MS4 trying to figure out what I’m applying to in September. I’ve had a bear of a time trying to figure out my specialty. Choosing a specialty after a month or two of rotations is hard. When electives finally started for me earlier this spring I narrowed it down to EM, anesthesia, IM, or radiology.
Since then I ruled out EM (really love the specialty for a number of reasons but I was concerned with longevity).
I did an anesthesia elective back in April and I liked it, but I wasn’t over the moon with it. We spent two weeks at a community level 1 trauma hospital and 2 weeks at a big tertiary children’s hospital. Most of the cases I were put in were pretty straight forward with healthy patients (like ASA 1-2 ortho, gallbladders, tonsillectomies, etc.) I did get to see a big serious trauma and a Norwood at the children’s hospital which was incredibly interesting. My thoughts overall on the rotation were that it was good, but I didn’t find a ton of the cases that interesting, but I also recognize that I wasn’t seeing the pinnacle of anesthesia with the majority of these cases and I was basically shadowing the entire time. Not once was I asked to try and come up with an anesthetic plan myself. I really liked how it was basically applied physiology, I liked how hands on it was, I like the critical care and occasional high acuity aspect of it (I like acuity and would likely do a critical care fellowship if I did anesthesia or IM), and it has minimal bs like notes, spending half your day mindlessly clicking through epic etc. It did feel a little repetitive with one case being about the same as the next but again I spent a lot of time doing things like tonsillectomies on healthy children. I also didn’t think through diagnoses a lot which is something I enjoy, but I guess isn’t an absolute must for me.
After that rotation I was kind of thinking I may apply to anesthesia if I didn’t like my radiology rotation or my IM rotation. I did my radiology rotation and found it super interesting even if it was just shadowing. I loved the huge knowledge base, focus on diagnosis, being the “doctors doctor”, technology, and the lack of bs. Although I’d be lying if I didn’t have big reservations about staring at a screen for 8 hours a day churning out study after study. I also really like acuity and critical care and would have to say goodbye to that with radiology which is causing me major pause. It’s also 6 years and if it turns out I don’t like imaging that much then I can only really do IR or switch specialties completely.
I thought IM could be a good mix with diagnosis, physiology, pharm, etc. on paper IM is super interesting to me as it’s basically all the interesting stuff you learn in medical school, however I’m currently on my IM sub I and I’m really disliking it. Sure the medicine can be very interesting (thinking through nephrotic syndrome vs. nephritic syndrome work ups, infectious disease, etc) but so much of the job just isn’t that. It’s so much care coordination, being on the computer but not really thinking too hard, and epic chats. I feel exhausted at the end of the day, but not in a good way. IM obviously offers a ton of flexibility with fellowships and everything but I’m not sure if I want to do three years of IM just to hopefully match into a competitive fellowship and then do another 3 years after that. I can only delay gratification for so long and I don’t think I’d be happy as a PCP or hospitalist. Of note I’ve felt this way on every IM rotation but I keep trying to convince myself it’s a good fit.
I guess I’m leaning towards radiology at this point, but I’m considering doing an anesthesia subspecialty rotation (cardiac, transplant, etc) right before applications just to make sure that my feelings about the rotation weren’t just due to the cases I was placed in. On paper I think I’d really enjoy CT anesthesia and anesthesia critical care and it would be the same years of training as DR. I’ve spoken with a number of anesthesiologists who admittedly say they don’t find things like a ASA 2 lap chole interesting but love the bigger cases so I’m wondering if I just haven’t had enough exposure to those.
Any thoughts? And yes I know these are all very different specialties but I have interest in many things.
Since then I ruled out EM (really love the specialty for a number of reasons but I was concerned with longevity).
I did an anesthesia elective back in April and I liked it, but I wasn’t over the moon with it. We spent two weeks at a community level 1 trauma hospital and 2 weeks at a big tertiary children’s hospital. Most of the cases I were put in were pretty straight forward with healthy patients (like ASA 1-2 ortho, gallbladders, tonsillectomies, etc.) I did get to see a big serious trauma and a Norwood at the children’s hospital which was incredibly interesting. My thoughts overall on the rotation were that it was good, but I didn’t find a ton of the cases that interesting, but I also recognize that I wasn’t seeing the pinnacle of anesthesia with the majority of these cases and I was basically shadowing the entire time. Not once was I asked to try and come up with an anesthetic plan myself. I really liked how it was basically applied physiology, I liked how hands on it was, I like the critical care and occasional high acuity aspect of it (I like acuity and would likely do a critical care fellowship if I did anesthesia or IM), and it has minimal bs like notes, spending half your day mindlessly clicking through epic etc. It did feel a little repetitive with one case being about the same as the next but again I spent a lot of time doing things like tonsillectomies on healthy children. I also didn’t think through diagnoses a lot which is something I enjoy, but I guess isn’t an absolute must for me.
After that rotation I was kind of thinking I may apply to anesthesia if I didn’t like my radiology rotation or my IM rotation. I did my radiology rotation and found it super interesting even if it was just shadowing. I loved the huge knowledge base, focus on diagnosis, being the “doctors doctor”, technology, and the lack of bs. Although I’d be lying if I didn’t have big reservations about staring at a screen for 8 hours a day churning out study after study. I also really like acuity and critical care and would have to say goodbye to that with radiology which is causing me major pause. It’s also 6 years and if it turns out I don’t like imaging that much then I can only really do IR or switch specialties completely.
I thought IM could be a good mix with diagnosis, physiology, pharm, etc. on paper IM is super interesting to me as it’s basically all the interesting stuff you learn in medical school, however I’m currently on my IM sub I and I’m really disliking it. Sure the medicine can be very interesting (thinking through nephrotic syndrome vs. nephritic syndrome work ups, infectious disease, etc) but so much of the job just isn’t that. It’s so much care coordination, being on the computer but not really thinking too hard, and epic chats. I feel exhausted at the end of the day, but not in a good way. IM obviously offers a ton of flexibility with fellowships and everything but I’m not sure if I want to do three years of IM just to hopefully match into a competitive fellowship and then do another 3 years after that. I can only delay gratification for so long and I don’t think I’d be happy as a PCP or hospitalist. Of note I’ve felt this way on every IM rotation but I keep trying to convince myself it’s a good fit.
I guess I’m leaning towards radiology at this point, but I’m considering doing an anesthesia subspecialty rotation (cardiac, transplant, etc) right before applications just to make sure that my feelings about the rotation weren’t just due to the cases I was placed in. On paper I think I’d really enjoy CT anesthesia and anesthesia critical care and it would be the same years of training as DR. I’ve spoken with a number of anesthesiologists who admittedly say they don’t find things like a ASA 2 lap chole interesting but love the bigger cases so I’m wondering if I just haven’t had enough exposure to those.
Any thoughts? And yes I know these are all very different specialties but I have interest in many things.
