Hated everything third year...what specialty should I choose?

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Anakinmemer

Anakinmemer

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Unfortunately, I genuinely don't think I enjoy medicine. I figure at this point I just need to choose something with a good balance of lifestyle and pay that I can tolerate. Ophtho is on the table as those surgeries were pretty interesting to me when I got to watch, but I honestly don't enjoy clinic. Rads is on the table because of the complete separation from patient interaction, but I have no idea if I'd be bored looking at grayscale scans all day.

I would have to take a research year for ophtho as I don't have much, but this would essentially guarantee matching based on internal statistics from my school (100% ophtho match rate for past 15 years)

What are the hours and pay like for both these specialties?
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Usually the answer in these situations is rads or path. If what you didn't like about third year was patient interaction, I'm not sure that ophtho would be a good fit.
 
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Don’t take this the wrong way but - why did you go into medicine in the first place? I just think that if you are having these feelings right now then 1) you either didn’t know what medicine was really like or didn’t want to go into med school in the first place or 2) you have some sort of depression that makes everything seem dull and intolerable. Please don’t be offended - I know that text communication comes off as harsh but I don’t have any intention of being a jerk.
 
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HipiMochi said:
Don’t take this the wrong way but - why did you go into medicine in the first place? I just think that if you are having these feelings right now then 1) you either didn’t know what medicine was really like or didn’t want to go into med school in the first place or 2) you have some sort of depression that makes everything seem dull and intolerable. Please don’t be offended - I know that text communication comes off as harsh but I don’t have any intention of being a jerk.
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Parent died of cancer and for whatever reason I decided to do medicine and didn't look back. I just assumed it was the path for me. Obviously I should have considered other careers but it is too late now.

My life is great when I'm not working so I don't think I'm depressed. Hate was a strong word, it is more that I just didn't enjoy anything third year.
 
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Anakinmemer said:
Parent died of cancer and for whatever reason I decided to do medicine and didn't look back. I just assumed it was the path for me. Obviously I should have considered other careers but it is too late now.

My life is great when I'm not working so I don't think I'm depressed
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I’m very sorry for your loss. At this point I would just say to go to the field that you hate the least.
 
I’m not sure who would be a good resource to talk to about these things (maybe your career advisor?), but there are a ton of non-medicine things you can do with an MD. You can do consulting, research, teaching, biotech, etc. Not sure if you’re serious about giving up medicine altogether, but there are definitely other ways to make fantastic money with a medical degree. A lot of the business-MDs end up making more than they would as physicians
 
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Rads or path if you just want to get this over with.
 
as a pathology applicant who is in love with my field - please do not go into path by "default"? hahahah. its an amazing field with a fantastic job market, but give yourself to get to get to know it and to love it. i hate when ppl go into path by default.
 
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One of the top students in my class applied path this year. His rationale at the time of his decision, despite outstanding academic performance, was that he hated everything (else). But since deciding to go into path he has gone full nerd about it and loves it to bits. He is also mentoring students in my school who are in a similar predicament as you describe regarding a career in path, and from the sidelines, it seems, from his pitch, like a career I would at least consider. I say look into path
 
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Sorry you're in this situation, I'm sure it's stressful given how deep in the career path you've gotten. I'm assuming you mean you didn't like any of the core rotations overall. Were there any individual parts you liked? Certain procedures, certain pathologies, certain clinical settings, etc? MS3 is not a complete picture of medicine by any means. Moreover, the experiences as a resident, fellow, and attending are all different among each other, and very different than that of a student. There may be some flavor of clinical medicine that you'd like once you're actually a doctor. If you don't want to consider clinical medicine at all, rads and path are viable options. But you have to like that kind of work. Are you visually detail oriented? Did you like anatomy and/or histology in pre-clinical? These are things to consider in regards to those specialties.

EDIT: Also consider preventive medicine. It's a lesser-known specialty that does have dedicated residency programs. After intern year, the remaining two years are split with half of your time being outpatient clinic-type stuff, and the other being pursuit of a degree such as an MPH. It can set you up for public health jobs, and if you want, you can still do outpatient clinical medicine.
 
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M&L said:
fantastic job market
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Is this a new development? I was under the impression that some pathologists had to do two fellowships or move to an undesirable area due to the lack of jobs in some locations.
 
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voxveritatisetlucis said:
Is this a new development? I was under the impression that some pathologists had to do two fellowships or move to an undesirable area due to the lack of jobs in some locations.
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Yes. Pathology is a field you can practice for a a long time in and can get easier with experience and age. COVID has finally pushed out the numerous 80+ year olds who have been in the field since the 70s. Probably 3-5x more jobs posted now than there were in 2019. It’s an intellectually demanding speciality with great pay for hours worked and stress level. We need more passionate quality medical students and less autism spectrum disorder misfits who couldn’t cut it in clinical medicine.
 
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SunBakedTrash said:
Yes. Pathology is a field you can practice for a a long time in and can get easier with experience and age. COVID has finally pushed out the numerous 80+ year olds who have been in the field since the 70s. Probably 3-5x more jobs posted now than there were in 2019. It’s an intellectually demanding speciality with great pay for hours worked and stress level. We need more passionate quality medical students and less autism spectrum disorder misfits who couldn’t cut it in clinical medicine.
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yeah i am obsessed with pathology. i have been wanting to do it for a long time, and for me it's a dream come true pretty much, as nerdy as it sounds. i truly believe that it is the best specialty out there hahahha. i am in love. i honestly hope more people like me go into the field. definitely planning to mentor med students from my school.
 
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This one time... in peds camp... I was sitting on a zoom call between a nephrologist and a pathologist. I enjoyed it. It was very cerebral. 100% recommend!
 
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Esmolol said:
This one time... in peds camp... I was sitting on a zoom call between a nephrologist and a pathologist. I enjoyed it. It was very cerebral. 100% recommend!
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Was it about glomerular diseases??
 
SunBakedTrash said:
Yes. Pathology is a field you can practice for a a long time in and can get easier with experience and age. COVID has finally pushed out the numerous 80+ year olds who have been in the field since the 70s. Probably 3-5x more jobs posted now than there were in 2019. It’s an intellectually demanding speciality with great pay for hours worked and stress level. We need more passionate quality medical students and less autism spectrum disorder misfits who couldn’t cut it in clinical medicine.
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Ah interesting. What about places like quest and labcorp though? Would that worry you at all or are they alright places to work too
 
Is it really possible to understand what clinical medicine is like before ever doing it? I feel like I got glimpses of what medicine is like shadowing/working as a scribe, but now, just as a 3rd year, I realize how incomplete my impression of the field was.
 
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Tenk said:
Ophtho. It’ll give you the high ground.
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The tales of retina specialists making 1.5mm+ are hard to ignore...almost as enticing as the power to save others from dying...
 
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voxveritatisetlucis said:
Ah interesting. What about places like quest and labcorp though? Would that worry you at all or are they alright places to work too
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Pathology was the first medical field to go corporate, largely because the high cost of lab equipment, relatively non-emergent nature of the specialty and ability to ship materials allowed places like quest and labcorp to move in. Everything in medicine is becoming corporate now, you can really only escape it with niche cash only type stuff like cosmetic derm. Am I worried? No. They still need us to slap glass and by the time AI comes in and gets FDA approved, we will all be long retired and we won’t be the only ones replaced. As a matter of fact, no one wants this turf and we’re likely the least of all specialties susceptible to midlevel encroachment.

As far as work conditions, quest and labcorp have a certain culture that some people love. Sit in a cubicle or small office 9-5 with coffee, biopsy slides, one line of medical history and no interaction with whoever sent the case. May not even be from the same state. Relatively high pay (350-400k+) with big incentives to move the meat. Some of us don’t feel enough like doctors and prefer a hospital gig where you know the surgeon and oncologists. Others like it- no call, no lab crap, no autopsies, no tumor boards, no resection cases or grossing, etc.
 
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SunBakedTrash said:
Pathology was the first medical field to go corporate, largely because the high cost of lab equipment, relatively non-emergent nature of the specialty and ability to ship materials allowed places like quest and labcorp to move in. Everything in medicine is becoming corporate now, you can really only escape it with niche cash only type stuff like cosmetic derm. Am I worried? No. They still need us to slap glass and by the time AI comes in and gets FDA approved, i’ll be long retired and we won’t be the only ones replaced. As a matter of fact, no one wants this turf and we’re likely the least of all specialties susceptible to midlevel encroachment.

As far as work conditions, quest and labcorp have a certain culture that some people love. Sit in a cubicle or small office 9-5 with coffee, biopsy slides, one line of medical history and no interaction with whoever sent the case. May not even be from the same state. Relatively high pay (350-400k) with big incentives to move the meat. Some of us don’t feel enough like doctors and prefer a hospital gig where you know the surgeon and oncologists. Others like it- no call, no lab crap, no autopsies, no tumor boards, no resection cases or grossing, etc.
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yeah thats what i love in pathology - there are SO many options to mold your career and change it depending on personal life goals and on what your life is looking like at the moment. I personally think i want to do academics/practice in a big academic hospital for a few years after fellowship (hopefully in one of big places like CO or UT where i'll do some teaching, some practicing), and then we will see. This way i will be able to forgive my student loan (because residency counts as well), and i love teaching. But then - we shall see. pathology is so diverse.
 
I'll say to you what was said to me many years ago by a mentor/supervisor: "Everyone has to chose a specialty track and become fully qualified in something. If you don't, you get stuck in limbo as a non-specialist/non-board certified physician. If you don't know what you want to do, pick a generalist specialty, such as Internal Medicine or Family Medicine, which gives you the most flexibility in terms of future specialisation choice and reasonable work-life balance. And get the training done as soon as practically possible; your work and personal life gets somewhat better after you're an Attending in whatever specialty."
 
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Another good thing about path is no mid-level creep…nobody else would ever be allowed to diagnose cancer from a path specimen (despite their taking a weekend seminar on the subject and then receiving a document of certification after completion, from ABOMiNation (the American Board of Midlevels in our Nation).
 
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EthylMethylMan said:
Sorry you're in this situation, I'm sure it's stressful given how deep in the career path you've gotten. I'm assuming you mean you didn't like any of the core rotations overall. Were there any individual parts you liked? Certain procedures, certain pathologies, certain clinical settings, etc? MS3 is not a complete picture of medicine by any means. Moreover, the experiences as a resident, fellow, and attending are all different among each other, and very different than that of a student. There may be some flavor of clinical medicine that you'd like once you're actually a doctor. If you don't want to consider clinical medicine at all, rads and path are viable options. But you have to like that kind of work. Are you visually detail oriented? Did you like anatomy and/or histology in pre-clinical? These are things to consider in regards to those specialties.

EDIT: Also consider preventive medicine. It's a lesser-known specialty that does have dedicated residency programs. After intern year, the remaining two years are split with half of your time being outpatient clinic-type stuff, and the other being pursuit of a degree such as an MPH. It can set you up for public health jobs, and if you want, you can still do outpatient clinical medicine.
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I appreciate your advice. The tricky part for me is while I did enjoy the ophthalmic OR, I did not enjoy clinic, which is still the majority of what they do. I don't know if chasing the enjoyment of cataracts would be sustainable long term if I don't like clinic the other 3-4 days of the week.

Or I could go for something like radiology which doesn't have the highs of the OR for me but also doesn't have the lows of clinic. The problem is by the time I would take a rads elective to figure out whether I could do that for 30 years...it would be too late to start a research year and ophtho would be out of the running by default. So I kind of have to decide now before I even experience radiology.
 
Anakinmemer said:
I appreciate your advice. The tricky part for me is while I did enjoy the ophthalmic OR, I did not enjoy clinic, which is still the majority of what they do. I don't know if chasing the enjoyment of cataracts would be sustainable long term if I don't like clinic the other 3-4 days of the week.

Or I could go for something like radiology which doesn't have the highs of the OR for me but also doesn't have the lows of clinic. The problem is by the time I would take a rads elective to figure out whether I could do that for 30 years...it would be too late to start a research year and ophtho would be out of the running by default. So I kind of have to decide now before I even experience radiology.
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Anesthesia don't do clinic... anesthesia don't round... anesthesia barely chart... :lol::rofl::rofl::rofl:
 
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specialties aside, what things did you like, and what did you like about them. then what things didn’t you like and what didn’t you like about them?

what was it about clinic that you didn’t like it?


as noted above it’s important to think about whether things you don’t like are things unique to being a med student or trainee vs what it’ll be like as an attending and in vs out of academic settings. endless rounding in IM seems to be an example mentioned a lot as something not reflective of what it’s like out in community practice.

would you like clinic more with full ownership of the patient and full responsibility for accurately dxing their problem and coming up with a plan?
 
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Get an MBA and do healthcare management or something
 
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Yhwach said:
Get an MBA and do healthcare management or something
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Clinicians tend to better listen and respect Medical Administrators if they have qualified and worked at the coalface as an Attending Physician themselves. I say this as a clinician who has worked in hospitals and health services with naive Medical Administrators who come in with new ideas without evidently having the clinical knowledge and experience of working the wards and clinics to inform their decisions at the executive level, which can have harmful outcomes on patient care and the medical workforce.
 
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BigPikachu said:
Clinicians tend to better listen and respect Medical Administrators if they have qualified and worked at the coalface as an Attending Physician themselves. I say this as a clinician who has worked in hospitals and health services with naive Medical Administrators who come in with new ideas without evidently having the clinical knowledge and experience of working the wards and clinics to inform their decisions at the executive level, which can have harmful outcomes on patient care and the medical workforce.
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Every admin I’ve ever met makes plenty of money regardless of my or anyone else’s lack of respect for them.
 
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Ahhh... the evolution of the English language... vermin -> ermin -> edmin -> admin....
 
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lone_cypress said:
How does one become one of these admins?
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Don’t know exactly but some universities offer “hospital admin” programs. Notably, all the people I know who attend them are somewhat delusional…
 
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Med Ed said:
Get a MHA or MBA with healthcare concentration.

Seems like a nice gig from the outside, but the higher you go the more time you spend looking over your shoulder. Someone always has a knife out for you.
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Some of the people that go into it seem to thrive off that kind of environment lol
 
Would strongly consider gas, rads, path as others have noted above. Ophtho is very clinic heavy, though hours tend to be very solid.

Gas seems like it would hit a lot of the high points - high salaries, great lifestyle. There are also some subspecialty fellowship options that can expand your practice options. If maximizing salary is the goal, things like pain fellowships can be very lucrative. Highest paid doc in my hospital is a pain guy and he usually makes $1.3-1.5m in an employed position.

Non clinical positions are also a great option. You don’t need to do a residency for these but you’re often more appealing and have more options if you are licensed and board certified. It’s also hard to go back to clinical medicine if you never did a residency and it’s some time since Med school graduation. Doing some kind of residency would at least give you a fallback option if you found the non clinical world unappealing.

The final consideration is that you don’t have to love everything about a field. I definitely didn’t like clinic much as a Med student or even as a resident. I always found the OR much more enjoyable, but then I also didn’t like the OR so much that I wanted to just live in there. Now as an ENT I find I like the balance in my schedule. I’ll do a day of clinic and it’s actually somewhat interesting because I’m not shadowing, I’m actually making the big decisions. But after a day I’m usually glad my next day is more an outpatient procedure day, so I get to come to work and do something different. Then the next clinic day isn’t so much of a drag, and then I have an OR day after that, etc. I find the variety helps the week fly by and I’ve arranged my schedule such that I have a decent amount of free time outside of work. I could see Ophtho being very similar, so if clinic is at least tolerable, you might be able to make something like that workable too.
 
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Med Ed said:
Indeed, and they often turn out to be the worst
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Directors and Administrators tend to attract two types: people who are genuinely good leaders; and, people who like the power and position.

I have met some brilliant medical directors and administrators and they’re typically clinicians who haven’t forgotten where they can from in terms of their clinical background, and they genuinely work hard to influence executive and implement projects that improve a health service.

However this is far outweighed by the vast majority who just enjoy climbing the corporate ladder and playing office politics to push their agenda, usually at the detriment of the staff and patients.

There is a smaller subset of administrators who just do nothing but keep a warm seat and collect a pay check, which are equally hopeless.
 
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BigPikachu said:
Clinicians tend to better listen and respect Medical Administrators if they have qualified and worked at the coalface as an Attending Physician themselves. I say this as a clinician who has worked in hospitals and health services with naive Medical Administrators who come in with new ideas without evidently having the clinical knowledge and experience of working the wards and clinics to inform their decisions at the executive level, which can have harmful outcomes on patient care and the medical workforce.
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There are tons of people with MHA degrees making decisions w/o MDs. No cares if doctors respect them (unfortunately).
 
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Med Ed said:
Get a MHA or MBA with healthcare concentration.

Seems like a nice gig from the outside, but the higher you go the more time you spend looking over your shoulder. Someone always has a knife out for you.
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If they get an MD and an MBA, do they need to do residency?
 
Prehealth1011 said:
My friends who were like this ended up in psych or anesthesia
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I feel like psych should be the absolute last specialty to choose if you want to avoid patient interaction
 
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I would like to give my 2 cents.

What about each rotation did you dislike? What about each rotation in each field did you not get to experience that may have changed your outlook?

For example, if you did not get to see GI scopes, cath labs, pleural taps, code strokes, ICU management, TEEs, emergent procedures in the ED, etc then you may not be informed enough to say you dislike all fields wholly
 
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