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- Mar 12, 2007
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Which specialty has the most challenging diagnoses? I'm finding out that this is a BIG component of what I enjoy about medicine.
Just starting to dip my toes into clinical rotations, and I found myself insanely bored with outpatient peds. Don't get me wrong, I've learned a lot. Occasionally, there will be an interesting ADHD kid or something. But overall, it just has not been intellectually challenging at all. Look in everyone's ears, steroids for eczema, etc. etc.
And the frenetic pacing of it all: one patient after the next. It makes me wonder why we had to go through years and years of schooling just to make snap decisions about patients based on a few symptoms.
I guess I'm looking for a specialty with "mystery" cases that are difficult to solve, take extended thought (more than the "5 minute judgment call" that seems to comprise most visits).
So which specialty/what kind of practice would offer that?
In terms of patient population, I like psych patients the most. They are unpredictable, full of interesting back stories, and makes for an interesting history. Yet psych diagnoses don't seem that difficult either. But the interesting patients almost make up for that... except the one big problem I have with psych: medications. I just don't think I'd feel that comfortable prescribing many of the psychotropic drugs, especially to kids. This stuff has so many side effects, and I'm not sure the data is really there regarding long-term effects... or even efficacy above placebo, in general.
I know in our society it's pretty popular to take these drugs for granted as part of life. But I just am not quite convinced by the data that these psychotropic meds are all that great. Certainly anti-psychotics for the acutely psychotic schizophrenic patient are essential... but the less acute the condition, the more uncomfortable I am with the med...
I'd be the psychiatrist "prescribing" exercise for mild dysthymia over pills... and I don't think that would work out very well.
I also am fascinated by obscure brain disorders (think Oliver Sacks' "Man who Mistook his Wife for a Hat"). Neuro certainly does offer a level of diagnostic intrigue. Main prob with neuro is that I'm fairly bored by muscular disorders (i.e. pretty much the peripheral nervous system). Plus, I like to spend more time with the history, and apparently it isn't hugely important for neuro.
So... does that mean the specialty that I'm looking for doesn't exist?
I'm kind of terrified that the type of medical practice I'm looking for really doesn't exist.
Anyone else with similar worries over choosing a specialty?
Just starting to dip my toes into clinical rotations, and I found myself insanely bored with outpatient peds. Don't get me wrong, I've learned a lot. Occasionally, there will be an interesting ADHD kid or something. But overall, it just has not been intellectually challenging at all. Look in everyone's ears, steroids for eczema, etc. etc.
And the frenetic pacing of it all: one patient after the next. It makes me wonder why we had to go through years and years of schooling just to make snap decisions about patients based on a few symptoms.
I guess I'm looking for a specialty with "mystery" cases that are difficult to solve, take extended thought (more than the "5 minute judgment call" that seems to comprise most visits).
So which specialty/what kind of practice would offer that?
In terms of patient population, I like psych patients the most. They are unpredictable, full of interesting back stories, and makes for an interesting history. Yet psych diagnoses don't seem that difficult either. But the interesting patients almost make up for that... except the one big problem I have with psych: medications. I just don't think I'd feel that comfortable prescribing many of the psychotropic drugs, especially to kids. This stuff has so many side effects, and I'm not sure the data is really there regarding long-term effects... or even efficacy above placebo, in general.
I know in our society it's pretty popular to take these drugs for granted as part of life. But I just am not quite convinced by the data that these psychotropic meds are all that great. Certainly anti-psychotics for the acutely psychotic schizophrenic patient are essential... but the less acute the condition, the more uncomfortable I am with the med...
I'd be the psychiatrist "prescribing" exercise for mild dysthymia over pills... and I don't think that would work out very well.
I also am fascinated by obscure brain disorders (think Oliver Sacks' "Man who Mistook his Wife for a Hat"). Neuro certainly does offer a level of diagnostic intrigue. Main prob with neuro is that I'm fairly bored by muscular disorders (i.e. pretty much the peripheral nervous system). Plus, I like to spend more time with the history, and apparently it isn't hugely important for neuro.
So... does that mean the specialty that I'm looking for doesn't exist?
I'm kind of terrified that the type of medical practice I'm looking for really doesn't exist.
Anyone else with similar worries over choosing a specialty?