realistic career choices for someone who just wants to go home (rural)

[rachmoninov3]

I'm currently in my third year, and only about 1/3 the way through, so I'm trying to keep an open mind about what I want to be when i grow up. However, all I really want is to just to go home to the northern (rural) part of my state after I graduate/complete residency. And while the university gives me exposure to all the really cool, highly specialized fields of medicine, it seems like my career choice is actually going to be dependent on what my community needs.
I spoke with a few doctors back home, one (fellowship in ID) said that the majority of her practice is primary care, the other (urologist) said that it's always better to be over than undertrained, even if the community doesn't need it, because they eventually will.

Perhaps I'm just worried that I won't know what to do with my life after 3rd year is over. Still I feel there is a ligitimate reason for chosing a specialty that the community needs. Any thoughts? Anyone pick a specialty based on community need? Any regrets?

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[Doctor Bob]

all I really want is to just to go home to the northern (rural) part of my state after I graduate... I feel there is a ligitimate reason for chosing a specialty that the community needs. Any thoughts?

Farmer!

 

[SweetnessFollow]

Something to think about:

1. Do you want to go back home because you are homesick?
2. Is that the only life you have ever known, and that is what you want to do? There is nothing wrong with that - I mean the statistics say that rural people are the ones who go back and serve the communities that are desperately in need them like you. So Kudos to you if you really do want to go back.
3. I have thought about going rural, and the one thing I've been told is that you have to have a good foundation in the basics. So say you want to do rheumatology, know that you will spend most of your time doing NON-rheum stuff, so know your IM down cold, and expect to be the only rheum as well.
4. Personally, I think so much of what we plan in life isn't what we actually happens. So think about what YOU want, not what you think they need. I know this sound selfish, but what will you do if you fall in love with someone who lives in place X - and you choose to move for them, etc etc. You get the story.

Good luck.

 

[montessori2md]

The easy answer: FamMed w/ a strong Ob program, so you can help anyone who needs it. IM w/ possible specialty, so you can do both primary adult care and specialty care. Gen Surg, so you can handle emergency appys, OB/gyn, because women live in the boonies too, EM b/c everyone crashes their cars (hem, pick-ups).

The real answer:
I don't think that you should limit yourself based on a desire to practice in a rural area. If you really know the specific town you want to practice in, I would go talk to the nearest hospital director about what is realistic, and if you're paying for school, and you're SURE you'd be happy as a clam back home (not falling in love w/ a fellow student who loves the big city? for sure?), then I'd also ask them what sort of deal they'd make with me once I'm ready to practice, and what they need, so that you have specifics.

Rural folks need the same work done that everyone else does. There would be plenty of general surgery, I would think ortho (arthritis, football injuries) and GI would do well (scopes), derm (moles from too much tractor time w/o sunscreen). Lots of areas would love to have more interventional radiologists for cancer treatment. Other than plastics, or other self-pay specialties, I can't think of anything that would exclude you from a rural practice -ok, stuff like neurosurgery, or something really research oriented.

You could also practice a few days a week in a larger town nearby if you needed to expand your patient base. And if you became a surgeon/intven radiologist you would need to be ok with making less than your peers, because you probably won't ever match the volume of their practices. On the other hand, you'll have more free time than them too, and probably a lower cost of living.

OB is highly variable in rural areas, some are desperate and will pay, others have given up and women are driving to an urban hospital to deliver.

www.3rnet.org (recruiter site for rural clinics)

 

[Pinkertinkle]

ophtho

 

[AlexMorph]

ophtho

no no no. those farmers need a good dermatologist. all those hours out in the sun...doesn't help the skin tone/complexion