Does your specialty choice click during clinical year?

[Maybedoc1]

MS2 who just started clinical rotations. At this point I have no idea what I want to do, but I do have a wide variety of potential interests. I’ve spent some time shadowing during my first year, but I haven’t had an aha moment yet. Wondering what everyone’s experiences were with this and when they figured out what they wanted to do? Do things usually click during rotations for most people?

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[Dantes]

It's a wide spectrum. Some know from day one and then there's people like me submitting ERAS next week and still not feeling 100% sure. But I would say generally that yeah, clinical rotations tend to give a lot more insight about what interests you, and maybe more importantly, what your deal breakers are.

 

[Dral]

I went through 3rd year somewhat liking a lot of things. I was more in rule things out phase. Then first day of a beginning of 4th year specialty rotation I knew it was what I wanted to do.

 

[Blue_sky_endo]

Rotations made a big difference for me. There were things I really enjoyed doing and things I really disliked. I went into school with a tentative list of 3 things I might like, fairly strongly leaning toward my first choice, and I ended up all in on my third choice. There is a lot of your own personality that contributes to how you want to spend your days, and to some extent who you fit in with. This became more obvious spending my days in a given specialty.

 

[deleted1139416]

I'm about ~25% done with third year and so far, it has made me sure of the specialties I do not want to do. But it's cool because I didn't want to do them to begin with!!

 

[aldol16]

No, many people go into rotations with a good idea of the few specialties they've got it narrowed down to. Rotations then helps you further narrow it down because you see what it's like in real life. But not everybody goes this pathway. Some will have no idea and figure it out. For yet others, it will require some soul searching for what you truly enjoy and the balance of lifestyle and work that would make you happy.

 

[LunaOri]

First time I stepped into an OR. Click! OR is my happy place!
(I went to med school planning to do academic IM or heme-onc).

 

[Dr. Anonymouss]

One can hope that that you realize the "click" when you rotate in your desired specialty, but what I can tell you for sure is that it is much easier to find out what you don't like. I realized that I absolutely hate rounding. That drastically narrowed down my options and made things much easier.

 

[lanzhou_lamian]

First time I stepped into an OR. Click! OR is my happy place!
(I went to med school planning to do academic IM or heme-onc).

This is the exact opposite reaction I have to ORs. OR is my sad place, but different strokes for different folks I guess.

 

[deleted1079620]

MS2 who just started clinical rotations. At this point I have no idea what I want to do, but I do have a wide variety of potential interests. I’ve spent some time shadowing during my first year, but I haven’t had an aha moment yet. Wondering what everyone’s experiences were with this and when they figured out what they wanted to do? Do things usually click during rotations for most people?

Spend some time reflecting towards the end of each rotation on what you liked vs didn’t like:

Bored to death thinking about standing 4 hours for a surgery, or intrigued by the decision making process throughout?

Did you actually like the patient population in [insert rotation]?

Did you like the rotation or the “vibe” from the team you worked with? Conversely, did you really not like a rotation or was the site just toxic?

What was the most mundane, bread & butter part of each rotation (surgery: colonoscopies/EGDs/derm stuff; IM: HTN, CAD, T2D; peds: well-child visits; obgyn: well-ob, well-gyn, normal births…you get the idea)? Can you see yourself still wanting to go to work every day to do those things for the next 30-40 years?

How is the lifestyle & pay? Do you like taking call, staying at the hospital 12 hrs at a time, working nights; or are you looking for a 9-5 M-Th, 9-12 F “lifestyle” specialty? Do you want to live in a big city or a rural area? Do you have a SO with a career? Kids?

I would recommend literally keeping a journal or running pro/con list for each rotation. It will help you reflect & narrow things down as you go.

 

[esob]

Third year definitely did for me. However, just be careful not to let provider bias play too much into things. I made friends with a resident on one rotation and really thought I might be swayed into switching to that rotation. I realized later that the affinity I had for that specialty was more tied to having fun with my buddy than it was anything to do with the specialty.

 

[Neopolymath]

Third year definitely did for me. However, just be careful not to let provider bias play too much into things. I made friends with a resident on one rotation and really thought I might be swayed into switching to that rotation. I realized later that the affinity I had for that specialty was more tied to having fun with my buddy than it was anything to do with the specialty.

This is absolutely critical. Do not apply to a specialty because you liked some random attending during school. Classmates let their subconscious bias allow them to make bad choices and some of them either already switched out or are miserable residents.

 

[flapjack3d]

IMO, there's no way to make a super informed decision about specialty. Thinking about lifestyle, surgery/procedures vs not, inpatient vs outpatient, your perceptions of the "culture" in the specialty and personalities- all that can help narrow it down. TBH the things I cared about changed so much, and my perspective on medicine in general changed a bunch during intern year. Luckily i ended up in a specialty that works for me, but nothing's gonna be perfect, and i think that's important to remember.

 

[skeptastic]

Third year definitely did for me. However, just be careful not to let provider bias play too much into things. I made friends with a resident on one rotation and really thought I might be swayed into switching to that rotation. I realized later that the affinity I had for that specialty was more tied to having fun with my buddy than it was anything to do with the specialty.

Super sharp stuff here!