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Need help deciding on a specialty--please respond!

Discussion in 'Medical Students - DO' started by beachbunny, Aug 6, 2011.

  1. beachbunny

    beachbunny Member
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    Hi,
    I'm hoping some current residents can chime in on their experiences...here's the deal: I'm just starting my fourth year and have no idea what I want to do. I'm curious what residencies will be LEAST like my IM rotations.

    I don't think I'm a very competitive applicant due to my horrible step 1 score. Everything else in my app is average. HP on every rotation (we have a P-HP-H system). I think I'll do really well on interviews.

    The only rotation I have really disliked is IM--I hate managing chronic illnesses and disease states (particularly ones caused by obesity, smoking, alcohol, poor diet, etc--preventable things). I hate doing H&P's because I am overly thorough to a fault....I dislike spending a lot of time writing long notes.

    I LOVE procedures--really enjoyed my time in the OR, especially the minor things they let me do on my own like draining abscesses, etc. The highlight of my third year was doing a paracentesis. I was pretty excited when I got my first ABG, too.

    LOVED my OB/Gyn rotation--favorite parts were the uncomplicated vag deliveries and lap surgeries. But I also loved following the baby after delivery and performing the newborn exams.

    Really enjoyed my Psych rotation, too. Favorite part was ECT (the closest thing I could get to a procedure!).

    I plan to start a family during/after residency and medicine will not be my life--my family will. Ideally I would like to work part time. So based on that I have cut out gen surgery and OB as options due to the schedules and call. Kinda unfortunate b/c I really like OB.

    I have prior experience working in an ER and I was an EMT, so I know I would enjoy EM as well.

    At this point I would honestly be equally happy if I matched into anything but IM or anesthesiology (pharm, physio, and math are not my strengths, nor do I enjoy them). I would really like derm and rads, too, but step 1 won't help there.

    I'm thinking my only hope due to my step 1 score is FM, but I'm afraid the residency will be similar to what I've experienced on my IM rotations. Aside from the addition of peds, how similiar/different is an FM vs IM residency?

    Oh, and I'm a DO student, so the AOA match is an option for me. I thought about a traditional rotating internship, too, but I don't want to tack an extra year on to residency and would prefer not to have to go through the match twice.

    I would love some advice!!!! Thanks everyone!
     
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  3. colbgw02

    colbgw02 Delightfully Tacky
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    Maybe you know something about OB/GYN that I don't, because I don't see why you couldn't practice it part-time. After training, almost any specialty can be tailored to work as little or as much as you want to. You may have to give up other things to work part-time (location, pay per hour/procedure, etc.), but I wouldn't dismiss any specialty because you eventually want to work part-time.
     
  4. smq123

    smq123 John William Waterhouse
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    Moving to osteopathic.
     
  5. smq123

    smq123 John William Waterhouse
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    Depends on which one you go to. Some FM residencies are very inpatient heavy, so you spend a lot of months on an IM-like service.

    Some FM residencies are very outpatient heavy, so you're in the office at least 60% of the time. These are probably the least similar to IM residencies.

    If you're very thorough, "to a fault," FM may be a bad fit. Clinic is about seeing another patient ever 15-20 minutes (as a resident); if you're overly thorough, you may be there until 10 PM....if your patients haven't stormed out of the clinic in anger, that is.

    And FM is A LOT of prevention....you see so much diabetes, HTN, hyperlipidemia, etc. So your patient population, aside from peds and pregnant women, is not all THAT different from IM.

    As colbgw2 said, some OBs DO work part time. Residency would be a tough 4 years, but it wouldn't last forever.
     
  6. Colbert

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    You are a constant contradiction of yourself. You hate H&Ps because you're overly thorough but hate writing the note. You love procedures but loved psych, which is probably the least procedure-based field. You hate handling chronic conditions but are considering FM in which the lion's share of your time will be handling chronic conditions.

    You need to sit down and be really honest with yourself about what is really important to you and what you want to do with your time.

    I'd say based on what you said so far that you'd be happiest in EM. Luckily you've already worked in it and have the experience to know yourself. Also, in the osteopathic world, your audition rotations make or break you for EM, so if you go do auditions and knock them out of the park, you'll be in a good position.

    It's already August, you need to decide basically tomorrow what you want to do or do a transition year to figure it out. I have a few friends who are going the transitional route because they couldn't decide. It's not a bad option.
     
  7. Doctor4Life1769

    Doctor4Life1769 **tr0llin, ridin dirty**
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    Can those who did a TRI get credit for it at DO EM programs? Or, would it essentially turn into a 5 year thing? I don't know anything about DO EM, but just a thought.
     
  8. beachbunny

    beachbunny Member
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    Thanks for your response. Sorry--I think I was a bit unclear in my post. I know I can probably figure out a part time schedule with almost any specialty--it's the time commitment during an OB residency that scares me. I'm anticipating the first couple of years after having a baby to be the most time-consuming (I definitely want to breast feed), and I definitely don't want to be tucking my kids into bed over the phone from the hospital if you know what I mean.
     
  9. beachbunny

    beachbunny Member
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    I know I'm in constant contradiction--you said it perfectly. Perhaps this is a result of feeling burned out after third year and not knowing what I want to do because at this point I just want to match, get through residency, and be on my own. I'm not sure I'll practice clinical medicine forever, either. I'm a pretty easy going person, I believe most anything is what you make of it, and with my broad interests I hope I can tailor my future practice to fit my needs.
    And I do hate handling chronic conditions, but I would hope that FM would give me the opportunity teach my patients prevention so they won't end up with these diseases. I want to help people to quit smoking, lose weight and teach them to eat properly so they don't end up like so many of the patients we've all seen.
     
  10. beachbunny

    beachbunny Member
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    :( I was hoping to hear from some allopathic residents as well! I'm not set on the AOA match. That's why I didn't post in osteopathic...
     
  11. beachbunny

    beachbunny Member
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    :( I was hoping to hear from some allopathic residents as well! I'm not set on the AOA match. That's why I didn't post in osteopathic...
     
  12. Doctor4Life1769

    Doctor4Life1769 **tr0llin, ridin dirty**
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    You're still a DO and plenty of DOs do MD EM.
     
  13. smq123

    smq123 John William Waterhouse
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    While you may not be set on the AOA match, the fact that you CAN participate in it, the fact that you can do a rotating internship, and the fact that you may have taken the COMLEX but not necessarily the USMLE (which may limit which MD residencies you can apply for) all made me think that you'd get a more accurate answer in Osteopathic.

    Your fundamental question is: Which specialty should I shoot for? I don't see why a DO audience isn't just as well equipped to answer your question as an MD audience, or a mixed MD/DO audience.

    By the way, I'm an MD. Don't know if that changes the advice that I gave you....
     
    #12 smq123, Aug 6, 2011
    Last edited: Aug 6, 2011
  14. smq123

    smq123 John William Waterhouse
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    While I understand that you're interested in prevention, by the time most of your patients in an FM residency practice get to you, they are FAR beyond that point. These are people who have been smoking and eating poorly for decades, and are coming to you because the consequences are too much for them to ignore. If you're ok with that, you might do well in an FM residency. Otherwise, you will burn out pretty fast.

    Plus, if you do an FM residency with a lot of OB, you might still be tucking in your kid over the phone, a lot of nights. There are some FM residencies that are less OB-heavy, but it sounds like you enjoy that aspect of medicine.
     
  15. Colbert

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    Have you done a family medicine rotation? I understand the appeal of prevention but you'll go insane trying to convince all the diabetic/hypertensive/hyperlipidemia patients in the world to eat right.

    Have you ever thought about sports medicine? It's great for someone who doesn't plan on practicing clinical medicine forever. You can actually focus on people who will listen to preventative medicine and take care of themselves. And, you can get into it through both EM and FM. Look into it.
     
  16. colbgw02

    colbgw02 Delightfully Tacky
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    I know this is tough to do, but you really need to try to avoid picking a specialty based on its residency. We're talking about 3 to 6 years over a career that will hopefully last many decades. You may have more time during a family medicine residency to spend with your kids, but if you dislike family medicine, then what how will you feel in 10, 20, or 30 years?

    Since the discussion has turned this way, have you considered a preventive medicine residency?
     
  17. irJanus

    irJanus Falling into a burning ring of fire
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    get yourself a copy of Iserson's Getting Into a Residency"
    http://search.barnesandnoble.com/used/results.aspx?r=1&usedpagetype=usedisbn&pean=9781883620097&cm_mmc=Google%20Product%20Search-_-Q000000630-_-Isersons%20Getting%20in%20a%20Residency-_-9781883620097

    take a few hours, fill out the personal and be completely honest with yourself while doing it. It is a nice quick way to assess strengths/weaknesses, and what you want/don't want out of your career. It will be well worth it, and the sooner the better so you can have enough time to address the application process once you've chosen
     
  18. dozitgetchahi

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    I was gonna say that if you love procedures but don't like chronic disease management, then something like derm (especially if you set up your practice to do a lot of cosmetic procedures and/or Mohs surgeries) or optho would fit the bill.

    However, if you bombed step 1 as a DO your chances of matching allo residencies in either of these approaches nil.
     
  19. ensuii

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    Why don't you let him make his own decision as to the appropriate forum to post in? He's a big boy I think...
     
  20. Uranium678

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    What was your Step 1 score?-- maybe you're competitive for more than you think you are
     
  21. Brachyury

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    Did you enjoy your neuro rotation?

    Have you considered path?
     
  22. Isoprop

    Isoprop Fascinating, tell me more
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    Maybe rural EM?

    Good procedures, hardly any chronic, lots of procedures, even a little bit of OB if you are way out in the boonies, lots of "psyc", and reasonable hours.
     

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