Personal Statement: Risky to Express Interest in Subspecialization?

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Right now they want to know "Why do you want to become a physician", not what type of doctor will you be in 15 years. Personally, I believe that it's ok to talk about what you're interested in, so long as you aren't lying (e.g. I'm interested in ortho because I absolutely love sports and when my surgeon repaired my torn acl I was fascinated by the concepts involved in the surgery that allowed me to physically walk out of the hospital etc...not because I want to make money) That's something to talk about during the interview day, when it comes to your very specific interests within medicine and why you like that specialty/subspecialty, but overall, you should be focusing on why do I want to become a doctor.

Also, if you don't want to do primary care, don't say you want to do primary care just because you think it will help gain admission. Don't be afraid to speak your interests, but don't make it sound like you have to do X subspecialty or bust, or that you have a closed mind when it comes to what type of medicine you practice. In interviews when I've been asked what type of medicine I see myself entering/being interested in, I say ortho (which is what I believe I want to go into) but I've always made sure to mention that I believe it would be very naive of me to be hell-bent on doing ortho, and that I plan on entering medical school with an open mind to every possibility. Every school graduates different types of physicians, but make sure that your interests are genuine and you have an open mind. I included my interest in ortho in some secondaries, but only when it was asked/was appropriate (e.g. tell me what you're interested in).
 
I think it's more important to talk about the general reasons you're attracted to medicine in your personal statement. You obviously don't have to say you're interested in primary care if you're not, but I would avoid pinpointing a super specific career path. I think it's okay to say that (for example) your experiences working with children with metabolic disorders has influenced your decision to go into medicine, and that you hope that interest will carry over into your career, but saying "I am going into medicine to become a pediatric endocrinologist" is probably not the most tactful approach. It's better to leave room for ambiguity while still expressing passion than boxing yourself into a corner where you'll find yourself outmatched. However, if you have no experiences that point you towards a particular area, then I would leave it out of your PS altogether. Experience is the only authority you have to say things with here, and if you're saying you want to be a pediatric cardiologist on a whim just because it sounds interesting, you're going to weaken your personal statement. Now, there are specific questions on secondaries that ask what you envision your career path to be in 10 years or what specialty you're interested in, and in those instances it's appropriate to talk about a specific specialty, but in a general personal statement, it's probably not the best use of your limited space.
 
WedgeDawg said:
I think it's more important to talk about the general reasons you're attracted to medicine in your personal statement. You obviously don't have to say you're interested in primary care if you're not, but I would avoid pinpointing a super specific career path. I think it's okay to say that (for example) your experiences working with children with metabolic disorders has influenced your decision to go into medicine, and that you hope that interest will carry over into your career, but saying "I am going into medicine to become a pediatric endocrinologist" is probably not the most tactful approach. It's better to leave room for ambiguity while still expressing passion than boxing yourself into a corner where you'll find yourself outmatched. However, if you have no experiences that point you towards a particular area, then I would leave it out of your PS altogether. Experience is the only authority you have to say things with here, and if you're saying you want to be a pediatric cardiologist on a whim just because it sounds interesting, you're going to weaken your personal statement. Now, there are specific questions on secondaries that ask what you envision your career path to be in 10 years or what specialty you're interested in, and in those instances it's appropriate to talk about a specific specialty, but in a general personal statement, it's probably not the best use of your limited space.
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That sounds like a great way to balance everything, thanks for the tips.
 
Trust me, your interests will change. I'm only an M1, but my classmates have already changed their desired specialties.
 
walloobi said:
I don't have a desired specialty, just a desired patient population. Much broader, and much less likely to change. There are about a million branches off of peds, and I'm not claiming that I know which one I'll take. Just that primary care doesn't appeal to me.
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I said "specialties" (think multiple). And yes, your desired patient population can change as well. You might decide later on that you like geriatrics, it all depends on your experiences in medical school. Just be open to it. And admissions people want to see your desire to be a physician, no matter the population, and that you will do what you can for your patients.
 
EaglesontheWarpath said:
Right now they want to know "Why do you want to become a physician", not what type of doctor will you be in 15 years. Personally, I believe that it's ok to talk about what you're interested in, so long as you aren't lying (e.g. I'm interested in ortho because I absolutely love sports and when my surgeon repaired my torn acl I was fascinated by the concepts involved in the surgery that allowed me to physically walk out of the hospital etc...not because I want to make money) That's something to talk about during the interview day, when it comes to your very specific interests within medicine and why you like that specialty/subspecialty, but overall, you should be focusing on why do I want to become a doctor.

Also, if you don't want to do primary care, don't say you want to do primary care just because you think it will help gain admission. Don't be afraid to speak your interests, but don't make it sound like you have to do X subspecialty or bust, or that you have a closed mind when it comes to what type of medicine you practice. In interviews when I've been asked what type of medicine I see myself entering/being interested in, I say ortho (which is what I believe I want to go into) but I've always made sure to mention that I believe it would be very naive of me to be hell-bent on doing ortho, and that I plan on entering medical school with an open mind to every possibility. Every school graduates different types of physicians, but make sure that your interests are genuine and you have an open mind. I included my interest in ortho in some secondaries, but only when it was asked/was appropriate (e.g. tell me what you're interested in).
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What kind of reactions did you get in interviews when you said you were interested in ortho? I'd imagine you'd have to walk on eggshells even more so with a specialty as competitive as that (but it sounds like you nipped it in the bud pretty successfully by saying it might be naive and that you'd keep an open mind).
 
MediocreGunner said:
Trust me, your interests will change. I'm only an M1, but my classmates have already changed their desired specialties.
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Meh, I know plenty of people whose interests have not changed one bit. Probably best to just nurture other people's interests and not make predictions about what they'll pursue.


Large dogs
 
MediocreGunner said:
I said "specialties" (think multiple). And yes, your desired patient population can change as well. You might decide later on that you like geriatrics, it all depends on your experiences in medical school. Just be open to it. And admissions people want to see your desire to be a physician, no matter the population, and that you will do what you can for your patients.
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I know most people's change, and I'll certainly keep an open mind about different fields, but I'm just saying that I think it's very unlikely in my situation, not that I'll be resistant to it. I don't think pre-meds tend to have as much experience with the fields they plan on entering as I do with peds, however. Could be wrong though.

Out of curiosity, what is it about M1 and M2 that could so drastically change the patient population people want to work with? It seems like the mostly non-clinical nature of those years would make it tough to explore big shifts in goals like that.
 
walloobi said:
I don't have a desired specialty, just a desired patient population. Much broader, and much less likely to change. There are about a million branches off of peds, and I'm not claiming that I know which one I'll take. Just that primary care doesn't appeal to me.
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My desired patient population was the same as yours. I went through the pre-clinical years just as convinced as you are now, that I was destined to be a pediatrician.

Needless to say I am not a pediatrician.

It's great to have an interest, but don't feel like you have to convince anyone that your interests won't change. Just enjoy the ride and see where you end up.
 
22031 Alum said:
My desired patient population was the same as yours. I went through the pre-clinical years just as convinced as you are now, that I was destined to be a pediatrician.

Needless to say I am not a pediatrician.

It's great to have an interest, but don't feel like you have to convince anyone that your interests won't change. Just enjoy the ride and see where you end up.
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I'm not trying to convince anyone, just making a prediction about where I think I'll end up. I'll definitely keep an open mind.

And just as an aside, wanting to become a pediatrician is a very specific field, whereas wanting to work with kids is much more general and includes a bunch of different specialties. Not saying that this negates your point, but I just think that your plan was much more specific (and thus much more likely to change) than mine. Still, I'll make sure not to resist changing interests.
 
Yes, because it's most likely that you know nothing about the field other than it sounds cool.


walloobi said:
Especially for schools that like to churn out primary care docs, or schools that largely focus on care of underserved populations, would it be detrimental to make it known in my personal statement (or elsewhere) that I want to enter a small and very specialized field instead of primary care? (just to clarify, I obviously don't know exactly where I'll end up, but I'm confident that my future will entail subspecialization in pediatrics, rather than primary care). Of course schools have mission statements that convey the values they look for in applicants, but is the goal of subspecialization ever a death sentence, or do they tend to have some leeway for applicants like me? Certainly no med schools have graduating classes with 100% of students pursuing primary care, right?
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Goro said:
Yes, because it's most likely that you know nothing about the field other than it sounds cool.
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Even if the rest of my app proves that that's not the case?
 
walloobi said:
Even if the rest of my app proves that that's not the case?
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If you're saying that you rotated through your desired specialty, or specialties, for several weeks, then you can say that you know something about the field other than it looks cool. Even then, you don't know everything about the field. Not to beat you up or anything. I'm just saying to keep your mind open. Some of my classmates mentioned their desired specialties in their applications and they got in. But they also had good reasons to pursue medicine in general, that is what is most important IMHO.
 
walloobi said:
I have pretty extensive experience with both general pediatricians and pediatric subspecialists (for an undergrad, at least), through shadowing, and through volunteering in PICUs/NICUs/peds oncology departments/peds EDs/peds surgery units/peds cards units/etc., and some pretty dull general peds outpatient clinics.
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While I do not think I can add much to the excellent advice of @WedgeDawg, I have been musing over an analogy that may help you understand the adcom perspective on this issue.

Imagine you take a date to a fancy, expensive restaurant that they have never been to before. The person opens the menu, looks at the first item, then closes it and announces that the first item is what they will order. Naturally you would see that as rather silly, right? Why not at least peruse the other offerings before making a decision? Your date could offer a rationale for the haste, no doubt, and it might even be reasonable in some regards, but it doesn't change the fact that the choice was made without acquiring and considering all available information.

To that end, your clinical exposure is certainly compelling, but the simple truth is that all you can honestly say is that 1.) you want to do medicine for a career, and 2.) you could see yourself working somewhere in the realm of pediatrics. At this point acdoms are more interested in the former. The latter is all fine and good, but if you push the certainty too far you will simply come off as naïve.
 
walloobi said:
Working with kids is my main motivation for going into medicine, and I know I couldn't be nearly as happy working with any other patient population. And primary care is quite unappealing to me, with all due respect to those docs. It just doesn't happen to fit my personality or interests. I have pretty extensive experience with both general pediatricians and pediatric subspecialists (for an undergrad, at least), through shadowing, and through volunteering in PICUs/NICUs/peds oncology departments/peds EDs/peds surgery units/peds cards units/etc., and some pretty dull general peds outpatient clinics. No question about which environments appeal to me more. Don't worry, I'm not one of those ignorant high schoolers who "know they want to become a pediatric heart surgeon."
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The stuff in italics is good to say. Being able to back up why you like a specialty with experiences is awesome. Do NOT say that line in bold. Even if that's what you believe now, unless you somehow have shadowed every possibly specialty in every type of clinical setting, you don't know that. I myself love working with kids, but I recognize that since I haven't had the opportunity to shadow peds of any kind I don't know if that's something I would prefer.

walloobi said:
What kind of reactions did you get in interviews when you said you were interested in ortho? I'd imagine you'd have to walk on eggshells even more so with a specialty as competitive as that (but it sounds like you nipped it in the bud pretty successfully by saying it might be naive and that you'd keep an open mind).
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I tried to play it as close to the chest as possible. For starters I'm male, 6'2", 190 pounds, and I played water polo in college-I look like someone who would go into ortho (not to stereotype orthopods but in my personal opinion that's what your "standard stock orthopod" looks like (again, I mean no disrespect to anyone, just an n=1 visualization of a your standard orthopedic surgeon's appearance)). Most interviewers were cool with it, and just asked general "why" questions, and I always made sure to add in that while I absolutely love the concept of surgery, and think ortho is the path I want to go, it would be stupid of me to be hell-bent on doing that specialty, and that I need to keep an open mind in medical school. How competitive it is never really came up, and I did have an interviewer who looked at me like I had two heads for the rest of the interview, but for the most part it was fine. For me, my explanation always followed a similar path-I played sports in college, and was always the type of kid who spent all his free time running around throwing a football or a baseball or kicking a soccer ball into a net. On top of that, I am a very visual, literal learner and I love how concrete surgery is-you can see exactly what is going on with your patient and diagnose exactly what you need to do to fix them while they are on the table, as opposed to doing something like IM where you prescribe a drug, maybe it works and maybe it doesn't, where it can be a little more theoretical than literal. Combining those two interests, you get ortho therefore I'm interested in ortho.
 
Med Ed said:
While I do not think I can add much to the excellent advice of @WedgeDawg, I have been musing over an analogy that may help you understand the adcom perspective on this issue.

Imagine you take a date to a fancy, expensive restaurant that they have never been to before. The person opens the menu, looks at the first item, then closes it and announces that the first item is what they will order. Naturally you would see that as rather silly, right? Why not at least peruse the other offerings before making a decision? Your date could offer a rationale for the haste, no doubt, and it might even be reasonable in some regards, but it doesn't change the fact that the choice was made without acquiring and considering all available information.

To that end, your clinical exposure is certainly compelling, but the simple truth is that all you can honestly say is that 1.) you want to do medicine for a career, and 2.) you could see yourself working somewhere in the realm of pediatrics. At this point acdoms are more interested in the former. The latter is all fine and good, but if you push the certainty too far you will simply come off as naïve.
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That makes sense. I didn't mean to imply that I won't explore other options, but just that, as of right now, I think it's likely that I'll end up in peds. If my date thought the first thing on the menu sounded fantastic, said that she thinks she'll end up ordering that, and then continued looking through the rest of the menu anyways just in case, I wouldn't blame her. Perhaps I just came across as closed off to other options by expressing so much interest in peds.
 
walloobi said:
Got it, I'll avoid saying anything that absolute.

One last thing that I'm not yet grasping (this goes to everyone): why is it the case that your ideal patient population and your ideal specialty within that patient population aren't mutually exclusive? For example, if someone falls in love with orthopedics during med school, shouldn't that be mostly independent of the age group in which they want to practice orthopedics? There are essentially all the same specialties in peds that there are in adult medicine, so how is it possible that you could like peds much more in general, but come across a specialty in which you'd rather practice it with an adult population? It doesn't make sense to me that one would need to sample every specialty in both peds and adult environments in order to know that the peds environments are the ones they enjoy more, regardless of specialty. I guess my hangup is that I can't imagine finding a field during med school in which I'd decide to not work with kids instead of just pursuing that field within peds.
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To each their own. I think it comes down in your own mind whether you want to work with kids or not, and there are some people that feel strongly both ways (you like peds, some people might hate working with kids. Who knows.) Keep in mind though that often some specialties in peds are more competitive than their counterpart in adults (e.g. general surgery I believe) so that might be a reason why to do adults. Also, lets say you train as a general surgeon and by the time you are done with residency you just want to start working and making good money, you are tired of studying and train, and you want to start paying off loans, so instead of doing a fellowship in peds to do pediatrics you just call it quits and stick with adults (is that how peds general surgery works? I'm not sure @gyngyn @Goro). Maybe as an oncologist you just can't handle the emotional aspect of doing peds vs. adults. Also sometimes each specialty deals with relatively different issues-for example doing adult orthopedics you probably see a ton of hip replacements/knee replacements in the elderly, whereas in children you do more acl reconstructions in youth football players or ucl repairs in 10 year-olds trying to throw curveballs. Of the pediatric orthopedic surgeons I've followed, one big thing was they try to keep surgery as a last resort-they operate on something like less than 7% of the kids they see in the clinic, whereas in an adult ortho practice they're much more surgery inclined, and maybe you just love operating and want to operate a ton, and doing adults is a way to do more operations than kids. I can also imagine that doing something like a pediatric cardiology deals with greatly different issues than adult cardiology. If there wasn't a difference between doing peds vs. adults in each specialty, then why do we have a peds/adult split to begin with? My former pediatrician deals with drastically different issues than my current PCP, and so they need to be separate and go through separate training even though they could in a sense function the same on paper. (For the record I love kids and would love to end up doing something in peds too.)
 
Just to add, remember in any sort of Peds field you are not truly dealing with the kids.. It's their parents who you really have to handle.

*I say this as someone also interested in Peds.
 
walloobi said:
Got it, I'll avoid saying anything that absolute.

One last thing that I'm not yet grasping (this goes to everyone): why is it the case that your ideal patient population and your ideal specialty within that patient population aren't mutually exclusive? For example, if someone falls in love with orthopedics during med school, shouldn't that be mostly independent of the age group in which they want to practice orthopedics? There are essentially all the same specialties in peds that there are in adult medicine, so how is it possible that you could like peds much more in general, but come across a specialty in which you'd rather practice it with an adult population? It doesn't make sense to me that one would need to sample every specialty in both peds and adult environments in order to know that the peds environments are the ones they enjoy more, regardless of specialty. I guess my hangup is that I can't imagine finding a field during med school in which I'd decide to not work with kids instead of just pursuing that field within peds.
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Gynecology-Obstetrics?
Geriatrics?

If you write about your desire to go into specialty care, don't expect the schools that see their role as increasing the supply of primary care providers to fall in love with you. On the contrary, if they are truly mission driven they should shun you. Most pediatric subspecialties are practiced solely in academic settings because when kids get really sick their parents take them to specialized children's hospitals/academic medical centers. You may have better luck at the schools with missions to increase the supply of physicians in academic medicine.
 
walloobi said:
That all sounds pretty reasonable. I'd imagine that a preference for a certain patient population would often outweigh a preference for different bread and butter cases, but obviously that's not always true, and might not end up being true in my case. Who knows. Time will tell.
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I have no way of proving it, but from what I've seen the opposite is actually more common. People tend to figure out what they want their bread and butter cases to look like, and choose a field based on that. Then they adjust their desired patient population within that field. You can't say you're just going to "work with kids" without deciding if you'd prefer to:

Operate on them (gen surg --> peds fellowship)
Operate on a specific part of them (ex. Urology or Ophtho --> peds fellowship)
Manage them medically (pediatrics with or w/o fellowship)
Take care of them in emergencies (ER --> peds fellowship)
Take care of their mental health (psych--> peds)

And so forth. Those are very very different ways to end up working with the "same" population. Someone who'd be happy with one path would be quite miserable in another, and it'd be unwise to think the patient population decision should come first.
 
22031 Alum said:
I have no way of proving it, but from what I've seen the opposite is actually more common. People tend to figure out what they want their bread and butter cases to look like, and choose a field based on that. Then they adjust their desired patient population within that field. You can't say you're just going to "work with kids" without deciding if you'd prefer to:

Operate on them (gen surg --> peds fellowship)
Operate on a specific part of them (ex. Urology or Ophtho --> peds fellowship)
Manage them medically (pediatrics with or w/o fellowship)
Take care of them in emergencies (ER --> peds fellowship)
Take care of their mental health (psych--> peds)

And so forth. Those are very very different ways to end up working with the "same" population. Someone who'd be happy with one path would be quite miserable in another, and it'd be unwise to think the patient population decision should come first.
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I was referring to the differences between bread and butter cases in peds vs. adult within the same specialty (like peds ortho = a lot of scoliosis procedures, vs. general ortho = a lot of hip replacements), not different bread and butter cases between different peds specialties (obviously those differences are going to be much more drastic, like the ones you listed).
 
I had subspecialization interest in my personal statement last cycle. Zero interviews.

This cycle, no specifications in my personal statement. Four interviews. Multiple acceptances.

Obviously there are a lot of other factors at play here, but just an example. I regretted having it in there after I submitted it.
 
walloobi said:
how is it possible that you could like peds much more in general, but come across a specialty in which you'd rather practice it with an adult population?
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Here's how it happens:

You love working with kids, but then you discover that you love pediatric ortho. So you go into ortho, planning on doing a pedes ortho fellowship. Then, sometime over the 5 years of your residency, you realize that you really love doing total joints, especially knees. You do a fellowship in that. Guess what? You now have a geriatric practice, and you love it.
 
bc65 said:
Here's how it happens:

You love working with kids, but then you discover that you love pediatric ortho. So you go into ortho, planning on doing a pedes ortho fellowship. Then, sometime over the 5 years of your residency, you realize that you really love doing total joints, especially knees. You do a fellowship in that. Guess what? You now have a geriatric practice, and you love it.
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So it's probably pretty risky to go into a residency with the sole hope of getting into a specific fellowship afterwords, huh?
 
walloobi said:
So it's probably pretty risky to go into a residency with the sole hope of getting into a specific fellowship afterwords, huh?
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It depends. Some fellowships go unfilled. Others are very competitive.
 
walloobi said:
So it's probably pretty risky to go into a residency with the sole hope of getting into a specific fellowship afterwords, huh?
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Yes, if you're going into a specialty that you hate with the sole intention of getting a highly competitive fellowship later that you will like, you may end up very unhappy.

But that wasn't the point of my post. I was just addressing your question, by showing you how you might enter a specialty with the intention of going into a particular sub-specialty, but end up a different specialty which caters to a different age group.

When I was a med student, the chief of pedes told us that we should not go into pedes because we like children. We should only go into pedes if we liked treating children's diseases. Those were two different things entirely. Also, you have to like dealing with their parents.

Also, consider the possibility that your desire to care for children might be satisfied by having a few of your own. That might obliterate your desire to be around them all day.

It's my impression that the percentage of med students who end up in the same specialty that they expressed an interest in initially can be explained by random chance alone.
 
I go to a primary care-focused school and I distinctly remember being asked about if I was interested in any particular specialty during one of my interviews here. I'm not sure if it was because of my app or if this person asked everyone that question. (I did have a subspecialty in mind, but I don't think I mentioned that in my app.) I said something like, I have had such and such experience in this field, so that definitely makes me interested in it, but obviously there are many other fields to explore and I'm open to changing my mind. They must have liked that answer because they admitted me. I definitely agree the PS should be about your general call towards medicine and I don't think there is anything wrong with admitting you have interest in a specialty (especially if your application points that way with shadowing/volunteer work), but just know that they want you to be open to other specialties, too.
 
anthonycrispino said:
I had subspecialization interest in my personal statement last cycle. Zero interviews.

This cycle, no specifications in my personal statement. Four interviews. Multiple acceptances.
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To contrast, I wrote about sub specialization pretty heavily. It flowed well with personal story, academic experience, and research experience. I did caveat in the end of my statement (and in all my interviews) that while I had a genuine passion for a specific field I also found other fields intriguing and was open to exploring them. I think it helped that I wrote about what I learned from shadowing experiences outside of my field of interest as well as the specialty in my PS. I've had no issue with acceptances at research institutions. I HAVE had issues with my state school which is primary care driven... that is definitely something to give thought to when writing your PS and shaping your school list.

You can do it, but it is a risk and it will influence your school list for sure. Expect to defend yourself (without coming off as a naive know-it-all) in your interviews too.
 
I have a question about this, is it bad to talk about a specialty you are interested if all of your experiences revolve around it? Like neurology in my case? Here is what I mean in terms of experiences
  • I worked in one lab researching neurobiology and metabolism
  • Another lab focusing on neurological ataxic disorders, I have a first author pub regarding ataxia and the brain
  • I work in a lab currently focused on neurobiology and exercise, with a focus on neurogenesis and memory.
I shadowed a neurologist that focused on movement disorders and it really made me interested. Also, after I worked in that first lab I became very interested in the brain in general- this is the time when my grades went from crap to good (between sophomore and junior year). All of these research experiences combined are around 3000hrs and I know research isn't medicine per se but it piqued my interest in it. I've shadowed other specialties such as OBGYN, general surgery, trauma surgery, etc. I just feel like I'm having trouble explaining the "why medicine" part without talking about my interest in this directly. Or should I talk about it but not focus on it the whole time?

Thanks for the help
 
Id say use what you learnt about yourself and your desire to pursue medicine through exploring these specific specialties (you may have shadowed a specialist in the field for example). Dont specifically say that's ultimately what u want to do because, unless you worked alongside these specialists, your perception that this specialty is right for you might be flawed.
 
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