Problems of choosing a specialty by "what you like/enjoy"

[Slowpoke]

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I have found that most of my interests and hobbies change over time. I foresee a problem with picking a specialty just because I can see myself doing it and enjoying it.

What if I no longer find enjoyment after my 100th surgical procedure of the same thing?

What if I no longer find enjoyment from the 100th fever case today as a pediatrician?

I feel that it might be better to choose a specialty based off more of practical means: more time available to spend with family, higher financial/job security, lower litigation rates and low stress.

I probably wouldn't be able to cover all those bases, but I'm starting to try to plan for the future. One example is that emergency physicians I have talked to say that the day/night shifts over the years have taken a toll on them and though their job is interesting to them, they're not sure if its worth it anymore.

 

[witzelsucht]

Well, you could always quit medicine and get a job as an accountant or a hotel manager or a public high school administrator. Do you think that would be fun? Would that be fulfilling to you?

Yeah, of course you should take into account the lifestyle factors. It's your career, it's your life. Even the ****tiest job in medicine is still pretty interesting compared to a lot of things out there. However it is not reasonable to expect the level of fulfillment as a doctor as that of a billionaire playboy who spends his days banging models, studying classical french poetry and funding the latest AIDS research in mozambique.

Edit: drunk internetting. sincere apologies

 

[username456789]

This is actually a decent point that many or most people gloss over in their decision making process. Most of us can look back 10 years ago and think about who we were then, and what our interests were then, whether professional or recreational, and see a difference. Personally, the things I did and the interests I had were very different as a college sophomore compared with me now. The thing that hasn't changed, however, is my desire to commit a reasonable amount of my life to those recreational activities, regardless of how those things may change.

Everyone makes their own decisions based on very different criteria; however, there really isn't a guarantee any of us will still "love" the job we sign up for out of medical school. To me, at least, having enough time outside of my job to enjoy the evolving interests/activities (not to mention spending time with my family) is the one consistent thing I feel I can count on.

 

[username456789]

Well, you could always quit medicine and get a job as an accountant or a hotel manager or a public high school administrator. Do you think that would be fun? Would that be fulfilling to you?

Yeah, of course you should take into account the lifestyle factors. It's your career, it's your life. Even the ****tiest job in medicine is still pretty interesting compared to a lot of things out there. However it is not reasonable to expect the level of fulfillment as a doctor as that of a billionaire playboy who spends his days banging models, studying classical french poetry and funding the latest AIDS research in mozambique.

This is a rather unhelpful contribution, and falls into the classic extremism that shows up on these boards on a regular basis.

 

[Stellar Clouds]

What do you envision for your future? Being very hands on, procedure oriented? Being in clinic 5 days a week? Rounding for hours on the floor? Rounding for hours in the unit? Do you want a lot of patient interaction? Very little? None?

 

[FulfilledDeer]

I think you have to consider both. All jobs have downsides. Even being a celebrity (and nothing else) has problems. Find a minimum - what are you okay seeing yourself as - and go with lifestyle from there. You might change, but as you age you change less. And you're unlikely to go from hating something to loving it. But going from love to tolerate is definitely doable.

 

[Slowpoke]

What do you envision for your future? Being very hands on, procedure oriented? Being in clinic 5 days a week? Rounding for hours on the floor? Rounding for hours in the unit? Do you want a lot of patient interaction? Very little? None?

Though I enjoy the clinic now, I have no clue whether or not I will have a change of heart many years down the road. I can only hope, really.

Thanks for your input GWDS, I was hoping someone through med school would provide some insight, and also if I could ask you a question, what were some of your criteria used to select your particular specialty? and if you have any hindsight gems you could provide.

witzel, thank you for taking the time to provide your input.

 

[Slowpoke]

I think you have to consider both. All jobs have downsides. Even being a celebrity (and nothing else) has problems. Find a minimum - what are you okay seeing yourself as - and go with lifestyle from there. You might change, but as you age you change less. And you're unlikely to go from hating something to loving it. But going from love to tolerate is definitely doable.

Another thing that I have realized while working some odd jobs is regardless of what it is that I am charged to do, most of the satisfaction comes from the people that I get to interact with daily. It didn't matter whether it was stocking shelves at target, serving tables at a restaurant or putting together personal computors - the level of enjoyment that I got out of it directly correlated to the wonderful people people that were there. I would almost say that I wouldn't mind taking a "less fulfilling" specialty if it could satisfy many of the criteria that I listed. Helping people is why I went into medicine, but I don't think there are any specialties that is void of "helping people" in one way or another.

 

[projectlogic]

Won't every job get old and repetitive after a while? Just find the one that you can tolerate the most.

 

[Slowpoke]

Won't every job get old and repetitive after a while? Just find the one that you can tolerate the most.

For the most part, yes. Though there are variables: level of responsibility, people and perhaps location are some that come to mind.

 

[ManBroDude]

Another thing that I have realized while working some odd jobs is regardless of what it is that I am charged to do, most of the satisfaction comes from the people that I get to interact with daily. It didn't matter whether it was stocking shelves at target, serving tables at a restaurant or putting together personal computors - the level of enjoyment that I got out of it directly correlated to the wonderful people people that were there. I would almost say that I wouldn't mind taking a "less fulfilling" specialty if it could satisfy many of the criteria that I listed. Helping people is why I went into medicine, but I don't think there are any specialties that is void of "helping people" in one way or another.

This is really it. It may not make sense to those who've never had a job before, though.

 

[Snowdon48]

One of the things that enticed me about a career in medicine is that the field is always changing and evolving. I feel like this would help prevent boredom and weariness of your job. With new research and techniques constantly being developed it seems that you can always be improving yourself as a physician. Maybe this is more true of some fields than others but I would think it applies to every one in some form.

 

[Law2Doc]

I have found that most of my interests and hobbies change over time. I foresee a problem with picking a specialty just because I can see myself doing it and enjoying it.

What if I no longer find enjoyment after my 100th surgical procedure of the same thing?

What if I no longer find enjoyment from the 100th fever case today as a pediatrician?

I feel that it might be better to choose a specialty based off more of practical means: more time available to spend with family, higher financial/job security, lower litigation rates and low stress.

I probably wouldn't be able to cover all those bases, but I'm starting to try to plan for the future. One example is that emergency physicians I have talked to say that the day/night shifts over the years have taken a toll on them and though their job is interesting to them, they're not sure if its worth it anymore.

You are trying way too hard to create a justification for picking a low stress lifestyle field. Sorry but if you have to go down the "what if I don't still like it some time down the road" argument, you are working much too hard to get there. If you like surgery, you like surgery. If you like medicine, you like medicine. Every job gets a little routine down the road but that's never really a good argument to try to stomach something you aren't that into just because it's chill and not too taxing, and you'll probably get bored with whatever you choose. Please. if you don't enjoy it from day 1, you will hate it on day 100. Even in the most lifestyle friendly field, you still will be spending the bulk of your awake hours at work, so you have to enjoy some aspect of it. The whole "work sucks no matter what" argument is big cop out. You were smart enough to get into med school so you have choices in life. The guy stuck stocking shelves at Walmart is stuck, so he's allowed to live for the weekend -- you aren't. Sorry but if this "what if" argument is the best you got, you are trying to sell yourself a bill of goods.

 

[Law2Doc]

... It didn't matter whether it was stocking shelves at target, serving tables at a restaurant or putting together personal computers....

yeah, it matters. You are working very hard to spin this toward justifying taking the easy road over something you might enjoy but have to work at, and looking for support to justify that route. sorry but there will be a specialty or two that you will find enjoyment in, and a number you wont. You can try to sell yourself that it doesn't matter, but it does. You have choices in life, (unlike the typical person stuck as a waiter or computer assembly person) so saying it doesn't really matter is really just a colossal cop out.

 

[Law2Doc]

This is really it. It may not make sense to those who've never had a job before, though.

Speaking as someone who had a career before, no it makes no sense beyond trying to self justify an easy but less stimulating path.

 

[Slowpoke]

Law2doc, thanks for responding! I have enjoyed your posts over the years so this is awesome.

I suppose you are kind of right, I am sort of justifying "stomaching" a less fulfilling specialty for the comforts that it would be able to provide my future self and family. Though I think the major assumption here is that I would forgo selecting a specialty that I am genuinely passionate about -- where my enthusiasm can be seen oozing from my skin -- and choosing a more lifestyle based one. This is not true. I wouldn't. I just haven't had that moment of 'aw' yet. Most of the specialties are interesting to me so far, to a degree.

I have to make a choice at the end of the day, and I don't see the problem yet with basing this decision off practical means.

 

[Slowpoke]

Speaking as someone who had a career before, no it makes no sense beyond trying to self justify an easy but less stimulating path.

I have a bit of a hard time believing that you have not experienced what a dramatic difference it can be working with particular personalities to your overall job/career satisfaction.

 

[JShephard]

I have found that most of my interests and hobbies change over time. I foresee a problem with picking a specialty just because I can see myself doing it and enjoying it.

What if I no longer find enjoyment after my 100th surgical procedure of the same thing?

What if I no longer find enjoyment from the 100th fever case today as a pediatrician?

I feel that it might be better to choose a specialty based off more of practical means: more time available to spend with family, higher financial/job security, lower litigation rates and low stress.

I probably wouldn't be able to cover all those bases, but I'm starting to try to plan for the future. One example is that emergency physicians I have talked to say that the day/night shifts over the years have taken a toll on them and though their job is interesting to them, they're not sure if its worth it anymore.

I think most people think like this.

Also, as one poster said earlier, this doesn't have to be so extreme. What if you like one specialty as a 9 of 10 and others are 7 or 8 out of 10? What if the 9 requires 80 hr weeks and the 7 requires 45 hr weeks?

Most people in the field choose considering more than just "how much do I like this today? "

 

[Armadillos]

I have found that most of my interests and hobbies change over time. I foresee a problem with picking a specialty just because I can see myself doing it and enjoying it.

What if I no longer find enjoyment after my 100th surgical procedure of the same thing?

What if I no longer find enjoyment from the 100th fever case today as a pediatrician?

I feel that it might be better to choose a specialty based off more of practical means: more time available to spend with family, higher financial/job security, lower litigation rates and low stress.

I probably wouldn't be able to cover all those bases, but I'm starting to try to plan for the future. One example is that emergency physicians I have talked to say that the day/night shifts over the years have taken a toll on them and though their job is interesting to them, they're not sure if its worth it anymore.

I was talking to a cardiologist who has been in private practice for awhile, and he said to me that if you are the type of person who gets bored even a little bit after doing the same thing over and over, to seriously consider academics in whatever specialty you choose. He said among the people who he trained with, those that do academics seem to be much less likely to "get bored" because having students/residents around to teach, research to do, administrative stuff, etc. adds a ton of extra variety to any given week. He said he still loves his job, but often whole weeks or months will just seem like the exact same day repeated over and over.

Granted for a lot of people, the extra income made in private practice could probably buy enough nice vacations to make up for any difference in boredom

 

[christiandocj]

I agree with the above that being in academics helps to change up the routine. If there's a residency program/medical school and you do some occasional teaching, that can be very meaningful.

In terms of how to choose a specialty, Here are some thoughts I wrote down recently:
http://www.unfailingspring.com/2013/03/01/how-do-i-decide-what-specialty-to-go-into/

This is geared more towards the Christian physician wondering how to use medicine to service God, but I think some of the principles goes across the board. Good luck!

Jack

 

[Slowpoke]

christiandoc, I read your post, thank you for sharing - I do like the advice of talking to physicians and getting familiar with the bread and butter of their specialty.

armadillos, academic medicine has been something i've also been looking into and at this point seems to be the most attractive - though I think is rather difficulty to get into yeah?

 

[Armadillos]

christiandoc, I read your post, thank you for sharing - I do like the advice of talking to physicians and getting familiar with the bread and butter of their specialty.

armadillos, academic medicine has been something i've also been looking into and at this point seems to be the most attractive - though I think is rather difficulty to get into yeah?

I could be wrong, but Im pretty sure its rather easy to get into academics (assuming you aren't limiting yourself to trying to work at Harvard or something). Academic jobs are almost always going to be a lower salary and as far as I know its not hard at all to get an academic job somewhere. I think lots of people in academics get an attending job at wherever they did residency without too much effort.

Now if your trying to be a funded researcher where you do 80% research 20% clinical, then Im sure thats super tough. But I dont think its hard at all to get the 80% clinician, 20% "other" type jobs.

 

[Law2Doc]

I could be wrong, but Im pretty sure its rather easy to get into academics (assuming you aren't limiting yourself to trying to work at Harvard or something). Academic jobs are almost always going to be a lower salary and as far as I know its not hard at all to get an academic job somewhere. I think lots of people in academics get an attending job at wherever they did residency without too much effort...

Um no. Academics is extremely competitive despite the salary differential. private practice jobs are more plentiful. In academics you get to teach, research, and the hours are often better, so there's lots of things you get in lieu of $ which frankly is a very weak motivator after you've worked for a while.

 

[rocketbooster]

Um no. Academics is extremely competitive despite the salary differential. private practice jobs are more plentiful. In academics you get to teach, research, and the hours are often better, so there's lots of things you get in lieu of $ which frankly is a very weak motivator after you've worked for a while.

You would know, since you're only a resident right?

And no the hours are not necessarily better. The downside to academics is the salary and the loss of autonomy. You can't choose your hours anymore and there's little benefit to maximizing your efficiency of seeing pts in academics since you have more or less fixed salaries. Have you compared the productivity of docs in private practice and academics? The academic docs are way less efficient with their time. On the contrary, you can argue that some private practice docs don't spend enough time with their pts. I've personally seen more of the first.

 

[Armadillos]

Um no. Academics is extremely competitive despite the salary differential. private practice jobs are more plentiful. In academics you get to teach, research, and the hours are often better, so there's lots of things you get in lieu of $ which frankly is a very weak motivator after you've worked for a while.

Ah I didn't realize this, all the attendings I've done research with have made it sound like it will just be my choice whether I do academics or not. Granted, maybe they are assuming that seeing as I like research I would have a better shot at academic jobs?

 

[oldbearprofessor]

You would know, since you're only a resident right?

And no the hours are not necessarily better. The downside to academics is the salary and the loss of autonomy. You can't choose your hours anymore and there's little benefit to maximizing your efficiency of seeing pts in academics since you have more or less fixed salaries. Have you compared the productivity of docs in private practice and academics? The academic docs are way less efficient with their time. On the contrary, you can argue that some private practice docs don't spend enough time with their pts. I've personally seen more of the first.

And you would know since according to your profile, you're only a medical student, right?

Academics can be research track or clinical-educator track in MOST places. There are huge differences between these AND between fields both in hours, job description and salary differential such that generalizations are generally inaccurate.

As an academic neonatologist, even when on the clinical service (which is not often 😛), I still teach classes and do research and administrative work. Less efficient with my time? No benefit to being efficient? I don't see it that way, but perhaps you have worked with more academic pediatricians in subspecialty fields than I have?

 

[rocketbooster]

And you would know since according to your profile, you're only a medical student, right?

Academics can be research track or clinical-educator track in MOST places. There are huge differences between these AND between fields both in hours, job description and salary differential such that generalizations are generally inaccurate.

As an academic neonatologist, even when on the clinical service (which is not often 😛), I still teach classes and do research and administrative work. Less efficient with my time? No benefit to being efficient? I don't see it that way, but perhaps you have worked with more academic pediatricians in subspecialty fields than I have?

No I'm referring to time in clinic. My attendings don't do much research and are mainly clinicians. They see 6-8 pts in an afternoon while in private practice they see 15-20. I know sometimes academics have more complex pts but that's often not the case.