I'm having trouble choosing a specialty...

[blueadams]

In short, I am looking for a field of medicine that would enable me to work less hours (part-time even?) in exchange for a lower (but still decent) income.

I do not want to come off as money-hungry, so I am going to provide a little bit of a background here. To begin, believe it or not, money is not all that important to me. But, with that being said, it takes money to live and I would like to do so (at least somewhat) comfortably. My parents were both great providers (and I thank them for that), but I cannot say that I saw much of them growing up. I was raised by child-care workers, teachers, coaches and friends' parents. I do not want to have that kind of relationship with my children. I want to be able to support my children and spouse both financially and emotionally. I would also like to be able to be an assistant high school football coach august-november (this is very important to me, as I said, I was literally raised by coaches - I would not be where I am today without them - and I want to pay-it-forward so to speak).

HELPING PEOPLE is what is most important to me. There are many ways in which one can do this, and it has been a long road to the realization that medicine is the manner in which I have chosen to do so. I majored in History as an undergraduate and thought long and hard about going into several areas: politics/social policy, social work, education, psychology, etc...but in the end, nothing seemed as real to me as actually saving another human beings life. I do not mean to say that these other professions are less important than medicine, because I do not believe that they are. But after spending the last several years volunteering at medical clinics in developing nations around the world, I have decided that it is through medicine that I want to make a difference in my short time on this earth.

So, like I said, I am looking for a field of medicine that would enable me to work less hours (part-time even?) in exchange for a lower (but still decent) income. I know that dermatologists and dentists/orthodontists/maxiofacial and oral surgeons work reasonable hours...and not to demean those that battle skin and oral cancers...but these are not exacly the 'life-saving' areas that I am interested in pursuing. Radiology is one area that interests me, as I have read that some radiologists work in 'six months on/six months off' cycles. Do any of you have any other suggestions that might be of interest to me?

...a sincere thank you to anyone who may be able to provide any input (positive or negative) whatsoever!

- Blue

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[asmallchild]

There are no "lifestyle-friendly" "life-saving" fields in medicine. You usually have to pick one or the other.

 

[blueadams]

Really!? Not even Radiology!? It seems like there would be some middle-ground in at least one field. Something where there are large enough practices that I could work 40-50hrs/wk...or in month-by-month cycles.

 

[silas2642]

psychiatry? you're saving people's lives, but do you mean "saving people's lives" like on television?

 

[Winged Scapula]

There are no "lifestyle-friendly" "life-saving" fields in medicine. You usually have to pick one or the other.

I would think EM would qualify as does Rad Onc.

 

[asmallchild]

I think the op meant acutely life saving. Even melanoma excision is life saving

 

[Winged Scapula]

I think the op meant acutely life saving. Even melanoma excision is life saving

So EM would still qualify no?

 

[mercaptovizadeh]

In short, I am looking for a field of medicine that would enable me to work less hours (part-time even?) in exchange for a lower (but still decent) income.

I do not want to come off as money-hungry, so I am going to provide a little bit of a background here. To begin, believe it or not, money is not all that important to me. But, with that being said, it takes money to live and I would like to do so (at least somewhat) comfortably. My parents were both great providers (and I thank them for that), but I cannot say that I saw much of them growing up. I was raised by child-care workers, teachers, coaches and friends' parents. I do not want to have that kind of relationship with my children. I want to be able to support my children and spouse both financially and emotionally. I would also like to be able to be an assistant high school football coach august-november (this is very important to me, as I said, I was literally raised by coaches - I would not be where I am today without them - and I want to pay-it-forward so to speak).

HELPING PEOPLE is what is most important to me. There are many ways in which one can do this, and it has been a long road to the realization that medicine is the manner in which I have chosen to do so. I majored in History as an undergraduate and thought long and hard about going into several areas: politics/social policy, social work, education, psychology, etc...but in the end, nothing seemed as real to me as actually saving another human beings life. I do not mean to say that these other professions are less important than medicine, because I do not believe that they are. But after spending the last several years volunteering at medical clinics in developing nations around the world, I have decided that it is through medicine that I want to make a difference in my short time on this earth.

So, like I said, I am looking for a field of medicine that would enable me to work less hours (part-time even?) in exchange for a lower (but still decent) income. I know that dermatologists and dentists/orthodontists/maxiofacial and oral surgeons work reasonable hours...and not to demean those that battle skin and oral cancers...but these are not exacly the 'life-saving' areas that I am interested in pursuing. Radiology is one area that interests me, as I have read that some radiologists work in 'six months on/six months off' cycles. Do any of you have any other suggestions that might be of interest to me?

...a sincere thank you to anyone who may be able to provide any input (positive or negative) whatsoever!

- Blue

Its hard to find a happy medium. The specialty where you have undoubtedly the greatest direct impact on the patient is surgery. Then again, it's a brutal specialty and you won't see much of your family (or coach sports).

The lifestyle fields are: ophthalmology, ear-nose-throat, radiation oncology, radiology, anesthesiology, emergency medicine, dermatology, allergy and immunology (which can be done out of medicine or pediatrics). They are all high income with good hours. The good hours are in part because they don't involve life-threatening things (most of what I listed, with two exceptions) or they involve shift work (the two exceptions: anesthesiology and emergency medicine).

You can do something primary care-ish like medicine or pediatrics and then negotiate a reduced schedule or work in shifts as a hospitalist. The pay of a hospitalist will not be quite as great as in anesthesia or EM, but you can make 200k for a 7 days on/7 days off schedule as a hospitalist, and it's going to be less stressful than managing ER patients or anesthetized patients in the OR. If you do IM/peds you can also subspecialize into a lucrative (but time intensive) subspecialty such as gastroenterology or cardiology, if you wish.

Personally, if I don't go into IM/peds, I'm considering ophthalmology. That field has a nice mix of medicine, surgery, good hours, great pay, and vision is pretty crucial.

 

[McGillGrad]

Comfortable life: Hospitalist

Exciting and life altering (or life stabilizing): EM

Lifestyle and acute: Sports medicine and taking care of a sports team

 

[tkim]

So EM would still qualify no?

It's certainly not a 'lifestyle' specialty like say derm. We work nights, weekends, and holidays. The shift lengths have changed to some degree - a lot of places are now offering 8 hour shifts versus 12's, which again is a tradeoff. There's no call, which is also a plus.

 

[SocialistMD]

So, like I said, I am looking for a field of medicine that would enable me to work less hours (part-time even?) in exchange for a lower (but still decent) income. I know that dermatologists and dentists/orthodontists/maxiofacial and oral surgeons work reasonable hours...and not to demean those that battle skin and oral cancers...but these are not exacly the 'life-saving' areas that I am interested in pursuing. Radiology is one area that interests me, as I have read that some radiologists work in 'six months on/six months off' cycles. Do any of you have any other suggestions that might be of interest to me?

A few observations:
1. I find it interesting that treating cancer isn't life-saving enough for you, but sitting in front of a computer with little patient interaction is. Truth be told, radiology should never really be necessary in "life-saving" situations except as an adjunct, and, in most cases, the problem doesn't need a radiologist for diagnosis.
2. You should probably base your decision on your own personal experience in those fields rather than on the opinions of people on an anonymous internet forum.

That said, from what I can tell your criteria are the following:
1. Work fewer hours
2. Save lives
3. Work in medical field

You have EM stamped all over you. The hours are nice (part-time is probably easiest from this career) and you acutely save lives on a daily basis.

 

[BobA]

I also had a difficult time deciding on a specialty. I settled on psychiatry, but it hasn't been an easy decision.

I might also have considered Radiology or Anesthesia. You can always do IR or Critical Care fellowship if you want to see higher acuity patients.

If you like peds, I think NICU/PICU work can be shift-work in the right set-up.

Here is my own personal (and devil's advocate) statement on why EM isn't a lifestyle specialty:

The problem with EM as a lifestyle is that you have to work nights, weekends, holidays. Not only that, working strange hours requires time (days!) to recover. As a 20-something you might not think that shift-work is all that bad, but as you get older this gets more difficult. It takes more time for your clock to shift gears, and your days-off are spent recovering. I have no data to back this up, but you might retire early (whereas Radiologists can work into their 70s if they want) and have a shorter earning span.

Also, the trouble with working part-time in EM is that groups usually won't pay for your health/malpractice/life/disability insurance if you're only part time. They are happy to hire part-time independent contractors, but then covering the insurance and benefits is usually up to you. Needless to say this can cut into your income rather quickly.

Finally, working in EM can be difficult for a marriage if the other person works a 9-5. If you're working nights and weekends you might not see your 9-5 spouse on your random Tuesday off. Unless your spouse is very flexible, it's usually better for your lifestyle and marriage for them to not work. Hence, lost spouse income.

But then again, I'm going into psychiatry.

 

[SoCuteMD]

Radiology or Anesthesia. Can always do IR or Critical Care fellowship if you want to "save lives."

If you like peds, I think NICU/PICU work can be shift-work in the right set-up.

Here is my own personal (and devil's advocate) statement on why EM isn't a lifestyle specialty:

The problem with EM as a lifestyle is that you have to work nights, weekends, holidays. Not only that, working strange hours requires time (days!) to recover. As a 20-something you might not think that shift-work is all that bad, but as you get older this gets more difficult. It takes more time for your clock to shift gears, and your days-off are spent recovering. I have no data to back this up, but you might retire early (whereas Radiologists can work into their 70s if they want) and have a shorter earning span.

Also, the trouble with working part-time in EM is that groups usually won't pay for your health/malpractice/life/disability insurance if you're only part time. They are happy to hire part-time independent contractors, but then covering the insurance and benefits is usually up to you. Needless to say this can cut into your income rather quickly.

Finally, working in EM can be difficult for a marriage if the other person works a 9-5. If you're working nights and weekends you might not see your 9-5 spouse on your random Tuesday off. Unless your spouse is very flexible, it's usually better for your lifestyle and marriage for them to not work. Hence, lost spouse income.

But then again, I'm going into psychiatry.

You make some really good points about EM. Another thing to mention is that even full-time positions can (and often are) independent contractor positions. Some cover malpractice but leave the rest up to you, some don't cover malpractice at all.

All that said, I've opted for a life of nights, weekends, holidays, and shiftwork

 

[dragonfly99]

I vote for ER, though I agree with some of BobA's points.
Also, I have to say it, but I wonder if medicine is the right career for this person, since he/she isn't going to have much say in how many hours are worked, etc. for many years (i.e. during med school and 4 or more years of residency). It can be a grind even for people who are really hard core...I'm not trying to trash the OP, just pointing out something kind of important. If the OP hates the 4 years of med school and 4 more years of residency b/c of lack of control over his life, excessive working hours, etc. it might make him pretty miserable, and 8 years is a long time.

 

[Winged Scapula]

It's certainly not a 'lifestyle' specialty like say derm. We work nights, weekends, and holidays. The shift lengths have changed to some degree - a lot of places are now offering 8 hour shifts versus 12's, which again is a tradeoff. There's no call, which is also a plus.

No its not a lifestyle specialty in terms of Derm. But the OP said he wanted to save lives and have a good schedule. Many many specialties work weekends and holidays. As you know, just because its a holiday doesn't mean that patients don't need us. EM also is more conducive to part time work, which is again what the OP is looking for.

Regardless of the whether you work 12s or 8s, nights or weekends, the fact remains that most EM attendings I know work 12 12 hour shifts a month which is much less than most other specialties, with good reimbursement and lots of saving lives.

Whether you consider working fewer hours or not working weekends as "lifestyle" depends on your own POV. I know most would consider working much fewer hours per month as a better lifestyle than working weekends or holidays. But these are good points to understand and this isn't about what field is the most lifestyle friendly. Perhaps the OP would't like the constant work of EM but would rather work longer hours with less action. There are lots of other choices as well, but the OP has to decide what fits him the best.

 

[Ludicolo]

Meh. Saving lives is overrated. Consider PM&R. While we don’t save lives, we make lives worth saving.

And the lifestyle ain’t bad either…

 

[blueadams]

Wow!!!

What an overwhelming number of intelligent responses...and in less than 24 hours...this website really is a great resource. Thank you very much to everyone that has responded!!! I'm seeing a lot of great ideas here and I'm going to look into them much more closely (I'll save those questions for those specific forums). EM and RadOnc in particular are two things that have been brought up that I'm quite interested in.

I do have a couple of follow-up questions though. I've just been accepted into a post-bac program (should have mentioned that in the OP), so some of these terms are unfamiliar to me:

1) Hospitalist?

2) NICU/PICU?

 

[oldbearprofessor]

2) NICU/PICU?

Neonatal Intensive Care Unit and Pediatric Intensive Care Unit.

Not lifestyle friendly during residency and fellowship. You CAN do some degree of shift work in these as an attending, but mostly it's a lot of nights. Babies and kids like to get really sick in the middle of the night.

 

[Winged Scapula]

Wow!!!

What an overwhelming number of intelligent responses...and in less than 24 hours...this website really is a great resource. Thank you very much to everyone that has responded!!! I'm seeing a lot of great ideas here and I'm going to look into them much more closely (I'll save those questions for those specific forums). EM and RadOnc in particular are two things that have been brought up that I'm quite interested in.

I do have a couple of follow-up questions though. I've just been accepted into a post-bac program (should have mentioned that in the OP), so some of these terms are unfamiliar to me:

1) Hospitalist?

This is a physician, usually Internal Medicine trained, who focuses on inpatient care (as opposed to someone who might have a largely office based practice)

2) NICU/PICU?

NICU = neonatal ICU
PICU = pediatric ICU

Places for sick babies and kids.

 

[oldbearprofessor]

This is a physician, usually Internal Medicine trained, who focuses on inpatient care (as opposed to someone who might have a largely office based practice)

The pediatric hospitalist movement is rapidly growing. Some do "daytime" only work, others do night coverage. If resident work hours decrease, you'll see a lot more of these folks day and night.

 

[Winged Scapula]

The pediatric hospitalist movement is rapidly growing. Some do "daytime" only work, others do night coverage. If resident work hours decrease, you'll see a lot more of these folks day and night.

Thank you for the clarification. I had forgotten about Pedi Hospitalists.

 

[smq123]

The pediatric hospitalist movement is rapidly growing.

As is the OB/gyn "laborist" movement.

I've also heard about the beginnings of a "traumatologist" movement, but am still not clear if that's common. Winged Scapula would obviously know more about that than I would.

 

[Winged Scapula]

As is the OB/gyn "laborist" movement.

I've also heard about the beginnings of a "traumatologist" movement, but am still not clear if that's common. Winged Scapula would obviously know more about that than I would.

After my day today, I feel like a laborist myself (it was tiring).

Traumatologists do indeed exist but there is some skepticism as to how they really differ from other trauma surgeons who do a lot of general surgery. There are obviously only a few places that really need a dedicated trauma surgeon on board who doesn't do gen surg to try and bring up his RVUs, but they do exist.

 

[Danbo1957]

"...the OP said he wanted to save lives and have a good schedule. Many many specialties work weekends and holidays. As you know, just because its a holiday doesn't mean that patients don't need us. EM also is more conducive to part time work, which is again what the OP is looking for."

Thank God they want to save lives!

Sometimes I look at the residents at my place and I cringe. They're just as smart and hopeful as we were 20 years-ago, but they sure do NOT want to work the same hours as we did.

For the better, I guess - but, shift work? In the future, we may have a crop of doctors who won't accept night float at all...

 

[blueadams]

Thank God they want to save lives!

Sometimes I look at the residents at my place and I cringe. They're just as smart and hopeful as we were 20 years-ago, but they sure do NOT want to work the same hours as we did.

For the better, I guess - but, shift work? In the future, we may have a crop of doctors who won't accept night float at all...

...in my case at least...i want to work less hours, but I don't want as much money. For whatever that's worth.

 

[SocialistMD]

Sometimes I look at the residents at my place and I cringe. They're just as smart and hopeful as we were 20 years-ago, but they sure do NOT want to work the same hours as we did.

For what it's worth, I'm pretty sure that, given the choice, you and your buddies from 20 years ago would have opted for fewer hours in the hospital as well.

I'm still not convinced the reduction in work hours has hurt anyone's training. You guys in medicine should be able to answer this question readily, since you have had entire classes graduate under the 80-hour rule. Are they lesser quality? Do they know less or are they less clinically adept than the classes that graduated 5-10 years ago? In surgery, we are still waiting for the first class of pure 80-hour residents to finish (the first full class will graduate next year, mostly because of lab). I don't think our chiefs now are more inept managing patients than the chiefs my intern year, but I do think their confidence in the OR is lower, although I attribute that more to a decrease in resident to resident operative teaching than the work hours (as our senior residents are in the OR from the start of the day until the end of the day, same amount of time they were before the 80-hour rule. As an aside, this is the reason the 56-hour rule won't work for surgery; the time in the OR will be drastically [~20-30%] reduced). Increasing RVU demands have "encouraged" attending physicians to scrub for the entire case so as to decrease operative times. All of this is at the cost of residents taking residents through cases. To me, that is the travesty and that is what is causing the problems in surgical training.

 

[mercaptovizadeh]

Wow!!!

What an overwhelming number of intelligent responses...and in less than 24 hours...this website really is a great resource. Thank you very much to everyone that has responded!!! I'm seeing a lot of great ideas here and I'm going to look into them much more closely (I'll save those questions for those specific forums). EM and RadOnc in particular are two things that have been brought up that I'm quite interested in.

I do have a couple of follow-up questions though. I've just been accepted into a post-bac program (should have mentioned that in the OP), so some of these terms are unfamiliar to me:

1) Hospitalist?

2) NICU/PICU?

You mentioned RadOnc and EM. You should know that RadOnc is one of the most competitive specialties out there and you will be fighting tooth and nail with MD/PhDs and other heavy researchers. You need to do research in oncology/radiation oncology and get published in their journals. I think one well known journal is called the Red Journal. You also have to excel on the boards. It seems to be a very intellectual field with lots of research and reading and less "doing".

EM is much less competitive than radonc but still quite a bit more than medicine. Medicine/pediatrics are not very competitive. However, unlike EM, they do not have shift work for the residency, so it is still an 80-hour-week residency. IM/peds hospitalists can work shifts, like EM, but the pay is less, there's less procedures, and the atmosphere is slower-paced and less frenzied. If you want to do shift work, but in a more controlled environment than EM, that may be for you. EM/IM/peds also have pretty good mobility, so you can do locum tenens, move around, etc.

 

[blueadams]

I've actually been thinking a lot about a joint PhD program...what sorts of PhD's do those in Radiology and RadOnc pursue??

 

[Pinkertinkle]

I've actually been thinking a lot about a joint PhD program...what sorts of PhD's do those in Radiology and RadOnc pursue??

Hmm one may consider moving this thread to pre-allo.

 

[danzman]

I love these threads where everyone tells the pre-med OP to go into derm/plastics/radsonc etc. Last time I checked there was a reason that these were the most competitive spots to get. My school had one person get into a IM/derm spot this year, no plastics, 1 rads, and five ortho's. Thats it....
OP. Don't go to medical school if you can't be happy working in, FM, IM Peds, psych, or gen surg, as these will (maybe) be the only spots that even come close to being guaranteed (psych and gen surg certainly may not be..) If you find somthing else that interests you, and have the grades/skills, then go for it. but do not assume that these doors will just magically open up for you. I had a great conversation with a girl in my class last week about becoming a dermatologist. She told me that it was the only reason she came to medical school, the only reason she came to our school (we have a derm program) and that if she didn't get in, she would not practice medicine at all. She said that she would rather quit and work for her father's business than do anything but derm. I have heard simillar stories about plastics and peds fellowships. These are the kind of people you will be competing with. They are nuts.

 

[Doctor Bob]

Want to save lives?
Want to have good hours?

Forensic pathology. Sure, you don't save your patients, but the things you find can help save others.


Taceant colloquia. Effugiat risus. Hic locus est ubi mors gaudet succurrere vitae - Giovanni Morgagni

(Let conversation cease, let laughter flee. This is the place where death delights to help the living)

 

[blueadams]

I love these threads where everyone tells the pre-med OP to go into derm/plastics/radsonc etc. Last time I checked there was a reason that these were the most competitive spots to get. My school had one person get into a IM/derm spot this year, no plastics, 1 rads, and five ortho's. Thats it....
OP. Don't go to medical school if you can't be happy working in, FM, IM Peds, psych, or gen surg, as these will (maybe) be the only spots that even come close to being guaranteed (psych and gen surg certainly may not be..) If you find somthing else that interests you, and have the grades/skills, then go for it. but do not assume that these doors will just magically open up for you. I had a great conversation with a girl in my class last week about becoming a dermatologist. She told me that it was the only reason she came to medical school, the only reason she came to our school (we have a derm program) and that if she didn't get in, she would not practice medicine at all. She said that she would rather quit and work for her father's business than do anything but derm. I have heard simillar stories about plastics and peds fellowships. These are the kind of people you will be competing with. They are nuts.

I'd really be willing to work in almost any area of medicine that allows me to get out of work a little early in the fall to coach high school football. I'm just trying to find out about fields that could fit the bill. Sorry if that offended you.

 

[BobA]

As I brainstorm, peds heme/onc comes to mind as a possible go home at 5pm type of job. Certainly not going to be able to coach football, though. Could go to a few games, maybe, but not coach.

 

[howelljolly]

1. this is not a general residency issue

2. Is "helping people" important to you, or is it "saving lives"? They arent the same thing, and they aren't any one thing. If you want to help people and save lives, go teach high school. You'll get your summers off, and wont work nights, weekend, or take call. Alternatively, go save some lives of folks that dont want their lives to be saved, and see how that goes. Also, a passion to save lives isnt going to get you thought med school.... it might even ruin you. What you need is to be interested primarily in biomedical science... thats whats going to get you through those cold dark nights in your first two years.

3. Its been said before, if you havent even started started med school, you dont need to choose a specialty. Yes, I totally agree that if you dont have any idea of what you want to do, then how can you know you want to do medicine... but... you shouldnt be so concerned at this point.

4. Nobody has mentioned Family Practice. I had a friend who's main selection criteria for a specialty were - hours, job flexibility, hours, low stress, and hours. He chose FP, and now works less than 40 hours, 4 days per week. All the percs are covered. And, if he wants, he has the ability to work as a hospitalist, or a doc-in-the-box, or shoot people in the face with lasers to make them pretty. Also, as a FP, you can really help people by going into primary care, work in an underserved area, or go on medical mission overseas.

So... try that on for size.

 

[SocialistMD]

...Also, a passion to save lives isnt going to get you thought med school.... it might even ruin you. What you need is to be interested primarily in biomedical science... thats whats going to get you through those cold dark nights in your first two years.

I don't know that I agree. There were people in my class who liked science, but were art or english lit majors. They weren't all majorly successful in the first two years (though some were), but they really excelled in the clinical years.

3. Its been said before, if you havent even started started med school, you dont need to choose a specialty. Yes, I totally agree that if you dont have any idea of what you want to do, then how can you know you want to do medicine... but... you shouldnt be so concerned at this point.

I sure went to school with a bunch of people who didn't know what they wanted to do prior to entering medical school, but they figured it out. I'm with you in that I didn't understand how they knew they wanted to be physicians if they didn't know what they wanted to do, but apparently it isn't all that uncommon and things seem to settle out in the end.

 

[quideam]

Also, a passion to save lives isnt going to get you thought med school.... it might even ruin you. What you need is to be interested primarily in biomedical science... thats whats going to get you through those cold dark nights in your first two years.

I really disagree with this. Loving biochem, etc, may help some people, but it did nothing for me - I hate biochem! I also hate molecular biology and pretty much anything having to do with tiny molecules, long reactions, and anything with the words "krebs cycle" (that's right, I was one of those liberal arts majors ). What got me through those first two increidbly painful years was NOT loving what I was studying - it was the knowledge that sucking it up and getting through that hell would eventually lead to being able to do some pretty awesome stuff. To remind myself, I shadowed EM docs, lead our EM interest group, and worked/traveled abroad as often as possible. (Yes, I matched EM! Woohoo )

Anyway, point of the story is - if you decide to go to med school, you can find a way to make a career in medicine work for you. EM is great if you want a flexible lifestyle, but it's a tough job with odd hours and requires a very particular personality (able to leap tall buildings in a single bound, that sort of thing).

Good luck with post-bacc... it's a long haul!

 

[howelljolly]

I really disagree with this. Loving biochem, etc, may help some people, but it did nothing for me - I hate biochem! I also hate molecular biology and pretty much anything having to do with tiny molecules, long reactions, and anything with the words "krebs cycle" (that's right, I was one of those liberal arts majors ). What got me through those first two increidbly painful years was NOT loving what I was studying - it was the knowledge that sucking it up and getting through that hell would eventually lead to being able to do some pretty awesome stuff. To remind myself, I shadowed EM docs, lead our EM interest group, and worked/traveled abroad as often as possible. (Yes, I matched EM! Woohoo )

Anyway, point of the story is - if you decide to go to med school, you can find a way to make a career in medicine work for you. EM is great if you want a flexible lifestyle, but it's a tough job with odd hours and requires a very particular personality (able to leap tall buildings in a single bound, that sort of thing).

Good luck with post-bacc... it's a long haul!

Fair enough. I couldnt stand biochem either. And for me, none of it stuck until we covered some stuff that might be useful in understanding nutrition... then I could struggle through it... then I could connect some things to lipid metabolism..... (then keeping in mind my interest in fitness)....metabolism related to muscle.... then i made some conceptual connections to anaerobic and aerobic metabolism.... So anyway... for me, nothing worked unless I was interested in it... No amount of "Im gonna be a doctor one day" helped take the edge off for me.

 

[danzman]

I'd really be willing to work in almost any area of medicine that allows me to get out of work a little early in the fall to coach high school football. I'm just trying to find out about fields that could fit the bill. Sorry if that offended you.

It most certainly did not offend me. I was simply stating that the responses you will get on SDN will not be helpful if all they talk about is plastics and derm, as less than 1(approximately) percent of medical students get to go into those fields. It is my suggestion that you try to find a few physicians to shadow. Obviously the more fields of medicine you are exposed to, the easier it will be for you to decide what you really want. Again, just make sure you are comfortable with not being a neurosurgeon/dermatologist/any other top tier specialty, as most people who get into med school will be at the top of their classes in undergrad and will be gunning for them also.

And now I will be a realist... If you have any thoughts of medicine, make sure you understand just what you are getting yourself into. If you majored in history, you may have a few science classes to take, and they will not be easy classes. To play devils advocate, it would be unlikely that anyone could finish all the required courses, take the MCAT, and apply to a school in less than three years. Two if they have nothing else on their plate and can stomach all the science classes at once. Then you are looking at four years of school, followed by three to seven+ years of residency and easily over a quarter of a million dollars in debt. That is ten to fifteen years before you practice medicine. And as most will attest to, organic chemistry, medical school, and a residency, while very interesting, will not leave you much time to coach football. So, even if someday, family medicine or dermatology could get you a cushy schedule and solid paycheck, are you really willing to wait fifteen years for it? Figure out what you want, and do it quickly. There are a lot of great careers out there that help people and do not require fifteen years of higher education and a half a million dollars in debt. Choose medicine because nothing else will make you happy.

 

[farrago]

I really disagree with this. Loving biochem, etc, may help some people, but it did nothing for me - I hate biochem! I also hate molecular biology and pretty much anything having to do with tiny molecules, long reactions, and anything with the words "krebs cycle" (that's right, I was one of those liberal arts majors ). What got me through those first two increidbly painful years was NOT loving what I was studying - it was the knowledge that sucking it up and getting through that hell would eventually lead to being able to do some pretty awesome stuff. To remind myself, I shadowed EM docs, lead our EM interest group, and worked/traveled abroad as often as possible. (Yes, I matched EM! Woohoo )

Anyway, point of the story is - if you decide to go to med school, you can find a way to make a career in medicine work for you. EM is great if you want a flexible lifestyle, but it's a tough job with odd hours and requires a very particular personality (able to leap tall buildings in a single bound, that sort of thing).

Good luck with post-bacc... it's a long haul!

So, you basically hate the foundations of medicine.

It is curious that, with the increasing advances in genetic and molecular science which allow us to actually understand pathology at the cellular and subcellular level, there has come a concurrent shift in admissions standards towards favoring students who probably are less likely to appreciate, and be able to make use of, these advances and this knowledge. And how can one keep up with the science if learning anything is so incredibly painful?

Do other graduate programs also attract so many people who actively hate what they are studying?

 

[SocialistMD]

So, you basically hate the foundations of medicine.

I'm not sure that they are the foundations of medicine, depending on how existential you want to be. Is the foundation of medicine the advancing scientific frontier, or is it the principles of beneficence and non-malfeasance? Perhaps a bit of both...

It is curious that, with the increasing advances in genetic and molecular science which allow us to actually understand pathology at the cellular and subcellular level, there has come a concurrent shift in admissions standards towards favoring students who probably are less likely to appreciate, and be able to make use of, these advances and this knowledge.

I don't think there is a shift at all. There are several medical schools that prefer the whiz-kids who can memorize and process volumes of scientific text. However, as the science becomes more and more specific and specialized, the rift between schools that focus on the potential of an applicant to be a good physician scientist and the schools that prefer to train a more "empathetic" physician becomes more obvious, but the difference has always been there.

 

[WaterAvatar]

Somebody had mentioned PM&R before. Little known specialty to the masses, but you can work towards a huge variety of practice settings (and easy lifestyles) and it's an nice mix of ortho, neuro, and medicine.

Like Medicine? do spinal cord or brain trauma
Like Procedures and Outpatient work? Do Interventional Pain or Sports/Spine fellowships. (more manageable hours).

Lifestyle is good. Money is there. The only thing that plagues it is a whole lot of ambiguity and confusion over what it actually is.

And the people you work with are some of the most easy-going people you'd meet.

 

[nancysinatra]

So, you basically hate the foundations of medicine.

It is curious that, with the increasing advances in genetic and molecular science which allow us to actually understand pathology at the cellular and subcellular level, there has come a concurrent shift in admissions standards towards favoring students who probably are less likely to appreciate, and be able to make use of, these advances and this knowledge. And how can one keep up with the science if learning anything is so incredibly painful?

Do other graduate programs also attract so many people who actively hate what they are studying?

Oh please. True hard scientists do not even typically go to medical school. No one in medicine should be getting on their high horse about understanding "pathology at the cellular and subcellular level."

 

[quideam]

So, you basically hate the foundations of medicine.

It is curious that, with the increasing advances in genetic and molecular science which allow us to actually understand pathology at the cellular and subcellular level, there has come a concurrent shift in admissions standards towards favoring students who probably are less likely to appreciate, and be able to make use of, these advances and this knowledge. And how can one keep up with the science if learning anything is so incredibly painful?

Not at all - i'm very interested in the foundations of medicine. When a patient comes to the emergency room with a constellation of symptoms, I want to figure out what's wrong and how to either fix it or at least make them better for the short term - that requires my understanding of diseases, their physiology/demographics/presentations, pharmacology, and a little social savvy to boot. That's all great stuff. What I disliked was having to learn about, say, what subset of cAMP molecules was responsible for helping to transport some other molecules, or what the molecular structure of linoleic acid looks like. Etc. Frankly, unless i'm doing basic science research or very heavily specializing in a field that requires a deep understanding of minute biochemical processes, I never have to know or even look at that stuff again.

As far as admissions processes go, my medical school is VERY heavy into research and has a lot of resources - our MD/PHDs are phenomenal, and there is probably another 10-20% of the class that's active in basic science research. BUT they definitely also love the liberal arts kids who are also capable of getting through the basic sciences and will then excell (in most cases) in the clinical arena and pursue those slightly more touchy-feely specialties. So it's both - I don't think one is emphasized over the other. Unless of course you're concerned that med schools prefer students who have outside interests and accomplishments and don't want to just sit around studying Robbins all day... then you may be in trouble.

 

[nancysinatra]

Unless of course you're concerned that med schools prefer students who have outside interests and accomplishments and don't want to just sit around studying Robbins all day... then you may be in trouble.

Maybe I'm wrong, but that's the impression I got from farrago's post... Hopefully he/she meant more like what you're saying.

I don't really think the way we learn minute biochemical processes in medical school is all that scientific anyway--we just memorize and regurgitate a lot of stuff, but we aren't presented with new problems where we have to solve things using our understanding of concepts. (At least not at my school.) This maybe happens a somewhat on the clinical level, but not on the biochemical level. Memorizing a molecule structure doesn't seem all that scienc-y to me, is all. That's why I think it's hypocrisy for a med student to get preachy.

 

[tkim]

Maybe I'm wrong, but that's the impression I got from farrago's post... Hopefully he/she meant more like what you're saying.

... That's why I think it's hypocrisy for a med student to get preachy.

Or worse, a premed.

 

[Bernardo_11]

After reading all the posts in here, I think the main thing to take from this is to DO WHAT INTERESTS YOU. In almost any specialty out there, outside from residency training, you can put yourself in a job situation that allows you to work less hours, allowing time to spend with your family and "extra-medicular activities," yet feeling like you are making a difference somehow. My advice:
1) Get into med school first
2) Study your head off and do well enough to have a large option of specialties choose from
3) Enter the specialty which interests you the most
4) Then after residency training, look for a job situation which best fits your time/scheduling demands. The demand for physicians is high in enough that in most places (some places more than others of course) they are willing to take from you what you're willing to give, regardless of specialty. This includes locum tenens work in most specialties or hospitalist work.

Interest trumps most of the other factors in choosing a specialty. Even all the "lifestyle" pluses will not make up for you feeling crappy getting ready for a boring/tedious/stressful day at work.

Nardo

 

[BobA]

After reading all the posts in here, I think the main thing to take from this is to DO WHAT INTERESTS YOU. In almost any specialty out there, outside from residency training, you can put yourself in a job situation that allows you to work less hours, allowing time to spend with your family and "extra-medicular activities," yet feeling like you are making a difference somehow. My advice:
1) Get into med school first
2) Study your head off and do well enough to have a large option of specialties choose from
3) Enter the specialty which interests you the most
4) Then after residency training, look for a job situation which best fits your time/scheduling demands. The demand for physicians is high in enough that in most places (some places more than others of course) they are willing to take from you what you're willing to give, regardless of specialty. This includes locum tenens work in most specialties or hospitalist work.

Interest trumps most of the other factors in choosing a specialty. Even all the "lifestyle" pluses will not make up for you feeling crappy getting ready for a boring/tedious/stressful day at work.

Nardo

This is fair advice - and the advice I usually received from attendings. However, it doesn't completely hold water.

For example, Ophthalmology might be a good field for the OP. Very controllable hours, and simple surgeries that give people their vision back!!

However, in order to get into Ophthalmology you have to start research in that field ASAP. You have to start getting to know attendings and working with them to get great letters. You have to go out of your way to even get a rotation in this field since it is not in the standard medical school curriculum.

The same could be said for Urology, Ortho, Dermatology, PMR, Radiology and any host of fields that the OP might be interested in. You have to go out of your way to seek these fields out, learn about them, and make yourself a good candidate.

If I sound passionate about this it's because I wish someone had told me this when I was an MS1 or a Pre-Med. I never had the chance to explore these fields until it was too late because I sat on my hands waiting to find a field that interested me.

 

[howelljolly]

Gosh, the kid's in high school...

Im matching next year, why wont anyone help me choose a specialty?

 

[Bernardo_11]

If I sound passionate about this it's because I wish someone had told me this when I was an MS1 or a Pre-Med. I never had the chance to explore these fields until it was too late because I sat on my hands waiting to find a field that interested me.

Ahhh. I see your point. I would think that ones interest in a particular field could still very well develop during the basic science years of medical school. It could be from a histology lecture on the eye or the neurophysiology lecture on vision.

I have though, and again this is anecdotal, seen a fellow classmate work rather hard during her basic science years (but still performed average) and frequently talked about entering primary care. Nevertheless, when the clinical years started many of her strengths were realized. She did quite well in all her 3rd year rotations, was able to match into ophthalmology... and I know for sure that she did not develop this particular interest until her third year of medical school. Mind you, she was more than willing to rank a few "ghetto programs" (if such a concept exists for a field like optho ) in order to get into this field.

I do agree with you though. The OP should not feel like he/she must be a blank slate all the way up to his/her 4th year. One should be proactive in exploring what interests them from pre-med on out. I for one went into medical school to do peds (which I eventually got into), but had considered surgery because it was such a fun rotation.

Nardo

 

[speyeder]

This is fair advice - and the advice I usually received from attendings. However, it doesn't completely hold water.

For example, Ophthalmology might be a good field for the OP. Very controllable hours, and simple surgeries that give people their vision back!!

However, in order to get into Ophthalmology you have to start research in that field ASAP. You have to start getting to know attendings and working with them to get great letters. You have to go out of your way to even get a rotation in this field since it is not in the standard medical school curriculum.

The same could be said for Urology, Ortho, Dermatology, PMR, Radiology and any host of fields that the OP might be interested in. You have to go out of your way to seek these fields out, learn about them, and make yourself a good candidate.

If I sound passionate about this it's because I wish someone had told me this when I was an MS1 or a Pre-Med. I never had the chance to explore these fields until it was too late because I sat on my hands waiting to find a field that interested me.

You make some good points here. With more competitive fields it helps to plan research and away electives early to improve your chances of matching. In addition there are a few fields like ophtho and urology which are early match, so you have to get the process started even earlier.