas all day, every day? Hahaha So yeah, I'm not sure.

That's the long and short of it.
 
doinmybest5840 said:
Any reason in particular?
Click to expand...

Yah - because so many pre meds think that primary care can only = family practice, as if that's a bad thing.
Find out what it means before you knock it, people. (That's for dimness...and others who would fit that description...LOL)
 
Orthodoc40 said:
Yah - because so many pre meds think that primary care can only = family practice, as if that's a bad thing.
Find out what it means before you knock it, people. (That's for dimness...and others who would fit that description...LOL)
Click to expand...

Yeah, I've noticed this trend in a lot of members on this site. I don't see anything wrong with primary care, and have actually strongly considered it in the past couple weeks. Then again, I'm not going into this for the prestige or money, like some people might be (not pointing fingers), so for me, making a zillion dollars and being some big-shot surgeon is not what I'm looking for (although if I find being a surgeon or whatever to be what I love, I'll happily do it).
 
I think I've literally considered/wanted to be just about every specialty except OB/GYN and cosmetic plastics...
 
Zolar Czakl said:
Good points. Do you feel that a lot of FPs in more rural areas, though, are treating a lot of derm disorders? Supposedly derms oversaturate big cities, and are almost nonexistant in rural areas, so FPs are making doing all the derm procedures (within their rights).
Click to expand...

Well the thing about dermatology is that derms have total control over their own market. There aren't very many PGY training programs for it, and that makes them very happy because they only get the best medical students and wouldn't dare open the door to more competition by creating new programs. Dental hygenists do the same thing in my area. Long story short, if more people need derms, then they will just wait longer until the doctor is available. Result: lots of derm PA's to soak up the zit cases while the derm docs focus more on skin cancer.

Where I live, the derm can hang out in the city and place PA's in the smaller towns. I think that the docs only review 10% of the PA charts for which they bill out. Big bucks (hence it's incredibly tough to become a derm).

As for rural areas, primary care docs can cover for a lot of procedures that they wouldn't likely touch in the middle of suitable specialists, particularly if the patient population has insurance (again, not really an issue in rural settings because the patients are lesser insured). In my experience, a GP can schedule 30 pt's/day, use 10 of them as opportunities to refer out, and get reimbursed for the office visit anyway. Doing procedures may allow the doc to bill more, but the malpractice liability makes it an unnecessary gamble. Better to see 3 pts and refer them all out in the time it would take you to do a procedure for less pay and higher malpractice risk. The last FP I worked with (urban setting) wouldn't even remove a mole.

Regarding an initial desire to do family medicine, I'd like to see if we can get lilnoelle to offer her viewpoint. She might have something to add to the discussion now that her exams are over.
 
doinmybest5840 said:
What has turned you away from those two?
Click to expand...

Doing any cosmetic plastic surgery just rubs me the wrong way. If it was reconstructive it'd be okay with me, but I'm personally against people changing their image b/c they aren't confident in themselves.

OB/GYN is just a field I'm not interested in. I don't like the idea of looking at crusty vaginas all day. It would ruin the female body for me. 🙁
 
Davjc2009 said:
Doing any cosmetic plastic surgery just rubs me the wrong way. If it was reconstructive it'd be okay with me, but I'm personally against people changing their image b/c they aren't confident in themselves.

OB/GYN is just a field I'm not interested in. I don't like the idea of looking at crusty vaginas all day. It would ruin the female body for me. 🙁
Click to expand...

OB/Gyn's big disad these days is the malpractice insurance.

Most plastic surgeons I'm acquainted with do a little bit of both reconstructive and cosmetic. At least with image enhancement, you can take cash or credit cards and roll on 20's all the way to the bank. It's not for me, but it's up there with derm as far as a straight-to-plastics match is concerned.
 
Critical Mass said:
OB/Gyn's big disad these days is the malpractice insurance.

Most plastic surgeons I'm acquainted with do a little bit of both reconstructive and cosmetic. At least with image enhancement, you can take cash or credit cards and roll on 20's all the way to the bank. It's not for me, but it's up there with derm as far as a straight-to-plastics match is concerned.
Click to expand...


I'd be all about the pretty much straight cash business, considering the state of reimbursement, but it's one of those things I feel strongly about. So I won't end up selling my beliefs.
 
wow, 32 posts and no "it's too early to tell" or "wait till you get you first anatomy midterm back before setting your sights on neurosurg."
 
I thought I was dead set on surgery, but there are plenty of days where I hate being in the OR. I really like rounding though. If my whole day was rounds, I'd be happy.

I really don't know in what specialty I'll end up, but probably some branch of IM. I really like nephrology.
 
Critical Mass said:
Regarding an initial desire to do family medicine, I'd like to see if we can get lilnoelle to offer her viewpoint. She might have something to add to the discussion now that her exams are over.
Click to expand...

hmmmm... not really (although thank you for thinking about me).

I think my switch from a desire to do rural primary care to wanting to specialize was mostly due to "getting to know myself". I wanted to be a primary care physician because I felt that was where I would be most needed. I grew up in rural Iowa and liked living in rural areas - the idea of making a large impact on a community as a rural physician was very appealing to me.

Then I spent some time in clinics my first year and realized that I would probably strongly dislike primary care. I'm more of a hands on person and want tangible results for my work. I felt like most of the time the doctors I was working with were just playing a game of guess and check with their patients and that no one was really benefiting from the care they recieved. (I'm not saying this is true, I'm just telling it as I percieve it. I like to have immediate, tangible evidence for what I do.)

Basically, it looks like I will like things that I can do with my hands (perhaps surgery or anesthesiology), working with tangible evidence (radiologist or pathology) or quite possibly working with the mind (psychiatry really fascinates me). The last differs from my desire to work with tangible things, but it is something that just really interests me enough that I really like it anyway.

So the only thing I can really offer is that one really can't decide what they like until they've spent some time doing it, and even that might not be enough... for instance my preceptor hated working in a psychiatry in patient setting during M3 and steered clear of psychiatry until she had to work in an outpatient setting during residency. She really liked it then....
Another example is that I thought I'd like OB/GYN until I discovered I strongly disliked it in the last module of the school year. (Ewwww....)
 
Davjc2009 said:
Doing any cosmetic plastic surgery just rubs me the wrong way. If it was reconstructive it'd be okay with me, but I'm personally against people changing their image b/c they aren't confident in themselves.
Click to expand...

I actually am really interested in plastic surgery and have had a conversation recently with a plastic surgeon that really changed my opinion about the field (for the better). 75% of his work is reconstructive and 25% of it is cosmetic. (I figured it'd be the other way around) Generally the patients that come in wanting cosmetic surgery are relatively wealthy individuals (no duh) that are getting older and want to be made to look younger again. So they want to remove bags around their eyes, their double chin, or maybe they want some work done on their abdominal area because they just couldn't get rid of the extra flab after their fourth kid. We're not talking about people who are completely changing their appearance. It isn't really like it is on TV.

He also said that he won't take patients whom he believes are emotionally unstable (i.e. just broke up with her boyfriend and claims "I'm gonna show him!!").

I really don't have any problem with any of the above. Most of us are young and so we don't really understand what it feels like to age.... heck even my mom would like to have her double chin removed.

I've always really liked reconstructive surgery but have felt a little turned off to the cosmetic part.... until this conversation. Now I really think I would enjoy both.
 
Well, surgery's out for me for sure, considering I have a pretty low tolerance to blood - I can still watch a surgery (have done it before I decided on switching to premed), but I sure don't enjoy it and would not look forward to a surgery rotation. It's something I could briefly tolerate, but not something I'd want to surround myself with for hours on end every day of my life.
 
Yeah, the coolness wears off pretty quickly. There are still times when I'm "wowed" at something, but it's usually only something I've never seen before. It doesn't happen often enough for me.

I'm also pretty interested in EM and anesthesiology. I know I'll probably end up doing something totally unexpected.
 
little pebble said:
Infectious disease, or Emergency Medicine. I like bugs, and I need lots of stuff to keep me busy! Someone either here or somewhere else said that EM was like Internal Medicine for people with ADD. That defines me totally!
Click to expand...
I feel SARS in your future. Better keep that mask on.
 
DKM's short list
-EM or EM followed by a CCM fellowship
-Pathology (followed by a forensic path fellowship)
-Neonatology
-Anesthesiology (with or without a CCM fellowship)
-Transfusion medicine
-Plastics (I have no moral reservation against people changing their appearances for selfish and shallow reasons)
-Dermatology
-Radiology
-Ophthalmology

Things I would not do if I had no other choice:
-FP
-IM without a follow-on fellowship in something interesting
-Pediatrics
-OB/GYN (I've delivered 4 babies so far and I would prefer to keep it as close to that number for the remainder of my life as possible)
-Infectious disease (way too much work for not enough pay)
-General surgery
 
DropkickMurphy said:
DKM's short list
-EM or EM followed by a CCM fellowship
-Pathology (followed by a forensic path fellowship)
-Neonatology
-Anesthesiology (with or without a CCM fellowship)
-Transfusion medicine
-Plastics (I have no moral reservation against people changing their appearances for selfish and shallow reasons)
-Dermatology
-Radiology
-Ophthalmology

Things I would not do if I had no other choice:
-FP
-IM without a follow-on fellowship in something interesting
-Pediatrics
-OB/GYN (I've delivered 4 babies so far and I would prefer to keep it as close to that number for the remainder of my life as possible)
-Infectious disease (way too much work for not enough pay)
-General surgery
Click to expand...

Take out the plastics and we have similar interests [and dislikes].
 
Dropkickmurphy - neonatology is a sub-specialty of pediatrics...if you aren't interested in peds, you may not enjoy neonatology, because you have to do the three-year residency in peds first, and then you do a second three-year fellowship in neonatology...

Just some FYI...I'm shadowing and volunteering in the NICU right now, so this is something I've recently come to know more about...
 
neonatology is a sub-specialty of pediatrics
Click to expand...
Thank you, Ms. Obvious. 🙄 I hadn't realized that

f you aren't interested in peds, you may not enjoy neonatology, because you have to do the three-year residency in peds first, and then you do a second three-year fellowship in neonatology...
Click to expand...

I can do something I don't love for three years. I would not want to do it for the rest of my life. Case in point: the military.

Just some FYI...I'm shadowing and volunteering in the NICU right now, so this is something I've recently come to know more about...
Click to expand...

Just FYI, I've actually worked (you know....for pay?) in a NICU, not just followed someone around as padding for my application. Want to take bets on which of us knows more about this field?
 
Internal medicine subspecialty, probably cardio...I absolutely love cardio. Maybe interventional or even electrophysiology, I still have lots of time to decide. Then again I haven't ruled out anesthesia either, even though I think I prefer long-term relationships with my patients over the "one-night-stand" feel of anesth :laugh:.

So far I'm concentrating more on ruling things out rather than getting tunnel vision and becoming fixated on only one thing. That's the way to go. So far I've ruled out ob/gyn, urology, neurology, neurosurgery, derm, and ophtho (derm because it's boring as hell, but ophtho because i know im not competitive enough for that one, because I find it pretty cool...oh well 😎).

Cardio is #1 on the list, followed by another IM specialty maybe, or anesth.
 
Oh yeah, and I ain't doing peds either, no thank you.
 
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