Is knowing your specialty a bad thing?

[NeedtobeinNeuro]

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Hi Everyone,

I was talking with the Dean of Admissions from Boston University Medical School and mentioned I knew I wanted to go into Neurosurgery 100%. He said he would view that as a red flag when looking at my app. Is this the case everywhere?

Also its not like made this decision on a whim, I chose my undergraduate school to be in Boston so I could work at the Brigham where Harvey Cushing (the "father" of modern Neurosurgery practiced), landed a research position at Brigham where I have already gotten one publication and we're submitting at least 5 more in the next 2-3 months, attend lab meetings of a neurosurgeon we work, have gotten to observe her operate and attended weekly grandrounds. I didn't just decide this from watching Grey's anatomy or something stupid I literally have lived the past 5 years of my life trying to get as involved in neurosurgery as I possibly can.

And now that might hurt me?

 

[jemstone]

I understand where you're coming from, as I went into my app cycle 100% knowing I want to go into primary care. I was warned by several physicians not to mention this certainty in my interviews because it portrays "close-mindedness" and you need to be open to things like research, and you need to be a teachable, flexible student even if you know in your mind what you want to do. You can certainly mention your interest in neuro and your experiences in the field, but don't say you're 100% committed, even if you are.

 

[mmmcdowe]

The reason why it is a flag is usually people don't feel that pre-meds usually have a good understanding of the specialties that interest them and the vast majority of students, especially those interested in neurosurgery, change there mind during medical school.

Just say you have a lot of interest in neurosurgery but are keeping an open mind to your options.

 

[DrEnderW]

I think it comes off a little hot.

From an admission member's POV, you have to recognize that they have seen hundreds of students change their mind throughout medical school. It sounds like a freshman saying "I'm premed and going to an Ivy league med school!!" when we all know the vast majority never even make it to the app stage.

I think the red flag part comes from how difficult it is to land a neurosurgery residency - before medical school even starts you're saying you're going to be at the top of your class, way above average on the boards, and get killer LORs during clinical rotations all before gaining an acceptance.

Even though I'm 100% set on doing surgery (it's the reason I am going to med school), I was sure to say that I had a broad array of interests, hit the primary care thing, and said I'd approach medical school with a blank slate and open mind.

 

[FSU2013]

It's a red flag because no med school wants to have "that med student." From a practical stand point, someone who "was 100% sure they were going into nsg" is going to be a pain in the butt for administrators. Now, you may not be, but they don't know that. The nsg guy on his peds rotation isn't going to care about the difference between bacterial and viral infections (they're all viral), and you're not going to care about learning how to interpret the strips on OB, etc. There's a a reason you go to med school instead of going straight into residency. You need a broad understanding of medicine before you get a deep understanding. Again, I'm not saying you are 'that guy' but there are plenty of people who are 100% gunning for one specialty and act bored when it's not their specialty.

Further, you just don't know. That's not to sound pejorative, you just don't. I was "100% sure" I wanted to do radonc (didn't say that during interviews). I had my bachelor's in physics, tons of physics research, shadowed a radonc for quite a while, etc. It just made sense. As far as any pre-med went, I probably had more exposure to the field than almost anyone. At the beginning of fourth year, things changed. I'm going into EM. It's just a better fit. I love it and I'm really excited about it. No matter how engulfed you are as a pre-med, you still have other stuff going on in your life. It's different when you're a med student and your only responsibilities (other than family) are to your rotation. If you haven't done nsg from 5AM until 10PM 6-7 days a week for 2 months straight, you just can't say that you are "100% sure" that you want to do it.

 

[FSU2013]

I think it comes off a little hot.

From an admission member's POV, you have to recognize that they have seen hundreds of students change their mind throughout medical school. It sounds like a freshman saying "I'm premed and going to an Ivy league med school!!" when we all know the vast majority never even make it to the app stage.

I think the red flag part comes from how difficult it is to land a neurosurgery residency - before medical school even starts you're saying you're going to be at the top of your class, way above average on the boards, and get killer LORs during clinical rotations all before gaining an acceptance.

Even though I'm 100% set on doing surgery (it's the reason I am going to med school), I was sure to say that I had a broad array of interests, hit the primary care thing, and said I'd approach medical school with a blank slate and open mind.

Honestly, you'll be a better med student if you do that. My advisor told me the secret to third year is treating every rotation like it was what you were going to do for the rest of my life. He was right. I took that attitude into all of my rotations and it ended up serving me very well. I learned a lot more that way and I performed a lot better on each clerkship.

Plus, again, you may change your mind, and that's OK.

 

[Geebeejay]

It's a red flag because no med school wants to have "that med student." From a practical stand point, someone who "was 100% sure they were going into nsg" is going to be a pain in the butt for administrators. Now, you may not be, but they don't know that. The nsg guy on his peds rotation isn't going to care about the difference between bacterial and viral infections (they're all viral), and you're not going to care about learning how to interpret the strips on OB, etc. There's a a reason you go to med school instead of going straight into residency. You need a broad understanding of medicine before you get a deep understanding. Again, I'm not saying you are 'that guy' but there are plenty of people who are 100% gunning for one specialty and act bored when it's not their specialty.

Further, you just don't know. That's not to sound pejorative, you just don't. I was "100% sure" I wanted to do radonc (didn't say that during interviews). I had my bachelor's in physics, tons of physics research, shadowed a radonc for quite a while, etc. It just made sense. As far as any pre-med went, I probably had more exposure to the field than almost anyone. At the beginning of fourth year, things changed. I'm going into EM. It's just a better fit. I love it and I'm really excited about it. No matter how engulfed you are as a pre-med, you still have other stuff going on in your life. It's different when you're a med student and your only responsibilities (other than family) are to your rotation. If you haven't done nsg from 5AM until 10PM 6-7 days a week for 2 months straight, you just can't say that you are "100% sure" that you want to do it.

I agree with this. Also, while claiming to be 100% anything is a bad call, especially is claiming to be 100% neurosurg which is a competitive and very demanding field which surely no premed has full understanding of.

 

[ericksonj15]

.

 

[sinombre]

You need to understand that despite how much thought you've put into what you might want to do, claiming you're 100% certain of what you want to specialize in (especially one of the most competitive, grueling, and overly-romanticized specialties) before you've started medical school screams of naivety. Many, many students start medical school thinking they want to do neurosurgery, and most of them change their minds. There's a reason less than one percent of medical students apply to neurosurgery programs.

Anyway, this was probably a good lesson for you. I don't doubt your motivations or your potential, but you need to recognize that revealing "I want to go into neurosurgery" before you've started medical school will likely be perceived negatively by those ahead of you (despite your background and experience, and despite whether or not it's justified).

 

[chemsmith]

So you think you have a 100% chance of landing a neurosurgery residency at brigham and womens?

 

[def1]

I dont think saying you are sure you want to get into neurosurgery is a bad thing, I just wouldn't say you are 100% sure. That part sounds very closed minded. I'm interested in neurosx too and I mentioned it at a few schools, and I don't think it hurt me at all. However, I made it clear that although neurosx was the field I was most interested in and what I was shooting for, that all the medical specialties are interesting and I would keep an open mind during school.

I think for most people who say they want to go into neurosx it sounds a bit naive.

 

[mimelim]

It is a red flag.

The issue isn't that you have an interest in Neurosurgery. The issue is that you don't know what else is out there and haven't explored those as well. What if neurosurgery isn't all it is cracked up to be? You have barely scratched the surface of NSGY, maybe from a research perspective you are very advanced, but that is a far cry from medical school, NSGY residency and practicing as a neurosurgeon. The question is, are you interested in being a doctor? If you only know neurosurgery and decide that it isn't for you, are you going to be miserable and not finish medical school? The vast majority of people change their minds about what they are going into at least several time.

 

[deleted547339]

it is a red flag.

The issue isn't that you have an interest in neurosurgery. The issue is that you don't know what else is out there and haven't explored those as well. What if neurosurgery isn't all it is cracked up to be? You have barely scratched the surface of nsgy, maybe from a research perspective you are very advanced, but that is a far cry from medical school, nsgy residency and practicing as a neurosurgeon. The question is, are you interested in being a doctor? If you only know neurosurgery and decide that it isn't for you, are you going to be miserable and not finish medical school? the vast majority of people change their minds about what they are going into at least several time.

+1

 

[futureczar]

I think its fine to declare a 100% interest in NSG... if your interviewer is a neurosurgeon! Telling a family medicine doc (or any other doctor for that matter) that NSG is the only thing that you are interested in can come off as naive/condescending/immature. Not saying that you are those things. But for the record most pre-meds I know that say they are interested in NSG are very cocky for no damn reason. Say you are interested in the neurosciences based on your research, but also state that you have an open mind. Just dont sound like you are obsessed, that can turn out very badly.

 

[Ironmandoc]

10 people in my class said NSG day 1...probably down to only 1 or 2 now.

Don't close your mind off solely because you think you have it figured out, because you don't. Maybe you'll be a neurosurgeon, probably not. You can't be afraid of not being a neurosurgeon or you'll end up unhappy and dissatisfied in one way or another.

 

[mmmcdowe]

I think its fine to declare a 100% interest in NSG... if your interviewer is a neurosurgeon! Telling a family medicine doc (or any other doctor for that matter) that NSG is the only thing that you are interested in can come off as naive/condescending/immature. Not saying that you are those things. But for the record most pre-meds I know that say they are interested in NSG are very cocky for no damn reason. Say you are interested in the neurosciences based on your research, but also state that you have an open mind. Just dont sound like you are obsessed, that can turn out very badly.

Yeah, I don't think it would fly with a neurosurgeon either. See the neurosurgery resident's post above as to why.

 

[Arbor Vitae]

Hi Everyone,

I was talking with the Dean of Admissions from Boston University Medical School and mentioned I knew I wanted to go into Neurosurgery 100%. He said he would view that as a red flag when looking at my app. Is this the case everywhere?

Thinking you know your specialty is a bad thing.

It's just a super naive statement to make and you can't possibly know what you want to go into until you've gone through clinical rotations.

You haven't even experienced other fields of medicine so how can you say you won't like them?

 

[TheFamilyDoc]

Hi Everyone,

I was talking with the Dean of Admissions from Boston University Medical School and mentioned I knew I wanted to go into Neurosurgery 100%. He said he would view that as a red flag when looking at my app. Is this the case everywhere?

Also its not like made this decision on a whim, I chose my undergraduate school to be in Boston so I could work at the Brigham where Harvey Cushing (the "father" of modern Neurosurgery practiced), landed a research position at Brigham where I have already gotten one publication and we're submitting at least 5 more in the next 2-3 months, attend lab meetings of a neurosurgeon we work, have gotten to observe her operate and attended weekly grandrounds. I didn't just decide this from watching Grey's anatomy or something stupid I literally have lived the past 5 years of my life trying to get as involved in neurosurgery as I possibly can.

And now that might hurt me?

I interviewed with Dean Witzburg also, knowing my specialty 100%. He instructed me to close my eyes and imagine that I matched into Trauma surgery. He asked me how I felt and I said "sad" I expressed my understanding that my interests my change throughout the years. Was accepted a few weeks later through an early assurance pathway. I've shadowed a medical examiner and a few primary care. Admissions facstaff would like to see an open mind-that's pretty much the big picture here.

 

[NeedtobeinNeuro]

Thanks for the feedback! You guys all made good points, and definitely wouldn't want to come off as naive in an interview! I'll work on a more broad answer for the "Do you have a specialty you're interested in?" question.

 

[deleted547339]

Thanks for the feedback! You guys all made good points, and definitely wouldn't want to come off as naive in an interview! I'll work on a more broad answer for the "Do you have a specialty you're interested in?" question.

I don't think you need to give too much thought to that question. Just be somewhat ambiguous and you're fine. The only wrong answer is "I'm 100% sure I'm going to be a neurosurgeon" lol. Even the people who say "I want to be a family doc" or "I'm going to be a pediatrician" are fine because a lot of schools like to brag about their number going into primary care.

If you say "I'm not sure....I really like neuroscience, so I definitely think I'd like to do a rotation in neurosurgery and neurology, but I'm really open to anything. I see the appeal of X and Y, but I just don't know." touch the obligatory primary care button and you're completely fine.

This really isn't a question that can improve your interview unless you're going to a school that is geared towards primary care and you say you are really heavily leaning that way. Otherwise, it's generally a waste of a couple minutes making sure you are sensible and can hold a conversation.

 

[Doctor Strange]

The simple answer is that you have an interest in neurosurgery but know that many students change their minds in medical school and are willing to keep an open mind.

It's just that easy.

 

[alpinism]

I think it comes off a little hot.

From an admission member's POV, you have to recognize that they have seen hundreds of students change their mind throughout medical school. It sounds like a freshman saying "I'm premed and going to an Ivy league med school!!" when we all know the vast majority never even make it to the app stage.

I think the red flag part comes from how difficult it is to land a neurosurgery residency - before medical school even starts you're saying you're going to be at the top of your class, way above average on the boards, and get killer LORs during clinical rotations all before gaining an acceptance.
Even though I'm 100% set on doing surgery (it's the reason I am going to med school), I was sure to say that I had a broad array of interests, hit the primary care thing, and said I'd approach medical school with a blank slate and open mind.

Um no.

Nsx isnt nearly as competitive as plastics or derm and you definitely dont have to be near the top of your class to match nsx (unless you're shooting for barrow or mayo etc...). The thing w nsx is that it is a largely self-selecting field. Most med students, regardless of their step 1 score or class rank dont want to deal w the lifestyle or the 7+ year residency.

As long as you have a solid step 1 score (230+) , good grades, and letters (research also helps a lot) and apply broadly, you'll likely match somewhere.

It is a red flag.

The issue isn't that you have an interest in Neurosurgery. The issue is that you don't know what else is out there and haven't explored those as well. What if neurosurgery isn't all it is cracked up to be? You have barely scratched the surface of NSGY, maybe from a research perspective you are very advanced, but that is a far cry from medical school, NSGY residency and practicing as a neurosurgeon. The question is, are you interested in being a doctor? If you only know neurosurgery and decide that it isn't for you, are you going to be miserable and not finish medical school? The vast majority of people change their minds about what they are going into at least several time.

Unless you have access to some data to back this up, what you're saying is pure speculation. Do people change their minds? Of course. Do the "vast majority" change their minds "several times"? eh I doubt it. There are plenty of med studens who have a pretty good idea of what they're interested in even before starting rotations (maybe 2-3 specialties). Not surprisingly, many of them end up in one of those fields (esp those w prior medical experience) without changing their minds multiple times.

 

[AlteredScale]

For sure I know I will be a neurosurgeon specializing in microvascular surgery while running a NIH lab studying immunological therapies to glioblastomas.

NO ONE WILL STOP ME.

-(future gunner)


LOL

 

[Mt Kilimanjaro]

I have also been told by admissions officers that it is a red flag if your clinical exposure or interests lie in a single field of medicine. I get their point about "how will you get through MS-3/4 if you only like one thing," but I think it's a silly reason to weed someone out.

Medicine is a vast field, so even if you enter with the sole intention of becoming a famous heart surgeon like Dr. Oz, then realize on the first day of your surgery clerkship that you hate everything about surgery, you can still find something in medicine that will lead to a rewarding career. If someone can't do this, they are malcontent and would not be happy in any career.

 

[deleted547339]

I have also been told by admissions officers that it is a red flag if your clinical exposure or interests lie in a single field of medicine. I get their point about "how will you get through MS-3/4 if you only like one thing," but I think it's a silly reason to weed someone out.

Medicine is a vast field, so even if you enter with the sole intention of becoming a famous heart surgeon like Dr. Oz, then realize on the first day of your surgery clerkship that you hate everything about surgery, you can still find something in medicine that will lead to a rewarding career. If someone can't do this, they are malcontent and would not be happy in any career.

I suspect that is the minority opinion.

 

[Mt Kilimanjaro]

I suspect that is the minority opinion.

Really? I got the opposite sense form this thread. BTW, I meant shadowing in a single specialty, not clinical exposure as in working only in a pediatric clinic.

 

[deleted547339]

Really? I got the opposite sense form this thread. BTW, I meant shadowing in a single specialty, not clinical exposure as in working only in a pediatric clinic.

Saying you're going to do a certain specialty and only having experience in one specialty are two different things. I worked in an ED for 2 years in undergrad. No one brought it up.

 

[sunshine02]

Do they ask you what you want to specialize in in the primary/secondary? Or is it just in interviews?

Also, @TimesNewRoman, did you volunteer in an ED or did you actually have a job there? Either way, it must have been so cool! Our hospital doesn't allow volunteers to go into ED.

 

[Non Pizza Lunch]

Um no.

Nsx isnt nearly as competitive as plastics or derm and you definitely dont have to be near the top of your class to match nsx (unless you're shooting for barrow or mayo etc...). The thing w nsx is that it is a largely self-selecting field. Most med students, regardless of their step 1 score or class rank dont want to deal w the lifestyle or the 7+ year residency.

As long as you have a solid step 1 score (230+) , good grades, and letters (research also helps a lot) and apply broadly, you'll likely match somewhere.

Though I don't deny there is a lot of self selection, I would say a specialty with just 1 point less than ortho for step 1, but with almost double the research pubs via the 2011 charting outcomes... I would still call it pretty damn competitive. lol

 

[NeedtobeinNeuro]

Though I don't deny there is a lot of self selection, I would say a specialty with just 1 point less than ortho for step 1, but with almost double the research pubs via the 2011 charting outcomes... I would still call it pretty damn competitive. lol

So hopefully my publications in neurosurgery from before med school will help! Neurosurg is probably still competitive simply because they type of people who go into fields like that or cardio are generally quite competitive people. Not that its a bad thing, it makes all the surgeons at my hospital some of the best in the world.

 

[deleted547339]

Do they ask you what you want to specialize in in the primary/secondary? Or is it just in interviews?

Also, @TimesNewRoman, did you volunteer in an ED or did you actually have a job there? Either way, it must have been so cool! Our hospital doesn't allow volunteers to go into ED.

$$bills y'all. lol.

I got paid to push people to and from CT/X-ray/Cath-lab/floors when admitted. Not all that exciting, but you gotta pay rent somehow.

 

[NeedtobeinNeuro]

So you think you have a 100% chance of landing a neurosurgery residency at brigham and womens?

No I just said I had based my decision on where to go college on what would help me in get into medical school/be competitive when I do a neuro rotation in med school

 

[Ruminate]

To answer the question, I'd make an analogy to knowing which research field you will end up in PhD training, post-doc training, or academic training. Your PhD training may have been identification of lncRNAs in role of liver disease, post-doc training in non-coding RNA in role of skeletal muscular disease, and then a faculty position in to identify some microRNA and its role for some disease. Each time you apply, the statement you write is more to convey that you're well-versed and well-trained to think. This person may have stated an interest to stay in the RNA field for PhD applications and stuck to it.

Knowing what specialty is not a good or bad thing. What you should think about is how you write. What's important is if you're expressing yourself in a mature way. With 0 days in medical school setting with minimal exposure to all fields, it's very unlikely you will ascertain yourself beforehand. Before being certain of neuroscience, you'd first have to figure out if you actually like surgery. Observing is not the same as doing. You're not really going to know that until you try out ...surgery. Just like the example above, your strong desire in neuroscience may stick with you. However, so many fields include background of neuroscience that you may end up elsewhere in neurosurgery.

In addition to the way you write, it will also depend on the reader. When you say this to someone who has ...life experience, they may take it in several ways: positively, negatively. You can't help when a negative reader reads the most positive writing and still is critical of it.

Just think about how you're writing it. Be open. Make yourself known that you're interested in neurosurgery but still very open to new opportunities. Your interest comes from such and such, but you're not limiting yourself.

 

[Law2Doc]

Hi Everyone,

I was talking with the Dean of Admissions from Boston University Medical School and mentioned I knew I wanted to go into Neurosurgery 100%. He said he would view that as a red flag when looking at my app. Is this the case everywhere?

Also its not like made this decision on a whim, I chose my undergraduate school to be in Boston so I could work at the Brigham where Harvey Cushing (the "father" of modern Neurosurgery practiced), landed a research position at Brigham where I have already gotten one publication and we're submitting at least 5 more in the next 2-3 months, attend lab meetings of a neurosurgeon we work, have gotten to observe her operate and attended weekly grandrounds. I didn't just decide this from watching Grey's anatomy or something stupid I literally have lived the past 5 years of my life trying to get as involved in neurosurgery as I possibly can.

And now that might hurt me?

You need to have an open mind. (1) most med students change their minds at least once during med school. You rotate on something you didn't think you'd like but love it, or vice versa. Until you get into the wards you simply don't know. Publications, meetings and being an undergrad "tourist" into the world of surgery may be interesting, but it's not close enough to really know. (2) lots of people who want competitive things won't be able to put of competitive scores. Everyone who gets into med school was a college superstar but half are going to be in the bottom half of their class and/or end up with pedestrian step scores. schools hate the group of people who spend the latter two years moping because their dreams were dashed, or worse, the people that still think they can get derm without the stats. (3) there is nothing more troubling to attendings than for med students to show up on a core rotation already knowing that they have no interest in what they are about to do for the next month. If you know you are going to do surgery, you might have a tough time feigning interest in your month of psych. They'd rather have the person with the open mind rather than deal with the yawning. (4) intelligent people hold off making decisions until they have enough data. You have no clue what 90% of the specialties actually are like. Schools want good thoughtful decision makers at the start. Teaching you to make snap decisions comes much later.

For these reasons, it's best to show up with an open mind. Even if it's really not.

 

[mmmcdowe]

No I just said I had based my decision on where to go college on what would help me in get into medical school/be competitive when I do a neuro rotation in med school

Most of what you are doing and learning is not going to be useful during a sub-i in neurosurgery (plus you'll likely forget a lot of it during pre-clinicals) nor in a neurology rotation.

 

[pdxhopeful]

A lot of how your interest in a particular specialty is viewed is going to depend on how you present it. For the reasons others have stated above, giving the impression you are dead set on one without having done a sub-i or even any med school coursework is going to come off as arrogant and even a bit immature. Especially if it's unprompted. Answering 'because of X and Y, I'm really interested in neurosurg' if you're asked about potential specialties or your career goals shows a passion without giving the impression you're unduly rigid in your plans.