Retrospective on Residencies

[CowboysFan]

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I'm not even close to being a resident....will be an M1 this August..

However, everytime I shadow with a doctor with a different expertise or read about a different specialty, that immediately becomes what I want to be ....truth is, most areas appeal to me right now, but that might change in a few......

My question is.....for most folks who post here, already being in residency, did you peg a certain specialty heading into med school, and if so, did you end up in that field.....why or why not, what changed your mind?

 

[Winged Scapula]

"My" specialty going into medical school was going to be a subspecialty of IM, maybe Endocrine or perhaps Neurology. After spending a few years doing research in both these fields, they captivated my interest. I also considered FM as well.

There was NO WAY I was going to be a surgeon or OB-Gyn. Never mind that I didn't know anybody in either field (save for my own personal Gynecologist). I was too squeamish, too unsure of myself, and didn't care much for babies.

I changed my mind during 3rd year - I liked surgery, liked Ob-Gyn and I HATED FM and IM. Rounds were too long, there wasn't enough "let's get this done" attitude, and hated what I felt was the droning recitation of differentials and the repetitive nature of what we saw in the office, on the wards. Of course, I was too naive to know that EVERY specialty has its albatrosses - the non-compliant patient, the lawsuit happy patient, the patient who doesn't listen and the patients with the "same ol, same ol" complaints.

Because of my experience I always advise people to keep an open mind; you never know what you don't know about other fields.

 

[Apollyon]

I went into med school planning on EM, mentally flirted briefly with peds, didn't expect much from Ob/Gyn or surgery, so I didn't get let down (really, who you rotate with makes or breaks it - if the Ob/Gyn and surgery seniors weren't so vicious and worthless as people, it is likely my perspective on their specialties may have been different), was good at IM and thought I liked it until I did a prelim year, and psych? Yeah, right - I TRIED to be a bad student, and STILL got an "A".

Essentially was EM all the way - and am in practice now as an EM doc.

 

[mlw03]

i'm an MS4 and i came into med school having a little experience with pathology and thinking that was what i'd want to do. i've found i enjoy spending time with the microscope more than time with patients, time rounding, or time being in an OR, thus i will apply for path next year. but i do strongly agree with Dr. Cox's point about keeping an open mind. yes, i went in favoring path, but i also started MS3 thinking that if i enjoyed something else more, then that's be fine too. i also agree with her point that every specialty has stuff that's cool, and everybody has stuff that's boring. when you start out, everything is new and interesting, but over time you'll figure out what turns you on the most.

another issue to consider is lifestyle - this shouldn't be the sole factor you think about of course, but to ignore it completely is equally foolish. you will see some specialties are more demanding of your time than others, and part of your decision should involve how much time you're willing to dedicate to your job.

 

[Medical123]

I went through my third year clerkships feeling the same way as the original poster. I liked everything---except psych and still do. It was a hard decision for me to decide what I wanted to do for the rest of my life. In the end, I discovered that I liked continuity of care and dealing with very complicated patients. In the end, I chose Internal Medicine.

 

[Winged Scapula]

I went into med school planning on EM, mentally flirted briefly with peds, didn't expect much from Ob/Gyn or surgery, so I didn't get let down (really, who you rotate with makes or breaks it - if the Ob/Gyn and surgery seniors weren't so vicious and worthless as people, it is likely my perspective on their specialties may have been different), was good at IM and thought I liked it until I did a prelim year, and psych? Yeah, right - I TRIED to be a bad student, and STILL got an "A".

Essentially was EM all the way - and am in practice now as an EM doc.

One's personal experiences with specialty house staff and attendings can really make or break your decision. My surgery faculty and house staff during medical school were wonderful, encouraging, genuinely pleasant people; I enjoyed being around them and was naive enough to think my experience was common. Much to my suprise during residency, not all surgeons were calm, polite and rarely prone to raising their voices!

 

[Medical123]

One's personal experiences with specialty house staff and attendings can really make or break your decision. My surgery faculty and house staff during medical school were wonderful, encouraging, genuinely pleasant people; I enjoyed being around them and was naive enough to think my experience was common. Much to my suprise during residency, not all surgeons were calm, polite and rarely prone to raising their voices!

This can be so true. I was on a surgical team where the attending could make all activity on the floor come to a halt with his screaming tirades and chart-throwing episodes. I was the unfortunate victim of a few of those and I can tell you that it was not a pleasant experience!

Don't let one jerk turn you away from a field that you may really love. For those getting ready to choose a specialty, try to focus on the PATIENT CARE itself. Do you like a certain type of patients? Do you like procedures? What types of patients do you not like? These are questions that you are going to have to take into consideration when it comes time to choosing a field.

 

[werewethere]

One's personal experiences with specialty house staff and attendings can really make or break your decision. My surgery faculty and house staff during medical school were wonderful, encouraging, genuinely pleasant people; I enjoyed being around them and was naive enough to think my experience was common. Much to my suprise during residency, not all surgeons were calm, polite and rarely prone to raising their voices!

This is absolutely true, the specifics of your experience will really affect your perception of the field. Having said that, if you are able to keep your mind open enough to separate what you do from the people you're actually doing it with, you're more likely to choose the best field for you. There were a number of experiences I truly enjoyed as a med student, but came to realize, in the long run, that even with the great people I was learning from, I would not be able to do it for any length of time (a few years, yeah, but a career, no).

 

[PediBoneDoc]

i would have to agree with those previous statements about exerience on clinical services.

i do ortho. it was my reason for going into medical school. i don't think i was like the gunner or one tract minded student of 12 types of medical students . i tried to give every field a chance. (don't tell anyone i actually like ICU medicine) hated OB/GYN (it was the experience as stated above)

i think in the end it comes down to a couple of factors. what field best suites your personality? what interests you? what life style you would like? a lon with other factors that are individually based.

i ended up in ortho with a plan to place metal and plastic joints into older people (my research interests). i said i would NEVER do peds or spine.

my current subspecialty is pediatric ortho with primary cinical interests in spine and limb deformity. go figure.

 

[AmoryBlaine]

Alot of the problem is that M1/2s tend to categorize specialties according to a few stereotypical phrases ("well I would never want to do surgery, the lifestyle is just brutal"). What you find as you go into clinical years is that stuff just sort of stands on its own.

In reference to my previous example I would cite my friends who are planning to apply to GenSurg. They agree wholeheartedly that the residency will be punishing and that they're going to work pretty damned hard. But guess what? They love the OR (and trauma and laproscopy and surg onc etc etc) so there really isn't much else for them to do...

 

[mlw03]

This can be so true. I was on a surgical team where the attending could make all activity on the floor come to a halt with his screaming tirades and chart-throwing episodes. I was the unfortunate victim of a few of those and I can tell you that it was not a pleasant experience!

Don't let one jerk turn you away from a field that you may really love. For those getting ready to choose a specialty, try to focus on the PATIENT CARE itself. Do you like a certain type of patients? Do you like procedures? What types of patients do you not like? These are questions that you are going to have to take into consideration when it comes time to choosing a field.

good points, but i would counter that some stereotypes exist for good reason. by that i mean certain specialties attract certain types of people consistently. and i think this is also somewhat of a self-perpetuating cycle. mean attendings produce mean residents, who go on to become mean attendings. at our school we have some real jacka#% surgeons, and guess what, a lot of the surgical residents are too. same with b*%#y ob-gyn attendings and residents. and so i pick on my own a bit, pathology has a rep for attracting 'interesting characters' as i've been told, and i think my own uniqueness will fit in well in such a group. of course they aren't all this way, but i think people, whatever they're like themselves, tolerate similar people. so the jerk student can tolerate the jerk surgeon much better than a shy, introverted person, who is a better fit in pediatrics or something less brutal.

but the main point that everyone seems to be making, that clerkship experiences strongly sway career choices - despite the complementary points i made above, i still would agree with that sentiment.

 

[CrazyPeds527]

As a currently upcoming MS4 having just survived most of 3rd year (xcept for the damn medicine shelf in 2 weeks...ahh!), I can say my thoughts were molded throughout the year. After actually doing the different rotations, I started every rotation with the thought of "Im going to try on this hat...could I wear it for a career?" And for most, the answer was no. Having decided on pediatrics, and being very excited about it, I can say you will likely have an experience or an accumulation of experiences thoroughout 3rd year that will guide you.

Until then, keep an open mind, learn a lot and continue to remember why you wanted to be a doc in the first place. It will carry you a long way

🙂

 

[Freibi]

One's personal experiences with specialty house staff and attendings can really make or break your decision. My surgery faculty and house staff during medical school were wonderful, encouraging, genuinely pleasant people; I enjoyed being around them and was naive enough to think my experience was common. Much to my suprise during residency, not all surgeons were calm, polite and rarely prone to raising their voices!

I`m wondering if you can fall off the horse on the other side, too? Can you like a (sub)specialty a lot because you`re working with great people, but then later on, you would regret your choice when you`re working in that field alone/ with other people who aren`t as fun?

 

[kungfufishing]

Im in EM. I had no idea what I wanted to do, but pretty much knew after my shift. I dont know that everyone is as lucky - I honestly STILL love my freakin' job and am almost done with residency. However, I think the above advice is sound. Keep your mind open. There are so many different personalities and opinions in medicine, and we are all pretty sure that we are right. Dont be swayed by anyone's opinion but your own.

 

[Circumflex]

I started med school thinking that I would do surgery. Even in 3rd year, I enjoyed my surgery rotation much more than any other, but I was still having doubts in the back of my mind. I did a pathology rotation in the first month of my 4th year and I fell in love with it. I had never considered pathology because I always equated it with the 2nd year pathology course. But, the clinical practice is totally different.

Keep an open mind and do some exploring during med school.

 

[Winged Scapula]

I`m wondering if you can fall off the horse on the other side, too? Can you like a (sub)specialty a lot because you`re working with great people, but then later on, you would regret your choice when you`re working in that field alone/ with other people who aren`t as fun?

Well, that's exactly what happened to me. I worked with great people during medical school but my residency faculty weren't nearly as supportive or interested in mentoring me. I often wondered if I made the wrong decision. Obviously I ended up finishing because I like the work, but in spite of the people around me who did very little to support my goals.

 

[CowboysFan]

Thanks for all the advice.....i'll try to keep an open mind in during rotations, even though i still have some predilections towards certain areas....love scrubs and K. Cox's avetar....