Loosing the Passion?

[Leukocyte]

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It is hard for me to say this, but I am going to go ahead and open up.

I loved my MS-1 and MS-2 years, and I continue to enjoy studying disease pathophysiology and treatment. However, I do not like my MS-3 year. I hate being on the wards and clinics (any one here likes the smell of feces?), and frankly, I do not like the interpersonal interaction with patients and the rest of the medical staff. It seems like that I enjoy studying medicine, but do not like the reality and the routine of everyday medical practice. My confusion is further complicated by my inability to decide on a specialty for residency.

Others in the same boat? Any advice regarding residency options?

Thanks.

 

[the citizen]

What about pathology or radiology?

 

[Leukocyte]

Thanks for the reply.

Pathology and radiology are great diagnostic specialities. However, I am interested in disease diagnosis and direct tx.

 

[dredd]

I didn't really like 3rd year either to tell the truth. It's really annoying to have to do rotations in specialties that you have no interest in learning about (even though I know that this is the wrong attitude, since theoretically, all core rotations are important towards your medical education), and having to deal with those long hours doing things like retracting and watching a laproscopic video. The only advise that I can give you is that things do get much better during your fourth year when you can pick and choose your rotations. If you liked your medicine rotation, that's one path to consider. Others may be things like neurology, PMR, psychiatry, etc. You don't have to like everything about the specialty to go into it either, that's why there are sub-specialist.

 

[dchristismi]

Maybe you're destined to be an MD/PhD. Clinical research would give you both treatment opportunities as well as pathophysiology - teaching too, if you'd like.

Interventional neuroradiology? (That would keep you in residency a looong time, you'd be treating, but with minimal contact)

As a fellow 3rd year (practically 4th! woo hoo!), I can understand what you're going through. I actually felt pretty similarly at the beginning of the year, but I think it was more from being utterly lost in clinics. As the year has progressed, I've been lucky to be able to discern what I like and what I don't. I hope that you'll eventually find something that strikes you and fits your list of requirements.

 

[lf777]

Hi

Certainly research might be a good option for you. You could still see a small percentage of patients, and do research. You wouldn't be in the hospital much. As far as residency goes, you could try a clinical investigator track for something.

lf

 

[wooo]

I think you should consider radiology. I have noticed after several trips to the reading room while on medicine rotations that radiologists have to know disease processes and often spit out differentials for certian lesions/conditions that show up on the xr/ct/mri/etc...

 

[doc05]

radiology.

 

[fourthyear]

I'm not sure how you plan to be involved with "direct treatment" without interpersonal interaction with patients or other medical staff. This is tough to find.

I think radiology does offer the best in terms of still thinking through the pathophysiology of a disease and having the fun of making a diagnosis but tends to be more independent work than the routine of the wards you dislike. Interventional radiology offers the opportunity to be involved in treating without long-term follow up with the patient after you do your procedure to them. So this may suit your interests well. You still have to do a medicine or transitional intern year to do radiology though.

 

[Weil-Felix]

Have you thought about anesthesia? You can have your cake and eat it too, if you like hands on treatment of patients, but would prefer minimal social interaction. (because for the most part, the patient is either asleep, or fairly well sedated when you are treating them.) My husband is an anesthesia resident, and he often tells me that this is one of the many reasons he enjoys his field....no rounding (just quick stops up to the floor for short pre and post surgical notes), no dealing with social issues, no writing looong discharge summaries. Lots of cool physiology and pharmacology, which you deal with in real-time scenarios. Plus they learn some mad skills for emergency/critical care situations.

If I was more of a hands-on, procedure type of person, I would have thought about it myself. Cool field.

 

[Finally M3]

However, I do not like my MS-3 year. I hate being on the wards and clinics (any one here likes the smell of feces?), and frankly, I do not like the interpersonal interaction with patients and the rest of the medical staff. It seems like that I enjoy studying medicine, but do not like the reality and the routine of everyday medical practice.

I think I'm gonna join the chorus calling for you to look into Rads or Path. Both fields require encyclopedic knowledge while minimizing the interpersonal interaction component of medicine.

Your post made me laugh, because you sound like my girlfriend, minus the 'enjoy studying medicine' part.

 

[erichaj]

Go into radiation oncology. No much rounding, good amount of book knowledge like physics.

EH.

 

[hillofbeans]

What's the saying...

those who can't do---teach

 

[Leukocyte]

What's the saying...

those who can't do---teach

Thanks to everyone who posted.

And Hillofbeans, I love to teach and "do" (I am interested in academic medicine). I just do not like to "do" it with patients and nursing staff constantly around me.

 

[Foxxy Cleopatra]

I just do not like to "do" it with patients and nursing staff constantly around me.

You are incredibly wise to figure this out now instead of after getting into residency. I also enjoy the treatment aspect and thought I absolutely wanted that (and not the diagnostic part alone.) However, I've had it almost up to my ears with some of the b.s. I 've had to deal with as a surgery resident that I couldn't fault anyone for heading into rads or gas.

To echo the same sentiments over (and over) maybe check out anesthesia your 4th year- yes, there are downsides but you would get a mix of some of the things you like (and hopefully get away from the ones you've noticed you don't.)

 

[E Z Daring]

You are incredibly wise to figure this out now instead of after getting into residency. I also enjoy the treatment aspect and thought I absolutely wanted that (and not the diagnostic part alone.) However, I've had it almost up to my ears with some of the b.s. I 've had to deal with as a surgery resident that I couldn't fault anyone for heading into rads or gas.

To echo the same sentiments over (and over) maybe check out anesthesia your 4th year- yes, there are downsides but you would get a mix of some of the things you like (and hopefully get away from the ones you've noticed you don't.)

here here!

You could always take some time off and pursue an MPH or something. (Every person I have met so far who got an MPH after their MD absolutely loves it) Or research may be something you enjoy.

I will agree with a lot of the other sentiments out there regarding 3rd year. It blows.

 

[Billie]

I have found that my passion comes and goes. And I am starting my PGY-3 year in EM. There are days I love it and days even now I think "boy was this a mistake"

Good luck to you!

Billie

 

[Lonestar]

Hey billie,
there are ups and downs with every field. Just look at it this way, you will have a PHAT check in just over a couple of years. That will certainly decrease the likelihood of those "bad" days. So the next time a crack addict comes in lying about "chest pain", you can just say to yourself "well atleast I will be compensated adequately for this bull$hit". It could be worse; you could have been a generalist and you would have been paid peanuts for your work. just let it roll off your back.

 

[drusso]

This is an interesting scenario: Do you think if admission committees could successfully screen out people who would go on to not like direct patient care and being on the wards, they should? There's an increasing push towards more humanistic and cooperative medicine and quite frankly not everyone *HAS* or can be taught humanistic and cooperative patient care skills.

 

[Weil-Felix]

This is an interesting scenario: Do you think if admission committees could successfully screen out people who would go on to not like direct patient care and being on the wards, they should? There's an increasing push towards more humanistic and cooperative medicine and quite frankly not everyone *HAS* or can be taught humanistic and cooperative patient care skills.

I don't think so. There are enough non-patient care specialties available that people who aren't enamored with the wards can still find a niche in medicine. One is not a "failure" or a "cop-out" if one goes on to realize that a non-patient care area is the one that's right for them. Are you are suggesting that folks who choose fields that don't involve lots of patient contact never had any business in med school? I'm not sure if that's what you're trying to say, but if so, I vehemently disagree. If the only people you allowed into medical school were the people who remain totally gung-ho about the wards after their clinical years (and you hypothetically had some fantastic way to predict this), you wouldn't have anyone left to be pathologists, radiologists, or anesthesiologists. Most of us will find a way to be successful in medicine if that's what truly interests us....it's just a matter of finding our niche.