If you could do it over and you had the option to choose any specialty, which specialty would you choose and why?
If you had the chance to choose your specialty again...
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While I wouldn't do medicine again (see the other thread currently boiling away here) I would do EM again or anesthesia. I think EM or gas are the places to be.
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Agreed. I feel very blessed to have found a field (radiation oncology) that I am truly passionate about and cannot wait to begin help to cure/alleviate/palliate those stricken with cancer.
I agree that rad onc is a good field, but don't you guys find it a bit boring? I wanted to just see it for a day, and after few hours I was truly bored out of my mind. I am sure some people like to work at that pace, but would not work for all of us...
Any more opinions?
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What you may not recognize StanleyCup is that filter is NOT a Radiation Oncology resident...I believe him to be stating that he would change fields.
At any rate, its a bit premature for medical students and residents to say whether or not they would switch - after all, until you are out in practice you don't *really* know whether you like something.
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Call it Winner's Curse or "Grass is greener", but everyone 2nd (or 3, 4, 5th) guess their initial choice.
Whatever the case may be, it's a waste of time and energy to dwell on something like that. If you want to switch, switch. If not, don't dwell on it but instead divert your energy into being the best doctor in the specialty you're in as you can.
The worst feeling in the world is to feel the sense that you don't belong somewhere, that you shoulda-coulda-woulda (or worse, deserved...) to be somewhere else. You end up emotionally being in this no-man's land... Total waste of time; and chances are, you're no good at your current job.
If you read enough SDN, you'll find a lot of posts with some flavor of this: people feeling sorry for themselves. Always reminds me of the line in American History X when the Edward Norton's old principal asked him: "What have you done... to make your life better?"
Whatever the case may be, it's a waste of time and energy to dwell on something like that. If you want to switch, switch. If not, don't dwell on it but instead divert your energy into being the best doctor in the specialty you're in as you can.
The worst feeling in the world is to feel the sense that you don't belong somewhere, that you shoulda-coulda-woulda (or worse, deserved...) to be somewhere else. You end up emotionally being in this no-man's land... Total waste of time; and chances are, you're no good at your current job.
If you read enough SDN, you'll find a lot of posts with some flavor of this: people feeling sorry for themselves. Always reminds me of the line in American History X when the Edward Norton's old principal asked him: "What have you done... to make your life better?"
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As a former resident in a primary care field, I know full too well what it is like to be in this predicament. There was no way I would've made it through such a residency if I had stayed...I knew I had to get out and make the switch. We all learned in our deep education in the sciences, that genetics as well as environment molds us into who we are. Seeing my optimism and altruism slowly drain from within me, has been one of the most shockingly disturbing manifestations that I could ever have come to know in my life. Giving a piece of yourself away to only get stomped in return will fracture even the most hardened of souls.
I could clearly see even back then how primary care was quickly heading off a cliff. I needed to jump off that runaway car before I went over with it too. When I realized that my middle school home economics teacher, who got to bake cookies all day, made even more than an attending in the student health clinic (working a 40 hr work week), I knew things were getting bad. The endless rounding left my head spinning, the paperwork was outright suffocating, and the long thankless days drained me of my life energy. And all for what? To make peanuts when all was done and finished while still working as hard as a racehorse?
I laugh whenever I hear that there is a coming shortage in primary care. This is crap propaganda put out by the AAMC to woo even more naive premeds into this mouse trap by opening up more first year positions. Face it, primary care is dying. Greed from outsiders eviscerated what was once a very noble profession. "Shortage" is the secret password used by schools to start explosively cloning themselves. NP schools are spreading like wildfire. The noctors are coming whether you like it or not. http://medicinesux.wordpress.com/2009/12/23/noctors-aka-nurse-doctors/ Primary care salaries will never go up when you have an endless supply of people coming out of these doctor wannabe factories.
So for those already stuck in med school, my advice would be to specialize. You must specialize or risk getting payed like a social worker in another decade. Sadly, I realize that the number of med school grads is also increasing and the competition for these residency spots is only going to get worse. Unless you are a cerebral cortex superstar, premeds are definitely taking on some risk of winding up in the cesspool of a primary care field. Keep working even harder for less...sounds like such a worthy tradeoff
I could clearly see even back then how primary care was quickly heading off a cliff. I needed to jump off that runaway car before I went over with it too. When I realized that my middle school home economics teacher, who got to bake cookies all day, made even more than an attending in the student health clinic (working a 40 hr work week), I knew things were getting bad. The endless rounding left my head spinning, the paperwork was outright suffocating, and the long thankless days drained me of my life energy. And all for what? To make peanuts when all was done and finished while still working as hard as a racehorse?
I laugh whenever I hear that there is a coming shortage in primary care. This is crap propaganda put out by the AAMC to woo even more naive premeds into this mouse trap by opening up more first year positions. Face it, primary care is dying. Greed from outsiders eviscerated what was once a very noble profession. "Shortage" is the secret password used by schools to start explosively cloning themselves. NP schools are spreading like wildfire. The noctors are coming whether you like it or not. http://medicinesux.wordpress.com/2009/12/23/noctors-aka-nurse-doctors/ Primary care salaries will never go up when you have an endless supply of people coming out of these doctor wannabe factories.
So for those already stuck in med school, my advice would be to specialize. You must specialize or risk getting payed like a social worker in another decade. Sadly, I realize that the number of med school grads is also increasing and the competition for these residency spots is only going to get worse. Unless you are a cerebral cortex superstar, premeds are definitely taking on some risk of winding up in the cesspool of a primary care field. Keep working even harder for less...sounds like such a worthy tradeoff
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D
deleted87716
^ Sorry to hear you couldn't hack it in primary care.
Fortunately, some of us know what we're doing.
To answer the O.P.'s question, I made the right decision.
Fortunately, some of us know what we're doing.
To answer the O.P.'s question, I made the right decision.
D
deleted4401
I would never, ever, ever considering changing.
Choosing rad onc was the best decision I've ever made in my life out of all decisions. No joke. Things may change (probably will), but it's very satisfying, interesting, intellectually stimulating, and ... lifestyle ain't half bad
-S
Choosing rad onc was the best decision I've ever made in my life out of all decisions. No joke. Things may change (probably will), but it's very satisfying, interesting, intellectually stimulating, and ... lifestyle ain't half bad
-S
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^ Sorry to hear you couldn't hack it in primary care.
Fortunately, some of us know what we're doing.
To answer the O.P.'s question, I made the right decision.
Couldn't hack it?
More like I finally took off the rose colored glasses and began to see things for what they really were. I guess that is why my PD was practically begging me to reconsider and stay Sorry, but thanks to doing very well on the USMLE's, I was fortunate enough to switch into a more competitive specialty at a major university program. Best decision I ever made. I would be stuck in medicine for another decade if I didn't.
D
deleted87716
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Yeah, you sound really happy.
relatively speaking of course
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agreed, I did research (unrelated to the field, in health policy) with a breast cancer radiation oncologist for a year, and though she is bar none the most brilliant person I've ever met, and very committed to her field, it was not my cup of tea. I also found it terribly boring.
I'm still a first year, so can't really answer the original question. I'm leaning anesthesia or EM, with an interest in critical care - I function better in a pressure cooker. But I am hoping most people, like myself, have looked at many different fields before coming to a decision that will affect decades of my life.
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I know I'm still a med student, but I think that the adage about choosing specific residency programs ("there's no right program, just a right program for you") holds true for specialty choice in general.
You can't run some algorithm about time worked and compensation and amount of paperwork and encroachment by para-medical professionals, etc, to arrive at the magic "perfect specialty." It's all about fit.
I wouldn't last a week as a radiology resident. Literally. Nor could I do rad-onc for more than a month. Anesthesia (the other golden goose) would leave me howling in despair that I was on the wrong side of the curtain.
The motto for all of this is 'physician, know thyself.' If you are a person for whom free time and compensation are extremely important, then choose your career accordingly... but please, let everyone else alone and stop disparaging our paths! There are multiple competing goods in life, and people are simply cut out for different things. The whole universality of preference thing gets very, very old on these threads.
You can't run some algorithm about time worked and compensation and amount of paperwork and encroachment by para-medical professionals, etc, to arrive at the magic "perfect specialty." It's all about fit.
I wouldn't last a week as a radiology resident. Literally. Nor could I do rad-onc for more than a month. Anesthesia (the other golden goose) would leave me howling in despair that I was on the wrong side of the curtain.
The motto for all of this is 'physician, know thyself.' If you are a person for whom free time and compensation are extremely important, then choose your career accordingly... but please, let everyone else alone and stop disparaging our paths! There are multiple competing goods in life, and people are simply cut out for different things. The whole universality of preference thing gets very, very old on these threads.
As much as I thought about going into rad onc, anaesthesia or radiology, in the end I frankly couldn't bring myself to consider anything but medicine and general surgery. Anything else and I'd have felt like I hadn't gotten comprehensive medical training; like I'd taken some narrow tangential path and left 90% of my med school knowledge behind. Just my personal opinion.
HOWEVER, I agree that primary care is a poor, poor choice for someone who can even conceive of going into anything else. Internal Medicine residency is an odd species, as it subjects you to 3 years of the worst of what medicinesux is talking about, but afterward opens up into many of the best options available. Aren't electrophysiology and GI as golden as rad onc and anaesthesia from a lifestyle, compensation, and satisfaction point of view? Even moreso once you factor in the self-gratification of having been fully trained in medicine and comprehensively knowledgeable? This was my line of reasoning. Next step: keep my head down through endless paperwork, calls to homeless shelters and community clinics, being treated like an idiot by malingering patients, etc.
I feel a similar way about general surgery, although the light at the end of the tunnel doesn't seem quite as bright from a lifestyle perspective.
HOWEVER, I agree that primary care is a poor, poor choice for someone who can even conceive of going into anything else. Internal Medicine residency is an odd species, as it subjects you to 3 years of the worst of what medicinesux is talking about, but afterward opens up into many of the best options available. Aren't electrophysiology and GI as golden as rad onc and anaesthesia from a lifestyle, compensation, and satisfaction point of view? Even moreso once you factor in the self-gratification of having been fully trained in medicine and comprehensively knowledgeable? This was my line of reasoning. Next step: keep my head down through endless paperwork, calls to homeless shelters and community clinics, being treated like an idiot by malingering patients, etc.
I feel a similar way about general surgery, although the light at the end of the tunnel doesn't seem quite as bright from a lifestyle perspective.
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I'm generally confident that I picked the right specialty for me (anesthesiology). After an especially harrowing call, patient death, lost airway-->lost or almost lost patient, liver transplant or cardiac case from hell, dead fetus on OB etc, I sometimes think I could have been a very good and very happy pathologist. I never really explored the field outside of 2nd year pathology class which I enjoyed a lot. Unfortunately, our time is so limited in exploring the none core specialties. I never even remotely considered things like pathology or rad onc as serious career choices because I never had time to explore them. I don't know if I would have chosen anything else ultimately, but it does make you wonder.
While the overall hours for anesthesiology are definitely more controlled that for something like general surgery, it's still one of the few specialties where you'll probably take in house call for a significant portion if not all of your career which most other specialties don't have to deal with (save OB and trauma surgery). I love being able to wash my hands of everything at the end of the day (save in the ICU, occasionally on OB), but my worst calls as an intern don't even hold a candle to the stress levels as my worst days in anesthesiology. And that can be compounded when everyone else thinks your job is the easiest thing in the world (had a medical student say to me the other day, "the nice thing about anesthesiology is that it's really M-F, 9-5 anyway." WTF???? ARGH!!!!!!!! My response to that is always the same. If OB and surgery and critical care are not M-F, 9-5, then my job is not M-F, 9-5.)
While the overall hours for anesthesiology are definitely more controlled that for something like general surgery, it's still one of the few specialties where you'll probably take in house call for a significant portion if not all of your career which most other specialties don't have to deal with (save OB and trauma surgery). I love being able to wash my hands of everything at the end of the day (save in the ICU, occasionally on OB), but my worst calls as an intern don't even hold a candle to the stress levels as my worst days in anesthesiology. And that can be compounded when everyone else thinks your job is the easiest thing in the world (had a medical student say to me the other day, "the nice thing about anesthesiology is that it's really M-F, 9-5 anyway." WTF????
ARGH!!!!!!!! My response to that is always the same. If OB and surgery and critical care are not M-F, 9-5, then my job is not M-F, 9-5.)
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I would do EM again. The drug seekers/scumbags, circadian shifts, and heavy night/weekend component are made up for by (generally) interesting work, (usually) grateful patients, and not having to carry a pager. Plus I feel like I'm better at EM then I would be at any other specialty.
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I would rather not be a physician than be in a specialty not named radiology. I don't know what I would do with myself, but I know it wouldn't be medicine. Anecdotally, this seems to be a relatively common feeling in my specialty, as many of my colleagues from both my program and my medical school feel the same way.
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Wouldn't change a thing.
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GoLytely
"Aren't electrophysiology and GI as golden as rad onc and anaesthesia from a lifestyle, compensation, and satisfaction point of view? "
Is EP and GI really that cush?
"Aren't electrophysiology and GI as golden as rad onc and anaesthesia from a lifestyle, compensation, and satisfaction point of view? "
Is EP and GI really that cush?
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Yeah, but EP and GI take far longer to finish than anesthesiology. EP and GI are banking more than anesthesiology, at the moment. Not sure how long that will last. In fact, not sure how long anesthesiology will last, either.
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PATH!!! I would choose path. I did a 2 week rotation as a med student. I remember talking to the intern (in september)...who was getting an MPH. As an intern. She was taking night classes, 2 a semester. To get a graduate degree. Intern year. And they took home call. As an intern.
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Ummm have you researched the issues with the path job market at the moment???
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The path job market right now is incredibly bad. It's a decent gig if you can land a job, that is willing to give you partnership... but good luck on that.
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I have not. Are you applying for jobs? are there a lot of out of work pathologists?
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Just go read a few threads in the Path forums ... 10 minutes max to get a grasp on it.
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And yet everyone wants to open more residency spots and have this happen to EVERY specialty?
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Sweet avatar pic. What specialty are you currently practicing that is still hell, but somewhat better than primary care?
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Plus, I'm not sure how "cush" these are in terms of time off. Anesthesiology tends to get good amounts of vacay, while I don't hear the same thing about cards and GI. Just my 2 cents from what I've read here.
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My gf's dad is a GI. He gets several weeks vacation a year, usually works M-F about 10 hr days with call one weekend a month. Pulls somewhere between $400-$500k a year.
Anecdotal, FWIW. But from what he's told me his situation isn't too far outside the average, at least for PP docs.
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I'm in PM&R and right now pretty happy with that decision. On rare occasions, sometimes I wish I had done neurology or something random.
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I probably would have gone to vet school. Or at least I have a few days when I feel that way.
I actually really do like my specialty (Pulm/CC), though in my weaker moments I really get tired of the hours and hours of family conferences.
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I'm in Psychiatry and I would choose it again. The lifestyle is very reasonable, the patients are very interesting, and there are many different ways to practice psychiatry that can be tailored to your interests (from a psychotherapy-based outpatient practice to hospital-based, biologically-focused psychosomatic medicine).
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Yeah, my impression is that interest in Psych has been increasing the last couple of years. People have started to catch on that it has a good lifestyle.
However I definitely don't think that people should go into just for lifestyle. You have to be comfortable dealing with the underdogs in the world like homeless drug addicts and unbathed schizophrenics (and ideally you should actually care about what happens to such people).
However I definitely don't think that people should go into just for lifestyle. You have to be comfortable dealing with the underdogs in the world like homeless drug addicts and unbathed schizophrenics (and ideally you should actually care about what happens to such people).
Thats's what I am thinking to. I am from Germany and RadOnc is anything but competetive. Actually they are happy to find people that go into that field. Two of my friends do it, one because she is a little kid and only went in it because she gets out at 4:3opm every day and the other because he got a stipend from the hospital but no position in Gyn was open so he is doing RadOnc till something else opens up (Here people apply right at the hospital not central for residency like in the USA) and both don't wanna stay in that field because they do more internal med work (Rad onc has its own unit where you are the main physician) and find it pretty boring. Was always wondering what makes US students want to go into that field. Money? Money here is surely no reason to go into any field since it is socialized medicine and you can't make big money in any specialty.
Anyways, I love peds/Neo and would always go into that field again. Also like Gas and OB but not that much that I want to do it 40 years. But Peds+Gas+OB= NEONATOLOGY (perfect!)
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I wanted to join army and then special forces, but then went to med school and now in surgery residency, still have a big crush on my first love.
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I'm a family physician in a large Southeast city - lifestyle is great - work 4 and 1/2 days a week - no nights or weekends - very light telephone call only - no hospital work and no OB - and make an above average salary.
Nearly all specialties that are tied to a hospital (or are government reimbursed) WILL see their salaries fall in the next 5 years. In other words, any specialty that can take cash and not rely on hospital services will flourish.
Those specialties that do not require hospital services: Primary Care (with the exception of OB/GYN), Psych, Neuro, Allergy, Derm - I really see Psych becoming much more competitive.
Nearly all specialties that are tied to a hospital (or are government reimbursed) WILL see their salaries fall in the next 5 years. In other words, any specialty that can take cash and not rely on hospital services will flourish.
Those specialties that do not require hospital services: Primary Care (with the exception of OB/GYN), Psych, Neuro, Allergy, Derm - I really see Psych becoming much more competitive.
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Same here man, same here. Still dream about being a navy seal or an Ranger, but as a 1st generation american that was not going to happen....
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Would anybody have picked infectious disease if they had it to do over again? Just curious - I haven't seen it mentioned, but it doesn't mean someone reading this isn't thinking it...
I know it isn't a big moneymaker, but it is something I am considering strongly, and I was curious what the feelings were about it from practicing physicians who may wish they had picked something else.
I know it isn't a big moneymaker, but it is something I am considering strongly, and I was curious what the feelings were about it from practicing physicians who may wish they had picked something else.
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Job Satisfaction by Specialty based on the 1996-1997 Community Tracking Physician Survey (CTS) data:
Job Satisfaction by Specialty based on the 2004-2005 Community Tracking Physician Survey (CTS) data, ranked from most satisfied to least:
The best specialties of them all -- Path, Rads, and Gas -- were excluded from the survey. Otherwise they'd obviously pawn the rest (lulz).
Anyways, hope this helps.
Job Satisfaction by Specialty based on the 2004-2005 Community Tracking Physician Survey (CTS) data, ranked from most satisfied to least:
The best specialties of them all -- Path, Rads, and Gas -- were excluded from the survey. Otherwise they'd obviously pawn the rest (lulz).
Anyways, hope this helps.
Based on the survey you posted, the specialties that got the most medicare cuts that year, were the most unhappy. It is pretty much a very unreliable survey as to general happiness. For instance, this year, ophthalmology got extra funding from medicare compared to all other specialties, so we would be perhaps happier than cardiologists who got a beating with the healthcare reform.
I would totally do ophthalmology again if I had to do it all over again. Being interested in academic medicine, I would also consider psychiatry because psych is the last frontier of medicine and this is an exciting time to be doing psychiatric research.
I would totally do ophthalmology again if I had to do it all over again. Being interested in academic medicine, I would also consider psychiatry because psych is the last frontier of medicine and this is an exciting time to be doing psychiatric research.
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Dear GOD, 5 times???
Ive never heard of that. Never.
I hope you find peace heretic...
I wouldnt change a thing, but of course Im special...
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