Please Help me choose a field

[FellowPaisan]

---

Members don't see this ad.

Having a lot of problems choosing a specialty. In fact this decision has been weighing on me for months now. And the stress and anxiety is only increasing now that I am a new 4th year.

I just started my subI in urology and am very unsure if I want to continue down this road. I am lukewarm to the specialty. It is an early match and I have other aways set up but am not going to put myself through them if by the end of the first month I am not dead set on the field. I have been feeling like this for at least 2-3 months but with everyone telling me I have to set up aways in case I do want to do it I went ahead and did it -not fun setting them up by the way. I have made pretty good connections in my dept but ultimately will not to commit to anything if I am unhappy.

I am looking for a field I can have some interactions with patients. I like radiology but am uncertain about the job market and I think that probably swings to the other side in terms of patient interaction. I am quite extroverted so even though I love the basic science of medicine and anatomy and technology I am thinking I am not going to be thrilled with limited patient contact.

I really love cool and interesting pathology. Big passion of mine. Like whenever I hear about some rare disease I immediately am interested. I also love physiology and anatomy. I know its shallow but I really do care about salary and lifestyle. I liked ENT the past 3m but its def too late for that - also prob not competitive.

A lot of people keep saying internal medicine and then doing a subspecialty which I have thought about but i really didn't like my medicine rotation much at all. I dreaded admitting nights and rounding. It is also hard to say though if much of my experiences this past year has been cast through a negative light because I don't like the minimal involvement one has as a medical student.

Basically, if this month doesn't go well. I will be completely SOL and have no idea what to do.

US MD. I scored 243 on step 1 and have a mix of high passes and passes for grades. Step 2 soon.


Please help.

 

[zoopers]

What don't you like about urology? People normally don't stumble onto it as a field in general, so I'm just curious.

It sounds like neurology might be a good fit for you, that has a lot of interesting pathology without being actual IM.

 

[FellowPaisan]

What don't you like about urology? People normally don't stumble onto it as a field in general, so I'm just curious.

It sounds like neurology might be a good fit for you, that has a lot of interesting pathology without being actual IM.

I like the cool toys and robotic aspect of urology a lot. I like the largely male population. I like that urology is slightly less crazy as general surgery. Most of the cases are also not ridiculously long. I actually liked a lot of general surgery largely bc of how broad the field is but seeing my dad do it and his constant persuasion against has eliminated that.

Neurology is interesting. I liked outpatient neurology on my rotation but I wasn't captivated by it either especially inpatient which were a lot of strokes and incurable brain masses.

 

[bashwell]

Having a lot of problems choosing a specialty. In fact this decision has been weighing on me for months now. And the stress and anxiety is only increasing now that I am a new 4th year.

I just started my subI in urology and am very unsure if I want to continue down this road. I am lukewarm to the specialty. It is an early match and I have other aways set up but am not going to put myself through them if by the end of the first month I am not dead set on the field. I have been feeling like this for at least 2-3 months but with everyone telling me I have to set up aways in case I do want to do it I went ahead and did it -not fun setting them up by the way. I have made pretty good connections in my dept but ultimately will not to commit to anything if I am unhappy.

I am looking for a field I can have some interactions with patients. I like radiology but am uncertain about the job market and I think that probably swings to the other side in terms of patient interaction. I am quite extroverted so even though I love the basic science of medicine and anatomy and technology I am thinking I am not going to be thrilled with limited patient contact.

I really love cool and interesting pathology. Big passion of mine. Like whenever I hear about some rare disease I immediately am interested. I also love physiology and anatomy. I know its shallow but I really do care about salary and lifestyle. I liked ENT the past 3m but its def too late for that - also prob not competitive.

A lot of people keep saying internal medicine and then doing a subspecialty which I have thought about but i really didn't like my medicine rotation much at all. I dreaded admitting nights and rounding. It is also hard to say though if much of my experiences this past year has been cast through a negative light because I don't like the minimal involvement one has as a medical student.

Basically, if this month doesn't go well. I will be completely SOL and have no idea what to do.

US MD. I scored 243 on step 1 and have a mix of high passes and passes for grades. Step 2 soon.


Please help.

What about IR?

 

[ACSurgeon]

Having a lot of problems choosing a specialty. In fact this decision has been weighing on me for months now. And the stress and anxiety is only increasing now that I am a new 4th year.

I just started my subI in urology and am very unsure if I want to continue down this road. I am lukewarm to the specialty. It is an early match and I have other aways set up but am not going to put myself through them if by the end of the first month I am not dead set on the field. I have been feeling like this for at least 2-3 months but with everyone telling me I have to set up aways in case I do want to do it I went ahead and did it -not fun setting them up by the way. I have made pretty good connections in my dept but ultimately will not to commit to anything if I am unhappy.

I am looking for a field I can have some interactions with patients. I like radiology but am uncertain about the job market and I think that probably swings to the other side in terms of patient interaction. I am quite extroverted so even though I love the basic science of medicine and anatomy and technology I am thinking I am not going to be thrilled with limited patient contact.

I really love cool and interesting pathology. Big passion of mine. Like whenever I hear about some rare disease I immediately am interested. I also love physiology and anatomy. I know its shallow but I really do care about salary and lifestyle. I liked ENT the past 3m but its def too late for that - also prob not competitive.

A lot of people keep saying internal medicine and then doing a subspecialty which I have thought about but i really didn't like my medicine rotation much at all. I dreaded admitting nights and rounding. It is also hard to say though if much of my experiences this past year has been cast through a negative light because I don't like the minimal involvement one has as a medical student.

Basically, if this month doesn't go well. I will be completely SOL and have no idea what to do.

US MD. I scored 243 on step 1 and have a mix of high passes and passes for grades. Step 2 soon.


Please help.

What about general surgery? Just because you have a high step score doesn't mean you have to apply to surgical specialties.

I guess it depends what about urology bothers you. Some of the same things will exist in surgery as a resident.

 

[ACSurgeon]

I like the cool toys and robotic aspect of urology a lot. I like the largely male population. I like that urology is slightly less crazy as general surgery. Most of the cases are also not ridiculously long. I actually liked a lot of general surgery largely bc of how broad the field is but seeing my dad do it and his constant persuasion against has eliminated that.

Neurology is interesting. I liked outpatient neurology on my rotation but I wasn't captivated by it either especially inpatient which were a lot of strokes and incurable brain masses.

Most general surgery operations are short. You won't be doing whipples or transplants every day for five years.

If you like the pathology and breadth encountered in general surgery and don't mind doing a five year busy residency, it's something to consider. Your father trained in a different era. It's normal to expect work-life balance these days. After residency that is.

 

[FellowPaisan]

What about general surgery? Just because you have a high step score doesn't mean you have to apply to surgical specialties.

I guess it depends what about urology bothers you. Some of the same things will exist in surgery as a resident.

I liked general surgery especially because of the broadness of the field and the ability to do so many things afterwards but I don't want the lifestyle. My dad is a g surgeon and he has basically persuaded me against my whole life.

 

[FellowPaisan]

What about IR?

I am definitely still considering this. Even if I apply for diagnostics and do IR after -its a thought.

 

[FellowPaisan]

What about general surgery? Just because you have a high step score doesn't mean you have to apply to surgical specialties.

I guess it depends what about urology bothers you. Some of the same things will exist in surgery as a resident.

I realize that step score thing. Like i said at the end of the day I just want to be happy. I don't care what it is. Very hard to put my finger on what bother me about uro. Maybe i'm not gung-ho about cystoscopies.

 

[bashwell]

I am definitely still considering this. Even if I apply for diagnostics and do IR after -its a thought.

I thought it might be a cool field for you since you seem to like patients, are extroverted, seem to have a surgical mindset, like anatomy, like technology, etc. 🙂

Also, can't you apply directly to IR now? I haven't paid attention to changes in DR/IR residencies, but I thought this might be the case now or soon?

 

[FellowPaisan]

I thought it might be a cool field for you since you seem to like patients, are extroverted, seem to have a surgical mindset, like anatomy, like technology, etc. 🙂

Also, can't you apply directly to IR now? I haven't paid attention to changes in DR/IR residencies, but I thought this might be the case now or soon?

Yup you can apply for it now. I haven't had much exposure to it honestly but it seems pretty neat. Really appreciate the response 🙂

 

[akwho]

If you hate rounding, and admitting, and like radiology but want more patient contact, why not interventional radiology? Sounds right up your alley.

 

[FellowPaisan]

If you hate rounding, and admitting, and like radiology but want more patient contact, why not interventional radiology? Sounds right up your alley.

That's what the above mentioned. I am considering it. Hopefully, the radiation exposure long term won't kill me.

 

[JPSmyth]

That's what the above mentioned. I am considering it. Hopefully, the radiation exposure long term won't kill me.

Is the radiation exposure in the IR suite something to actually worry about over 20+ years?

 

[FellowPaisan]

Also how common is it for someone to do a subI in something and then decide against it? I was speaking to someone in my class and he made it out to be a big negative.

 

[ACSurgeon]

Also how common is it for someone to do a subI in something and then decide against it? I was speaking to someone in my class and he made it out to be a big negative.

That's part of what sub-Is are for

 

[FellowPaisan]

That's part of what sub-Is are for

cool this is reassuring. Appreciate your responses.

 

[ERDOC555]

I liked ENT the past 3m but its def too late for that - also prob not competitive.

Not sure why you wouldn't be competitive for ENT if you're competitive for Urology. Both are very competitive with high step 1, high emphasis on research, and low match rates (although ENT has been an anomaly here the past 2 years).

Also as for IR, Integrated IR is literally the most competitive residency by a long shot. It put derm and plastics to shame. I want to say there were about 100 spots for 300+ applicants last year. You could try for a good Rads program and then hope to get a fellowship, but matching integrated IR at this point would be highly unlikely.

 

[FellowPaisan]

Not sure why you wouldn't be competitive for ENT if you're competitive for Urology. Both are very competitive with high step 1, high emphasis on research, and low match rates (although ENT has been an anomaly here the past 2 years).

Also as for IR, Integrated IR is literally the most competitive residency by a long shot. It put derm and plastics to shame. I want to say there were about 100 spots for 300+ applicants last year. You could try for a good Rads program and then hope to get a fellowship, but matching integrated IR at this point would be highly unlikely.

Because research and connections is in uro. I have no aways set up for ENT. Also my grades this past year weren't great. There is a chance I won't get uro either but I am not going to spend the money to even try to apply unless I actually want it.

When you say ENT is an anomaly what do you mean?

 

[ERDOC555]

Because research and connections is in uro. I have no aways set up for ENT. Also my grades this past year weren't great. There is a chance I won't get uro either but I am not going to spend the money to even try to apply unless I actually want it.

When you say ENT is an anomaly what do you mean?

That makes sense

By anomaly I meant that despite still attracting very high caliber applicants, ENT had around a 90% match rate for MD seniors the last 2 years if I recall correctly. For whatever reason less people applied ENT than usual in 2016 and 2017

 

[IM2GI]

GI baby

 

[FellowPaisan]

GI baby

that would be the field of medicine i would go towards but not sure if I can do 3 years of internal medicine.

 

[IM2GI]

that would be the field of medicine i would go towards but not sure if I can do 3 years of internal medicine.

I mean you said you want patient interaction and seem to like procedures. Thats Cards/GI territory if you don't want to be a full blown surgeon.

Medicine residency isn't so bad.

 

[LyMed]

Emergency?

 

[JPSmyth]

I mean you said you want patient interaction and seem to like procedures. Thats Cards/GI territory if you don't want to be a full blown surgeon.

Medicine residency isn't so bad.

Not that bad? I thought medicine residency was one of the worst lifestyle wise

 

[IM2GI]

Not that bad? I thought medicine residency was one of the worst lifestyle wise

Nah surgical residencies are way worse.

 

[FellowPaisan]

I will say I absolutely dreading this decision and have no idea how to approach eras or who to ask for letters besides those who know very me well independent of field. Hope everything clears up in the next month.

 

[Entadus]

I will say I absolutely dreading this decision and have no idea how to approach eras or who to ask for letters besides those who know very me well independent of field. Hope everything clears up in the next month.

good luck that sounds like a very stressful spot to be in.

 

[TypeADissection]

Emergency?

Brah. Surgery residency is cake. Work daylight hours only. Every weekend off. Just straight chillin.

 

[FellowPaisan]

thinking i'm going to end up doing medicine. Like the broad knowledge base. Don't think I want to do surgery long term. Not being a morning person the hrs are a killer. Enjoy talking to patients so I don't think I can do radiology. Even though I didn't really like my medicine rotation I figure I can most likely find something in the field in terms of a subspecialty I will enjoy doing long term. Hopefully, I won't regret the decision but ultimately I just want to be happy. Yes I want to make good money but if I am not enjoying learning which is why I went to med school then I will be miserable. I also think I can prob choose a more desirable location near family. Just nervous bc there are so many people unhappy that they chose IM any people out there that want to allay those fears?

 

[FellowPaisan]

Feel like I'm in the exact same position as you. Similarly, I spent most of med school setting myself up for a very competitive field, and recently Ive been realizing that I am not as interested in it as I thought I was and don't know if I would be happy long term (despite the lifestyle)..

Going into other competitive fields is near impossible this late in the game, but i quite frankly dont know what is the best field for me when factoring in type of work, pay, hours, etc. I dabbled with radiology as well, but like you, I also love seeing patients. I didn't enjoy my medicine rotation either (bad residents), but think about "just going into it" nearly every day with the thought that I'll eventually find SOMEthing for me. I dont know if this is the right way of thinking.

With that being said, EM is probably my lead at the moment bc of the actual medicine, but the schedule really makes me second guess this thought..

Yup you sound like me quite a bit. I like ENT alot actually and I have always seen myself in a surgical field so to go to medicine as a default is extremely unsettling. I could see if I could swing 2 aways for ent and then apply broadly with medicine - if I don't get it it would be like nothing ventured nothing gained (would kind of expect it since I am not really competitive at all). My advisor is tired of dealing with me and wants me to just go with medicine and call it a day. I don't have family that I need to be home for so gen surg is crossing my mind a bit to do a fellowship but then i got to be cool with 7-8 more years of training and that is a hard pill to swallow. So many people have basically said I am dumb for not doing urology seeing I put alot of work into it but I just don't have enough interest in the field.

PM me if you want to talk more.

 

[Osteoth]

I think the current medical school training methodology is antithetical to the maintenance of passion/interest.

You show up wide-eyed, bushy tailed and ready to hit the ground running, except the ground quickly hits you. Over. And over. And over.

I don't think its uncommon for people to feel their "passion" start to wane by the later years of their medical education, and I don't think that you should let it dissuade you.

Urology is one of the most competitive specialties out there for a reason. Good pay, good life-style once you finish residency, good respect, good future, good control over the field by the higher-ups.

Yes you might be having a lull in your interest right now but at the same time how is IM/GS any better? If you aren't passionate about cystoscopies are you going to magically become passionate about colon resections/midnight admissions?

Every field has their negatives, and I tend to believe in the collective wisdom of the other thousands of medical students out there. You have to pick your poison and of all the fields listed it seems that urology wouldn't be the worst say to go.

 

[FellowPaisan]

I think the current medical school training methodology is antithetical to the maintenance of passion/interest.

You show up wide-eyed, bushy tailed and ready to hit the ground running, except the ground quickly hits you. Over. And over. And over.

I don't think its uncommon for people to feel their "passion" start to wane by the later years of their medical education, and I don't think that you should let it dissuade you.

Urology is one of the most competitive specialties out there for a reason. Good pay, good life-style once you finish residency, good respect, good future, good control over the field by the higher-ups.

Yes you might be having a lull in your interest right now but at the same time how is IM/GS any better? If you aren't passionate about cystoscopies are you going to magically become passionate about colon resections/midnight admissions?

Every field has their negatives, and I tend to believe in the collective wisdom of the other thousands of medical students out there. You have to pick your poison and of all the fields listed it seems that urology wouldn't be the worst say to go.

I came to realize I don't care much for the kidney and bladder. I like male repro but not the other half.

 

[Osteoth]

I came to realize I don't care much for the kidney and bladder. I like male repro but not the other half.

Are you passionate about CBCs or patching up the colon?

 

[deleted497653]

I feel like you will regret it if you choose IM. You didn't like the rotation and now you want to force it. Please reconsider. You might be able to take an extra year to do ENT research. As for your mentor, it's his job to help you so I wouldn't worry about his feelings in your indecisiveness

 

[FellowPaisan]

I feel like you will regret it if you choose IM. You didn't like the rotation and now you want to force it. Please reconsider. You might be able to take an extra year to do ENT research. As for your mentor, it's his job to help you so I wouldn't worry about his feelings in your indecisiveness

interesting take. should i dual apply to gen surg then? my dad is one and literally my whole life as discouraged me but he was also trained in the old days where malignant programs were common. Obv my family is important to me but I don't have like a wife and kids so it doesn't matter how often I am in the hospital. I think i was looking at medicine as a means to have more time in residency but I am beginning to see they work arguably just as hard. Maybe slightly better hours but not measurably.

Edit: something I am seeing in the middle of this surgery rotation is I actually don't hate surgery. I hate having to watch 3 hour surgeries X3 each day and maybe being able to close one lap incision each time. Actually don't like waking up in the morning but my body has actually adjusted surprisingly.

 

[FellowPaisan]

Are you passionate about CBCs or patching up the colon?

probably more the latter. Rounding is a killer for me. Can't say I like it very much at the same time if you work at a practice as cardiologist you don't necessarily have to be doing rounding. When you go in the hospital you see who you need to see.

 

[FellowPaisan]

I think the current medical school training methodology is antithetical to the maintenance of passion/interest.

You show up wide-eyed, bushy tailed and ready to hit the ground running, except the ground quickly hits you. Over. And over. And over.

I don't think its uncommon for people to feel their "passion" start to wane by the later years of their medical education, and I don't think that you should let it dissuade you.

Urology is one of the most competitive specialties out there for a reason. Good pay, good life-style once you finish residency, good respect, good future, good control over the field by the higher-ups.

Yes you might be having a lull in your interest right now but at the same time how is IM/GS any better? If you aren't passionate about cystoscopies are you going to magically become passionate about colon resections/midnight admissions?

Every field has their negatives, and I tend to believe in the collective wisdom of the other thousands of medical students out there. You have to pick your poison and of all the fields listed it seems that urology wouldn't be the worst say to go.

That's a solid pt and fellowship could always direct individual interests. I haven't done the best on this audition rotation to say the least so I'm think uro is prob dead in the water. Gen surg has many attractive fellowships that do appeal long term, but then again so does IM.

 

[Osteoth]

probably more the latter. Rounding is a killer for me. Can't say I like it very much at the same time if you work at a practice as cardiologist you don't necessarily have to be doing rounding. When you go in the hospital you see who you need to see.

That being said which one is more palatable to you, the colon or GU/nephro?

Although you've said you're not super into nephro A&P the point remains that you haven't experienced the gen surg areas yet to the point where you could reasonably say one is more interesting.

That's a solid pt and fellowship could always direct individual interests. I haven't done the best on this audition rotation to say the least so I'm think uro is prob dead in the water. Gen surg has many attractive fellowships that do appeal long term, but then again so does IM.

Yes, but I noticed you mentioned lifestyle as a factor up above. General surgery is still an exceedingly arduous residency, more difficult from what I've been told than urology based on the frequency & necessity of coming in when called. After that while other members on this board have mentioned you can more or less set your own schedule as an attending, the more you work the more you bring home, especially in private practice.

No group or hospital is going to pay you advertised rate to not take call and be half a general surgeon. When you graduate residency you're still going to be working harder for a field that you might or might not be interested in going forward. What happens if you drop urology for general surgery and then hate that too? Then you're really be up the creek.

I think it bears thinking about taking a year off. This is a choice about what you're going to be doing for 60-100 hours a week for the rest of your days. Do not take it lightly. Talk to your advisors. Talk to general surgeons. Talk to urologists. Talk to your mother. Make sure you consider all the angles.