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Alright, it's just about that time: I need to decide what I want to do for a living. I'm looking for opinions. This is going to be way too long for anyone to read, but that's really y'all's problem and not mine.
Rotations I've done: Psych, Medicine, Family, Ortho Surgery, General Surgery, Peds, Neuro, Emergency Medicine, and Ob/Gyn (3 weeks down, 5 to go)
Top 3 choices, right now: Peds, Psych, Emergency Medicine
About me: military HPSP, step 1 score a couple of points below the average, no honors or failures in any rotations (all HP except for a P in surgery), and I'm in a race against time to get some research on my otherwise barren CV. I'm deeply religious and would like to one day get involved in mission work. I'm definitely not a workaholic, I didn't particularly love clinics, and I hated the OR.
Pros and Cons of my top choices:
Peds:
Pros: This was one of only two rotations where I actually enjoyed being in the hospital and the only one where I liked more than one patient in ten. I was actually anxious to talk about my patients when I was off. The hours, though not particularly short, didn't seem very rushed (there was a lot more conversation between the docs). Also I feel like Peds gives me the most options down the road. In Peds I don't need to choose EM, or Neuro, or whatever right now, because there is a Peds fellowship in pretty much everything. Finally I really liked neonatology. Peds is definitely a strong favorite right now.
Cons: Well, the main issues are money and length of training. I don't see myself as a generalist, as to become a Peds subspecialist I would be looking at 6 years of residency and fellowship for a relatively modest financial reward. Also as I mentioned above, the hours don't seem particularly good. I'm worried I'm going to be 50 years old and wake up wondering how I poured my entire life into a hosptial and ended up with crap savings and no personal life. Finally I had really good attendings for this rotation and I'm worried that that is unfairly biasing me towards Peds as a career and that I'll hate it at a worse site.
Psych:
Pros: This was the other rotation where I enjoyed being in the hospital, and felt like I saw the physicians making a significant impact on their patients' lives. The training is shorter and much less intense than I would have to suffer through with Peds. The financial rewards are better and way better when you look at them in terms of dollars per hour. Finally I'm in the military and Psych training is much easier to get in the military than the other careers I'm considering.
Cons: Depressing in a way that Peds isn't. The patients get better, but they're never exactly good. The patients are, almost by definition, difficult and non-compliant. Also I can't shake the feeling that Psychiatrists are 'fake doctors', I feel like I'd always wonder if I chose psych because I was just too dumb to manage the complexities of drug regimines and flid boluses.
EM:
Pros: A lifestyle specialty. Great pay relative to the hours, and even the residents only work 4 days a week. I loved shift work, and I found out I particularly love night shifts. The opportunity to consistently sleep in the sunlight is, wierdly enough, one of the biggest draws for me to this profession: I have real trouble getting to sleep at night that for some reason evaporates when I go to sleep at ten in the morning and I would seriously consider rearranging my career just to stop feeling tired when I wake up (Is there night shift work in Peds? Anyone?). I liked the ADD atmosphere and, while I can't say I particularly loved the hospital, it was nice to be in a cynical atmosphere where everyone admitted that they wanted to go home. Finally of the three professions that I'm interested in this is the only one that feels 'impressive' to me without fellowship training, and the only profession that I feel like would give me the financial freedom to fund major charitable projects, or the free time to do a lot of volunteering without quitting my job.
Cons: I feel like this would be the cynical choice for a career. I also think the constant waves of hopelessness that flow through mak this profession a spiritual dead end. On the other hand, maybe I'm being unfairly biased because I worked at a Charity hospital in a major city? Maybe the quality of patients is better in a more rural ER? I did feel like shift work made me drag my feet and I think that might get worse with time. Also EM is very difficult to get in the military, so this might be a pipe dream in any event. Finally, as I said earlier, while I liked the hours I didn't particularly like the actual minutes. Even 3 shifts a week is a lot when you don't particularly want to go into work in the morning (or evening, whatever)
So: thoughts? Perspectives? Any professions I haven't tried that I should be setting up rotations in? I haven't looked at Gas, Rads, or PM&R to name a few. I feel like just writing this out helped a little. I feel a little more sanguine about my Peds SubI. So I guess the real question is whether or not I need to set up either a Psych subI or another EM rotation. I'm thinking no to EM, but I can't decide on Psych.
Rotations I've done: Psych, Medicine, Family, Ortho Surgery, General Surgery, Peds, Neuro, Emergency Medicine, and Ob/Gyn (3 weeks down, 5 to go)
Top 3 choices, right now: Peds, Psych, Emergency Medicine
About me: military HPSP, step 1 score a couple of points below the average, no honors or failures in any rotations (all HP except for a P in surgery), and I'm in a race against time to get some research on my otherwise barren CV. I'm deeply religious and would like to one day get involved in mission work. I'm definitely not a workaholic, I didn't particularly love clinics, and I hated the OR.
Pros and Cons of my top choices:
Peds:
Pros: This was one of only two rotations where I actually enjoyed being in the hospital and the only one where I liked more than one patient in ten. I was actually anxious to talk about my patients when I was off. The hours, though not particularly short, didn't seem very rushed (there was a lot more conversation between the docs). Also I feel like Peds gives me the most options down the road. In Peds I don't need to choose EM, or Neuro, or whatever right now, because there is a Peds fellowship in pretty much everything. Finally I really liked neonatology. Peds is definitely a strong favorite right now.
Cons: Well, the main issues are money and length of training. I don't see myself as a generalist, as to become a Peds subspecialist I would be looking at 6 years of residency and fellowship for a relatively modest financial reward. Also as I mentioned above, the hours don't seem particularly good. I'm worried I'm going to be 50 years old and wake up wondering how I poured my entire life into a hosptial and ended up with crap savings and no personal life. Finally I had really good attendings for this rotation and I'm worried that that is unfairly biasing me towards Peds as a career and that I'll hate it at a worse site.
Psych:
Pros: This was the other rotation where I enjoyed being in the hospital, and felt like I saw the physicians making a significant impact on their patients' lives. The training is shorter and much less intense than I would have to suffer through with Peds. The financial rewards are better and way better when you look at them in terms of dollars per hour. Finally I'm in the military and Psych training is much easier to get in the military than the other careers I'm considering.
Cons: Depressing in a way that Peds isn't. The patients get better, but they're never exactly good. The patients are, almost by definition, difficult and non-compliant. Also I can't shake the feeling that Psychiatrists are 'fake doctors', I feel like I'd always wonder if I chose psych because I was just too dumb to manage the complexities of drug regimines and flid boluses.
EM:
Pros: A lifestyle specialty. Great pay relative to the hours, and even the residents only work 4 days a week. I loved shift work, and I found out I particularly love night shifts. The opportunity to consistently sleep in the sunlight is, wierdly enough, one of the biggest draws for me to this profession: I have real trouble getting to sleep at night that for some reason evaporates when I go to sleep at ten in the morning and I would seriously consider rearranging my career just to stop feeling tired when I wake up (Is there night shift work in Peds? Anyone?). I liked the ADD atmosphere and, while I can't say I particularly loved the hospital, it was nice to be in a cynical atmosphere where everyone admitted that they wanted to go home. Finally of the three professions that I'm interested in this is the only one that feels 'impressive' to me without fellowship training, and the only profession that I feel like would give me the financial freedom to fund major charitable projects, or the free time to do a lot of volunteering without quitting my job.
Cons: I feel like this would be the cynical choice for a career. I also think the constant waves of hopelessness that flow through mak this profession a spiritual dead end. On the other hand, maybe I'm being unfairly biased because I worked at a Charity hospital in a major city? Maybe the quality of patients is better in a more rural ER? I did feel like shift work made me drag my feet and I think that might get worse with time. Also EM is very difficult to get in the military, so this might be a pipe dream in any event. Finally, as I said earlier, while I liked the hours I didn't particularly like the actual minutes. Even 3 shifts a week is a lot when you don't particularly want to go into work in the morning (or evening, whatever)
So: thoughts? Perspectives? Any professions I haven't tried that I should be setting up rotations in? I haven't looked at Gas, Rads, or PM&R to name a few. I feel like just writing this out helped a little. I feel a little more sanguine about my Peds SubI. So I guess the real question is whether or not I need to set up either a Psych subI or another EM rotation. I'm thinking no to EM, but I can't decide on Psych.
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