How do decide?

[jackets5]

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How did you guys decide on what you wanted to pursue. Im a third year and one day i want to do Ortho, next is Vascular surg., then Cardiothoracic, Interventional Cards/Rads, even things like hem/onc etc. Like when i do my surgery rotation am i going to get exposure to vascular, cardio etc. or just gen. surg.

 

[jackets5]

Wanted to know how did you decide or will decide what specialty to go into, when you are interested and enjoy many different things. I mean one day i want to do Ortho, next Cardiothoracic or Vascular Surg. Internvential Rads or Cards another, then going to other end of the spectrum with Hem/onc. Just looking for advice, thanks

 

[FlowLimited]

Where are you in your medical training? Once you get on the wards and experience the various fields you'll be better equipped to make decisions about your career path.

 

[jackets5]

Where are you in your medical training? Once you get on the wards and experience the various fields you'll be better equipped to make decisions about your career path.

3rd year. been exposed to a few of the specialties but havent done rotations in all but i like alot of them and can see myself doing a few things. I mean the only things i have ruled out so far are OB/GYM, Peds, FM and Psych.

 

[Rendar5]

3rd year. been exposed to a few of the specialties but havent done rotations in all but i like alot of them and can see myself doing a few things. I mean the only things i have ruled out so far are OB/GYM, Peds, FM and Psych.

What rotations have you done?

 

[AlexMorph]

your board scores will narrow down your options real fast

 

[J ROD]

your board scores will narrow down your options real fast

qft

 

[LadyWolverine]

I struggled with my specialty decision up until the last possible minute (and actually a little bit past). Most people will know by the end of 3rd year what they want to do. The majority of the rest decide after the first 2 months of 4th year. Some people will have the same problem that I did, and end up choosing late. A small few will probably apply in 2 specialties.

It's OK to enjoy aspects of many different specialties. I certainly did. I loved emergency medicine, vascular surgery, ENT, Gyn Onc, general surgery, cardiology, radiology, trauma surgery, pediatric heme/onc, plastics, and critical care. I seriously considered several of these options, and was still debating my choice even as late as September of my 4th year. In the end, however, you have to realize that you really can't have it all. Overall, it's much better to have to pick one specialty from a list of many that you enjoyed, than to have to settle for the specialty that you "hated the least." At a minimum, you have this going for you.

It is most important to do a longer rotation (sub-internship) in the specialties in which you are most interested. This will give you a better idea of what your day-to-day life will be like. Still, even a sub-I is not much of an exposure, at least for making such a momentous decision. In the end, you have to go with your gut. You can only match in 1 residency in March next year.

 

[GuzzyRon]

Like when i do my surgery rotation am i going to get exposure to vascular, cardio etc. or just gen. surg.

I don't have an answer to the first part of your question. But for the second part, the answer is that it varies from school to school. In my school, we get 12 weeks of general surgery clerkship which is split into three rotations each lasting 4 weeks. There is a mandatory 8 weeks of general surgery and 4 weeks of any subspecialty you chose.

 

[MexicanDr]

See, I am still not a medical student, but what if something similar like this happens?

The only reason why I would consider or considered PA was because of the flexibility among specialties. You could not be an expert on one, but yet you could move through different ones. Unlike Physicians, which is really hard to do.

 

[DrJD]

I struggled with my specialty decision up until the last possible minute (and actually a little bit past). Most people will know by the end of 3rd year what they want to do. The majority of the rest decide after the first 2 months of 4th year. Some people will have the same problem that I did, and end up choosing late. A small few will probably apply in 2 specialties.

It's OK to enjoy aspects of many different specialties. I certainly did. I loved emergency medicine, vascular surgery, ENT, Gyn Onc, general surgery, cardiology, radiology, trauma surgery, pediatric heme/onc, plastics, and critical care. I seriously considered several of these options, and was still debating my choice even as late as September of my 4th year. In the end, however, you have to realize that you really can't have it all. Overall, it's much better to have to pick one specialty from a list of many that you enjoyed, than to have to settle for the specialty that you "hated the least." At a minimum, you have this going for you.

It is most important to do a longer rotation (sub-internship) in the specialties in which you are most interested. This will give you a better idea of what your day-to-day life will be like. Still, even a sub-I is not much of an exposure, at least for making such a momentous decision. In the end, you have to go with your gut. You can only match in 1 residency in March next year.

So what did you end up picking?

 

[Taurus]

3rd year helps a lot. It helped me learn what aspects I hated about medicine and surgery. Doing admissions, writing daily progress notes, ROUNDING, discharge summaries, playing social worker, standing for 10 hours a day. And to think I saw myself as a surgeon going into medical school.

 

[dude1344]

3rd year helps a lot. It helped me learn what aspects I hated about medicine and surgery. Doing admissions, writing daily progress notes, ROUNDING, discharge summaries, playing social worker, standing for 10 hours a day. And to think I saw myself as a surgeon going into medical school.

This is completely OT, but I've been going through your links in your sig, and I'm becoming increasingly disturbed and concerned.

 

[Taurus]

This is completely OT, but I've been going through your links in your sig, and I'm becoming increasingly disturbed and concerned.

Being informed is the first step to taking back medicine from the nurses. Remember that the NP/DNP's no matter what they say are dependent on physicians to train them once they finish school because they get inadequate training during school. You make the decision to hire and train them. You make the decision on what you want medicine to look like in the future. There are non-nursing alternatives. PA's and AA's.

 

[njbmd]

You don't have to decide on a surgical fellowship as a third year medical student. You likely will decide first if you are interested in surgery or something nonsurgical. After that, decide if you are going to pursue General Surgery or Ortho, or ENT or Urology or Neurosurgery.

When you do a General Surgery residency, you can think about a General Surgical Sub-specialty at that time or you can do a 4th year elective in things like Peds Surgery, Vascular Surgery or CT Surgery if you haven't had any experiences there. The thing to remember is that if you want to get into a very competitive surgical fellowship, you need to train at a very strong university residency (good med school grades and board scores).

At my school during third year, we did 4 weeks of General Surgery/Trauma and 4 weeks of Surgical Sub-specialties (Ortho, ENT, Plastics, Neuro and Uro). We were able to get a taste of CT and Vascular on our General Surgery subrotations. Essentially those folks who wanted to do Ortho, ENT, Neurosurgery or Urology figured out that they wanted to pursue those residencies early in third year or before. Again, since ortho, uro, plastics and neuro are pretty competitive, you need to have the grades and board scores which you would know about before third year.

We had an additional 4 weeks of required Surgery rotation during 4th year which most of us used to do a rotation on things like Peds, vascular, CT or Onc Surgery.

I would say that loads of folks are enamored with surgery until they get to third year and actually have to do it.

 

[Hoody]

This is completely OT, but I've been going through your links in your sig, and I'm becoming increasingly disturbed and concerned.

Remember, there are no adequate studies regarding differences in the outcomes of Patients treated solely by MDs/PAs versus NPs. Being evidence based clinicians it would be incorrect to label NPs inferior. In other words….:troll:

would you like some cheese....?

 

[Taurus]

Remember, there are no adequate studies regarding differences in the outcomes of Patients treated solely by MDs/PAs versus NPs. Being evidence based clinicians it would be incorrect to label NPs inferior.

I'll be the first to support opening hospitals where there are only NP's and CRNA's on staff. Let NP's and CRNA's train themselves without physician involvement. It'll be the blind leading the blind. Let's see how the outcomes are when there are no physicians to save your butts and when there are enough volume and case complexities to make conclusions. I don't hide my desire to limit the scope of NP's and CRNA's through litigation. Just because you have the scope to do something doesn't mean you should be doing it. One or two high profile court cases is all you need.

I refuse to precept any NP or CRNA students. I won't hire any NP's or CRNA's. Why hire them when you can hire PA's and AA's. The training that NP's receive is a joke. Some of the smartest decisions that the AMA did was expand PA's and increase med school classes everytime the NP's made aggressive moves.

 

[pingouin]

How about we get back on topic in this thread? Thanks.

 

[RisingSun]

She really gives some good advice. With regard to many students being enamored with surgery until actually doing the rotation, no truer words were said.

The great thing about a surgery rotation is that you (should) get a great exposure to so many aspects of medicine. You are always looking at films (might give you insight into whether or not radiology is in your future), spending time in the ICU (do you like managing really sick patients? think anes or medicine), spending time in the ER, managing floor issues (do you absolutely hate debriding wounds, focusing on the return of bowel function, or fretting over drain o/p quantity and quality? surg is probably not for you), the list goes on and on. At one point during my rotation I was in surgery for SBO and around 7:30 PM we were still lysing adhesions - and as much as I wanted things to go well for the patient, all I could think of was getting home to my family. There will be a-ha moments during your rotations where you can't wait to get the hell out of there, or you want nothing more than to stay and help out or see more. Specialty decisions should at least in part be based on such moments.

You really do not know what you will like until you actually live it for 6 or 8 weeks.

 

[Imp]

Hahaha. Well, it's nearly November and I'm in 4th year, and I'm STILL deciding. Nothing like down-to-the-wire decision making.

Like you, I really enjoyed all my rotations. There are certain surgical specialties I wouldn't do, and I wouldn't do Gyne, but that's about it. Everything else I love, especially Internal Medicine (loved Critical Care), and Emergency. But then there are lots of great things about Family Practice, too!

Like someone said earlier... it's much better to be in this spot and know that no matter where you end up, you will like your work. 🙂

One piece of advice - if you're REALLY not sure, make sure you're getting reference letters for the different options you're considering - you don't have to use them, but it'll be really hard to go back months later and try to get them.

 

[azzarah]

I recommend ophthalmology. 😀 GREAT field. Lots of surgery, yet you still have your own patients. You interact with all different fields since everything pretty much has an eye manifestation. Lots of opportunities for public health/international health/research. Great hours, good money. Patients really value their vision and appreciate your work.

 

[thefritz]

I recommend ophthalmology. 😀 GREAT field. Lots of surgery, yet you still have your own patients. You interact with all different fields since everything pretty much has an eye manifestation. Lots of opportunities for public health/international health/research. Great hours, good money. Patients really value their vision and appreciate your work.

Isn't it one of the most, if not the most competitive specialties to match into? I thought it was harder than ortho and derm.

 

[gluon999]

Isn't it one of the most, if not the most competitive specialties to match into? I thought it was harder than ortho and derm.

Derm, ortho, rads, plastics are more competitive. But ophtho is a lifestyle specialty and you certainly need good scores (230) or more.

 

[thefritz]

Derm, ortho, rads, plastics are more competitive. But ophtho is a lifestyle specialty and you certainly need good scores (230) or more.

Rads is more competitive than optho? By which measure?

 

[Taurus]

Rads is more competitive than optho? By which measure?

It is true. Ophtho lost a lot of its luster since the govt cut reimbursement for cataract surgery in the 80's. Furthermore, many of the big cities are saturated with ophtho's. If you come from a half-decent school, you can match into ophtho with step 1 as low as 200-210. I have heard from many sources that new grads can start as low as 90k in saturated cities.

Ophtho and urology are hard to compare to the other specialties because they have their own matches. The ophtho match system I heard is archaic and frustrating compared to ERAS and NRMP.

 

[gluon999]

Rads is more competitive than optho? By which measure?

Last time I checked ophtho step 1 avg. was 232 and rads was 238. Google it.

 

[Dral]

Stay keen on experiencing fields that you may be interested in that you might not otherwise experience 3rd year. I'm going for something that isn't a 'typical' 3rd year rotation. One really should experience the field to decide, so unless you're straight up Peds, IM, OB/GYN, etc, you need to search out your experiences in some other way.

 

[Caboose]

I think I know what you mean. It seems like every rotation I discover an amazing wondrous niche I could see myself doing. I decided that I'd pick my top ones and try to judge which one I'd be better at. What options are realistic comes later for me.

Caboose.

 

[Music MD]

Last time I checked ophtho step 1 avg. was 232 and rads was 238. Google it.

Ophtho = 235
Rads = 238

These two links are pretty good resources for future fake arguments settled over the internets:

http://www.nrmp.org/data/chartingoutcomes2009v3.pdf

http://www.sfmatch.org/residency/ophthalmology/about_match/match_report.pdf

 

[howelljolly]

You don't have to decide on a surgical fellowship as a third year medical student...

Excellent advice.

That post can be freeze-dried and reused in the future. Many times we see posters who are unsure of what they want to go into, and they list cardiology or vascular surgery as options, and they say they like almost everything.

If you dont have to insight to decide what you want to do, to the extent that youre a 4th year, and posting on the SDN about it, and you like many different things... don't think about fellowships. Decide what residency you want to go into.

By the time you're a 2nd year resident, you might finally know what you want to do, so there no need to think about what fellowship you think you might like as a med student.

Decide if you want to be a medicine resident, or a surgery resident, or one of the other dozen or so residency fields like Path, Rads, Psych, OB.

 

[zinki949]

How did you guys decide on what you wanted to pursue. Im a third year and one day i want to do Ortho, next is Vascular surg., then Cardiothoracic, Interventional Cards/Rads, even things like hem/onc etc. Like when i do my surgery rotation am i going to get exposure to vascular, cardio etc. or just gen. surg.

LOL... How about experiencing all, then find which one you are great in. Not just good at, but something you can truly excel and take it to the next level...