Picking my specialty

[Jccripe]

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[Dello]

Which one do you like more? What do you see yourself doing for the REST OF YOUR LIFE? OB/Gyn and GI have quite different lifestyles.

 

[BigRedBeta]

Here's the recommendations I give to third year students:

1) How important are procedures to your life? Obviously it's a major dividing line and something that you MUST figure out because it puts you on a surgical path if it's your overwhelming concern. Being a "doer" though can mean lots of different things to different people.

2) What types of patients do you want to see - Adults vs kids, mostly healthy vs lots of problems, women vs men? Again, obvious difference and puts you on specific paths

3) Outpatient vs inpatient - or how much do you like clinic? This is tougher, but also important, particularly once you've gotten past items 1 and 2. Certainly this is a major difference between Critical Care and endocrinology in either peds or medicine.

4) When you say "doer" what do you mean? Some people love diagnosis, some people love being a manager (in either the short - ICU - or long term - general medicine [diabetes] or peds [ADHD]), and some people are treaters.

5) Do you want to know one system extremely well, or know a little about a lot of systems. For me, I'm looking to go into Peds Critical Care, and the appeal of dealing with lots of different body systems is one of my favorite aspects of the field. Other people want to focus on one organ and give two licks about the rest. What do you prefer?

6) Along the lines of #5, remember that every specialty has it's 5 things that you see over and over and OVER again. Can you find the field where you don't mind those five things waking you up at 3 in the morning?


I think that GI and OB/GYN actually do have a lot of similarities, and so it's not that surprising you think both are good fits. Both have a nice combination of inpatient/outpatient issues, have procedural aspects, and provide the opportunity for some significant continuity of care. You can really develop some strong relationships and provide significant levels of care to make your patient's life better in both fields.

And before you get the onslaught of people hating on OB/GYN because of the residents' cattiness, being male will help a lot.

Good luck with your decision.

 

[vicinihil]

also you must consider lifestyle and compensation. ppl freq leave this out. you may be happy working 12 hour days 6 days a week but in 20yrs your colleague that works 4 days a week and makes more money than u.

all above is also important but dont leave off lifestyle

 

[Jccripe]

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[smq123]

Thanks for the reply. I have been thinkin about all the above. Gi makes good money for now. I think I would end up doing Gyn-Onc or REI. Def not general Ob. I think babies are great, fascinating, exciting, but after ten years I would be sick of the hours and litigation potential. Which brings be back to GI vs Gyn. I feel both are fascinating, both have procedures but Gyn has surgery. I like doing things with my hands but I also really think things out and like the esoteric factoids of medicine.

Please keep in mind that gyn onc and REI are both quite competitive. So I would not recommend doing OB/gyn with the expectation that you will be able to do gyn onc or REI - you very well might end up being forced to be a general OB/gyn.

 

[MJB]

I wish there was a Urogyn residency. I liked OB, but I'm starting to think it wouldn't be very cool for very long, and I'm quite sure I wouldn't be overly tolerant of the call.

 

[Doctor4Life1769]

Outta curiosity, do urologists do urogyn as well, or is that mainly an OB thing?

 

[medking]

Outta curiosity, do urologists do urogyn as well, or is that mainly an OB thing?

....seriously?

 

[Doctor4Life1769]

....seriously?

There's too many turf battles out there that I don't know what one does that other can't do anymore. For example, a clear urology case was taken over by gen surg the other day ... complications did occur; however. So yes, seriously.

 

[medking]

There's too many turf battles out there that I don't know what one does that other can't do anymore. For example, a clear urology case was taken over by gen surg the other day ... complications did occur; however. So yes, seriously.

But we're talking about different anatomical parts, no?

 

[Doctor4Life1769]

But we're talking about different anatomical parts, no?

I had something else going on in my head, I think I'm sleep deprived - ignore the last few posts. 😴

EDIT: Good thing to know my thought process with 2 hrs of sleep wasn't completely shattered.

 

[Jccripe]

Regarding SMQ123's comment, I totally agree however GI is also super competetive and I think I would be happier as a general Ob/Gyn than a general IM/hospitalist, but I guess there are many other specialties in IM. Sooo back to square one.

 

[vicinihil]

my vote is im bc there r many options out there in the event u dont get gi. the hours r also not killer and you may have various opp for procedures to fulfill the doer part in you.

 

[Acabee]

Outta curiosity, do urologists do urogyn as well, or is that mainly an OB thing?

Urologists do indeed do urogynecology.

 

[ACSurgeon]

....seriously?

Why so surprised? if gyn docs can do a "uro" fellowship and become urogyn's, why can't uro docs do a gyn fellowship and also become urogyn's?

To the person asking the question: yes. Urologists can become urogynecologists if they chose to. They also learn to do more surgeries than a gyn--> urogyn surgeon would (I was told this by a gyn to urogyn surgeon. He said if anyone was interested in urogyn that they should do urology then a fellowship in gyn)

But we're talking about different anatomical parts, no?

See above. You obviously don't know which parts we're talking about 😉

 

[ACSurgeon]

Urologists do indeed do urogynecology.

true that...

 

[C5toC9]

How do people pick specialties before they start rotations?

 

[Doctor4Life1769]

Why so surprised? if gyn docs can do a "uro" fellowship and become urogyn's, why can't uro docs do a gyn fellowship and also become urogyn's?

To the person asking the question: yes. Urologists can become urogynecologists if they chose to. They also learn to do more surgeries than a gyn--> urogyn surgeon would (I was told this by a gyn to urogyn surgeon. He said if anyone was interested in urogyn that they should do urology then a fellowship in gyn)



See above. You obviously don't know which parts we're talking about 😉

That's what I thought, good to know I wasn't out in left field with my initial thought process. Thanks for the info, btw.

 

[Doctor4Life1769]

How do people pick specialties before they start rotations?

Everyone picks, then they change their mind. I've not really changed my mind since M2 and rotation experience has re-affirmed it.

 

[Doctor Bob]

Please keep in mind that gyn onc and REI are both quite competitive. So I would not recommend doing OB/gyn with the expectation that you will be able to do gyn onc or REI - you very well might end up being forced to be a general OB/gyn.

This holds true with any of the subspecialties. Don't go after any subspecialty for which you are unwilling to spend the rest of your life doing the base practice. It is no guarantee that you will get a fellowship.

There are plenty of IM residents out there who spend every day hating their residency but keep telling themselves that soon they'll be in fellowship doing what they love. And not all of them will land one of those spots.

(I feel like I just wrote this same advice in another thread)

 

[Ferrismonk]

This holds true with any of the subspecialties. Don't go after any subspecialty for which you are unwilling to spend the rest of your life doing the base practice. It is no guarantee that you will get a fellowship.

There are plenty of IM residents out there who spend every day hating their residency but keep telling themselves that soon they'll be in fellowship doing what they love. And not all of them will land one of those spots.

I understand what you're trying to say, but it isn't like there is much choice in some instances. For example, I'm interested in Heme/Onc, but I have a pretty strong distaste for a lot an IM doc does. I don't like psych for instance. Knowing myself, I'd also get pretty bored dealing with non-life-threatening problems day-in and day-out. But there isn't any other way to do Heme/Onc, so we all must go through it. Luckily, Heme/Onc isn't terribly competitive, and I'm lining my ducks up pretty well so I shouldn't have much of a problem, but still, I think I might be one of those residents who hates big portions of IM residency while aiming for the fellowship happy times.

btw, nice profile pic. Can't beat the Chaos Orb (or "Chorb" as my friends and I affectionately called it)😎👍

 

[smq123]

But there isn't any other way to do Heme/Onc, so we all must go through it.

No interest in peds heme/onc? Some people who really can't stand the bread-and-butter of IM find peds (where the children are often sick, but usually do recover fairly well) more tolerable.

 

[Ferrismonk]

No interest in peds heme/onc? Some people who really can't stand the bread-and-butter of IM find peds (where the children are often sick, but usually do recover fairly well) more tolerable.

I actually don't care much about Peds either. Don't get me wrong, I love kids, but all the things that can go wrong with them scares the crap out of me. I could probably do fine in peds/onc, but the peds residency would keep me up at night thinking I missed some minor sign of a terrible congenital abnormality. :/