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Right time to pick a specialty

Discussion in 'Clinical Rotations' started by Vash311, May 13, 2002.

  1. Vash311

    Vash311 Senior Member

    Feb 9, 2002
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    When do you guys feel, in the most part, that med. students decide what specialty they are going into? Is it ususally in the 3rd year, or can it even extend well into your 4th year? Thanks!
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  3. spiderman719

    spiderman719 Member

    Jul 2, 2001
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    I don't think there is any magic time to pick your specialty. There are plenty of students who know what they want to do from day one of medical school. Almost all of them change their mind at some point.

    That said, it would optimize your residency application process if you know by midway through your 3rd year, especially if you're thinking of an early match specialty--ENT, optho, urology, neurosurgery, or neurology. If you do know by midway through 3rd year, it will make it easier to do the following:

    1) Arrange to work with a private doctor in the community in your chosen specialty (these doctors often have very different practices from the academic doctors at your school)
    2) Schedule your electives and away rotations early
    3) Work on a special project in your field of choice (research or otherwise)
    4) Attend grand rounds, etc. for your specialty of choice to learn more and to gain contacts
    5) Compare your specialty with others to make sure it's the right field for you

    Of course, there are many people who change their mind at the last minute and they still seem to match well, even in competitive specialties. I even know someone who applied to 2 different specialties because he couldn't make up his mind, and didn't decide until he made his rank list! He ended getting his first choice for ENT.

    Good luck!
  4. Winged Scapula

    Winged Scapula Cougariffic!
    Staff Member Administrator Physician Faculty Lifetime Donor Classifieds Approved

    Apr 9, 2000
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    Attending Physician
    Spidey has given you some excellent advice. MOST students decide sometime during their 3rd year - this tends to be crucial because applications for ALL specialties (even non-early match) have to be submitted early in the 4th year.

    However, all is not lost if you cannot decide. It is not unheard of to take a year off, do some research, etc. if you cannot make up your mind. In the olden days, students used to take a Transitional or Prelim year to try and help them make up their mind. However, in this day and age of restricted HCFA funding, that extra year might make things difficult for your when you decide to match (ie, you will have 1 less year of full funding). Deciding during the mid-to-late 4th year really means you either have to scramble for a position or wait out another year.

    As Spidey says, while a lot of students go into medical school "sure" they will pursue a certain specialty, a large percentage of them eventually change their mind. I did.
  5. wes c. adle

    wes c. adle Member

    Oct 21, 2001
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    In looking at residency appointments of schools I am considering, I see several preliminary/transitional years. What does this mean?

    Also, what is an "early match?"

  6. njbmd

    njbmd Guest
    Moderator Emeritus

    May 30, 2001
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    Attending Physician
    </font><blockquote><font size="1" face="Verdana, Helvetica, sans-serif">quote:</font><hr /><font size="2" face="Verdana, Helvetica, sans-serif">Originally posted by wes c. adle:
    <strong>In looking at residency appointments of schools I am considering, I see several preliminary/transitional years. What does this mean?

    Also, what is an "early match?"

    Thanks.</strong></font><hr /></blockquote><font size="2" face="Verdana, Helvetica, sans-serif">Hi there,
    Preliminary slots are generally in medicine or surgery. They are one year contracts that enable you to follow-up with anesthesia, radiology, opthamology,neurology etc after doing one year. Most anesthesia, radiology, opthamology or neurology residencies match into the Post Graduate 2 year (PGY-2) as opposed to PGY-1.

    A transitional medicine year is the equivalent of the old rotating internship. You get to spend one-month rotations in peds, critical care, and other internal medicine rotations and electives for the PGY-1 year. These transitional programs are great preparation for specialties like radiology or anesthesia.

    The Early Match Specialties are done through the San Francisco Match program. This match system works much the same as the NRMP (National Residency Match Program) but have deadlines that are about one month earlier. ENT, Ophthamology, Neurosurgery and Neurology are early match specialties. (There may be others so look them up on the San Francisco Match website).

    The original question was: When is the right tme to pick a specialty? I would start to investigate your interests during the first year of medical school by joining several specialty interest groups. You get to interact with upperclassmen and residents who are doing various specialties and you get a better idea of lifestyle. The worst that can happen is that you decide early that a specialty is not for you.

    Pay close attention to what you love to do during third year. I was interested in pathology and peds right up until I did my clerkship in surgery. After that clerkship, I knew that I was not going to be happy in a non-surgical specialty. If you are interested in anesthesia or radiology, I would suggest trying to get a summer elective right after you pass Step I and before your start third year so you can have a good idea of working conditions before you finish third year.

    When picking a specialty, do not try to anticipate future income or job availability as your main reason for choosing that specialty. Income levels and job opening change from year to year. When I started medical school, primary care was had lots of openings in residency programs. As I finished medical school, general surgery had plenty of openings in residency programs with a projected shortage. Anesthesia currently has a shortage of practictioners but will be pretty saturated when this crop of residents finish in four years. Geriatrics is pretty hot now with loads of openings. There is a projected shortage as the population is aging.

    In short, try to get as much information from as many sources as early as possible. Interview residents and attendings in specialties that you have an interest. Know yourself and your tolerance for certain types of patients or working conditions. If you don't like being in the hospital, you are not going to like anesthesia or surgery. If you love to interact with patients, you are going to hate pathology. Good luck! :cool:

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