I'm curious if you all have any thoughts about how to choose a specialty within IM, e.g. characteristics that would make one more or less likely to enjoy a particular field. I've pretty much got the picture that GI and cards are the people who like to do procedures and make lots of money, but I'm interested in more nuanced points about personality fit as well as thoughts about the other specialties (of particular interest--heme/onc, endocrine, rheum).
Heme/Onc - Hate long term follow-up. In 5 years they're either "cured" or dead. Either way they're either the PCP's or the pathologist's problem, not yours.
Endo - How much do you love following A1c's and teaching surgeons how to write orders for insulin drips?
Rheum - You can carry a single prescription pad, preprinted w/ "Prednisone __mg PO daily x __ days" and just fill in the blanks.
Clearly, I'm joking here...kind of.
FWIW, I'm going into Onc and I like the challenges posed by the molecular basis of the diseases (I'm a researcher at heart) and the rapid pace of development in treatment options.
There's obviously more to Endo than managing sugars but, unless you do an outpt Endo rotation you'll never discover this as the vast majority of the inpt work (which is what most med students and residents get exposed to) is managing "brittle diabetics." Neurosurgery and Ortho define these patients as anyone w/ a CBG >100 on admission.
Rheumatology is actually progressing nearly as quickly as Oncology wrt molecularly targeted therapies these days. In general, once an internist tries steroids and they don't work, Rheum swoops in and saves the day w/ some sort of DMARD or molecular therapy. Or they act like oncologists do w/ the hopeless cases/non-responders and do symptomatic support/treatment.
Cards and GI are the surgeons of IM, they hate getting consulted, yell at you when you call and generally belittle your knowledge base and your mother's virtue when they answer your page. And then they do their magic and the patients love them.
