Aug 11, 2015
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Undecided MS1 here just thrust upon the world of medicine. Talking to a lot of older students has made me want to start looking around for a specialty that interests me. I've always wanted to go into a procedural field, whether it's surgery or an IM specialty like cards/GI. However, my med school showed us the Abraham Verghese ted talk and it struck a cord deep inside of me.

Do all medical specialties have rather intimate patient contact? I can imagine surgeons not being able to get too intimate with their patients, whether it be verbally or through the physical exam. If not, are there any procedural specialties that also offer the physical intimacy between doctor and patient that Abraham Verghese was talking about? Should I avoid any specialties?
 

karayaa

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If you're looking for physical intimacy, consider Gyn, Urology, GI, and PRS...
If you want emotional intimacy, consider those that deal with death a lot: surgical oncology, trauma, EM, or primary care (because you help patients who are going through all their major life events, and can develop close relationships)
edit: and peds. All the peds.

Btw, wht led you to apply to med school if you were "thrust upon" medicine?
What have you shadowed? What did you think of those doctors?

What appealed to you in the TED talk, specifically? What are you looking for?
 
OP
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Aug 11, 2015
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By thrust into the world of medicine, I was talking about transitioning into medical school after the frivolities of senior year in undergrad!

I've always seen myself as a surgeon, and I've scrubbed into some CT, neurosurgery, ortho procedures. Up until now a lot of my exposure to medicine has been after the patient has already been sedated and on the table. I completely love the intense focus demanded in the OR.

However, when I saw the Ted talk, I saw how powerful listening to a patient and conducting a physical exam could be. I want that to be a part of my weekly practice in medicine while still being able to get into the OR.
 

karayaa

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By thrust into the world of medicine, I was talking about transitioning into medical school after the frivolities of senior year in undergrad!

I've always seen myself as a surgeon, and I've scrubbed into some CT, neurosurgery, ortho procedures. Up until now a lot of my exposure to medicine has been after the patient has already been sedated and on the table. I completely love the intense focus demanded in the OR.

However, when I saw the Ted talk, I saw how powerful listening to a patient and conducting a physical exam could be. I want that to be a part of my weekly practice in medicine while still being able to get into the OR.
Surgeons usually see patients in clinic or in the hospital and examine them to see if they're candidates, right? So I don't see a problem with that...
 
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Winged Scapula

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By thrust into the world of medicine, I was talking about transitioning into medical school after the frivolities of senior year in undergrad!

I've always seen myself as a surgeon, and I've scrubbed into some CT, neurosurgery, ortho procedures. Up until now a lot of my exposure to medicine has been after the patient has already been sedated and on the table. I completely love the intense focus demanded in the OR.

However, when I saw the Ted talk, I saw how powerful listening to a patient and conducting a physical exam could be. I want that to be a part of my weekly practice in medicine while still being able to get into the OR.
So where, pray tell, did you get the idea that surgeons don't listen and examine their patients? Curious impression.

Any surgical field dealing with chronic problems such as Surg Onc, Vascular, Colorectal, Transplant are going to form LT relationships with patients which can be very emotionally intimate. I know a lot about my patients and their families probably more than their PCPs.

I suggest figuring out what you feel comfortable doing during 3rd year.
 
OP
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You're right, the best thing for me is to sit tight until 3rd year when I can get more exposure to a lot of these fields. However, I do feel a bit of pressure to start narrowing down specialty choices in order to network, find research opportunities, etc. Will there still be time to put together a decent application if I settle on a specialty in my 3rd year?
 
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karayaa

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You're right, the best thing for me is to sit tight until 3rd year when I can get more exposure to a lot of these fields. However, I do feel a bit of pressure to start narrowing down specialty choices in order to network, find research opportunities, etc. Will there still be time to put together a decent application if I settle on a specialty in my 3rd year?
That is when the majority of students decide, and when you're expected to decide, so I'd assume yes...
If you're aiming for a tip top residency, then maybe not, because you might need to have done research in the specific field, and other requirements. It also depends on your Step score and clinical grades and your med school (the strength of your home departments etc)
 
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I'd suggest exploring fields in the preclinical years that interest you based on the medicine/science. Then when you go through 3rd year and go through rotations, you'll get a better idea of daily routine, amount of time spent with patients, lifestyle, etc. in different fields and can adjust your interests accordingly.
 
OP
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Thanks everyone for the advice! I think it's best for me right now to keep my head down and stay focused on the material that's coming my way. I'll keep the board updated on my experiences!
 

masaraksh

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If you really wanna do research now do something with cancer, applies to most fields
Ideally, do a project on endoscopy after image guided radiation therapy for head and neck osteosarcoma metastatic to skin and bladder. Should cover all the more competitive fields: GI, rads, radonc, ent, ortho, derm, uro.

Oh and first author that **** to the Lancet
 
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bc65

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Don't take TED talks too seriously. You certainly shouldn't base a career on it. I have heard several TED talks on topics that I was familiar with. These talks are dramatic performances, not journalistic reporting. Real life isn't like what you hear on TED talks. Base your career choices on your own experiences, not on someone else's version of reality.

e.g You might be enthralled with beautiful photographs of snowy landscapes, but you won't like shoveling out your car or getting frostbite.
 

sholamd

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I'm surprised nobody has said it yet - but you're describing dermatology perfectly. It's physically and emotionally intimate, heavy stress on the physical exam, and you get to do tons of procedures. This is actually the reason I went into dermatology - I shadowed some other specialties and didn't like the fact that they hardly touched their patients, or didn't have close long-term relationships. When I shadowed a derm doctor, everything clicked.

But if you want to do derm, it is probably good to start planting some seeds early, since it's so competitive. PM me if I can help!
 
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Undecided MS1 here just thrust upon the world of medicine...However, my med school showed us the Abraham Verghese ted talk and it struck a cord deep inside of me.

Do all medical specialties have rather intimate patient contact? I can imagine surgeons not being able to get too intimate with their patients, whether it be verbally or through the physical exam. If not, are there any procedural specialties that also offer the physical intimacy between doctor and patient that Abraham Verghese was talking about?
:whoa:
 
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I'm surprised nobody has said it yet - but you're describing dermatology perfectly. It's physically and emotionally intimate, heavy stress on the physical exam, and you get to do tons of procedures. This is actually the reason I went into dermatology - I shadowed some other specialties and didn't like the fact that they hardly touched their patients, or didn't have close long-term relationships. When I shadowed a derm doctor, everything clicked.

But if you want to do derm, it is probably good to start planting some seeds early, since it's so competitive. PM me if I can help!
I think so too. It is intimate when you touch someone's skin, and I think you can also show how much you really care to the patient by doing that. I think surgeons can too if they operate on a certain part.
 

username456789

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I deleted my post because I (think I) mistook her for a different poster . . . a very annoying one who claims to be a dermatologist and advertises themselves as such on here when in reality they are FM or IM trained and masquerade as one.
 
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ImmunoLove

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You can have intimate patient contact in the manner in which Verghese describes in any field, because that has to do with your approach and rapport with the patient. Fields vary with respect to the frequency with which a given patient is seen, however, but this is a different matter. For example, an interventional radiologist may rarely see a given patient twice, whereas a PCP follows a given patient for years. This prolonged continuous care lends itself to building a solid rapport and relationship with patients over time, but that doesn't mean a physician seeing a patient only once can not also establish a profound relationship with his/her patients in the moments during which he/she is involved in their care.

You've got some time to figure out exactly how you want to practice medicine. Explore and enjoy.
 

CherryRedDracul

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What about IR?
I had so much patient contact during my IR rotation that I fell in love with it. Every paracentesis that I did led to long conversations about life, philosophy, sports, food, standing up to the Man, etc. because there's nothing else to do while you're waiting for the bottles to fill up with ascites fluid.

Definitely one of my favorite moments in medical school.
 

karayaa

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I had so much patient contact during my IR rotation that I fell in love with it. Every paracentesis that I did led to long conversations about life, philosophy, sports, food, standing up to the Man, etc. because there's nothing else to do while you're waiting for the bottles to fill up with ascites fluid.

Definitely one of my favorite moments in medical school.
But is that what the attendings did also, or did you have the conversations only because you are a student and had lots more time with them?
As a student, almost everything has much more patient contact than what a real doctor will experience, because they're much more busy.
Eg, the private practice IR doc that I shadowed pushed in the needle, then left the room to go back to reading images, then returned to withdraw the needle 5-10min later. He doesn't have time to wait with the patient.
 

DrBowtie

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I had so much patient contact during my IR rotation that I fell in love with it. Every paracentesis that I did led to long conversations about life, philosophy, sports, food, standing up to the Man, etc. because there's nothing else to do while you're waiting for the bottles to fill up with ascites fluid.

Definitely one of my favorite moments in medical school.
If you're around longer than two minutes after the catheter is in and draining, you're doing it wrong.
 

ridethecliche

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Ideally, do a project on endoscopy after image guided radiation therapy for head and neck osteosarcoma metastatic to skin and bladder. Should cover all the more competitive fields: GI, rads, radonc, ent, ortho, derm, uro.

Oh and first author that **** to the Lancet
Radiation induced sarc? That'll be nature or science fosho.
 

CherryRedDracul

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But is that what the attendings did also, or did you have the conversations only because you are a student and had lots more time with them?
As a student, almost everything has much more patient contact than what a real doctor will experience, because they're much more busy.
Eg, the private practice IR doc that I shadowed pushed in the needle, then left the room to go back to reading images, then returned to withdraw the needle 5-10min later. He doesn't have time to wait with the patient.
Oh, definitely a strong reason why I had so much time to chill with patients was because of my student status, but there were quite a few times the attendings had time to do the same thing, especially if it was towards the end of the day. I guess it varies from practice to practice. The hours for our IR physicians was usually 9-4 (including all the add-on PICC lines) and most of them did pure IR rather than a mix of IR/DR.
 

Winged Scapula

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Was going to say, I think any surgical oncology field including gyn/onc, breast, surg onc, etc.

So many patients I know of who refer to their surgical oncologist simply as "my doctor"
Yep.

We really do form an intimate relationship with these patients - they see us first, we often do the biopsy, we spend more time with them etc. It is not at all uncommon for patients to ask us for advice on adjuvant therapy and even other non-surgical medical issues because they view as a "their doctor". Since I (and surgeons in general) like to run the ship, this agrees with our mentality.