Questions to ask residents and attendings to best figure out specialty

[rollingstone27]

I'm getting toward the end of my third year and thinking of narrowing down my specialty choices. What are some good questions to ask residents and attendings to engage them and get information that will help me make a choice ? I'm choosing between EM, IM, and psych. Any other advice for choosing the right specialty?

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[235009]

People will usually not speak ill of their own specialty so you will get a skewed perspective from asking.

Observation is your strongest tool. For instance I wanted to do EM in med school because the attendings seemed cool and the work seemed exciting. What changed my mind was experiencing the EM schedule which you never get a break from, even as an attending, realizing that the exciting stuff was rare and you actually spend most of your time taking care of patients who shouldn't be there, working at 110% the whole shift with no break or downtime.


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[rollingstone27]

what did you end up going into and how'd you arrive at that decision? what did you do that made the biggest impact? for example, observation helps but only if you know what to look for. what exactly were you looking for during your rotations?

 

[Tenk]

I was debating between trauma surgery and ER in med school. I used to actually work out with one of the trauma attendings at the gym when he was on call. He was the only attending who has ever spotted me on bench. We would talk about ER and trauma surgery and his life. One day he told me straight up, if he could do it all over again, he would have done ER. Not because he didn't love surgery, but because he loved his family more and he wished he could spend more time with them. My decision was set in stone that day. He died 2 years later.

The reason I say this is because a lot of people will say all sorts of stuff about why you should or shouldn't go into X or Y specialty but you always have to remember that at the end of the day this is just a job. Figure out what you want out of LIFE then pick the job that supports that lifestyle. You'll be a hell of a lot happier if you do. I know I am.

 

[bashwell]

I was debating between trauma surgery and ER in med school. I used to actually work out with one of the trauma attendings at the gym when he was on call. He was the only attending who has ever spotted me on bench. We would talk about ER and trauma surgery and his life. One day he told me straight up, if he could do it all over again, he would have done ER. Not because he didn't love surgery, but because he loved his family more and he wished he could spend more time with them. My decision was set in stone that day. He died 2 years later.

The reason I say this is because a lot of people will say all sorts of stuff about why you should or shouldn't go into X or Y specialty but you always have to remember that at the end of the day this is just a job. Figure out what you want out of LIFE then pick the job that supports that lifestyle. You'll be a hell of a lot happier if you do. I know I am.

 

[midwestm2]

I was debating between trauma surgery and ER in med school. I used to actually work out with one of the trauma attendings at the gym when he was on call. He was the only attending who has ever spotted me on bench. We would talk about ER and trauma surgery and his life. One day he told me straight up, if he could do it all over again, he would have done ER. Not because he didn't love surgery, but because he loved his family more and he wished he could spend more time with them. My decision was set in stone that day. He died 2 years later.

The reason I say this is because a lot of people will say all sorts of stuff about why you should or shouldn't go into X or Y specialty but you always have to remember that at the end of the day this is just a job. Figure out what you want out of LIFE then pick the job that supports that lifestyle. You'll be a hell of a lot happier if you do. I know I am.

Wouldn't you just be thinking about all the other stuff in your life while you're on the job and wishing you weren't at work? This advice seems in opposition to other advice I've read on SDN about "finding what you love to do" / "do something you can see yourself doing for 40 years" / "DON'T pick a job based on lifestyle or salary" ??

 

[awared2]

I was debating between trauma surgery and ER in med school. I used to actually work out with one of the trauma attendings at the gym when he was on call. He was the only attending who has ever spotted me on bench. We would talk about ER and trauma surgery and his life. One day he told me straight up, if he could do it all over again, he would have done ER. Not because he didn't love surgery, but because he loved his family more and he wished he could spend more time with them. My decision was set in stone that day. He died 2 years later.

The reason I say this is because a lot of people will say all sorts of stuff about why you should or shouldn't go into X or Y specialty but you always have to remember that at the end of the day this is just a job. Figure out what you want out of LIFE then pick the job that supports that lifestyle. You'll be a hell of a lot happier if you do. I know I am.

This is what terrifies me about ortho. I wish I had more exposure to it outside of an academic hospital.

 

[Stagg737]

Wouldn't you just be thinking about all the other stuff in your life while you're on the job and wishing you weren't at work? This advice seems in opposition to other advice I've read on SDN about "finding what you love to do" / "do something you can see yourself doing for 40 years" / "DON'T pick a job based on lifestyle or salary" ??

I think he/she is trying to say to keep your priorities straight. Obviously we all want to end up doing something we enjoy, but unless your top priority is your job you should pick a field where you don't have to give up your other major life goals. I was pretty gung-ho on one field when I started med school. However, I've quickly realized that I want more out of my life than spending 60-70+ hours/week at work and then being on call regularly. At the end of the day, you've got to figure out what you really value and try and create a balanced lifestyle around those priorities, otherwise you'll be looking forward to a future of burnout and excessive stress.

 

[PhysicianOnFIRE]

FYI, you are choosing from 2 specialties (EM, IM) with the highest burnout rate and 1 with the 2nd lowest (psych)
Medscape Physician Lifestyle Report 2015

As a med student, I asked straightforward questions. "What do you like most about being a ______ ?" "What's the worst part of your job?" I also saw what their day to day job looked like, although it can be very different in private practice compared to an acedemic setting.

I liked the way the anesthesiologists answered those questions, the fast-paced day with occasional downtime, ability to do procedure,s and the lifestyle seemed OK. I went that route; still glad that I did.

 

[midwestm2]

Imagine someone went into ER with the idea that "yeah I like the work but what I really like is the fact that it is shift-work, no call, I get days off" ... The days off are great for that person but the days on are annoying, stressful, and full of daydreaming about having the next day off. That sounds like as much of a recipe for burnout as someone who is working 60+ hours a week but maybe chose the specialty because they really liked the work itself.

Am I off on this thinking? (Caveat - I'm a 2nd year who really doesn't know a lot about anything except studying for Step 1)

 

[PhysicianOnFIRE]

Imagine someone went into ER with the idea that "yeah I like the work but what I really like is the fact that it is shift-work, no call, I get days off" ... The days off are great for that person but the days on are annoying, stressful, and full of daydreaming about having the next day off. That sounds like as much of a recipe for burnout as someone who is working 60+ hours a week but maybe chose the specialty because they really liked the work itself.

Am I off on this thinking? (Caveat - I'm a 2nd year who really doesn't know a lot about anything except studying for Step 1)

Good luck with Step 1!

You're not entirely off, but your ER doc likes the work, and really likes the days off. That's a pretty good life. If she said "well, I hate the work but what I really like is the fact that it is shift-work, no call, I get days off" then maybe she chose the wrong specialty.

It's true that medicine is a calling for many physicians, but stresses and annoyances exist in medicine, hence the higher burnout rates when compared to other careers. Here is a good hypothetical question to ask your attendings: "Would you rather work the rest of the week or have the rest of the week off?" If you add that their income will not be affected either way, I think most would opt to take the time off. Not necessarily because they dislike their chosen profession, but that there a lot of other things they might rather do with that time.

 

[Celestia]

I think that you can't make hard and fast recommendations about how to make a career choice.

We are all wired differently.

I've often told people to only choose an intense surgical specialty only if you can't see yourself happy doing anything else. If you love that type of clinical work, perhaps one might say were born to do it, would always regret not pursuing that field - then go ahead armed with the knowledge of what that will mean for the rest of your life. Find a partner who can see that you are the best you in that field and support you.

On the other hand, most people can be happy in many fields of medicine and don't have that singular drive / attraction to just one specialty.

Also, for many people, things outside of work are equally important passions - family, community, even recreational passions...

I think I fall into this latter category. I enjoy about 80% of my job (which I consider a very good percentage) and am fortunate that it gives me enough time to pursue other interests. I also can tolerate that 20% and try not to dwell on it. I probably could have found another career that would have suited me as well - I certainly don't feel my greatest sense of identity comes from my work.

So lots of soul searching is involved in addition to the usual questions about what are the pros and cons of each career path.

 

[235009]

what did you end up going into and how'd you arrive at that decision? what did you do that made the biggest impact? for example, observation helps but only if you know what to look for. what exactly were you looking for during your rotations?

I ended up doing IM. I basically went through a process of elimination.
What you look for depends on your priorities as others have said, in your personal and professional life

 

[Tenk]

Wouldn't you just be thinking about all the other stuff in your life while you're on the job and wishing you weren't at work? This advice seems in opposition to other advice I've read on SDN about "finding what you love to do" / "do something you can see yourself doing for 40 years" / "DON'T pick a job based on lifestyle or salary" ??

This may be true if you hated your job. I don't. I enjoy my job. I was picking between the two because I enjoyed both, not because I loved one and hated the other but it had a good life style. My point was that if you pick your career based solely on what you enjoy in the hospital, you may find your life outside of it much less enjoyable. Just something to consider that's all.

 

[Snoopy2006]

"If you could go back and do it again, would you still choose the same field?"
"What are the biggest positives and negatives of this field?"
[If family/work balance is important to you]: "Do you feel like your practice allows you to balance work and family/hobby time?"

They sound generic and cliched, but the key is finding the right attendings - people who'll be honest with you. There are no magical questions. As an M2 I liked EM (a fantastic field) and went to a EM Interest Group meeting where I sat next to an older ED doc in his 50s and talked to him over dinner about his field and the pros/cons. He was very candid, and I realized it probably wasn't for me. I kept an open mind until I rotated through, but the point is - just find the right time to have these conversations and be polite, respectful, and ask basic genuine questions.

Everyone within each field will have different experiences. The higher your sample size and the more you work in a field, the better your understanding of that field and whether it's right for you.

 

[sloh]

I'd try and ask attendings that have been practicing for at least 5-10 years their opinions, preferably in an environment where they can be candid.

Do not discount lifestyle, the hours required of certain specialties, and the rotating shift work of others (EM). Can you see yourself tolerating that lifestyle into your 30s and 40s? If you can't, something you love could be something you despise if it eats into other values unique to you.

Leave you with some words of wisdom from the white coat investor.

"many medical students would feel fulfilled and happy practicing more than one specialty. If that is you, choose the one with the better salary and lifestyle."


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