I'm an MS4 who dual applied, help me pick which specialty to prioritize in my rank list.
I never found my "true calling" in any field, so I applied into both of these as they had components I liked but there are a number of cons too. I'm not sure which is a better fit / path for me. My favorite topics are pharmacology, physiology, immunology - I find choosing and modifying treatments based on understanding of how the body works, and watching the patient improve to be fun. I enjoy analyzing labs and vitals, as I'm more of an objective person. I never loved procedures, and would prefer to be non-procedural, but anesthesia ones are short and quick. I just couldn't do surgery. I also have interests in health tech and pharma outside of clinical medicine.
IM:
- In IM inpatient, I don't mind the workflow. Rounds, note writing, calling consults, etc are all tolerable. It seems like a reasonable set of tasks to get through during the day at your own pace without a set schedule, and you can sit at a desk and do most of it rather than running around
- I like that you can see a patient get better over the course of days in the hospital, and you're relying on lab trends to adjust treatments
- I really don't like diagnosing undifferentiated patients, drawing from a wide fact base of context clues to pick the right diagnosis. Unfortunately, this is foundational to IM
- I HATED clinic in medical school. The stress of 15 minute patient blocks, to go through a patient's full history, see them, talk to them, write the note, for like 25 pts a day seemed daunting. However, it seems like clinic becomes chill as an attending once you know your patients and I like chill. The idea checking in on their state of disease and just talking about life to build a relationship sounds fun.
- I'd prefer a specialty like allergy where you get immunology, physio, pharmacology, it's lower acuity, and most diagnoses are straight forward or given to you by a test result
- I don't have much interest in the procedural fellowships like cards/GI/pulm or heme onc, so pay will be lower
Anesthesia
- I love the pharm and phys and constant analysis of vitals - it's intellectually a lot of fun
- No clinic schedule, minimal notes is amazing
- Any differential diagnoses is from a smaller subset of possibilities than in IM, and your primary inputs are vitals rather than subjective inputs from the patient -- I like this type of diagnostic thinking much better than in IM
- Lots of reflexive pharmacology, which is again fun
- Pay is much better
- I don't love the acuity or the life/death aspect, but have heard you get used to it. This may keep me stress and may contribute to burnout but I'm not sure
- I don't really like doing procedures, but incubating, IVs, etc. are not that bad. I probably wouldn't enjoy a difficult central line or nerve block.
- Early mornings and cold OR is uncomfortable
- Less applicable to health tech and pharma
I never found my "true calling" in any field, so I applied into both of these as they had components I liked but there are a number of cons too. I'm not sure which is a better fit / path for me. My favorite topics are pharmacology, physiology, immunology - I find choosing and modifying treatments based on understanding of how the body works, and watching the patient improve to be fun. I enjoy analyzing labs and vitals, as I'm more of an objective person. I never loved procedures, and would prefer to be non-procedural, but anesthesia ones are short and quick. I just couldn't do surgery. I also have interests in health tech and pharma outside of clinical medicine.
IM:
- In IM inpatient, I don't mind the workflow. Rounds, note writing, calling consults, etc are all tolerable. It seems like a reasonable set of tasks to get through during the day at your own pace without a set schedule, and you can sit at a desk and do most of it rather than running around
- I like that you can see a patient get better over the course of days in the hospital, and you're relying on lab trends to adjust treatments
- I really don't like diagnosing undifferentiated patients, drawing from a wide fact base of context clues to pick the right diagnosis. Unfortunately, this is foundational to IM
- I HATED clinic in medical school. The stress of 15 minute patient blocks, to go through a patient's full history, see them, talk to them, write the note, for like 25 pts a day seemed daunting. However, it seems like clinic becomes chill as an attending once you know your patients and I like chill. The idea checking in on their state of disease and just talking about life to build a relationship sounds fun.
- I'd prefer a specialty like allergy where you get immunology, physio, pharmacology, it's lower acuity, and most diagnoses are straight forward or given to you by a test result
- I don't have much interest in the procedural fellowships like cards/GI/pulm or heme onc, so pay will be lower
Anesthesia
- I love the pharm and phys and constant analysis of vitals - it's intellectually a lot of fun
- No clinic schedule, minimal notes is amazing
- Any differential diagnoses is from a smaller subset of possibilities than in IM, and your primary inputs are vitals rather than subjective inputs from the patient -- I like this type of diagnostic thinking much better than in IM
- Lots of reflexive pharmacology, which is again fun
- Pay is much better
- I don't love the acuity or the life/death aspect, but have heard you get used to it. This may keep me stress and may contribute to burnout but I'm not sure
- I don't really like doing procedures, but incubating, IVs, etc. are not that bad. I probably wouldn't enjoy a difficult central line or nerve block.
- Early mornings and cold OR is uncomfortable
- Less applicable to health tech and pharma
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