Picked the wrong specialty, failing. Help.

[amakhosidlo]

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I'm a US allopathic grad with Step scores in the 240's and recently passed Step 3, who applied in the match with an excellent application.

Last year, I made an enormous mistake, and ranked a specialty that is not at all compatible with my personality or skill set. As the year progressed, faculty began to express concerns, health issues began to impact the quality of my work, and now 12 months into my internship, I'm in remediation due to being unable to meet milestones to transition to an R2. My problem is that I can't multitask, and I'm socially anxious. I have difficulty with oral presentations, and I make mistakes. My medical knowledge is fine, my decision-making is appropriate, but I have difficulty getting my point across verbally, and things just get missed when I lose track of tasks.

At this point I can see that I'm not cut out for direct patient care. When I applied originally, I double-applied in this field and in radiology, and had plenty of interviews. I picked my specialty because of job prospects and this foolish idea I had of what kind of a doctor I wanted to be. Even though I enjoyed radiology, the field is full of "my people", and I had an aptitude for it. Now, I'm getting negative reviews in my program, and I don't know if or how to transition to another field. I'm going to try to re-enter the match and go for radiology, hat-in-hand, but I feel like this is an exercise in futility given the scarlet letter I now bear.

I have no idea what to do at this point. I have hundreds of thousands of dollars in debt, and honestly at this point I'd do anything so long as I'd have a job and a roof over my head. I never thought 5 years ago that I'd wind up posting this type of thread. Honestly, I feel like I'm in my worst nightmare: Like I'm trapped and the walls around me are closing in.

I guess I'm wondering, what are my chances of re-matching into any field? How do I put together another application without any LOR's, or new experiences? What do you do when you picked the wrong field and it shows in how poorly you've done?

 

[doc05]

no reason why you can't match into radiology. speak with your PD and get the support of your program. be sure to stay positive in this process, because you want to highlight how much you like radiology, rather than your negative experiences in your current field.

 

[mercaptovizadeh]

I'm a US allopathic grad with Step scores in the 240's and recently passed Step 3, who applied in the match with an excellent application.

Last year, I made an enormous mistake, and ranked a specialty that is not at all compatible with my personality or skill set. As the year progressed, faculty began to express concerns, health issues began to impact the quality of my work, and now 12 months into my internship, I'm in remediation due to being unable to meet milestones to transition to an R2. My problem is that I can't multitask, and I'm socially anxious. I have difficulty with oral presentations, and I make mistakes. My medical knowledge is fine, my decision-making is appropriate, but I have difficulty getting my point across verbally, and things just get missed when I lose track of tasks.

At this point I can see that I'm not cut out for direct patient care. When I applied originally, I double-applied in this field and in radiology, and had plenty of interviews. I picked my specialty because of job prospects and this foolish idea I had of what kind of a doctor I wanted to be. Even though I enjoyed radiology, the field is full of "my people", and I had an aptitude for it. Now, I'm getting negative reviews in my program, and I don't know if or how to transition to another field. I'm going to try to re-enter the match and go for radiology, hat-in-hand, but I feel like this is an exercise in futility given the scarlet letter I now bear.

I have no idea what to do at this point. I have hundreds of thousands of dollars in debt, and honestly at this point I'd do anything so long as I'd have a job and a roof over my head. I never thought 5 years ago that I'd wind up posting this type of thread. Honestly, I feel like I'm in my worst nightmare: Like I'm trapped and the walls around me are closing in.

I guess I'm wondering, what are my chances of re-matching into any field? How do I put together another application without any LOR's, or new experiences? What do you do when you picked the wrong field and it shows in how poorly you've done?

Would your intern year count for radiology?

 

[Gadofosveset]

I'm a US allopathic grad with Step scores in the 240's and recently passed Step 3, who applied in the match with an excellent application.

Last year, I made an enormous mistake, and ranked a specialty that is not at all compatible with my personality or skill set. As the year progressed, faculty began to express concerns, health issues began to impact the quality of my work, and now 12 months into my internship, I'm in remediation due to being unable to meet milestones to transition to an R2. My problem is that I can't multitask, and I'm socially anxious. I have difficulty with oral presentations, and I make mistakes. My medical knowledge is fine, my decision-making is appropriate, but I have difficulty getting my point across verbally, and things just get missed when I lose track of tasks.

At this point I can see that I'm not cut out for direct patient care. When I applied originally, I double-applied in this field and in radiology, and had plenty of interviews. I picked my specialty because of job prospects and this foolish idea I had of what kind of a doctor I wanted to be. Even though I enjoyed radiology, the field is full of "my people", and I had an aptitude for it. Now, I'm getting negative reviews in my program, and I don't know if or how to transition to another field. I'm going to try to re-enter the match and go for radiology, hat-in-hand, but I feel like this is an exercise in futility given the scarlet letter I now bear.

I have no idea what to do at this point. I have hundreds of thousands of dollars in debt, and honestly at this point I'd do anything so long as I'd have a job and a roof over my head. I never thought 5 years ago that I'd wind up posting this type of thread. Honestly, I feel like I'm in my worst nightmare: Like I'm trapped and the walls around me are closing in.

I guess I'm wondering, what are my chances of re-matching into any field? How do I put together another application without any LOR's, or new experiences? What do you do when you picked the wrong field and it shows in how poorly you've done?

If you can't multitask, you will fail in radiology. If you can't express yourself well verbally, you will fail in radiology.

Make sure you really like radiology and you're not imagining it to be something it's not.

 

[amakhosidlo]

Would your intern year count for radiology?

Only if I successfully remediate. If not, the last 12 months will count for absolutely nothing. My program director says he/she will support me no matter what, but I need to meet that they've set out to get credit for the year.

If you can't multitask, you will fail in radiology. If you can't express yourself well verbally, you will fail in radiology.

Make sure you really like radiology and you're not imagining it to be something it's not.

I realize that. But there's a difference between actively entering orders on & managing a high inpatient census, and reading X# of films while protocoling Y and being interrupted to comment on Z. A huge difference between standing in front of your team and talking for five minutes per patient and calling teams over the phone to update them with results. I did a radiology rotation as a med student, I took a good long look at the field and passed for illogical reasons.

 

[mercaptovizadeh]

Only if I successfully remediate. If not, the last 12 months will count for absolutely nothing.

Then focus on remediating. I would forget about radiology right now. Try to become the best internal medicine/surgery/pediatrics/ob-gyn/whatever PGY1/2 you can be. Only once you are out of the remediation phase can you objectively assess the situation, and furthermore, garner the support from your PD you would need for a successful switch. Who knows, once you do better you might actually enjoy your current specialty?

 

[Law2Doc]

If you can't multitask, you will fail in radiology. If you can't express yourself well verbally, you will fail in radiology.

Make sure you really like radiology and you're not imagining it to be something it's not.

This was my thought as well. All they do is verbally try to convey what they see and are concerned about. Much of the time they are speaking into a dictaphone and the reader reads a transcription of what was said, but conceptually it's the same. The rest of the time they are discussing their reads by phone or in person. So if verbal explanations are really your issue, I think this would potentially be the worst field for you. The folks that do well in radiology are the ones who love to explain what they are seeing.

If you can't multitask every specialty is going to be a problem for you. I don't think many doctors get the luxury of a single patient with a single problem and without interruptions.

 

[Law2Doc]

...I did a radiology rotation as a med student...

I think most med students do a radiology rotation because it's pretty light fare -- there's very little you as a med student can even help out with on that rotation. The lights go out and it's nap time. I'd bet the experience is a bit different at the resident level and beyond.

 

[Gadofosveset]

I realize that. But there's a difference between actively entering orders on & managing a high inpatient census, and reading X# of films while protocoling Y and being interrupted to comment on Z. A huge difference between standing in front of your team and talking for five minutes per patient and calling teams over the phone to update them with results. I did a radiology rotation as a med student, I took a good long look at the field and passed for illogical reasons.

Law2Doc is right. It's an honest mistake, but you got the wrong impression from your rotation.
If you think rads is made up of people with social anxiety, you are mistaken… there're some autism-spectrum people, but they usually aren't shy. A good part of your job (and some of the most rewarding parts of your job) are discussing patients over the phone or heading multidisciplinary rounds. If you can't show reasonable confidence in these arenas, you're going to be useless. You may slink by, but the qualities you're describing are not those of a great radiologist.

 

[Gadofosveset]

If you want to choose rads because you have positive associated skills (visual recognition, etc.) and you want to work on communication skills and presentation skills, in order to eventually develop them into a strength, then that may work. But it's probably not a good idea to choose a field that you think caters to negative skills.

 

[Law2Doc]

If you want to choose rads because you have positive associated skills (visual recognition, etc.) and you want to work on communication skills and presentation skills, in order to eventually develop them into a strength, then that may work. But it's probably not a good idea to choose a field that you think caters to negative skills.

Agree. You don't want to pick a field because you think they are more likely to let you skate by. If you do you are going to hate life.

But more so you seem to say your issues are with verbal expression and multitasking and then pick the field that imho probably maximizes both those things, but then suggest that this is going to be easier for you than carrying a lot of patients.

if you are reading 150 studies a shift, all of which your name goes on and you can be sued for anything missed, and the phone is constantly ringing, and surgeons keep interrupting to go over a case, and you have a tumor board to cover each week, and other administrative obligations to boot, does that sound like what you are picturing from your radi-holiday from med school? Because that's closer to what these guys and gals do when the training wheels come off. Your described areas of weakness are kind of what they need to get by imho.

 

[Dral]

Agree. You don't want to pick a field because you think they are more likely to let you skate by. If you do you are going to hate life.

But more so you seem to say your issues are with verbal expression and multitasking and then pick the field that imho probably maximizes both those things, but then suggest that this is going to be easier for you than carrying a lot of patients.

if you are reading 150 studies a shift, all of which your name goes on and you can be sued for anything missed, and the phone is constantly ringing, and surgeons keep interrupting to go over a case, and you have a tumor board to cover each week, and other administrative obligations to boot, does that sound like what you are picturing from your radi-holiday from med school? Because that's closer to what these guys and gals do when the training wheels come off. Your described areas of weakness are kind of what they need to get by imho.

Don't forget if you're at a hospital where you're doing interventional and the nurse is pulling you every hour to do those cases...yet another thing to juggle.

You get the pic, OP. Just really look into it first.

 

[Arcan57]

Putting aside that you have this idea of radiology as an escape hatch, the problems you're describing are going to be limiting in any field. Organization and confidence in expressing yourself are pretty much universal skills in medicine. Rather than cling to a fantasy that if you had just made a better choice you wouldn't be your current situation, you need to figure out how to successfully acquire these SKILLS. Very few people are innately organized, it's just that somewhere in the pre-med/pre-clinical/clinical years their native intelligence stopped sufficing and they figured out a system that worked for them. You need to figure out what you can't reliably keep in your short-term memory and have a system for quickly recalling it (pt note cards, worklist, to do apps, etc). My thought is that having ready access to that information is going to make it easier to present because you're not going to be so overloaded trying to keep all the balls in the air at the same time.

 

[Arcan57]

Putting aside that you have this idea of radiology as an escape hatch, the problems you're describing are going to be limiting in any field. Organization and confidence in expressing yourself are pretty much universal skills in medicine. Rather than cling to a fantasy that if you had just made a better choice you wouldn't be your current situation, you need to figure out how to successfully acquire these SKILLS. Very few people are innately organized, it's just that somewhere in the pre-med/pre-clinical/clinical years their native intelligence stopped sufficing and they figured out a system that worked for them. You need to figure out what you can't reliably keep in your short-term memory and have a system for quickly recalling it (pt note cards, worklist, to do apps, etc). My thought is that having ready access to that information is going to make it easier to present because you're not going to be so overloaded trying to keep all the balls in the air at the same time.

 

[Doctor Bagel]

Putting aside that you have this idea of radiology as an escape hatch, the problems you're describing are going to be limiting in any field. Organization and confidence in expressing yourself are pretty much universal skills in medicine. Rather than cling to a fantasy that if you had just made a better choice you wouldn't be your current situation, you need to figure out how to successfully acquire these SKILLS. Very few people are innately organized, it's just that somewhere in the pre-med/pre-clinical/clinical years their native intelligence stopped sufficing and they figured out a system that worked for them. You need to figure out what you can't reliably keep in your short-term memory and have a system for quickly recalling it (pt note cards, worklist, to do apps, etc). My thought is that having ready access to that information is going to make it easier to present because you're not going to be so overloaded trying to keep all the balls in the air at the same time.

This. You also don't have to be the best at this stuff, but you can learn to do a decent job to get you through training. I've heard of people doing things like Toastmasters to get over fear of public speaking -- it could be worth looking into that. Otherwise, it's much easier to present when you've got the information you need in front of you. It might be that you'll be a little slower to put together presentations just because of that, but that's OK. You often have the option of waiting until you've written something before you have to present it such as presenting an admission on rounds the next day.

 

[Taurus]

Give the OP credit for realizing how much clinical medicine sucks. Radiology is the best field in medicine. I would jump off a bridge if I were a clinician. The OP can do fine in radiology. Most if my interactions with clinicians is calling to tell them how ******ed their request is.

 

[dozitgetchahi]

Give the OP credit for realizing how much clinical medicine sucks. Radiology is the best field in medicine. I would jump off a bridge if I were a clinician. The OP can do fine in radiology. Most if my interactions with clinicians is calling to tell them how ******ed their request is.

Yeah, I was kinda thinking this too. Not sure if I'd be so quick to judge the OP as inadequate for this job...most radiologists I've seen would utterly hate rounding with teams, and their skill sets generally don't jibe well with the more hands-on specialties either.

 

[Gadofosveset]

Yeah, I was kinda thinking this too. Not sure if I'd be so quick to judge the OP as inadequate for this job...most radiologists I've seen would utterly hate rounding with teams, and their skill sets generally don't jibe well with the more hands-on specialties either.

What normal human being actually enjoys rounding with teams? But keep the cliches coming.

Ex-surgeons make excellent radiologists, in my experience.

 

[Arcan57]

Speaking of radiology/surgery connections, I imagine (I've only ever heard the surgeon's end of the call) it requires some excellent communication skills on the radiologist's part when a surgeon is lighting into them for a non-specific read on a critical patient.

 

[amakhosidlo]

This. You also don't have to be the best at this stuff, but you can learn to do a decent job to get you through training. I've heard of people doing things like Toastmasters to get over fear of public speaking -- it could be worth looking into that. Otherwise, it's much easier to present when you've got the information you need in front of you. It might be that you'll be a little slower to put together presentations just because of that, but that's OK. You often have the option of waiting until you've written something before you have to present it such as presenting an admission on rounds the next day.

So here's the thing. I'm fine communicating one-on-one. People work with me directly and wonder what it is that other people have issues with. When I'm put on the spot and I have 2 minutes to impress my team of 6 people, I can still communicate but I take a circuitous route to get my point across and people lose patience. My other problem "multitasking" is really just following through on orders and making sure things get done. This is what I mean when I say I don't think direct patient care is for me. My consult teams love me, I come up with and leave recs like a champ ED? Not an issue, talk things over with my attd one-on-one and I come up with solid, reasonable plans, dispo like its my job. Rads is a dream that I don't expect to happen. Like I said I'll do effing anything at this point. Path, psych, Rads, hell I'll do occupational health if they'll take me. People are missing the point, that I got into something I'm not cut out for, I'm sucking as a result, and need to figure out how to transition into something else.

 

[Taurus]

Simple. Try to scramble into any radiology spot you can find. Complete your intern year.

There's this perception that there's a job crisis in radiology and that's why you see this drop in interest in the field. But I can tell you that perception is overblown and this past year you see the job market opening up. Jobs are going unfilled even in major cities. Jobs that I turned down in Phoenix and Austin get reposted 6 months later. So because of this misperception, it's much easier to get into radiology now before most med students realize that the job crisis is not real.

 

[Law2Doc]

...My other problem "multitasking" is really just following through on orders and making sure things get done...

You posted this like its not a big deal. It is. It's basically what separates management personnel from fry cooks. You really can't be any kind of professional without cultivating this skill. The low level employee can say, "hey I did my thing and don't really know what happened next. No doctor can. This is the heart of what you ought to get out of intern year -- how to take ownership of a patient and following up on things. The idea that you think this doesn't happen in every field, and is not a big deal is mind boggling. I don't think you necessarilly picked the wrong residency so much as grossly underestimated the skillset needed to be (any kind of) a doctor.

 

[SierraMist14]

I'm a US allopathic grad with Step scores in the 240's and recently passed Step 3, who applied in the match with an excellent application.

Last year, I made an enormous mistake, and ranked a specialty that is not at all compatible with my personality or skill set. As the year progressed, faculty began to express concerns, health issues began to impact the quality of my work, and now 12 months into my internship, I'm in remediation due to being unable to meet milestones to transition to an R2. My problem is that I can't multitask, and I'm socially anxious. I have difficulty with oral presentations, and I make mistakes. My medical knowledge is fine, my decision-making is appropriate, but I have difficulty getting my point across verbally, and things just get missed when I lose track of tasks.

At this point I can see that I'm not cut out for direct patient care. When I applied originally, I double-applied in this field and in radiology, and had plenty of interviews. I picked my specialty because of job prospects and this foolish idea I had of what kind of a doctor I wanted to be. Even though I enjoyed radiology, the field is full of "my people", and I had an aptitude for it. Now, I'm getting negative reviews in my program, and I don't know if or how to transition to another field. I'm going to try to re-enter the match and go for radiology, hat-in-hand, but I feel like this is an exercise in futility given the scarlet letter I now bear.

I have no idea what to do at this point. I have hundreds of thousands of dollars in debt, and honestly at this point I'd do anything so long as I'd have a job and a roof over my head. I never thought 5 years ago that I'd wind up posting this type of thread. Honestly, I feel like I'm in my worst nightmare: Like I'm trapped and the walls around me are closing in.

I guess I'm wondering, what are my chances of re-matching into any field? How do I put together another application without any LOR's, or new experiences? What do you do when you picked the wrong field and it shows in how poorly you've done?

Perhaps the realest statement I've seen on SDN. One that (being that I'm deciding between two specialties) needed to hear. Thanks, and I hope everything works out for you.

 

[scootad.]

If the OP has trouble "making sure things get done" I'm not sure radiology is a great fit. You need to be FAST at getting all the reads done with quick turn-around time unless you get a job with the VA. Those VA jobs are not easy to get btw. Or unless you do academics and have residents do a lot of the dictating for you, but then you have to teach them and organize research projects. Rads is not as cush or relaxed as a lot of med students think.

 

[AStark]

So here's the thing. I'm fine communicating one-on-one. People work with me directly and wonder what it is that other people have issues with. When I'm put on the spot and I have 2 minutes to impress my team of 6 people, I can still communicate but I take a circuitous route to get my point across and people lose patience. My other problem "multitasking" is really just following through on orders and making sure things get done. This is what I mean when I say I don't think direct patient care is for me. My consult teams love me, I come up with and leave recs like a champ ED? Not an issue, talk things over with my attd one-on-one and I come up with solid, reasonable plans, dispo like its my job. Rads is a dream that I don't expect to happen. Like I said I'll do effing anything at this point. Path, psych, Rads, hell I'll do occupational health if they'll take me. People are missing the point, that I got into something I'm not cut out for, I'm sucking as a result, and need to figure out how to transition into something else.

This sounds like more of an issue of poor presentation skills than anything intrinsic to "direct patient care". These don't develop without work, though, and the point is not to "impress" people but to provide succinct information about a patient's status and your assessment and plan. What do you mean by "circuitous" route? Might trying to stick to a script in your head work better? I just a lot of mental check lists and mnemonics to remember to cover everything. These become less important over time.

Similarly, why do you have trouble following through on orders? I always start by marking little check boxes on my patient list with each task to be done, and then simply checking them off as a I go. It's ridiculously simple.

Having said that, you may well be right that you're not "cut out" for (what I gather is) IM. I tend to think it's a fairly broad specialty that similarly has a fair diversity in personality types and skill sets. My concern is that the issues you've identified are not especially specific to IM. At my centre, a radiologist attends ICU imaging rounds and goes through daily CXRs and other studies in front of two staff intensivists, 3-4 residents, and usually the ICU pharmacist and some others.

 

[Doctor Bagel]

Give the OP credit for realizing how much clinical medicine sucks. Radiology is the best field in medicine. I would jump off a bridge if I were a clinician. The OP can do fine in radiology. Most if my interactions with clinicians is calling to tell them how ******ed their request is.

OK, you're right that there's also some truth to this. Doing formal style presentations on rounds is certainly not the type of thing lots of us have to do in practice, and it's also certainly not something I miss. And yes, I hated IM wards and would much rather do radiology. Either way, though, the op will do better if he figures out a way to survive his remediation and get credit for his internship, which to me seems doable.

 

[Doctor Bagel]

So here's the thing. I'm fine communicating one-on-one. People work with me directly and wonder what it is that other people have issues with. When I'm put on the spot and I have 2 minutes to impress my team of 6 people, I can still communicate but I take a circuitous route to get my point across and people lose patience. My other problem "multitasking" is really just following through on orders and making sure things get done. This is what I mean when I say I don't think direct patient care is for me. My consult teams love me, I come up with and leave recs like a champ ED? Not an issue, talk things over with my attd one-on-one and I come up with solid, reasonable plans, dispo like its my job. Rads is a dream that I don't expect to happen. Like I said I'll do effing anything at this point. Path, psych, Rads, hell I'll do occupational health if they'll take me. People are missing the point, that I got into something I'm not cut out for, I'm sucking as a result, and need to figure out how to transition into something else.

So definitely transition, but it sounds like your options might be better if you can get through this remediation. About the presenting thing, it does sound like a social anxiety type of thing, and there are treatments for it. Again, not to say you stick with IM, but treatments could make your short term life better. About getting stuff done, lists and lists and more lists -- really. Run your list of things to do at the end of the day to make sure it's done.

I'm right there with you on preferences and dislikes, including hating presenting on rounds (and jeez, hating formal rounds for that matter -- how anyone can do peds or IM I don't know) and being on the disorganized side for medicine. Definitely think about switching to a specialty that doesn't emphasize your weaknesses, but finding some tools to get better at public speaking and at organization can't hurt. It'll also potentially save you from having to repeat more medicine types of months in an internship in the future.

And actually thinking about the remediation, I'm guessing the multitasking, not getting stuff done is the bigger issue than the circuitous presentations. So if you focus on one thing in remediation, focus on that.

 

[mk04447]

Maybe try being less socially awkward? Seems you're being given a lot of off topic advice.

 

[rokshana]

So here's the thing. I'm fine communicating one-on-one. People work with me directly and wonder what it is that other people have issues with. When I'm put on the spot and I have 2 minutes to impress my team of 6 people, I can still communicate but I take a circuitous route to get my point across and people lose patience. My other problem "multitasking" is really just following through on orders and making sure things get done. This is what I mean when I say I don't think direct patient care is for me. My consult teams love me, I come up with and leave recs like a champ ED? Not an issue, talk things over with my attd one-on-one and I come up with solid, reasonable plans, dispo like its my job. Rads is a dream that I don't expect to happen. Like I said I'll do effing anything at this point. Path, psych, Rads, hell I'll do occupational health if they'll take me. People are missing the point, that I got into something I'm not cut out for, I'm sucking as a result, and need to figure out how to transition into something else.

the multi-tasking that you mention doesn't seem to be a patient interaction issue but a time management and follow through issue..something that transcends all specialties of medicine...including radiology.

and it seems the one "effing thing you don't seem to be willing to do is buckle down and work on remediation...which IS the one thing you should be focusing on...complete your remediation and you get the support of your PD WITH him being able to give you credit for your intern year...which will go a long way with you being able to get into something else...the fact that you are a US grad with high steps score will be trumped by the fact that you basically failed your intern year...

 

[IlDestriero]

Do whatever you need to do to complete the intern year successfully or you will make it 10 time harder to match into radiology. There's a huge difference between someone that wants to change careers after a year or two of residency and someone that was fired from their program.

 

[Doctor Bagel]

Do whatever you need to do to complete the intern year successfully or you will make it 10 time harder to match into radiology. There's a huge difference between someone that wants to change careers after a year or two of residency and someone that was fired from their program.

I think you'd ever had a hard time switching into psychiatry with a failed remediation in internship. Thinking more about the op's story, I'm becoming more convinced that his/her struggles are about not following through on things, which could potentially complicate patient care. No one has to remediate due to having circuitous, somewhat disorganized presentations. Those likely don't help when dealing with attendings who are already annoyed with him/her because of this whole not following through with tasks thing. Being a good intern is so much more about be reliable than it is about knowledge. Getting those lab orders in, responding to your pager and writing notes in a timely fashion are what it's all about.

 

[Dral]

They should make all premeds wait tables before they sign up for medicine. Haha.

I need to get this persons food (since their order is up) to their table while it's hot, then I have to refill that woman's water, then I need to get change for that couple. Wait, that couple said they are in a hurry, change, then order up, then water.

I need to get a repeat CXR on the guy with PNA, then I have to place that Derm consult, then I need to order an EKG for the new pt. Wait, that new pt is a diabetic woman with PUD like Sxs, her EKG first, then CXR, then Derm consult.

 

[NRAI2001]

What field are you in currently?? You never mentioned it in your OP?

 

[calvnandhobbs68]

You posted this like its not a big deal. It is. It's basically what separates management personnel from fry cooks. You really can't be any kind of professional without cultivating this skill. The low level employee can say, "hey I did my thing and don't really know what happened next. No doctor can. This is the heart of what you ought to get out of intern year -- how to take ownership of a patient and following up on things. The idea that you think this doesn't happen in every field, and is not a big deal is mind boggling. I don't think you necessarilly picked the wrong residency so much as grossly underestimated the skillset needed to be (any kind of) a doctor.

So in what instances do radiologists put in orders and have to make sure they're carried out sometime today? Seriously, people keep acting like these skillsets are exactly they same but you aren't really giving any specific examples. Yes, radiologists have tons of reads that they themselves have to personally do. No, radiologists don't have to put in 50 orders during rounds on 10 patients and make sure the nurses actually do them. Radiologists in no way have to "take ownership" of a patient and follow up on things. They can recommend whatever they want but they aren't responsible for what happens next. Don't get why you guys are acting like they do.

 

[stevesteve123]

What field are you in currently?? You never mentioned it in your OP?

take a guess

 

[NRAI2001]

take a guess

I ll take a guess and say its radiology? But what does the field of radiology itself have to do with failing a 12 month internship?

 

[bashwell]

I ll take a guess and say its radiology? But what does the field of radiology itself have to do with failing a 12 month internship?

Actually, OP wants to switch over to radiology from his current specialty.

Also, radiology has to do an intern year prior to radiology.

(Based on some of OP's past posts, although I didn't bother to read most of his posts so I could easily be totally wrong here, it sounds to me like OP is IM at UW -- go Huskies? For example, OP said: "I have three fields I'm strongly considering, medicine being one of them as a route to Heme/Onc or ID.")

 

[stevesteve123]

I ll take a guess and say its radiology? But what does the field of radiology itself have to do with failing a 12 month internship?

pretty sure its IM

 

[bashwell]

Last year, I made an enormous mistake, and ranked a specialty that is not at all compatible with my personality or skill set.

This is a good lesson for medical students. It's not enough to just have a passion for your specialty. "Just do what you love" etc.

Ideally you also have to know what you're good at as well as what you're not so good at. Know your strengths and weaknesses, know your limitations, etc.

But a problem with "knowing thyself" is sometimes we can delude ourselves into thinking we are good at this or bad at that even if it's not true. That's why it's also important to ask our friends who might know us, family members, older peers or colleagues with more experience and whom we trust to give us an objective perspective on ourselves. In other words, ask lots of different people whom we know and trust, our peers and those older than ourselves, etc. for some honest advice about our strengths and weaknesses.

Like if you think you really love and can do a gen surgery residency but everyone else around you knows you're the type of person who needs 6-7 hrs of sleep per night or else you'll start massively screwing things up the next day, then maybe gen surgery might not be for you even though you love it right now. Or if you think you are awesome with procedures because maybe you had a few nice people tell you this, but everyone else around you knows you actually fumble around a lot more with your hands, then strongly procedural specialties might not be the best path for you to pursue. (I'm talking about people who can't significantly improve even with tons of practice.)

 

[bashwell]

Another thing is that passion and interests aren't always set in stone. You might think you love a specialty so much you can't live without it. But passions wax and wane. Interests can come and go. And to be frank, people tend to be interested and like things that they know more about and are good at. For instance, it's sort of like learning a foreign language. At first you might not like it but you have to do it because it's a requirement. You hate all the nouns and verbs and grammar and so forth because they're so confusing and a chore or pain to memorize and learn. But as you get better at it, then you realize you can actually start reading books in their original language and understanding them well enough to some degree. So you begin to grow in appreciation for the foreign language. Maybe eventually you even start to be interested in it and come to love it. Same or similar with many specialties, in my opinion. Of course it's not a hard and fast rule. But just something to consider.

 

[Gadofosveset]

So in what instances do radiologists put in orders and have to make sure they're carried out sometime today? Seriously, people keep acting like these skillsets are exactly they same but you aren't really giving any specific examples. Yes, radiologists have tons of reads that they themselves have to personally do. No, radiologists don't have to put in 50 orders during rounds on 10 patients and make sure the nurses actually do them. Radiologists in no way have to "take ownership" of a patient and follow up on things. They can recommend whatever they want but they aren't responsible for what happens next. Don't get why you guys are acting like they do.

As you correctly point out, the details of clinical medicine are different from radiology. But the management of many details quickly is similar in both fields. Making a decision under pressure is similar to both fields. "things just get missed when I lose track of tasks" will kill you in rads. This is true even if you don't understand it.

Good radiologists are consultants and take ownership of their patients through responsible reads, which take discipline.
You are completely incorrect that they are not responsible for the patient after they read the scan. They are ethically and legally responsible for how their report impacted management. They are even responsible for over-recommendation.

I suggest that the OP switch over into radiology.
Either the OP will develop management skills and will learn confidence when being grilled…
...or in three or four years time the OP will be on Aunt Minnie telling everyone how awful radiology is ("I wish I could just read in peace! Stop the phone calls!!") and how he or she was duped into thinking radiology is for them. This happens too often, which is part of the reason I'm wasting time on all these responses.

Regardless, the OP should pretend that they enjoy team dynamics and giving presentations for his or her personal statement. If I saw the original post in a personal statement, I would throw the application out. If they told me that in an interview, I would not rank them. I am not alone in this.

 

[Dral]

This is a good lesson for medical students. It's not enough to just have a passion for your specialty. "Just do what you love" etc.

Ideally you also have to know what you're good at as well as what you're not so good at. Know your strengths and weaknesses, know your limitations, etc.

But a problem with "knowing thyself" is sometimes we can delude ourselves into thinking we are good at this or bad at that even if it's not true. That's why it's also important to ask our friends who might know us, family members, older peers or colleagues with more experience and whom we trust to give us an objective perspective on ourselves. In other words, ask lots of different people whom we know and trust, our peers and those older than ourselves, etc. for some honest advice about our strengths and weaknesses.

Like if you think you really love and can do a gen surgery residency but everyone else around you knows you're the type of person who needs 6-7 hrs of sleep per night or else you'll start massively screwing things up the next day, then maybe gen surgery might not be for you even though you love it right now. Or if you think you are awesome with procedures because maybe you had a few nice people tell you this, but everyone else around you knows you actually fumble around a lot more with your hands, then strongly procedural specialties might not be the best path for you to pursue. (I'm talking about people who can't significantly improve even with tons of practice.)

True true. I really really wanted to be that guy who could manage acute stuff and be in the fray saving lives. I'm not, and I'm glad I admitted that before I chose my specialty.

Derm/Dermpath...rarely any emergencies...and the true emergencies are not really the critical seconds to minutes type of emergencies.

I probably could have gotten used to running codes or bringing back crashing patients, but since I'm not a natural at it, why should I risk it? Let the people who rock it do that stuff.

 

[calvnandhobbs68]

As you correctly point out, the details of clinical medicine are different from radiology. But the management of many details quickly is similar in both fields. Making a decision under pressure is similar to both fields. "things just get missed when I lose track of tasks" will kill you in rads. This is true even if you don't understand it.

Good radiologists are consultants and take ownership of their patients through responsible reads, which take discipline.
You are completely incorrect that they are not responsible for the patient after they read the scan. They are ethically and legally responsible for how their report impacted management. They are even responsible for over-recommendation.

I suggest that the OP switch over into radiology.
Either the OP will develop management skills and will learn confidence when being grilled…
...or in three or four years time the OP will be on Aunt Minnie telling everyone how awful radiology is ("I wish I could just read in peace! Stop the phone calls!!") and how he or she was duped into thinking radiology is for them. This happens too often, which is part of the reason I'm wasting time on all these responses.

Regardless, the OP should pretend that they enjoy team dynamics and giving presentations for his or her personal statement. If I saw the original post in a personal statement, I would throw the application out. If they told me that in an interview, I would not rank them. I am not alone in this.

The types of responsibility are completely different. Passive vs active responsibility are two very different things. Yes, obviously the radiologist is responsible for how their read affects patient care, as they should be. They aren't following up on that patient's I/Os every morning or hearing about every time his blood sugar is 130 though. "Taking ownership of their patient through responsible reads" translates into "doing my job reading imaging correctly". Not the same thing and that's the point I was making.

 

[Doctor Bagel]

So in what instances do radiologists put in orders and have to make sure they're carried out sometime today? Seriously, people keep acting like these skillsets are exactly they same but you aren't really giving any specific examples. Yes, radiologists have tons of reads that they themselves have to personally do. No, radiologists don't have to put in 50 orders during rounds on 10 patients and make sure the nurses actually do them. Radiologists in no way have to "take ownership" of a patient and follow up on things. They can recommend whatever they want but they aren't responsible for what happens next. Don't get why you guys are acting like they do.

Radiologists do have to complete a general medicine internship, though, right? So these skills are still important in getting the op through his/her remediation or through another repeat internship (and who wants to repeat internship?). So yeah, learning how to be somewhat organized and how to follow through on placing orders/writing notes are important skills for all of us.

 

[Jeffrety]

It sounds like you need help with SAD my friend. You cant escape people no matter where you go in this game.

 

[charmiedermie]

You posted this like its not a big deal. It is. It's basically what separates management personnel from fry cooks. You really can't be any kind of professional without cultivating this skill. The low level employee can say, "hey I did my thing and don't really know what happened next. No doctor can. This is the heart of what you ought to get out of intern year -- how to take ownership of a patient and following up on things. The idea that you think this doesn't happen in every field, and is not a big deal is mind boggling. I don't think you necessarilly picked the wrong residency so much as grossly underestimated the skillset needed to be (any kind of) a doctor.

There is a big difference with Radiology in that you can vent outwardly the moment you slam down the phone. You can't do this as a rounding intern, or not without being reported to someone. If even ASD people can be successful in Radiology, that right there tells you the degree of communication isn't the same. Conceptually it is the same, but in practice it is different. The tasks are very very different between clinical rounding and sitting at a radiology table reading scans, taking a breath, pick up ringing phone, answer, hang up, take a breath, start reading again.

 

[Crayola227]

someone said, "can't you just stop being socially awkward"
like sure, OP loves being socially awkward and knows how to stop and just refuses to because they're having the time of their life

I fully believe that you are a competent person that maybe doesn't have the most organized verbal skills ever and that when put in front of a bunch of uptight shaming detail freaks that start slamming on you the anxiety takes hold and then you really sound like you don't have a clue and then the slamming just gets worse and now you're in a vicious cycle because the more they tell you to stop stuttering the more you stutter
maybe then the unbearable agony of it all impacts your ability to organize your thoughts leading to having a hard time herding the cats that is getting **** done on an inpt census

yeah there's slamming and shaming in all of medicine but in radiology it doesn't seem like the twice daily verbal and mental gang-rape that goes on in some IM AM reports and rounds

I could be wrong, I'd love to know how they do the ass-reaming in radiology, my impression is that it's a more personal one-on-one kind of abuse, but I could be romanticizing it I guess
I'm kinda fascinated now by the politics of who hates on who by how many in what specialty to what other specialty

 

[Arcan57]

someone said, "can't you just stop being socially awkward"
like sure, OP loves being socially awkward and knows how to stop and just refuses to because they're having the time of their life

I fully believe that you are a competent person that maybe doesn't have the most organized verbal skills ever and that when put in front of a bunch of uptight shaming detail freaks that start slamming on you the anxiety takes hold and then you really sound like you don't have a clue and then the slamming just gets worse and now you're in a vicious cycle because the more they tell you to stop stuttering the more you stutter
maybe then the unbearable agony of it all impacts your ability to organize your thoughts leading to having a hard time herding the cats that is getting **** done on an inpt census

yeah there's slamming and shaming in all of medicine but in radiology it doesn't seem like the twice daily verbal and mental gang-rape that goes on in some IM AM reports and rounds

I could be wrong, I'd love to know how they do the ass-reaming in radiology, my impression is that it's a more personal one-on-one kind of abuse, but I could be romanticizing it I guess
I'm kinda fascinated now by the politics of who hates on who by how many in what specialty to what other specialty

Calm yourself. And it's not an issue so much of social awkwardness (although may be underlying cause), it's training a specific set of skills that are useful in a host of situations.

 

[Baller MD]

Give the OP credit for realizing how much clinical medicine sucks. Radiology is the best field in medicine. I would jump off a bridge if I were a clinician. The OP can do fine in radiology. Most if my interactions with clinicians is calling to tell them how ******ed their request is.

I love you. No homo.

 

[Crayola227]

any updates?