How and when did you choose your specialty?

[MSV MD 2B]

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What would you recomend to at least narrow down a specialty before third year?
also, is there a usmle/step 1 correlation? like if i get an avergae step 1 score should i know that it is highly unlikely that i would get into a certain specialty? is there anything that says okay if you get below a 230 dont' apply to surgery or something?

Thanks!

 

[PimplePopperMD]

I think you're best off if you DONT narrow down your specialty choices until the middle of your third year... Keep an open mind, but continually assess whether this specialty/lifestyle is right for you.

There are some cutoffs, but really only for the ultracompetitive specialties, like dermatology, radiology, orthopedic surgery, neurosurgery, otolaryngology, to name a few. These specialties probably require a MINIMUM of 230, and may have cutoffs at 240 or so.

Things change every year, though.

It's frustrating not knowing how competitive your score is, and your application is, and that's why I'm responding with such detail, which can of course be disputed; this is generally true for this year's match.

If you are interested in general surgery, and would be happy at any program, you'll have no problem becoming a general surgeon. The community programs were hungry for recruits this year.

 

[Brewster]

I agree...don't decide until third year. You can get some idea of what fields of medicine you like intellectually from second year. However, you have no idea what the practice is like until you do it in third year. Also, it pays to start third year with an open mind and as few preconceptions as possible. A few people I know did not decide for sure what they wanted to do until early fourth year.

I do, however, disagree with the previous poster's statements regarding minimum board score for some specialties. You should probably beat the mean (220 or so) if you want to be competitive (higher is better). However, I don't think a score below 230 puts you out of the running. Your best bet is to find a field you like, then find an advisor, share you board scores/grades/resume with him/her and get some advice about your situation in particular from someone who has a lot of experience with these things.

 

[MSV MD 2B]

so, it's not beneficial to try to shadow during 1st and second year and the summer in between? i was thinking of trying to shadow 1-2x a month during first and second year and take some time when i can to go on rounds, etc. i just have seen too many people who don't know why they want to to when the time comes to apply for the match. and then i heard that with opthamology you need research experience and know that you want to do this coming into medical school basically.
I was going to try to target some areas fo interested and keep an open mind if that makes sense. i basically woudl target these areas knowing that i dont' know much about them or any other fields.

 

[Brewster]

By all means...shadow doctors. It may help you get some idea of what you like and what you find interesting.

However, as you said, it is important to approach third year with an open mind. Third year is quite different from shadowing experience you will have.

 

[Gator05]

Shadowing docs is very helpful. But there are some caveats:

1. There is no continuity of experience when you shadow for just a day. Some of these specialties involve following patients for longer periods of time.

2. As a first year, it's very hard t understand what is going on when discussing patient labs. I've found that by end of 2nd year, rounds make a lot more sense than in 1st year.

3. Specialties in academic medicine are practiced differently than those in private practice. Just because it is/isn't a blast at your medical school doesn't mean it is the same in teh real world.

4. I think there's something I call a maturation-bias in med school. As a social construct, med school resembled high school more so than college in many ways. When you look for a specialty as a 3rd year, students are usually in their early-mid 20's, single and with no children. This stage of life doesn't last forever. How will certain specialties adjust as do your priorities in life? No answer here, but I think something to keep in mind...

 

[MSV MD 2B]

I actually am a non trad student. I am 30 with a husband and a child which is why i am so eager to make sure i don't choose th ewrong path again. i beleiev that medicine in general is the right path but don't wnat to be in the wrong specialty which is why i am so eager to figure out what i want to do. 4th year seems ideal to explore with electives but by that time it is too late in regards to applying to residency programs. i guess it is good to know which speicalties tend to be more family friendly than others (surgery is a no go) and with that list in mind, keep my mind open.
Thanks!

 

[DrQuinn]

One thing that you can do (and I did) during 1st and 2nd year is to check out the websites on the internet about specialties. Do a google search for "choosing your medical specialty" or something along those lines. Sometimes you'll come across a website that has "pros and cons" which can help with your decision. Have you always liked to work with your hands and do procedures? Pick a procedure heavy specialty. If you just prefer the easy stuff and getting to know people, Primary Care is likely for you.

Obivously, family is of the utmost import to most of us... but are you cool with working 50-60 hours a week? Or is 40 hours your max? Lots and lots of things to consider.

But the best advice (that has been said here numerous times) is to keep your options open. About halfway through your third year (when you begint o get your app ready), you'll have a much better idea.

Now's the time to do well during class and try to do well on your boards.

Shadowing can be of benefit but I wouldn't do it more than once or twice a month. Right now you need to enjoy 1st/2nd year, spend time with your child and husband, and do well in class...

Q

 

[Brewster]

Iserson's book has great descriptions of each specialty. I highly recommend you go to your library and take a look at it if you want to learn more about your options.

The internet is a great idea as well. I did that...looked at the websites of the various specialties' professional organizations.

I also looked at the various specialty journals in the library to get a sense of what the hot topics of the day in each specialty were.

 

[Foxxy Cleopatra]

I'd guess that pathology, radiology, emergency medicine, and ophtho would be some of the most family-friendly specialties, especially after residency. I'm guessing this based on little or no in-house call and more regular hours.

Most primary care residencies are not that bad, though this is probably depending on the institution. FP, Peds, and medicine are all only 3 years. Some programs use a float system for call (this means little to no overnight call ~ 10 months of the year with ~2 months taking only ~6PM to 6AM shifts.) Outpatient rotations often give some weekends completely off. At my home medical school, almost all of the females in internal medicine are married and over half have kids.

I love surgery but I am also single and don't want kids. I could see that it would be very difficult working >15 hours a day and taking call every third night if you had a child. On the other hand, if you are surgically-inclined, it may be worth checking out ophthomology or ENT, which may have more predictable hours and less call.

As for the boards, the higher, the better, but if you were to get a 220 and were dying to do radiology, I'd stilll go for it. You may not get as many interviews as someone with a 260 who is AOA but I've known lots of people with average scores and grades who matched into very competitve specialties. I think as long as you beat the national average, you will have your doors open. And if Step 1 doesn't go as well as you want, take step 2 early and do very well. Programs will be impressed with your improvement.

Have as much fun as possible during time off during the summer. If there is something you are particularly interested in, shadow once in a while, but not so often that it becomes stressful or not enjoyable. Do all of the fun things you like- you have plenty of time 3rd year in rotations to get a taste of different specialties.

good luck!

 

[hotbovie1]

By all means, shadow during med school. Even if you don't understand everything, it will help you realize why you are in med school during those years of sitting on your butt memorizing trivia.

I actually worked very part time during school suturing in our trauma center. Plus that hospital in general, and the trauma area in pariticular, is very welcoming of med students in any level of training. I have seen many students come through over the years I have held my part time job. THose who take the job as well as those who come on a fairly regular basis to just shadow have usually had some advantage when they started rotations...they started to get comfortable interacting with patients. Also, it's a very, very busy place and it's not unusual for the residents to grab any student to help them (sometimes they grab a brand new M1 who knows nothing, but they are good at talking you through what they want you to do). This has been especially good for those interested in surgical areas other than general...several students over the years have become well known to the ortho and neurosurg residents. They will let nearly any student srub, and will let you do things like put in nails (ortho) or drill holes in the skull (neuro) and teach you to sew. Plus, I've taught a multitude of students to sew.

Bottom line...a little time hanging out with folks who practice various aspects of medicine during the early years of med school can give you a little hands on, and be a welcome distraction from studying (don't do it too much, though). Plus you can start finding out what might interest you, and if research in that area is helpful for the match, you could probably arrange relevant
research much easier if you're seen as an insider.

 

[njbmd]

Hi there,
You really can't make an informed opinion of what you like until you have done most of third year. When I entered medical school, I was totally sure that I would be a pediatrician. I kept with the pediatric vein all through third year up until I scrubbed on my first case in surgery. After that, I couldn't get enough cases and OR time. I still have that feeling.🙂 I love surgery and I love to operate.

You can talk yourself out of certain specialties with things like lifestyle, family time etc. but the bottom line is do what you really love. Your kids will grow up and you family will adjust. Just because you are a surgeon, you don't have to spend every waking hour at the hospital. There are going to be days when you are there and you will have to operate all night but I see no difference between operating all night and spending the night in the MICU with a patient who is crashing or having to do an emergency cardiac cath.

Sure the radiologists can take call from home and look at films over the internet but if you don't enjoy radiology, you are going to be at home and miserable. Do what you like and find a way to adust your career to your lifestyle. Here at UVa, we have been polling and adjusting to actual number of hours worked. The chief residents have all been under the 80-hour work week but a couple of interns on the busier services have gone over. Adjustments have been made so everyone will work no more than 80-hours. As an attending, you can set you own hours based on how much money you think you need to make.

Do what you like but don't spend first and second year agonizing over something that may drastically change. I knew many a budding surgeon in my medical class who totally bombed when it came to doing the clerkship🙁 , even after shadowing the surgeons. Toward the end of third year, you are going to hone in on what you like. Good luck!

njbmd

 

[girlwithaknife]

Shadowing a doc during first and second year, in addition to the benefits described above, can also help you realize your dislikes in medicine and can help you narrow down your choices earlier in third year. I spent a lot of time in first and second year working with an fp doc, and while I didn't hate any of my time spent there, I didn't love it either. I spent a lot of time kind of bored and thinking I was not capable of being interested in anything. Then I started third year with neurology, surgery, and ob, and pretty much LOVED every minute of it. When you have first and second year experiences to compare your third year to, it can really help you figure out early whether you prefer inpatient vs. outpatient environment, procedures vs. referring patients out for procedures, healthy vs. sick patients, etc. If you have the time, and especially if your school offers organized preceptorships, I would definitely take advantage of the experience early in med school. It also helps break up the monotony of your basic science years.

 

[HamSandwich]

one thing to keep in mind too is what is it REALLY like in that specialty after residency?

for example our peds residents do many cool procedures and see lots os rare diseases but when it comes time to get out, remember it is mostly office hours with many many many ear infections.....