ER vs. Derm Please help

[Wacaggie]

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[pseudoknot]

I don't think irregardless is a real word. I do think that your choices are enviable and you're unlikely to get any helpful advice from this thread...

 

[Wacaggie]

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[pseudoknot]

So, being a first year I don't think I can really give you any useful advice (I'm interested in EM at this point though and also have an EMS background, FWIW). I'm really curious to know: do you really not know which field you like better, even having rotated through both? I always figured things would become clearer at that point in the game.

 

[Wacaggie]

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[docjagermeister]

I have rotated through both, and have no desire to do either so hopefully I can give you some objective advice: You state that the common thread between the two if the lifestyle, but in actually this is perhaps where they are the most dissimilar. Derm has bankers hours, the exceptionally rare true emergency, and the chance to change one's A&P in subsequent visits with little repercussion. ER requires various hours, one who thinks well on their feet, and little room for error. So not only will you be missing time with your future family, but the pacing will be entirely different. Derm has the great hours, and you certainly are of high enough caliber to pursue and succeed in it. ER seems to be the reason you went to med. school in the first place and you do bring years of experience to from the start... both have pros and cons in the end.
But it begs to be asked: With all of your talk of ego and superego, have you considered psych?

 

[Roy7]

I was in a similar situation (only it's ortho versus ER), and the reason I went with ER is simply that I wouldnt get bored as fast, and the second reason was I feel that the selection in where I go would make those 3 year of residency infinitely more enjoyable than ending up at my 5th ranked school . Life is short, I want to spend those 3 years enjoying residency, my family, and my friends - come out and practice in the same area.

Ultimately the decision can only be answered by you, and I'd suggest you go with what you feel would make you happiest 20 years from now.

 

[Wednesday]

Rotate through both. You are dealing on theoretical pros and cons right now. You need to actually see what you're getting yourself into. That's what med school is for! If anything, you will only waste one month of your entire school career and it will be well worth it. EM is probably a required rotation anyway, right? And derm would be helpful as an EM doc if that's what you choose.

PS I would agree that EM is not really a "lifestyle" specialty.

 

[pseudoknot]

pseudoknot: TO be perfectly honest, I have not rotated through either. I'm basing my ER knowledge off of 2 years of EMS, 10 days shadowing in ER, and a one month pedi-ER rotation. I'm basing derm off of ~10 days of shadowing and research experiences with derm faculty (who praise derm up and down). I won't be able to rotate through either until 4th year. Problem is, I really don't want to have to rotate through both or worse, apply to both.

Well, I can understand wanting to be able to make up your mind, but it sounds like you will need to rotate through both to really know. Also, if they are both fields you might want to stay in for the rest of your life, why wouldn't you look forward to the rotation?

 

[Wacaggie]

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[Wacaggie]

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[Brian Griffin]

I think there's this phenomenon that occurs when a person starts medical school wanting to go into a field they're passionate about, something that is sort of on the less competitive side (like primary care), but then does better than maybe expected in classes, boards, and rotations during medical school. Then they realize there are doors open for them in more "lifestyle" specialties, specialties that they know they could grow to like and enjoy, but maybe not love....(but either way, the idea of a great lifestyle, money, prestige, etc is so hard to turn your back on). Ultimately, it ends up coming down to a "head" choice vs. a "heart" choice.

I came into medical school thinking I'd probably be an average med student. Fast forward to now, I guess I kind of sold myself short, because while I don't have the stats necessarily to do Derm (at least at a place I'd want to do it in), I did do considerably better than I thought I would over the course of the past 3 years. For a while this year, I seriously started to consider maybe doing Ophtho or Anesthesia. I had a tiny bit of exposure to both of these, thought they were cool, and I pretty much have liked all my rotations, so I figured I would enjoy these careers (I actually think I'd enjoy doing any number of things in medicine). But... I came into medical school originally thinking I wanted to do something general like Family Med, Int. Med or ER, and I ended up loving my Family Med rotation... and I can't deny that primary care is really a heart choice for me. I like variety, and I love close patient interactions, and I like the traditional role of a doctor, and while having a huge paycheck and great hours are obviously rewarding, being a primary care doc is something I think I'd get a lot of personal fulfillment from. And I can think of many ways that ophtho and anesthesia are very rewarding, and very important to patients' lives, but still something doesn't sit right with me about them. I think everything I've ever chosen to be involved with (in college and med school) and everything I've always found personally rewarding leads me to primary care.

Sorry to be longwinded, but basically, I can totally relate to the ego vs. the superego thing. I think you just need to figure out - how important is it to you that your job feeds your superego? We have to do this for the rest of our lives...I just made a decision that, even though some days will be hard, some days maybe I'll wish I had more money, and some patients will be annoying, when all is said and done, I really want to have a job that feeds my superego. It's something that's important to me, personally.

One more thing - this is just me, and this might come across as obnoxious, but I like the idea of being somewhat overqualified for the field I choose in the whole residency application/match process. I want to have a lot of options, and I'm sick of the constant over-achieving... I'll always try and do my best because that's my personality, but I'm ready for this constant pressure to ease up a bit... I don't really want to be in a field where everyone had to be super cutthroat to get there. To the OP - as much as your stats are amazing, I still don't necessarily think you'd be "overqualified" for derm (speaking purely in the sense of the match process)...there are just so few spots and most people who apply are just as amazing. I think you'd still have to do a lot of competing, and it's still gonna be super stressful. In ER, you'd have a ton of options...you could find a place you really love and feel confident that you'd get a spot. Just another thing to think about (i.e. how important is a stress-free 4th year to you).

 

[roja]

A couple of things: I agree with what everyone is saying here. You need to do a rotation. Although you are definately on the right path having shadowed.

The two fields are incredibly disparate. I can't really speak to derm but you have a general idea of what EM on the surface is like.

If you have experience in derm and like it, that is good. My limited knowledge was one person who was AOA, 2/210 and all set for derm. did her rotation in her fourth year and hated it. went FP.

EM is a specialty. It is great for lifestyle and family but it is variable hours-not bankers hours. You do have to deal with difficult people, but so do manymany specialties. And even scum get sick. but if you really hate it, EM is definately not a good field.

 

[Wacaggie]

I think as of now I'm leaning towards derm. Not many people even get the chance to consider derm and If I find it at least more interesting than some students then I should really give it a try. Its competitive for a reason, right? It must be a good deal!

This decision process has been the hardest thing in med school yet. Harder than step 1, third year clerkships, anything. Its crazy to make a decision that will effect your ENTIRE life based on such little info.

thanks for your help,guys. good luck to all in your own decision-making

 

[Brian Griffin]

I think as of now I'm leaning towards derm. Not many people even get the chance to consider derm and If I find it at least more interesting than some students then I should really give it a try. Its competitive for a reason, right? It must be a good deal!

This decision process has been the hardest thing in med school yet. Harder than step 1, third year clerkships, anything. Its crazy to make a decision that will effect your ENTIRE life based on such little info.

thanks for your help,guys. good luck to all in your own decision-making

I agree that this process has definitely been harder than anything else I've experienced in medical school. I've felt considerably more stressed out in the past month or two than I did when applying to medical school, taking exams in 1st 2 years, and studying for boards. It really sucks.

 

[roja]

I think as of now I'm leaning towards derm. Not many people even get the chance to consider derm and If I find it at least more interesting than some students then I should really give it a try. Its competitive for a reason, right? It must be a good deal!

This decision process has been the hardest thing in med school yet. Harder than step 1, third year clerkships, anything. Its crazy to make a decision that will effect your ENTIRE life based on such little info.

thanks for your help,guys. good luck to all in your own decision-making

Best of luck!