Help. What specialty suits me?

[Miss Education]

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I am in my transitional year in medicine and am having a bit of a problem choosing a specialty. I have been reading Brian Freeman's book "The Ultimate Guide to Choosing a Medical Specialty," taking personal personality assessments, and overall taking time to be completely honest and accepting of my strengths and my weakness. I have provided some info about myself and any advice is much appreciated.
So about me- I am a highly independent, self-motivated, and studious person. I have done well in every specialty, but I am not interested in all of them. I realize that I enjoy working in environments that are very relaxed with high autonomy and minimal/no supervision. I like to work at my own pace. I do not like late hours or call. I do not like rounding on patients for hours. I also don’t really desire to clinically manage or treat patients, particularly patients with chronic, unremitting conditions. I like seeing immediate results in treatment, or otherwise. I thoroughly enjoy researching and ultimately finding a diagnosis based on the clinical information, recommending a treatment plan, but not particulary providing the treatment. I enjoy reading, and prefer to read rather than see patients. I find that I am really good at memorizing diagnostic criteria and treatment for many disease processes. I also love to teach; I’ve felt very gratified helping other med students and residents when they have questions. I do not like diagnostic ambiguity. I find that my happiest days are when I am free to do my work in a quiet space without someone hovering over me or constantly critiquing my performance. In addition, I am more of a solo flyer, and prefer independent duties rather than team related jobs. Mind you, I do not have an issue working with people. Most people say I am quite friendly, sociable, and laid back. Nevertheless, I avoid certain personalities and environments that I’ve come across in certain specialties, which is why I’ve eliminated surgical residency. Moreover, I want regular 9-5 hours, preferably 4-5 day work weeks. I am a pretty confident and self motivated person, yet very laid back; I want a practice where I am in control and I am my own boss. Based on an assessment I took, I am best suited for derm, psych, path, and radiology. Does anyone have any advice/assessments about any of these specialties? Are there any other specialties I should consider? Are there any other resources I should look into for making my final decision? Thank you for your time.

 

[Winged Scapula]

Perhaps some pathology residents or attendings can weigh in, but for someone who likes to work at their own pace, who doesn't like surgeon personalities and doesn't like to work on a team or with others hovering over them, pathology may not be for you.

The pace of your work as a pathologist is very important, especially when doing intra-op frozen sections, and believe me, the surgeon will be hovering if it takes you a long time to get the results back. Same goes for permanent sections. You MUST be able and willing to work with all sorts of physicians in pathology - this is why, like rads, it is a "physician's physician", as you will come into contact with lots of different specialties.

Are you competitive enough for Derm? What was your Step 1 score? Rads is pretty competitive as well, although not on the level of Derm.

Psychiatry might meet your needs except for the comment that you prefer to read rather than see patients. Last time I checked, Psychiatry meant a LOT of patient contact.

You might want to edit your post to include a few paragraphs here and there; its awfully hard to read.

 

[radslooking]

On first glance, I would suggest rads. The only problem with that is the pace. You can go at your own pace, but sometimes you will need to burn through a bunch of studies.

I really don't know if you'll find anything that meets all those criteria. Little patient contact, few chronic conditions, good hours, no rushing, not treating.

Academic radiology would not be rushed and would allow you to teach residents. Also, hours would be good, and your transitional year would count. Something to think about.

 

[Winged Scapula]

With rads, she would have to adjust to being able to read stat exams, doing wet reads in the trauma bay, and essentially have practitioners (mostly surgeons) breathing down her neck for the study results which may change our management plan. Most of us are taught to read our own studies, but for liability reasons (or insecurity) may prefer the read from Rads.

Nothing worse than ordering a stat exam for which the patient may need to get to the OR only to have it take hours to be completed and then you're in the OR late at night.

I agree - finding something which meets all of her criteria will be very difficult. You'll have to decide which things you can give up, as there will have to be some compromise.

 

[radslooking]

With rads, she would have to adjust to being able to read stat exams, doing wet reads in the trauma bay, and essentially have practitioners (mostly surgeons) breathing down her neck for the study results which may change our management plan. Most of us are taught to read our own studies, but for liability reasons (or insecurity) may prefer the read from Rads.

Nothing worse than ordering a stat exam for which the patient may need to get to the OR only to have it take hours to be completed and then you're in the OR late at night.

I agree - finding something which meets all of her criteria will be very difficult. You'll have to decide which things you can give up, as there will have to be some compromise.

yes, there is no "pressureless field". Everything has its own pressure to work under some time contraints. If you're seeing patients...its because you have patients scheduled in time slots....surgery...its because they need surgery right now...rads...you need the study right now....path...you need the frozen section right now.

Some are better than others though.

 

[elwademd]

as far as other specialties to consider, perhaps pm&r would fit the bill. while there are some in pm&r that do injections, its not a requirement. there definitely is a team aspect, where you gather input/data from different modalities, and direct the therapy. the hours aren't grueling. any "emergency" means out of rehab and to the medical floor.

 

[BabyPsychDoc]

I am in my transitional year in medicine and am having a bit of a problem choosing a specialty. I have been reading Brian Freeman's book "The Ultimate Guide to Choosing a Medical Specialty," taking personal personality assessments, and overall taking time to be completely honest and accepting of my strengths and my weakness. I have provided some info about myself and any advice is much appreciated.
So about me- I am a highly independent, self-motivated, and studious person. I have done well in every specialty, but I am not interested in all of them. I realize that I enjoy working in environments that are very relaxed with high autonomy and minimal/no supervision. I like to work at my own pace. I do not like late hours or call. I do not like rounding on patients for hours. I also don’t really desire to clinically manage or treat patients, particularly patients with chronic, unremitting conditions. I like seeing immediate results in treatment, or otherwise. I thoroughly enjoy researching and ultimately finding a diagnosis based on the clinical information, recommending a treatment plan, but not particulary providing the treatment. I enjoy reading, and prefer to read rather than see patients. I find that I am really good at memorizing diagnostic criteria and treatment for many disease processes. I also love to teach; I’ve felt very gratified helping other med students and residents when they have questions. I do not like diagnostic ambiguity. I find that my happiest days are when I am free to do my work in a quiet space without someone hovering over me or constantly critiquing my performance. In addition, I am more of a solo flyer, and prefer independent duties rather than team related jobs. Mind you, I do not have an issue working with people. Most people say I am quite friendly, sociable, and laid back. Nevertheless, I avoid certain personalities and environments that I’ve come across in certain specialties, which is why I’ve eliminated surgical residency. Moreover, I want regular 9-5 hours, preferably 4-5 day work weeks. I am a pretty confident and self motivated person, yet very laid back; I want a practice where I am in control and I am my own boss. Based on an assessment I took, I am best suited for derm, psych, path, and radiology. Does anyone have any advice/assessments about any of these specialties? Are there any other specialties I should consider? Are there any other resources I should look into for making my final decision? Thank you for your time.

How about completing residency in path and then doing research/academic career? If you want to use your medical degree, I am afraid there is no specialty that would fulfill all of your requirements (ie, derm sounds good, but you would have to provide treatment as well - and you do not like the idea of it). IMHO, path is as laid back a residency as it can get (but I am not a pathologist), and after the residency you could just delve into research and teaching and minimise your clinical commitments.

Good luck.

 

[yaah]

I would caution any person against the selection of specialty based on "avoidance" methods. That is, don't pick a specialty because it's what's left after you eliminate other things, or because it has less of whatever you find objectionable. It may be that the specialty you like and are suited for has these characteristics, but it's no way to define a career.

 

[fakin' the funk]

I am in my transitional year in medicine and am having a bit of a problem choosing a specialty. I have been reading Brian Freeman's book "The Ultimate Guide to Choosing a Medical Specialty," taking personal personality assessments, and overall taking time to be completely honest and accepting of my strengths and my weakness. I have provided some info about myself and any advice is much appreciated.

If you haven't found your way by using that book, you're beyond help. I'm only half kidding. It is an excellent book I would recommend to anyone considering multiple specialties.

 

[Ludicolo]

as far as other specialties to consider, perhaps pm&r would fit the bill. while there are some in pm&r that do injections, its not a requirement. there definitely is a team aspect, where you gather input/data from different modalities, and direct the therapy. the hours aren't grueling. any "emergency" means out of rehab and to the medical floor.

I would say that the OP's aversion to working with a team and dislike in managing/treating patients with "chronic, unremitting conditions" - makes PM&R a less than desirable choice.

 

[AlternateSome1]

I am a highly independent

Perhaps find the field with the most irony?


Seriously though, have you considered Ophtho? You eliminated surgical specialties, but it is pretty much pseudo surgical (no offense). You spend most of residency doing clinic (9-5, one on one, no team experience, lots of instant gratification) then do a couple of tiny delicate operations, many with microscopes. There is a bulk of material to read about, and you wind up knowing a lot more about your niche than non ophtho physicians. Plus, you have several options to subspecialize into if desired.

 

[speyeder]

Perhaps find the field with the most irony?


Seriously though, have you considered Ophtho? You eliminated surgical specialties, but it is pretty much pseudo surgical (no offense). You spend most of residency doing clinic (9-5, one on one, no team experience, lots of instant gratification) then do a couple of tiny delicate operations, many with microscopes. There is a bulk of material to read about, and you wind up knowing a lot more about your niche than non ophtho physicians. Plus, you have several options to subspecialize into if desired.

I'm an ophtho resident and I agree with the above. It's definitely the most laid-back surgical specialty. Most of your work is in the clinic (about 60%). When you do operate (about 40%) the procedures are usually short and quick. Anywhere from 20-30 minutes for a cataract to a couple of hours for a complex ruptured-globe repair or retinal surgery. Hours are very amenable for having a life outside work. According the FREIDA/AMA ophtho residents work on average 50 hrs/week. Call is from home and usually not bad. Most of the time you work independently with attending supervision. No rounding and not much teamwork involved. Lots of opportunities for immediate gratification if you can cure someone of eye disease and help them see better. There is tons of reading in ophtho. It's such a broad field that there are 8 subspecialties within ophthalmology, more than any other field that I know of: glaucoma, retina, cornea, neuro-ophthalmology, peds, oculoplastics, uveitis, ocular pathology.

 

[dragonfly99]

I vote for path, derm, radiology or optho
agree with other posters - there are no pressureless fields of medicine.
You will have to deal with insurance companies/3rd party payers if you go into private practice. If academics, you have to deal with office politics/BS/promotion issues.
Avoid internal med, physical med/rehab, psych and neurology and peds and fp if you don't like ambiguity.

 

[NewmansOwn]

Perhaps find the field with the most irony?

Hilarious.

 

[lowbudget]

Wow, really? How about board-certified housewife or househusband? Hairdresser also meets your criteria. How about that guy in ICU 5? You know, the one who's in a persistent vegetative state?

I say Preventive Medicine/Public Health. Desk job. No call. No patients. Normal business hours. Work on your own. "At your own pace" (which is also called "FEMA pace" or "Airport Security pace"). Read journal articles. Write reviews. Write meta-analysis. Write guidelines, criterias, and policies but never carry them out.

And once you get board certified in do-nothing-but-tell-everyone-else-what-to-do, you can work for the government or insurance company or become someone's spouse.

 

[BlondeDocteur]

I read your post and-- due to the positives, not the negatives, I immediately pegged you as pathology, radiology, or medical genetics.

Definitive diagnosis, exhaustive knowledge, minimal supervision, high degree of autonomy, regular hours. I think you'd enjoy any of the three.

 

[Freibi]

I read your post and-- due to the positives, not the negatives, I immediately pegged you as pathology, radiology, or medical genetics.

Definitive diagnosis, exhaustive knowledge, minimal supervision, high degree of autonomy, regular hours. I think you'd enjoy any of the three.

Maybe not Genetics, as you would be seeing patients in clinic for most of the day. Emergencies are rare, though.
I 've been trying to think of a field that doesn't involve ambiguity, but there is no such thing in medicine. Not all is clear-cut in any specialty, think for example about how many times a Radiologist has to write "X finding could represent Y condition; clinical correlation recommended". At least in Pathology, you would find out more about what's been going on than any of the other specialties involved in that patient's care, without having direct patient contact ever (Radiologists do get some when doing contrast enemas, VCUGs etc).

 

[Winged Scapula]

Pathologists do biopsies in many hospitals so there may be some clinical/patient exposure.

 

[pdp2001]

perhaps looking at the reasons you chose an MD over a PhD will help you decide. it sounds like you want to be a lab PI and not an MD, so maybe elaborating on the things about patient care that you DO like will help you make a decision.

 

[Anton Chigurh]

I would caution any person against the selection of specialty based on "avoidance" methods. That is, don't pick a specialty because it's what's left after you eliminate other things, or because it has less of whatever you find objectionable. It may be that the specialty you like and are suited for has these characteristics, but it's no way to define a career.

What's your opinion on picking a specialty based on the first two years of medical school? For example, if I enjoyed, let's say, anatomy, maybe I should look into surgery or rads.

 

[dragonfly99]

I think you should try to narrow down the list of what you might like to do during 1st and 2nd year of med school. I think all the people who say "Just do 3rd year and let it happen...it will be fine" are criminally naive. This may work well if you end up wanting peds or psych, but for competitive fields you'd be behind the 8-ball. My suggestion is to try to narrow it down to 2-4 "possibles" by the time you start 3rd year, but do it by spending some time with attendings and residents in various fields, and/or asking them questions about the specialties/lives. 1st and 2nd year courses might give you some idea of what you might like, but there are so many other factors such as who you will be working with, personality type, lifestyle, how much hospital/inpatient work you desire, pay/money, etc. that may factor in for people in deciding a specialty. Also, if there is a career advisor person/office at your school, I'd get with them and see if they can offer you some "what color is your parachute?" type of advice.

 

[DrJosephKim]

Have you considered public health or preventive medicine?

You may also be very satisfied doing some non-clinical work on a population health level. There are many options out there. Explore them and find your ideal career.

 

[ROBINHO]

reading your Post. I feel I just read a desciption of a Pathologist

 

[yaah]

What's your opinion on picking a specialty based on the first two years of medical school? For example, if I enjoyed, let's say, anatomy, maybe I should look into surgery or rads.

You should definitely look into things that appeal to your interests - but at the same time you shouldn't close the door to the rest. The thing is, the unfortunate truth is that you have to basically start thinking about what residency/specialty you want before you know a ton about what it is really like. That doesn't mean that you have to decide 100% though. It just means that if you think your interests are trending towards surgical/procedural fields that you try to do those rotations or schedule electives for earlier, that way you can experience them earlier and know more.

I really don't know whether it is true that people who really like anatomy tend towards surgery. I suspect there are many successful surgeons who hated anatomy, successful pediatricians who hated genetics, etc. But you definitely have to let your experiences and perceptions inform your future decisions.

I would say that the impressions you start to make during years 1 and 2 of med school are much more valid than preconceived notions prior to med school. You never want to be completely noncommittal as to what your future path will lead to, but you also don't want to close the door to something you might discover you like.

 

[Winged Scapula]

So I was thinking about the anatomy --> surgery thing.

I really liked anatomy in medical school; it was easy for me to memorize structures rather than concepts and I liked dissection. Well, except for the fatty body parts...to this day I cannot stand being greasy. Funny that I selected a body part to operate on that is very greasy.

But I don't think I chose surgery based on any perceived love of anatomy but rather I liked doing things with my hands. I liked moving around, doing something different during different parts of the day, I liked the black (and sometimes blue) sense of humor surgeons had. Yet, I also like my day to be somewhat predictable (hence my specialty choice).

As you note, I'm sure there are many surgeons who disliked anatomy or at the very least, thought it was ok. I'll bet there are plenty more of us who liked surgical diseases, treatment and lifestyle/practice. Many a person has selected a specialty based on what the practitioners are like in that field.