i really need to decide...

[remote]

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hey all, so i have gone back and forth trying to decide what field of medicine to apply to and i still can't make up my mind and really am having a tough time. so first, i've rotated and experienced all of the following fields and enjoyed them all pretty much equally. I'm trying to decide between radiology, urology, and orthopedics.

radiology: enjoy the technology, enjoy reading images and being able to be an integral part of the plan for any service in the hospital, like interacting with all specialties, also like the option to do procedures (IR, neuro, etc) that some subspecialties have. what worries me a bit is the "uncertain" future of the field (at least that's all i keep hearing...who knows how true it really is), also about the current job market and how it's very difficult to find a job for graduating residents (again who knows how true this is).

urology: really enjoy the mix of medicine and surgery, the ability to have a very flexible practice depending on whether you want to be more surgical or not, the cool technology (lasers, robot, endoscopic), the relatively good lifestyle among surgical subspecialties. what concerns me is the future of urology - not sure what the demand will be in the future and what that will mean for compensation, feasibility of finding a desirable job, etc.

ortho: enjoy the surgeries, like the fact that ortho essentially has its own turf and will always have patients to see, like the overall good outcomes for patients. what I don't like much is the hours/lifestyl associated with ortho, the fact that it is purely surgical and will require me to operate my entire career, the fact that orthopods are viewed as "dumb" doctors by other fields (although this doesn't bother me too much).


so looking for any insights from those who also considered the above fields or have some info that they would like to share about them and why you chose what you ended up choosing.

 

[Illusive Man]

Just choose the field that you think you will enjoy the most and appeals to you. Good luck.

 

[EeePC1005PR]

hey all, so i have gone back and forth trying to decide what field of medicine to apply to and i still can't make up my mind and really am having a tough time. so first, i've rotated and experienced all of the following fields and enjoyed them all pretty much equally. I'm trying to decide between radiology, urology, and orthopedics.

radiology: enjoy the technology, enjoy reading images and being able to be an integral part of the plan for any service in the hospital, like interacting with all specialties, also like the option to do procedures (IR, neuro, etc) that some subspecialties have. what worries me a bit is the "uncertain" future of the field (at least that's all i keep hearing...who knows how true it really is), also about the current job market and how it's very difficult to find a job for graduating residents (again who knows how true this is).

urology: really enjoy the mix of medicine and surgery, the ability to have a very flexible practice depending on whether you want to be more surgical or not, the cool technology (lasers, robot, endoscopic), the relatively good lifestyle among surgical subspecialties. what concerns me is the future of urology - not sure what the demand will be in the future and what that will mean for compensation, feasibility of finding a desirable job, etc.

ortho: enjoy the surgeries, like the fact that ortho essentially has its own turf and will always have patients to see, like the overall good outcomes for patients. what I don't like much is the hours/lifestyl associated with ortho, the fact that it is purely surgical and will require me to operate my entire career, the fact that orthopods are viewed as "dumb" doctors by other fields (although this doesn't bother me too much).

so looking for any insights from those who also considered the above fields or have some info that they would like to share about them and why you chose what you ended up choosing.

Ortho will be manually intensive and mechanical. They do go into details about certain calculations too. Orthopods do save critically sick patients eg. major traumas. You can also play important role in military surgery. You probably won't have much of life outside of work. People won't expect you to know any internal medicine, so you can shamelessly ask all other teams to look after your patients (and they'll do it cuz they know if they don't, your patients will just be let to die).

Radiology is imaging medicine and imaging surgery. Nice broad and relatively deep coverage. Mostly diagnostic but has the option of interventional which plays increasingly important roles vascularly. There is a turf issue with vascular surgeons, and increasingly other specialties. You will see all facets of medicine. Great lifestyle. You won't be the hero saving category 1 crashing patients. Those are for general surgeons and orthopods. But if given the time and just some patient stability, you can enjoy some pretty neat ways of saving people eg. cerebral revascularisation. Technology is always your friend, and is a friend who only gets more powerful each decade.

Urology you will be doing lots of urogenital stuff. Is that what you want? Good balance between medicine and surgery. Have some of the friendliest surgeons of all surgical specialties. In the surgical field however, I get a feeling orthopods and urologists are more commonly mocked by colleagues of other surgical specialties. I think a lot of urological procedures, a good general surgeon can also perform.

Forget about job market. Assume equal employment rates. What are your core values? What do you want out of life and work? What do you prefer? What can't you stand? etc. Think through those and you should have a clearer idea which specialty.

 

[BoogieWoogieWow]

Do you like to sit or stand all day?
Look at beautiful black and white pictures, or penises all day?
Also, which of those specialties can you do until the day you die, and your colleagues won't run you out when you get old?

 

[choweee]

Your qualms with rads/uro are job market based not work based, your ortho concern is work based. I would try to delineate more between rads and uro. Again, do something you could see yourself doing for 30-40 years. Will you still want to be operating when you're in your 60s? Sounds like you are fascinated by uro/ortho. However, assume after 5 years the novelty will wear off. How badly do you want to be a surgeon?

I am only an intern, but this is the advice I have heard repeatedly from superiors.

 

[shark2000]

It seems you are more interested in surgical subspecialties. Go for it. Likely you will hate radiology.

 

[jbru3423]

As odd as it sounds, I am in the same position as the OP (never thought I'd meet another person considering these same 3 fields). I can see a lot of the arguments for all of them, however, am still having difficulty making the decision so I can totally sympathize....

Best of luck with your decision...keep us updated...

 

[remote]

As odd as it sounds, I am in the same position as the OP (never thought I'd meet another person considering these same 3 fields). I can see a lot of the arguments for all of them, however, am still having difficulty making the decision so I can totally sympathize....

Best of luck with your decision...keep us updated...

so i'm leaning towards urology...b/c of multiple reasons:

1. almost every urology resident/attending urologists i have met has been happy with his/her choice to go into urology and persuades me to do the same... i definitely can not say the same about ortho or rads. but again, my sample size is small but hey i gotta go on something right?

2. Lifestyle - among all 3 fields these days, you can make a very strong argument that urology has the best lifestyle as an attending esp. given how hard radiologists are working. lifestyle is a big deal even though i know many medical students dont' seem to consider it much.

3. Flexibility of the field - prob. the best thing i like about urology is the flexibility one can have in it. you can easily decide to be more surgical or more office-based in urology with the amount of variety that you see/do. like as a younger attending, i can operate more and then phase into a more office based practice as i get older which i'm pretty sure i'll want to as I can't see myself doing crazy surgeries my entire life.. this is not possible in ortho. also this will give me a little more variety in my career than either ortho or rads.

4. future - given the current shortage and expected shortage of urologists in the future with the baby boomer generation becoming elderly, i think urology will be in a great position in the future in terms of demand, compensation, etc. and since there really isn't any turf battles, urologists will be the only ones to take care of these patients.

5. Variety- as i briefly mentioned, urology really offers a great variety of conditions to treat from infectious, benign, malignant, acquired, anatomic, trauma, etc...as well as a great variety in the OR from endourology, laparoscopy, robotics, open, lasers, etc. really cool technology too.


so because of these main reasons, i'm leaning towards urology...hopefully they make sense.

 

[shark2000]

If you like urology, do it. Don't try to justify your interest. A lot of what you talked about are your own justifications, and are far from truth. I don't want to go to details, but nothing beats the variability of radiology. Lifestyle means different to different people. I'd choose 10 hours of radiology work over 2 hours of urology work any time. You can talk about future and baby boomers in any field, from family practice to ortho.

You are interested in Urology, go for it. That is great. What are you asking for here? Compliments? approval? agreement?

 

[Doctor D]

Urology like most surgical fields will lead to further specialization and less variety. This is fairly maintained in radiology. Also, you are still a surgeon so your lifestyle especially in residency is not the best. Urology is a great field but I don't think it compares in those two aspects.

 

[MrBurns10]

Urology like most surgical fields will lead to further specialization and less variety. This is fairly maintained in radiology. Also, you are still a surgeon so your lifestyle especially in residency is not the best. Urology is a great field but I don't think it compares in those two aspects.

Well, radiology is also becoming much more subspecialized. If you do academics you'll pretty much only be doing the field in which you did your fellowship, and private practices are also heading in that direction. The bigger the group, the more specialized...I even know of one group that has subspecialists from every field 24-7 (meaning there's a dedicated neuro guy, a dedicated body guy, etc even at night). And while it's true that the more common studies will be read by everyone (body/chest CTs, plain films), the more advanced subspecialty modalities will often be limited only to those who did a fellowship in it. Right now I'm trying to decide between doing neuro or MSK for a fellowship and I hate knowing that, chances are, if I go into neuro I will not get to read much of any MSK MRI in practice. Kinda sucks as I find both fascinating.

At least, this is what I've gleaned from talking to people in practice and heading to practice.

 

[shark2000]

Radiology fellowships are only one year, other than some Neuro fellowships.
You can do 10 years of Neuro, then do a year of MSK and do MSK, ...
I know of IR doctors who quit IR after 10 years and are now doing body, MSK or mammo.
The truth is nothing beats the variability of radiology.
A Urologist can not do one year fellowship and becomes neurosurgeon. Or an ortho guy can not do a year of fellowship and then become a nephrologist.
Other than MR, even in subspecialized groups everybody almost reads everything.
I am out in practice in a highly specialized large group and pretty much read everything including brain MR (I am MSK trained). The only modalities I do not read is mammo, breast MR and breast US and high risk OB US. Our Neuro people do not read MSK MR, but they read almost everything.