Please help me decide on a specialty.

[Mr.Thrive]

Another 4th year medical student that can't decide on specialty choice. Step 1/2: 230/260

I enjoy a field with a lot of variety within the day. Enjoy suturing and small procedures but hated surgery. Really enjoy a diagnostic work-up. This sounds like emergency medicine but I ruled it out (perhaps too early) because I don't like being rushed. I am a pretty laid back person and enjoy taking my time. Enjoy patient interaction but also talking to coworkers.

So I'm looking into Family, Peds, Internal:
- I like dealing with children as patients more but enjoy the medicine of internal.
- Well Child Checks can be fun but they can also get boring.
- The Overweight adult patient that doesn't care for him/herself can also be soul-sucking.
- I have no interest in OB
- I'm not planning on sub-specializing but it would be nice to have that flexibility.
- If I did sub-specialize then I would look into rheumatology/allergy.
- I would prefer not to do the 4 years of Med/Peds. The extra year would make me less likely to sub-specialize, at which point I should of just gone into Family.

I ruled out:
- Anesthesia because I don't enjoy the OR and feeling isolated. Pain management was fun but also got boring after watching the same 6 procedures.
- Neurology and PM&R - Neuro and MSK are my favorite subjects but I didn't enjoy the rotations. Probably because of the people I was with.

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[WedgeDawg]

Rheumatology might be up your alley

 

[FindMeOnTheLinks]

My first thought was rheum as well. Your best bet might be internal medicine as that would retain a lot of flexibility to subspecialize, be a hospitalist, do outpatient primary care etc. Family medicine also would be a good fit - kids and adults, some diagnostic workup involved though take awhile and if you find anything interesting it probably gets referred out pretty quickly, low acuity, can do small procedures like I&D, suturing lacs, pull some shifts in an urgent care if you feel like it.

Also consider radiology as it is more relaxed, lots of interaction with colleagues, obviously heavily diagnostic and can do a variety of small procedures.

 

[IMreshopeful]

Consider IM + procedural subspecialty
GI, cardiology, rheumatology, pulm/crit may all be good fits for you
Keep in mind though that no matter how much you enjoy a field, your procedures will become repetitive and rote. So don’t expect too much variety in that regard. A LHC is a LHC. A colonoscopy is a colonoscopy.
Your scores are competitive enough for IM.
Most IM + subspecialty training is 5-6 years total (longer if doing interventional cards or EP or advanced endo) so just keep that in mind, although to me the payoff was worth it

 

[karayaa]

Another 4th year medical student that can't decide on specialty choice. Step 1/2: 230/260

I enjoy a field with a lot of variety within the day. Enjoy suturing and small procedures but hated surgery. Really enjoy a diagnostic work-up. This sounds like emergency medicine but I ruled it out (perhaps too early) because I don't like being rushed. I am a pretty laid back person and enjoy taking my time. Enjoy patient interaction but also talking to coworkers.

So I'm looking into Family, Peds, Internal:
- I like dealing with children as patients more but enjoy the medicine of internal.
- Well Child Checks can be fun but they can also get boring.
- The Overweight adult patient that doesn't care for him/herself can also be soul-sucking.
- I have no interest in OB
- I'm not planning on sub-specializing but it would be nice to have that flexibility.
- If I did sub-specialize then I would look into rheumatology/allergy.
- I would prefer not to do the 4 years of Med/Peds. The extra year would make me less likely to sub-specialize, at which point I should of just gone into Family.

I ruled out:
- Anesthesia because I don't enjoy the OR and feeling isolated. Pain management was fun but also got boring after watching the same 6 procedures.
- Neurology and PM&R - Neuro and MSK are my favorite subjects but I didn't enjoy the rotations. Probably because of the people I was with.

Talk to advisors in Neuro/PMR about what the field is really like, and your experiences on your rotations and try to figure out if your rotations were representative or not.
PMR really sounds like a super good fit based on the bold.
IM or FM to sports med might be another good fit, too!
FWIW allergy doesn't strike me as having a lot of procedures or variety

 

[Mr.Thrive]

My first thought was rheum as well. Your best bet might be internal medicine as that would retain a lot of flexibility to subspecialize, be a hospitalist, do outpatient primary care etc. Family medicine also would be a good fit - kids and adults, some diagnostic workup involved though take awhile and if you find anything interesting it probably gets referred out pretty quickly, low acuity, can do small procedures like I&D, suturing lacs, pull some shifts in an urgent care if you feel like it.

Also consider radiology as it is more relaxed, lots of interaction with colleagues, obviously heavily diagnostic and can do a variety of small procedures.

Thank you for the advice! I considered radiology but didn't think I was competitive enough, and also didn't like the idea of being socially isolated. I can see now thats kind of a misconception. I think family is a good fit too. My only worry is if I don't like it then I'll be pretty much stuck. IM sounds great as well but then no kids. IM and FM are probably my two top picks.

Talk to advisors in Neuro/PMR about what the field is really like, and your experiences on your rotations and try to figure out if your rotations were representative or not.
PMR really sounds like a super good fit based on the bold.
IM or FM to sports med might be another good fit, too!
FWIW allergy doesn't strike me as having a lot of procedures or variety

Good points! I don't have any advisors, well at least ones that actually care.

PMR does sound like a good fit but I never felt it has its own identity. For inpatient, the purpose was basically to justify to insurance companies that patients are qualified for acute rehab. They would consult if anything not simple came along - even high blood pressure. Outpatient was basically offering treatments that didn't seem to have very good evidence behind them (besides botox for spasticity) and are already offered by other specialties.

I really liked Neuro - unexplained weakness, peripheral neuropathy, headaches, dementia, movement disorders, the physical exam. Not a fan of strokes and TBI. I was hoping I'd see enough of these cases in general medicine.

Any other advice is greatly appreciated. Thank you!

 

[jdh71]

Peds with a critical care fellowship

 

[SurfingDoctor]

Why not do pediatrics and then an allergy fellowship. They usually combined adult/pediatrics from what I've seen.