Most Valid Indicator of "the right" Specialty Choice?

[LeJoker]

Hi,

There are a lot of posts about how to choose the right specialty. But I'd like to specifically ask late residents and attending what drew them to their specialty and if this was a good indicator. There are SOO many books, adages, clinical opportunities and questionnaires out there, but which of these really made the "right" decision for you? Did anything make the "wrong" decision?

(The context, btw is that I've finished 3rd year and am torn between psychiatry and a specialty with more tangible results, possibly EM or anesthesia. I didn't get to rotate in EM or Anes, and am in research year now, thinking of shadowing both)

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[Raryn]

For the half-dozen big specialties you get to rotate on as an M3, I think the most telling indicators are A) seeing yourself able to do this type of work long-term B) finding the subject-matter interesting B) getting along with the general people you found in the specialty. It's a bit stereotypical to say that every specialty has it's own personalities it attracts, but it is also reasonably true in a lot of places. A is particularly important though: You could get along with EM docs like white on rice and love the idea of the work, but if you know that you'd never want to work nights/weekends/holidays, it is a very poor choice for you.

For the smaller specialties, it's a tough decision. You obviously need to find the subject matter and workload interesting, but the exposure to something like ophtho or rad onc isn't there for most medical students. You need to seek it out yourself if you think thats something you might be interested in and then decide how far you want to pursue it. Combine that with the fact you need to express this interest pretty early for a lot of small, competitive specialties (to start possible research experiences, set up electives, etc), and it's a road to go down.

 

[SurfingDoctor]

Like kids, like diverse physiology and watching pathophysiology evolve, dislike clinic... with a passion.

 

[LeJoker]

Like kids, like diverse physiology and watching pathophysiology evolve, dislike clinic... with a passion.

Haha - that's straightforward... for the record what is the specialty it led you to?

 

[LeJoker]

For the half-dozen big specialties you get to rotate on as an M3, I think the most telling indicators are A) seeing yourself able to do this type of work long-term B) finding the subject-matter interesting B) getting along with the general people you found in the specialty. It's a bit stereotypical to say that every specialty has it's own personalities it attracts, but it is also reasonably true in a lot of places. A is particularly important though: You could get along with EM docs like white on rice and love the idea of the work, but if you know that you'd never want to work nights/weekends/holidays, it is a very poor choice for you.

Thanks. So should I be a _____ maybe is most easily answered by Can I be a ______.

 

[SurfingDoctor]

Haha - that's straightforward... for the record what is the specialty it led you to?

Pediatric Critical Care

 

[Raryn]

Thanks. So should I be a _____ maybe is most easily answered by Can I be a ______.

That and Am I like a ______?

 

[Haybrant]

I think you have to focus on your life first, then decide on specialty. As much as med students get in a tizzy over what specialty to go into, pretty much anything is going to have interesting aspects and boring aspects. Medicine is very different than it used to be, old attendings cant guide you based on their experience. If you listen to young attendings we will all tell you you have to think about your life first and foremost. That means do you need certain geography, do you need time to be with your family, do you have to raise kids, do you have a spouse that is working hard as well and super early mornings are a big problem etc etc. Then you think about what specialty fits that.

 

[MDforME!]

I think you have to focus on your life first, then decide on specialty. As much as med students get in a tizzy over what specialty to go into, pretty much anything is going to have interesting aspects and boring aspects. Medicine is very different than it used to be, old attendings cant guide you based on their experience. If you listen to young attendings we will all tell you you have to think about your life first and foremost. That means do you need certain geography, do you need time to be with your family, do you have to raise kids, do you have a spouse that is working hard as well and super early mornings are a big problem etc etc. Then you think about what specialty fits that.

What specialty fits all the above?

 

[tiedyeddog]

Three different things to think about I tell medical students when pondering right speciality choice:

1. What speciality could cause you to be awoken in the middle of the night and you actually tolerate the problem at hand, perhaps even enjoy it?
2. Don't go into a specialty for the most exciting, rare disease or cases. Go into it the the mundane, bread-and-butter stuff because that is what you'll be doing for the next 30+ years. The rare stuff that is interesting is an added bonus but you have to enjoy, or at least tolerate, the common stuff.
3. don't pick your speciality based on what residency is like. Residency is a finite period that is incredibly unlike what being an attending is like. You have to tolerate residency but you won't be a resident for the next 30 years.

 

[bashwell]

Three different things to think about I tell medical students when pondering right speciality choice:

1. What speciality could cause you to be awoken in the middle of the night and you actually tolerate the problem at hand, perhaps even enjoy it?

Sadly none would be enjoyable for me, but I can tolerate some.

 

[67552931811]

Sadly none would be enjoyable for me, but I can tolerate some.

Bash, what field are you in? You can PM me if you don't want to share publicly.

 

[bashwell]

Bash, what field are you in? You can PM me if you don't want to share publicly.

Hey man, I'm just in Australia where we have to do two years (sometimes more) post med school, called intern/RMO (resident medical officer) years. They're just very general, not a specific specialty. After wards we apply for specialties ie become registrars. My understanding is it's more similar to the UK. Sorry probably not very helpul but I can PM you if you want more details.

 

[OnePunchBiopsy]

Questions to ask yourself during 3rd year or beyond.

1.) Inpatient, outpatient, or both?
2.) Do I like the OR?
3.) Am I passionate about children's health?

This will narrow your choices down substantially. When you get a short list, then decide based on whatever makes you feel happy at the end of the day. TBH, even though surgery had the longest hours of my rotations, I always left the hospital fascinated, happy, and hungry to learn more.

Every specialty becomes a "job" eventually, it will be normal to rather spend time with family than be called in in the middle of the night. Also everyone has their set of bulls*** consults. It's just a matter of what you can see yourself tolerating.

 

[NWwildcat2013]

Questions to ask yourself during 3rd year or beyond.

1.) Inpatient, outpatient, or both?
2.) Do I like the OR?
3.) Am I passionate about children's health?

This will narrow your choices down substantially. When you get a short list, then decide based on whatever makes you feel happy at the end of the day. TBH, even though surgery had the longest hours of my rotations, I always left the hospital fascinated, happy, and hungry to learn more.

Every specialty becomes a "job" eventually, it will be normal to rather spend time with family than be called in in the middle of the night. Also everyone has their set of bulls*** consults. It's just a matter of what you can see yourself tolerating.

This "do you like the OR" question has me all confused. I like being in the OR because it breaks up my day and I feel more insulated from the stupidity and busywork outside of it but I didn't like general surgery and am averse to procedures in anesthesia.

Maybe I just like it because, for a med student, it is a place to just chill and not worry about rounding and presenting.

 

[Postictal Raiden]

This "do you like the OR" question has me all confused. I like being in the OR because it breaks up my day and I feel more insulated from the stupidity and busywork outside of it but I didn't like general surgery and am averse to procedures in anesthesia.

Maybe I just like it because, for a med student, it is a place to just chill and not worry about rounding and presenting.

lol. very true

 

[Mad Jack]

I actually like rounding, wtf is wrong with me.

 

[NWwildcat2013]

I actually like rounding, wtf is wrong with me.

It can be fun with the right team or it can be the worst thing in the world.

I would just prefer to avoid playing that game of russian roulette.

 

[Stagg737]

This "do you like the OR" question has me all confused. I like being in the OR because it breaks up my day and I feel more insulated from the stupidity and busywork outside of it but I didn't like general surgery and am averse to procedures in anesthesia.

Maybe I just like it because, for a med student, it is a place to just chill and not worry about rounding and presenting.

I'd amend his quote from "Do I like the OR?" to "How much do I like the OR?" as I don't think it's necessarily an all or nothing thing. I fall into that in-between category where I really do enjoy being in the OR, but I don't feel like I'm "born to cut", so I'm starting to look more into fields that give a good mix of clinical time and procedures or surgery.

 

[witzelsucht]

Maybe I just like it because, for a med student, it is a place to just chill and not worry about rounding and presenting.

Rads? Psych?

 

[NWwildcat2013]

Maybe I just like it because, for a med student, it is a place to just chill and not worry about rounding and presenting.

Rads? Psych?

Just because you don't like rounding and presenting doesn't mean you can't like something like IM. Rounding/presenting as we know it is a phenomenon limited to academic settings. By rounding I dont mean just seeing patients. Rather, I mean the system where the attending walks around and sees each patient for half a second then they stand outside of the patient's room talking about differentials while pimping students and residents.

This is a huge problem I have with medical school. Not only are we supposed to make a decision with too little exposure (n=1 experiences) to core specialties and no exposure to many others, we view specialties through the distorting lens of rigid and hierarchical academic medicine. I have no idea what it is like being a surgeon in a community hospital, a neurologist in an outpatient clinic in the community, an anesthesiologist at an outpatient surgery center. Basically, I have no idea how the vast majority of physicians in a given field practice or what their day looks like.

 

[saveourpens]

I know someone last year who didn't match into urology. They said getting back to the west coast was most important to them, so they just scrambled into anesthesiology. The closer I get to graduating the more I think whatever the specialty, medicine is just medicine.

After my first month of IM in 3rd year, I was like, can we drop the rest of med school and go straight to IM residency? I liked it that much. I also ended up liking the mix of medicine and procedures in derm. I applied to both. I'm cool with whatever happens.