How do you know what you want to do?

[spumoni620]

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Hi all,

I'm relatively new to this forum so bear with me...as I'm about to enter med school this fall after having been out of school for a while (and I'm nontrad) I'm thinking about the next 8 years and getting nervous along with my anticipation

a lot of times i seem to get the impression that one already needs to "know" what they want to specialize in before they start med school - so they can find the right mentors, do the right research, get the right recommendations, etc. etc. but for me, there are so many fields that seem amazing and fascinating i'm having trouble narrowing it down (well, right now i'm leaning heavily toward peds, but i really know nothing much about the field.). i also am 70% sure i want to go into academic medicine afterwards.

my questions:
1. how did you guys find out what you wanted to do?

2. how do you get exposure to lesser-known fields?

3. Did you have time to get your foot in the door properly - i.e. make the right relationships, find mentors, do research, etc.?

4. Do you get an accurate idea in med school of what the lifestyles of these various options will be like as well? for ex - i really want to have a family; the surgeon that i shadow told me point-blank surgery is nearly impossible. do you get this type of reality-check in med school?

5. Finally - are there good books/resources you could recommend that give you an accurate, current breakdown of what the different specialties entail...what their lifestyles are like...etc.?

Thanks so much for your insight

 

[Kalel]

Besides joining different interest groups during your preclinical years and doing short-term shadowing experiences, I'd also reccomend that you purchase either "Iserson's guide for getting into residency" or "first aid for the match". Both of the books have similar, good advise regarding most of the questions that you have. In picking specialties, it's reccomended that you keep a relatively open mind about which specialty you want to do until at least pretty close to the end of your third year. Finding a mentor and doing research is an excellent idea. It's better if they both are in your chosen specialty, but they both can still be very helpful even if they aren't in your chosen specialty. Iserson's talks about this. You can also search websites for info about different specialties. Be sure to read the FAQ's in many of the specialty forums here on sdn, and here is one useful website too:
http://medicine.wustl.edu/~residenc/outside/spec/byspec.html

 

[Gleevec]

Another site: http://www.ucihs.uci.edu/com/meded/...ricularAffairs/residencyselection/IntMed.html

FRIEDA has a residency training database as well: http://www.ama-assn.org/vapp/freida/spcindx/0,2654,WF,00.html

The specialty forums here on SDN sometimes have really really good sticky's explaining a lot about the specialty.

 

[uclacrewdude]

shadow frequently. if you start getting recognized, you increase your chances of learning new procedures and generally gaining enough trust to actually DO something besides just asking Jack Mehoff questions like, "so where did you do your residency, what else were you considering, blah blah blah..." the closer you get to doing actual clinical work while still in your preclinical years, the more grounded your perception will be i think.

 

[lkjh]

Some people swear up and down they know what they want to do when they get to med school, some do it, most of them don't. I was one of those that swore off surgery and Peds, and now I'm going into a surg field and might do a peds fellowship. Most people I know didn't decide until their 3rd year, preclinical and clinical are incredibly different. I didn't decide until almost the beginning of 4th yr, and it was OK!

I agree that you should use summers wisely, do research, particularly if you are interested in academics. If there are some areas that you are really interested in, schedule them earlier rather than later in your 3rd year, and if they are non-core, schedule an elective. Meet with attendings to express your interest so they can give you intros, start networking early. Talk to 3rd and 4th years. The important thing is to focus on the NOW. Do well in your classes, rock the boards, publish, that way all doors will be open to you when you do decide.

You can get a good idea about lifestyles by doing rotations. But also consider that you will probably train at an academic center, and that privates often lead more chill lifestyles in amost any field. As far as surgery goes, I wonder if you talked to a general surgeon? And it is NOT near impossible. I'm a woman and know lots of other women going into surg fields, and we are fully aware of the ticking clock. A female surgeon told me that it is possible to have a family, but you will definitely need a full-time Nanny, and that may not be acceptable to some people. Planning is also key, lots of people decide to have kids during their research year in residency or during fellowship. G-Surg and Ortho are rough, but consider surgical subspecialties like Ophtho, Urology, & ENT, which offer good lifestyles and salaries, even in the academic arena. The reality check will come when you do rotations. If you are finding that you can't deal with getting up at 5AM and going home at 9PM, you might not stand for 5 years of it, even if things are much better when you are an attending. Also, going into a field for a lifestyle may not be the best thing. A surgeon once told me that 5 hours in an OR flies by like minutes because she loves it, but 1 hour doing another field for her seemed like an eternity. The sentiment is probably mutual for Medicine doctors having to suffer thru being in the OR.

 

[spumoni620]

awesome thanks gleevec, kalel, crewdude, lkjh for the great thoughts and useful links. i knew i'd get my answer soon enough here i've got a lot of reading to do now...

the only thing is - if i change my mind about what i want to do in the 3rd year, and did research in unrelated fields my 1st/2nd year, will it be a disadvantage? do you just get multiple mentors for the various fields you're interested in? thanks again for humoring my ignorance...

 

[Gleevec]

Originally posted by spumoni620
awesome thanks gleevec, kalel, crewdude, lkjh for the great thoughts and useful links. i knew i'd get my answer soon enough here i've got a lot of reading to do now...

the only thing is - if i change my mind about what i want to do in the 3rd year, and did research in unrelated fields my 1st/2nd year, will it be a disadvantage? do you just get multiple mentors for the various fields you're interested in? thanks again for humoring my ignorance...

Research is NEVER a disadvantage, especially if you want to go into an academic/competitive residency. Now, its of greater benefit if you do research and get pubs/letters from someone in the field you wish to do residency in, but its still beneficial to have conducted research in ANY field. Oftentimes, the skills translate and the very fact that you show interest will help your application. While itll help more if its in the field of interest (since residency directors will likely know your PI), it will still help if its in an unrelated field, and definitely so if you have pubs.

I think most people just join the interest groups of the fields they might be interested in, and there is generally a mentor associated with them. So I dont know about the mentor thing, plus that might vary by school. I think there are academic deans though that I believe you talk to during the middle/late clinicals that advise you on residency and point you in the direction of the field-specific advisor.

In any case, I hear most people, including myself, might have an idea of what they're going into, but end up doing something completely different due to clinical rotations. Id imagine if this is taken into account, that academic advising would start out more general for residency placement and get more specific once most of the core rotations have been completed (ie end of 3rd/beginning of 4th year maybe). Itll likely be earlier at Baylor since clinicals start a semester early.

In any case, you are 1 of approximately 170 students who doesn't know for sure (whether they know it or not) what they want to do for residency, so Im sure academic advising has taken into this account over the years. And its kinda cool we get to go through a bunch of clinical rotations before making such a big decision.

 

[oldbearprofessor]

Hi Spumoni:

I generally agree with the advice you've gotten so far, although I'm not sure that doing summer research will be as helpful in picking a clinical specialty. Lots of people, including me, do research slightly afield from what they practice in the hospital. Research may be inherently of use in your path to academic medicine, but it may not guide you into a field.

I usually recommend that as students go through their clinical rotations they pay close attention to two things. First, look at the life-styles and the type of doctors practicing the field you are considering. Can you see yourself having this life and lifestle?

Second and more importantly, pay attention to what type of patients you like to take care of. I could never have been a geriatric doc as I don't much like taking care of older people. But, as a certifiable baby (and baby fan), being a neonatologist fits easily. This doesn't always work of course, but its a start.

Finally, spend time throughout school talking with lots of people who are actually out there practicing the field you are considering. In medical school one tends to see an academic view of almost all specialties. Make sure to do a private practice month early on if you can in medicine or peds if you are interested in these things.

I always ask my second year students what they are interested in doing and then try to check back in the 4th year with them. Lots of changes occur, so don't expect it to become clear until you really spend some time in the clinics.

Regards

"oldbearprofessor"

 

[NemoFish]

A few of classmates have recommended a great new book out by Freeman, called "The Ultimate Guide to Choosing a Medical Specialty." It's really good for MS1's and MS2's, too. This one and Iserson are good buys.

 

[spumoni620]

oldbear, thanks so much for the great thoughts

right now i adore children/babies, but the thought of seeing them sick and suffering is sort of sad , which is the only reason i'm wavering. but you're right, i have much to learn...

 

[spumoni620]

Originally posted by Gleevec

In any case, you are 1 of approximately 170 students who doesn't know for sure (whether they know it or not) what they want to do for residency, so Im sure academic advising has taken into this account over the years. And its kinda cool we get to go through a bunch of clinical rotations before making such a big decision.

exactly, this is one of the biggest benefits imo of an innovative curriculum that allows for extra flexibility in scheduling rotations. knowing me though, and how interested i am in everything (i ruled out geriatrics and gastroenterology, but that's about it ) i hope i have enough time to focus on what i really want to do (when i find out what that is.)

thanks as always for the great input gleev

 

[spumoni620]

Originally posted by NemoFish
A few of classmates have recommended a great new book out by Freeman, called "The Ultimate Guide to Choosing a Medical Specialty." It's really good for MS1's and MS2's, too. This one and Iserson are good buys.

cool, i'll check this out. thanks!

 

[shekashi]

Hi,

Two other great sites about specialties:

http://www.pfizercareerguides.com/physician.html
-just d/l the pdf with great info about medicine and specialties.

http://medschool.umaryland.edu/OSFD/
-take a look at the specialties FAQ

Thanks everyone for your insights and links,

shekashi

 

[Gleevec]

Originally posted by shekashi
Hi,

Two other great sites about specialties:

http://www.pfizercareerguides.com/physician.html
-just d/l the pdf with great info about medicine and specialties.

http://medschool.umaryland.edu/OSFD/
-take a look at the specialties FAQ

Thanks everyone for your insights and links,

shekashi

Very interesting links, esp. the pfizer one. Thanks!

 

[promethius]

Hey spumoni620,

Where are you planning to go next year? Some places are more conservative than others so that may make an impact in what the physicians there say to the medical students. At Pittsburgh, we had a talk where a female trauma surgeon was working part-time while having a family. Her advice was to do what you want to do and then make it work for you. If you are willing to deal with the consequences (i.e. you may not rise as fast on the academic ladder as your fellow residents if you only work part-time), then you can definitely do what you want to do on your terms. Good luck with your first year. Most people end up changing their mind many times between their first and fourth years, so one piece of advice--do not rule anything out just yet!

 

[gwyn779]

I am currently right in the middle of this oh-so-fun decision making process. The vast majority of my classmates didn't know what they wanted to do when we started and there are quite a few who still don't know. If you want to do research, do it in a subject that interests you, it doesn't really matter what field it's in. As far as mentors go, even if you go into another specialty, they're usually willing to help as much as possible. And of course, 3rd year rotations are the biggest factor. I was pretty sure I wanted to do family medicine when I started, but I was certainly open to other possibilities. But as I went through, I realized that there was a family med resident on every rotation I did and they seemed to be the ones with the most practical view on medicine (including having a life outside it). Anyway, that's just the view from an MS3 who just decided (pretty much) for sure she's going into family med. The point is, looking at the residents can tell you a lot. What kind of people are they, what kind of outlook they have, etc. It might not be the stererotypical one you expect, but then again, it might.

 

[promethius]

Hey there,

Actually I would not bother looking at the residents. I would look at the attendings. You will only be a resident for 3-6 years or so, but you will be an attending for the rest of your life. If you want to know how much you will be working and what you will be doing, go straight to the source and not to the medium.

 

[gwyn779]

Look at both. You still have to spend those 3-6 years with the residents, plus they're the people who are soon going to be attendings. I'm sure they'll change some, but from what I've seen, not that much.

 

[ericdamiansean]

spumoni620
Wow, you have 1600 over post..and you are new? Where did you post?

BAsically, alot of people try to get to know which speciality they like during the various rotations.

Me, I didn't wait for rotations,but I seriously would like to work with the elderly ie. geriatrics. BUt to make sure, I got some rotations myself with some senior students during my hols, and worked with the elderly as well

 

[Flack Pinku]

Well, a nice intro would be watchin the Discovery Health channel--some shows feature Orthopods, to Oncologists to Pediatricians.

But the REAL way to know of course is during your 3rd and 4th years.

I had always wanted to be a doc, and that wasn't based on rational reasoning (though I did volunteer and shadow docs, which just confirmed it more).

Don't discount your "irrational" first-hunches thinking "Oh its not based on any real-world experience"... if I did that, I'd not have applied to med schools.