How do you figure out which speciality...

[yalla22]

---

Members do not see this ad.

I've been doing a lot of reading about med school and one of the questions that has come up is when do people usually figure out what they want to specialize in? For someone like myself who has average shadowing experience (shadowed a few different specialities) but still has absolutely no clue about what they want to do, when will i be able to figure this out? first two yrs we are in class and by fourth year when i have a chance to do electives, that may very well be too late. do most people have an idea going into medical school? or is it okay to wait until3rd/4th year?

 

[Ashers]

You may get excited about subjects in different classes, and you may absolutely detest other subject components or subjects in their entirety.

For example -- in gross anatomy, I absolutely lived for musculoskeletal stuff. I didn't mind the thorax and abdomen, but I hated head and neck and weird pelvis stuff. I couldn't dissect the skin off the face, and remembering locations of cranial nerves... forget it. I just don't care. It was hard studying for stuff I really don't care to learn. I also hated neuroanatomy the class in general (and psych... can't do psych)

In path, I still liked the musculoskeletal stuff and thorax/abdomen, but pelvis, ugh. I learned neuro well because my preceptor taught it, and he'd call on me in class, but I still don't understand it.

So leading up to... I'm interested in ortho. (The one internal med specialty I wouldn't mind too much would be endocrinology, but ortho >>>>>>> endocrine -- for me). I researched in a lab for an ortho doc after my M1 summer with opportunities to scrub in, and I'll do a rotation in it this year, and see if I really like it then.

I came in with a list of 4 or 5 possible specialties, and it's gotten narrowed down to 1.

You DON'T need to know right now. It'd pry be good to know towards the end of your 3rd year.

 

[DocOB]

3rd year of medical school mind you OP. Not 3rd year of UG. You've got plenty of time, I wouldn't worry too much.

 

[Hayden2102]

I don't think he's worried, I think he's just curious.

 

[Critical Mass]

Somebody should repost that cute flowchart.

 

[AmoryBlaine]

A highly underrated aspect of specialty shopping: reading the literature.

I had this weird inkling that I wanted to do EM as an M2, one of the things I started doing was reading the 2 major journals. I thought the issues were really interesting and enjoyed reading the original investigations.

Internal med journals? Not so much.

Obviously this is no substitute for shadowing/rotating, but if you think you want to do specialty X and find the "Annals of X" to be incredibly boring it might give you some pause.

 

[hlchess]

Go here to determine your specialty: http://umsis.miami.edu/~raycock/medical_decision_tree.jpg

 

[rmorriso]

Go here to determine your specialty: http://umsis.miami.edu/~raycock/medical_decision_tree.jpg

I always knew I was destined for emergency medicine 😉

 

[jeniffer lopez]

Once you start med school you can ask the dean of student affairs to give you an access code for the Career in Medicine program developed by the AAMC. It is supposed to be a very thorough assesment of values, preferences, skills, etc. I have not done it yet because I haven't started school, but a friend did and it takes forever (they kind of break it down to what parts you should do every year). That should narrow down your choices to 2-3.

 

[Dunce]

these are surprisingly accurate

http://www.med-ed.virginia.edu/specialties/

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

 

[YupGypsy]

these are surprisingly accurate

http://www.med-ed.virginia.edu/specialties/

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

Following the second link:

dermatology and radiation oncology top 2 for me. surprise surprise...

 

[Ladyfingers]

Go here to determine your specialty: http://umsis.miami.edu/~raycock/medical_decision_tree.jpg

This is freaking rad.

You've certainly left a smile on my face.

 

[alwaysaangel]

I liked the suggestion someone made on the "things you wish you'd known your first year" thread.

He said to write on a board/peice of paper all the specialties in existence. Then x them off as you realize you couldn't stand them. If you're not sure then find a doctor to shadow at the University hospital until you know if you can stand it or not. By the end he had narrowed it down to his realistic interests.

 

[foreverLaur]

i think you should have ideas, but always go into 3rd year with an open mind. you never know what you'll love or hate when you are actually doing it. what you thought you loved, you may hate and vice versa. don't go into it with a closed mine of "i'll never do this field" and "i have to do this field."

 

[Carmenita79]

these are surprisingly accurate

http://www.med-ed.virginia.edu/specialties/

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

really? I get very different results from each of them.

 

[foreverLaur]

i did the long one. the specialty i thought i would enjoy (and have spend 40 hours shadowing one) was near the very bottom 🙂 nuclear med was at the top - what?

 

[rmorriso]

Both exams were pretty spot on. I've been eying either thoracic or ortho surgery for a while and they were both top 3 with either, which is funny because as I answered questions I didn't feel like I was giving responses "typical" of those specialties.

 

[Dzeteo]

Following the second link:

dermatology and radiation oncology top 2 for me. surprise surprise...

I have the same results, don't know about radiation oncology, but was thinking derm might be interesting.
This was a nice tool.

 

[Trismegistus4]

I plan on adding up the number of different specialties in existence, then rolling one of those D&D dies with that number of sides.

 

[LifetimeDoc]

these are surprisingly accurate

http://www.med-ed.virginia.edu/specialties/

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

I tried the second link and came up with this list. I always thought I'd be going into Emergency Medicine, but can I do surgery when I'm starting medical school at age 36? 😱😕

Rank Specialty Score
1 thoracic surgery 47
2 obstetrics/gynecology 47
3 aerospace med 46
4 plastic surgery 45
5 nuclear med 45
6 orthopaedic surgery 45
7 neurosurgery 45
8 pulmonology 45
9 infectious disease 45
10 cardiology 45
11 otolaryngology 43
12 nephrology 43
13 neurology 43
14 preventive med 43
15 urology 41
16 pathology 41
17 general surgery 41
18 radiology 41
19 psychiatry 41
20 general internal med 41
21 endocrinology 41
22 family practice 40
23 allergy & immunology 40
24 gastroenterology 40
25 physical med & rehabilitation 40
26 pediatrics 40
27 occupational med 39
28 ophthalmology 39
29 hematology 39
30 med oncology 38
31 rheumatology 38
32 emergency med 38
33 colon & rectal surgery 37
34 anesthesiology 37
35 radiation oncology 36
36 dermatology 33

 

[acrunchyfrog]

hmmm....
The Virginia assesment had peds and oncology as top two, both things I'm not keen on right now. Kids are typically scared of me, too.

The Buffalo assesment has ortho,pulm, and GI as my top choices.

My personal first choice (at least right now) is EM and it's 1/3 of the way down the lists.

 

[LowlyPremed]

I tried the second link and came up with this list. I always thought I'd be going into Emergency Medicine, but can I do surgery when I'm starting medical school at age 36? 😱😕

Rank Specialty Score
1 thoracic surgery 47
2 obstetrics/gynecology 47
3 aerospace med 46
4 plastic surgery 45
5 nuclear med 45
6 orthopaedic surgery 45
7 neurosurgery 45
8 pulmonology 45
9 infectious disease 45
10 cardiology 45
11 otolaryngology 43
12 nephrology 43
13 neurology 43
14 preventive med 43
15 urology 41
16 pathology 41
17 general surgery 41
18 radiology 41
19 psychiatry 41
20 general internal med 41
21 endocrinology 41
22 family practice 40
23 allergy & immunology 40
24 gastroenterology 40
25 physical med & rehabilitation 40
26 pediatrics 40
27 occupational med 39
28 ophthalmology 39
29 hematology 39
30 med oncology 38
31 rheumatology 38
32 emergency med 38
33 colon & rectal surgery 37
34 anesthesiology 37
35 radiation oncology 36
36 dermatology 33

Is this the UAB tool? If it is then I think the higher scores mean less of a fit for the specialty. God I hope I'm right.

 

[humuhumu]

I have the same results, don't know about radiation oncology, but was thinking derm might be interesting.
This was a nice tool.

Rad onc may very well be the perfect specialty. You actually heal patients and they love you for it; intellectual challenge and variety (you know more about cancer than anyone); cool technology; outstanding compensation and livable hours; very bright future with no threat of mid-level providers taking over; etc. It's hard to think of anything wrong with it, other than the fact that it's very hard to match into it (for good reason). No, I'm not aiming for rad onc, but I probably should be.

 

[dubrovnik]

http://www.amazon.com/Ultimate-Guide-Choosing-Medical-Specialty/dp/0071479414

 

[Blanket]

Are you applying to medical school....if so then in the interview it would be wise to mention a couple speciality that you have specific interest in. Probably depending on the doctors you shadowed or your volunteer work. i.e. in my case, i had volunteered in the ER and I knew that was not the right thing for me so I just said that and mentioned couple other that were different from it that i thought would fit me better.

If you are in medical school then you will probably figure out during 3rd year. I am M2 and just going to let it come to me. (Step1 score is also going to be a determining factor on whether you get to choose a speciality or whether you will be forced into one).

 

[tacrum43]

http://www.amazon.com/Ultimate-Guide-Choosing-Medical-Specialty/dp/0071479414

I second this suggestion. I just finished reading this book because I had very little idea what specialty I might want to end up in, and I thought it was very helpful. It includes a detailed chapter about each specialty, written by a physician who is in that specialty, as well as overall advice for rotations, matching, etc.

Granted, I still don't know exactly where I'll end up but I feel much more comfortable now because I have a better idea of what's out there and I feel like there are several specialties that might work well for me.

 

[GreenShirt]

An EM physician I recently spoke with went on a rant about how bad the current arragnement for choosing a specialty is. Mostly his point was that you spend a brief month or so rotating through a unit in year 3 before you have to decide, since in year 4 you have to start your audition rotations. During that short time things may seem fun but when you hit residency and spend all your time there working for peanuts you may feel differently. He sees that with a lot of EM residents. Oh well, hopefully we'll all make an informed decision.

 

[spospo]

i've heard people say to shadow specialties of interest during first/second year. is this common at all? it seems like such a pre-med thing, but do med students do it that often?

 

[PeepshowJohnny]

i've heard people say to shadow specialties of interest during first/second year. is this common at all? it seems like such a pre-med thing, but do med students do it that often?

Yes, it's pretty common. My school has a first year "shadow a doctor" program that's pretty popular (I think it's going to become mandatory soon). It used to just be primary care but now you can follow pretty much whoever you're interested in: Between my friends we had someone following an Orthopaedist, Oncologist, Endocrinology, Pediatric GI, OBGYN, Neurology, and even a sports medicine Doctor (the team doctor for a nationally ranked college basketball team. Sometimes if your school doesn't have a program you may have to go through some channels in the main office to make sure a person you want to follow that they're in good standing with your school.

Also, look at how your school handles their rotations. In ours, we really don't get a chance to see certain things until fourth year. So if you're interested in something like Neurosurgery, and it's only offered as an elective in your fourth year, it's a good idea to maybe shadow someone so you can get some exposure, and build relationships with faculty so they can give you advice and connections if you decide to try to match in it.

 

[medanthgirl]

Obviously this is no substitute for shadowing/rotating, but if you think you want to do specialty X and find the "Annals of X" to be incredibly boring it might give you some pause.

oooh, good point...those will be your future colleagues/meetings/cme etc. too, so that is an interesting way to look at it. neat idea! thanks! 🙂

 

[NCF145]

Anyone remember the jump to conlusions mat in Office Space? What about a jump to a specialty mat?

 

[ayoung45]

these are surprisingly accurate

http://www.med-ed.virginia.edu/specialties/

http://www.smbs.buffalo.edu/RESIDENT/CareerCounseling/interior.htm?self-assessment.htm

Taking the buffalo assessment, GI was on top for me. I think it is interesting that internal medicine was about 3/4 down the list. Would you expect this since GI entails 3 year IM residency?

 

[Orthodoc40]

I've been doing a lot of reading about med school and one of the questions that has come up is when do people usually figure out what they want to specialize in? For someone like myself who has average shadowing experience (shadowed a few different specialities) but still has absolutely no clue about what they want to do, when will i be able to figure this out? first two yrs we are in class and by fourth year when i have a chance to do electives, that may very well be too late. do most people have an idea going into medical school? or is it okay to wait until3rd/4th year?

Heck yah it's okay to wait. I know 1 person who just switched his plans this week (the match lists were due Wed.) from surgery to psych. I know an anesthesiologist who switched while in the middle of interviews for cardio residencies. I know an orthopedic surgeon that didn't decide on ortho until their last rotation of their fourth year. Their stories are not that unusual. You'll also find some practicing physicians that went through residency, and after a few years went back & did another residency in something else. So, it's never too late.

While the links posted for quizzes are fun, I doubt using them to decide would be very useful!

There's also more than one specialty for your given interests. Like the poster earlier on who said they were interested in MS system - I mean, there's more than just ortho. There's physiatry, and you can go into family med/sports med, as well - which is basically clinical ortho (and the guys I know also are team physicians...) So find your interests, find your strengths, and find a few specialties that incorporate those, not just one.

Also, CiM helps because some people choose based on different priorities, like lifestyle, not their interests as much.

 

[deleted185747]

I am a 4th year med student and just decided to go into PM&R in the beginning of fourth year. I took the second link's quiz and it ranked derm, rad onc, ophtho, PM&R,,,

Interesting because during the first 3 years of med school I wanted to do G surg- I took the same test and g surg was my perfect fit!!!

I think my goals and desires changed during med school- its one thing to say you want a high pressure job with lots of responsibility and irregular hours UNTILL you do 6 weeks of surg and realize how bad this really sucks!!!

 

[dilated]

i've heard people say to shadow specialties of interest during first/second year. is this common at all? it seems like such a pre-med thing, but do med students do it that often?

very common. say you want to do ortho. you're probably not even going to SEE ortho until 4th year when you do a sub-i in it and decide you love it and have to figure out how the hell to match at that point.

whereas the other dude shadowed an ortho in 1st year, found out he liked it, went to ortho grand rounds in 3rd year, has ortho research projects, knows all the faculty and you're owned. maybe not a problem if you got a 250, but if you're borderline...

 

[riverwoman1040]

Here's what I don't understand, someone please enlighten me: Everthing I read says that if you want to go into a competitive specialty, it really helps to have research experience. I have no idea what I want to go into (well, I have ideas, but they're all over the board) If I don't decide until third year (which I'm sure I won't), how do I do research in that specialty? Do I try to do research in multiple areas? I plan on being very busy in med school, but I'd like to have time to eat every now and then. Plus, I've done the research thing, and I hate it, so I'd like to minimize it. confused...😕

 

[deleted77919]

Well, there's always the option of taking a year off. If that's not palatable try to get in some research elective time. We can schedule up to 8 weeks in our MSIII year, it's enough to at least get some case reports or a poster.

I was pretty set on EM until I spent the summer after MSI working in the ED for 8 weeks. EM is not out (in fact I'm currently working on some toxicology research) but there are two other specialties I'm more seriously considering now. I will schedule those early in my MSIII year, make the best decision I can betweeen the three, and spend 8 weeks of elective time at the end of MSIII working on research in the field I pick.

 

[riverwoman1040]

Well, there's always the option of taking a year off. If that's not palatable try to get in some research elective time. We can schedule up to 8 weeks in our MSIII year, it's enough to at least get some case reports or a poster.

I was pretty set on EM until I spent the summer after MSI working in the ED for 8 weeks. EM is not out (in fact I'm currently working on some toxicology research) but there are two other specialties I'm more seriously considering now. I will schedule those early in my MSIII year, make the best decision I can betweeen the three, and spend 8 weeks of elective time at the end of MSIII working on research in the field I pick.

So waiting until third year to do research is ok? That would make me really happy. Am I going to miss out on doing other, cooler things with that time? picturing myself in a mobile clinic in Africa vs. picturing myself hunched over a lab bench...

 

[roja]

For those of you early in your training, don't worry about this. If I had taken this test early in med school, I would never have had EM ranked high. Mostly because what I *thought* my work personality was (what I would like and dislike) wasn't what ended up happening.

I had NEVER thought EM. Not once. If someone in my ms1 or 2 year had told me I would be going into it, I would have laughed. Turned out half way through my third year, I hated what I thought I was going into and the types of environments I most loved working in and that I did well in were not what I thought they would be.


However, now I get EM at the top of my list. Probably because I figured out what I thought I loved wasn't and what I ended up loving was nothing like I thought. So, don't worry to much about it.

 

[deleted77919]

So waiting until third year to do research is ok? That would make me really happy. Am I going to miss out on doing other, cooler things with that time? picturing myself in a mobile clinic in Africa vs. picturing myself hunched over a lab bench...

Well, it all depends on how your medical school allocates elective time, how motivated you are (can you keep doing your research on your weekends off during your peds rotation? etc), and what you want to go into. If you look at the charting outcomes document if you want to go into Rad Onc you will notice that the majority of students have 1-5 research projects, and many who match have more than 5. Sure it doesn't speak to the quality of the work, etc, but you can tell that research is more important for that field than say, FM.

I just outlined what my general strategy is at this point. Based on my fields of interest I believe I have a realistic shot of matching with this strategy. However if I get struck by lightening and decide I really want to do nsgy in my thrid year then I'll take those 8 weeks of research to work on nsgy and talk to the faculty about the pros/cons of a year off.

Other students I know have advocated the strategy of picking the most difficult to match specialty you might be interested in and do research in that. If at the end of the day you decide you want to go to a community peds program that NSGY research won't hurt, just be prepared to explain your change of heart.

In the end don't worry about all this so much as an MSI. Try to get as much exposure to various fields as possible, get some good experience doing something over the summer between MSI and MSII, and then sit down and see if you really want to start doing a project of some type.

As far as sitting hunched over a bench, I did 2 years of bench research in undergrad in a micro lab. I hated it. Now I'm doing clinical outcomes research and trust me, it's much different (and clinical is also much easier to get a publishable result).

 

[angry energy]

everyone likes to think they choose their specialty, but i think in a lot of ways, the specialty tends to choose you.

even if you love surgery, if your a she-man little baby, you won't survive in a traditional general surgery. and even if you do, you won't be able to stand 90% of general surgeons.

if you love bones but are a 4'11" 80 lb girl who does her nails every night, the only way you'll get in is if you let the director nail you. its tough work, and no one wants someone that small dislocating hips. is it prejudice? yeah, but it happens.

why do medical fields carry such strong stereotypes? because we tend towards people similar to us. the doers, the quick thinkers, and the people who love pressure and high stakes end up in surgery. the thinkers and the tentative end up in medicine. obgyn requires half-doing women. the stereotype propogates because its populated by the appropriate students.

so, basically, u won't know for sure till your third year, when you start gaining exposure. this is where the VAST majority of students make/solidify/change their decisions.

don't worry, it'll happen to you too in due time, and everything will be fine

 

[riverwoman1040]

if you love bones but are a 4'11" 80 lb girl who does her nails every night, the only way you'll get in is if you let the director nail you. its tough work, and no one wants someone that small dislocating hips. is it prejudice? yeah, but it happens.

What if you're 5'3 and 125lbs? My mommy says I can be whatever I want In all seriousness though, this actually has crossed my mind lately, would it be an issue? What if I just gavfe the director a ticket to the gun show?

 

[HEADintheCLOUDS]

What if you're 5'3 and 125lbs? My mommy says I can be whatever I want In all seriousness though, this actually has crossed my mind lately, would it be an issue? What if I just gavfe the director a ticket to the gun show?

Well it didnt work to well for oliveoil.....so you would probably get laughed at!😀

 

[Ashers]

What if you're 5'3 and 125lbs? My mommy says I can be whatever I want In all seriousness though, this actually has crossed my mind lately, would it be an issue? What if I just gave the director a ticket to the gun show?

I never got that vibe from him during my rotation. 😉

Just so you know, there's really no time to do research M3 year if you're planning on going to my school, unless you're doing the Honors in Research (then there's a special elective). If people do research it's in between M1 and M2 year.

You're not even in med school yet. You don't have to know what you want to do. I could go on about how cool ortho is, but a lot of my friends are disgusted by bones/cartilage just as much as I am by guts and the face. You can shadow people here, most of the attendings welcome it.

 

[vtucci]

I took both of these tests in MS1==> Emergency Medicine as #1 for both.

I retook both of these tests yesterday (in MS 3)==> EM as #1 for both.

Future residency plans==> emergency medicine (even prior to starting medical school). Ah it is good to know one's self.

#1 Emergency Medicine😍
#2 Pulmonary/Critical Care 🙂
#3 Nephrology 😴

Although someone needs to explain how nephrology is close to being like EM😕

 

[DrJT]

Lots of excellent suggestions already. The US-based Careers in Medicine program looks like a good resource, though it is only available to students in the USA. BMJ Careers often has excellent articles on medical careers as well.

Our website is aimed at an Australian audience, but has plenty of useful information which would be applicable to medical students and doctors from around the world.

Good luck!

 

[RisingSun]

I'm always amazed at how many people know that they want to go into EM, get EM at the top of these tests, and eventually end up going into EM. Is there something about the field that some people are so attracted to? I know at least 10 people in my class who are pretty much set on EM.

Personally I'm afraid of the ER. There always seem to be more police/security at the Harborview ER than patients.😱

 

[DeadCactus]

 

[TXSurgResident]

Random Thoughs...

1) Research is may be a good idea for some hyper-competitive specialties, but no amount of research would trump someone with good board scores, great letters from someone who actually sounds like they know the student (not so easy to get sometimes) and good class rank. After that you have to be able to interview. I much prefer interviewing people who did something cool during med school than those who worked on a small piece of a project they really don't understand.

2)DeadCactus... Love the chart

3) When looking at specialties, consider them from the attending point of view. Just as importantly, try to shadow real private practice people as well(can probably get names from the school of local graduates), to get a sense of what the majority of people in the specialty actually do. If you decide as a med student not to go into something because the junior or even senior residents are tired/cranky/happy in a prozacky sort of way at an academic institution, you may miss the opportunity for 30-40 years of a great practice based on what the first 3-5 years at an academic institution was like, and thats not reality.

4) Bread and Butter. No matter what you do, you have to enjoy something about your bread and butter patient/case. It's easy to fall in love with something based on the midnight save in the ER, the simultaneous liver/kidney transplant or the kid with a strange syndrome who you help diagnose or treat. But if chest pain drives you nuts, ER will too. Hate routine hernias/appys/gall bladders? No general surgery. And so on.

Sorry for the rant, but I hope it helps.

 

[DwyaneWade]

I got the Ultimate Guide to Choosing a Specialty and it is helping me a lot. I highly recommend it (someone posted above in this thread about this book).