General Medicine VS Specialist

[gxb]

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Searched for threads that discuss this topic but couldn't find any. Would appreciate your input on the pros and cons of being a specialist vs "generalist". The most common reasons I can think of are compensation (for some but not all specialties. For example, pay decreases with ID), liking a specific field, wanting to be an expert in one area, not having the desire to deal with chronic conditions, etc... Are there any other reasons that medical students or those in training not aware of or perhaps should be aware of as they consider the decision to specialize? I know this question might be early coming from an MS3 but it would help shape my decision about specialty choice this year.

P.S question also applies to surgical specialties.
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EDIT: Thank you all for the helpful suggestions and feedback! I have been reading a book titled "how to choose a medical specialty" by Anital Taylor. So far, I've found some useful insights but I got a little confused when I came across this table in the book and found myself to be split between the two:

 

[Espressso]

It's so person-specific. So many individual factors. A lot of people I've heard from mention the idea of starting a family. Keeping a good work/life balance. That alone pushes you towards certain fields and away from others.

You should check out the podcast, The Undifferentiated Med Student. It's about this medical student who interviews different specialties to learn more about them and it's awesome.

Another thing I've heard of doing, and just recently started myself is to make a graph on an excel sheet. And at the start of, and at the end of each semester, rank the specialties you're interested in with a % from 0-100, 100% being you're so into that and want to do it, 0% being no interest at all. And as you go through, you keep ranking specialties and see at the end which ones on top and which ones consistently high. It would be harder for you since you're an M3 but I'm in my first year and I've been doing it and it's actually kind of neat. Added a few on my list, took a few off already.

 

[doc05]

Please use common sense. You choose whichever field you like best.

 

[Matthew9Thirtyfive]

You should check out the podcast, The Undifferentiated Med Student.

Second this.

 

[nlax30]

I don't think a Pros/Cons list would be helpful as someone may view an aspect of a specific field as a pro while another person may view it as a con.

Assuming you're out on rotations now you should be starting to develop some sort of idea of which fields or environments you enjoy.

Some questions I'd start asking myself in your situation:

Do you enjoy mostly inpatient/hospital based work vs purely outpatient, or a mix of the two

OR or no OR

Do you enjoy procedures or not.... and then can drill down further on what sort of procedures do you enjoy, long complicated surgeries, quick bedside procedures, office based procedures, etc...

Is there a particular body/organ system that seemed to click for you and that you particularly enjoyed learning about?

Do you enjoy handling multiple problems in a patient spanning multiple systems vs focusing on one particular problem

Is there a particular medical technology you are drawn to

Kids vs adults

 

[TypeADissection]

Dude. It's really not that hard. Do you like OR or not? How do you want to spend your days? What do you want to get woken up at 2AM for? What interests you? A pros/cons table does nothing because it's all about what you want, which will be different from what I want.

Which is how I ended up eventually removing a 12 inch pink phallic object from someone's rectum three years ago. If you want scenarios that make you question your life choices, there you go. Cheers.

 

[Osteoth]

Please use common sense. You choose whichever field you like best.

Dude. It's really not that hard. Do you like OR or not? How do you want to spend your days? What do you want to get woken up at 2AM for? What interests you? A pros/cons table does nothing because it's all about what you want, which will be different from what I want.

Which is how I ended up eventually removing a 12 inch pink phallic object from someone's rectum three years ago. If you want scenarios that make you question your life choices, there you go. Cheers.

Come now, lets not all pretend like we knew from day 1 what we wanted to do with our lives. Its an important and serious question and its pretentious to pretend otherwise.

 

[Matthew9Thirtyfive]

Come now, lets not all pretend like we knew from day 1 what we wanted to do with our lives. Its an important and serious question and its pretentious to pretend otherwise.

Considering ~80% of med students enter a different field than the one they were interested in at the start, I’d say it’s a pretty relevant question.

 

[WhiteCoatWonder]

Another thing I've heard of doing, and just recently started myself is to make a graph on an excel sheet. And at the start of, and at the end of each semester, rank the specialties you're interested in with a % from 0-100, 100% being you're so into that and want to do it, 0% being no interest at all. And as you go through, you keep ranking specialties and see at the end which ones on top and which ones consistently high. It would be harder for you since you're an M3 but I'm in my first year and I've been doing it and it's actually kind of neat. Added a few on my list, took a few off already.

i actually did this, but more along the lines of a pro/con list as i went through M3. i started it as a joke and ended up really pulling it out when i had to legit make a decision.

for example, minus all the expletives, my lists would have something like:
-do not like all the estrogen
-do not like sugar to **** in less than 30 seconds
-like sitting and thinking
-do not like all the not sitting
-like all the hands on but not all the guts
-do not like feeling like i cant fix patients
-they can have the OR

sounds silly, but i wanted to be as honest as possible with myself while the experience was still fresh in my mind. now granted, i had another epiphany during interview season, but i did NOT apply to/nor "end up" in any specialty where the con list > the pro list...no matter how many cool people i met while doing it.

noteworthy: its important to have a pretty good grasp on who you are as a person, as you go through this like/don't like setup. sure, things change but i think what satisfies you at your core and/or what you're adept at right now doesnt readily change.

 

[DrMcCoyDO]

If you’re lucky like some (me included), you’ll get some pretty clear signs during your clinical years. I knew within a couple days of being on my surgery rotation that I hated the OR and found it boring. As for what I matched into (emergency), it literally felt like falling in love on my rotations. I knew by the end of my first shift that’s what I wanted to do, and that feeling didn’t change for the next three months of my EM rotations. That’s not how it works for everyone, but sometimes you get lucky.

 

[gxb]

Thank you all for your input! I appreciate it!

 

[Planes2Doc]

Not entirely true... Let's take into account an internal medicine resident. Once you graduate, you can either be a general internist, or do a fellowship.

Let's pretend you decide to be a hospitalist. While you will probably see "frequent fliers" from time to time, you generally aren't seeing the same patients (no pun intended).

On the contrary, if you're a cardiologist, you will have your own patients that you will likely see on a regular basis.

It can go either way whether you're a generalist or specialist. Once you actually start doing it, you'll get a good sense of what you like and don't like.