Sharing Specialty Interests with Clerkship Attendings, A Good Idea?

[OnePunchBiopsy]

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Hello everyone!

I am going to start 3rd year soon and I have a question about attending physicians. Is it ever a good idea to share the specialty you are most interested in if they ask you, or is it best to say something like "I am not sure and still open to anything."

For example, I am MOST interested in hem/onc, but like IMED overall. If asked, should I share this with all my attendings/only my IMED attending/ none of the attendings?

 

[Dave89]

Hello everyone!

I am going to start 3rd year soon and I have a question about attending physicians. Is it ever a good idea to share the specialty you are most interested in if they ask you, or is it best to say something like "I am not sure and still open to anything."

For example, I am MOST interested in hem/onc, but like IMED overall. If asked, should I share this with all my attendings/only my IMED attending/ none of the attendings?

They will ask you.

It will never damage their opinions of you if you answer truthfully but politely.

"Well, I have an interest in Heme/Onc, but I haven't yet decided. So far, Surgery has been really exciting!"


(When the end of 3rd year comes around, though, it will look kind of weird if you still feign neutrality.)

 

[giantswing]

I was always super honest, and no one held it against me. That way when something ortho related came up they'd throw me a bone, even in say, IM (which is about as far away from ortho as it got) they'd give me osteomyelitis.

But keep an open mind. I gave gen surg a fair shake but the people were insane.

 

[mimelim]

Keep an open mind throughout 3rd year. But, nobody is going to care what you are interested in going into. If you are proactive and a helpful member of the team, they are going to keep you engaged and teach. (unless you go to a crappy school of course...)

 

[operaman]

Yeah I would definitely be honest with people but do tell them you're trying to keep an open mind. I think the biggest fear (and my biggest pet peeve) is that people will think and act like, "well, I'm going into X so I don't really care about Y and don't need to know this stuff, so I just need to do the bare minimum to pass." If you're honest AND you work hard and are truly engaged in what you're doing, people will usually try to help you out and give you cases/patients most applicable to what you're wanting to do.

 

[giantswing]

Yeah it really looks good if they know you dont gaf but you still work hard and for the team.

 

[mvenus929]

Of the two med students I had at the start of intern year, one wanted to go into my specialty, and one wants to go into psych. Both were fabulous med students, and we would try to give the one interested I psych some of th more complicated social situations to wade through.

I always ask my med students so that I can attempt to tailor their learning. I fully believe that you can learn something that will apply to your future practice in every clerkship. If you want to do Ortho, you can work on your suturing on other surgery clerkships, and on seeing the primary care side in non surgical fields. If you want to do IM, when you rotate through Peds, you can learn about some of the diseases that children are now goring old with so you can get a feel for them before they wind up in your IM clinic.

 

[HelpPleaseMD]

I agree with the above statement minus the social issues. Do not hide your subspecialty interest because it makes no difference to us. If you know your patients well, help out the team, and don't disappear after rounds, you will do well regardless of your interest.

 

[Doctor Bob]

In the ER/ICU, most med students coming through are 4th years. So a little bit of a different population. But we get 3rd years occasionally as well.
I much prefer that students tell me what they are really leaning towards or planning to go into. Then I'll tailor things to that goal.

Going into neurosurgery? Maybe I won't send you to see the vaginal discharge and instead I'll send you to see the arm numbness and tingling.
Going into pediatrics? Why don't you pick up the 8yr old with abdominal pain rather than the 90yr old with generalized weakness.

Sure, I'm still going to make sure you get an idea about the breadth of my specialty because that's what you're on the rotation to learn. But there are times when I can shine the spotlight on areas that are a little bit more interesting to you in the long run.

 

[NickNaylor]

I never really understood why people suggest that students be vague or frankly dishonest about their career interests. It is a fact that it is more likely that you will do something that isn't their particular field. I never found anyone to care.

 

[PrettyLadyDoc24]

Hello everyone!

I am going to start 3rd year soon and I have a question about attending physicians. Is it ever a good idea to share the specialty you are most interested in if they ask you, or is it best to say something like "I am not sure and still open to anything."

For example, I am MOST interested in hem/onc, but like IMED overall. If asked, should I share this with all my attendings/only my IMED attending/ none of the attendings?

For me this helped alot when I was upfront about it. I wanted to go into Pathology, which in most specialties (with the exception of Psychiatry, perhaps) there is a significant reliance on path to make medical decisions. Thus they were more than happy to let me see their field from the "path" point of view. And it was nice to have the tailored attention 🙂 good luck to you, OP!

 

[tco]

Just be honest. Residents might make jokes about it, but they don't care which field you're going into. We get excited if you share the same interests, but aren't going to think negatively if you want to do something else. I'm definitely going to need a physician that isn't in my field one day, so there's that.

 

[VisionaryTics]

I don't think I've ever judged a student for being interested in one specialty vs. another.

However, getting "I'm still keeping my mind open" in May of MS3 is complete BS. Just tell me. I'm here to help.

 

[Psai]

Well I had an attending ask me what specialty I'm interested in and they told me I must not be very smart when I said I'm applying to anesthesia
Maybe I chose it because I like it and I think it fits me, who knows though maybe I am dumb

 

[charmiedermie]

I don't think I've ever judged a student for being interested in one specialty vs. another.

However, getting "I'm still keeping my mind open" in May of MS3 is complete BS. Just tell me. I'm here to help.

Unless you're a prelim Surgery resident, you're an ENT resident on an off-service General Surgery rotation. Much different than being a General Surgery resident who evaluates you in their specialty.

Well I had an attending ask me what specialty I'm interested in and they told me I must not be very smart when I said I'm applying to anesthesia
Maybe I chose it because I like it and I think it fits me, who knows though maybe I am dumb

And now you know why the rest of us don't tell.

 

[seminoma]

Hello everyone!

I am going to start 3rd year soon and I have a question about attending physicians. Is it ever a good idea to share the specialty you are most interested in if they ask you, or is it best to say something like "I am not sure and still open to anything."

For example, I am MOST interested in hem/onc, but like IMED overall. If asked, should I share this with all my attendings/only my IMED attending/ none of the attendings?

The way I see it if you work hard and appear interested in a clerkship that isn't what you're interested in (and your attendings know about it), then the attendings/residents might be a little more impressed by you than your classmate who is 100% all about that particular clerkship as a potential career.

 

[operaman]

I really think the issues here stem from a long history of students who weren't interested in the current rotation as a career just phoning it in and doing at absolute bare minimum. The key is demonstrating that you, in fact, do care about the rotation you're on and want to get as much out of it as you possibly can regardless of your ultimate career choices.

 

[OnePunchBiopsy]

Thank you so much for all the replies! I am glad my first post went so well 🙂.

 

[OnePunchBiopsy]

In the ER/ICU, most med students coming through are 4th years. So a little bit of a different population. But we get 3rd years occasionally as well.
I much prefer that students tell me what they are really leaning towards or planning to go into. Then I'll tailor things to that goal.

Going into neurosurgery? Maybe I won't send you to see the vaginal discharge and instead I'll send you to see the arm numbness and tingling.
Going into pediatrics? Why don't you pick up the 8yr old with abdominal pain rather than the 90yr old with generalized weakness.

Sure, I'm still going to make sure you get an idea about the breadth of my specialty because that's what you're on the rotation to learn. But there are times when I can shine the spotlight on areas that are a little bit more interesting to you in the long run.

BTW, I like the Chaos Orb avatar.

 

[Doctor Bob]

BTW, I like the Chaos Orb avatar.

It was, and still is, my favorite card to play with. Banned list be damned!

 

[tco]

I really think the issues here stem from a long history of students who weren't interested in the current rotation as a career just phoning it in and doing at absolute bare minimum. The key is demonstrating that you, in fact, do care about the rotation you're on and want to get as much out of it as you possibly can regardless of your ultimate career choices.

I love that this is still perpetuated. Why? As an example, if a student is interested in Psych, why should they care about the OB physical exam, or the proper way to suture a facial laceration, or any number of other things that they will, quite literally, never do again? It's a complete waste of everyone's time (faculty, resident, and student) to try to teach it to them if they're not one of the "I want to try everything at least once" group. The current medical education system is so outdated it's sickening, and we continue to adhere to it.

With all of that said, I maintain that you can tell me whatever field you're going into, and I'll do my best to try to teach you something that pertains to that field. I will not waste your time by quizzing you about esoteric things I've learned during my intern year if you're going into Pathology, or Psych, or Surgery...Well, we can go over imaging if you're going into Surgery 🙂

 

[ShireCheshire]

Be honest and polite. Don't disrespect their field.

I had friends in 3rd yr lie about their specialty interest to game for grades, I knew it, maybe the clerkship consultants didn't, but I lost 90% of my respect and trust in them. Don't be a tool.

 

[operaman]

I love that this is still perpetuated. Why? As an example, if a student is interested in Psych, why should they care about the OB physical exam, or the proper way to suture a facial laceration, or any number of other things that they will, quite literally, never do again? It's a complete waste of everyone's time (faculty, resident, and student) to try to teach it to them if they're not one of the "I want to try everything at least once" group. The current medical education system is so outdated it's sickening, and we continue to adhere to it.

I wrestle with this too. A big part of me is a traditionalist who wants to know and do everything, but I recognize the reality like you describe above. I really don't have a good answer yet, mostly just a gut feeling that more knowledge is usually better and knowing I would have farted away much of the additional time I had if I didn't have to learn things I'll rarely/never use. The best I've come up with is that it's important to understand what other fields do and how they do it, even if you won't actually be "doing" it yourself. The psychiatrist isn't going to be doing pelvic exams and colpo or deliver babies, but he will surely take care of women who have or will go through those things. He'll take care of postpartum depression and psychosis, not to mention the more systemically active gynecological disease that may present with psych complaints. It may help him/her make the correct referral the first time rather than bouncing them through multiple MDs until they get the right diagnosis.

There's been a lot of talk about the "silos" of medicine, and truthfully being a medical student is one of the few times you get to move between them. I didn't think about this until one of my last rotations this spring when one of my residents asked me semi-jokingly, "do you know everybody in this hospital?" In the subsequent conversation, she said she had been like that as a student too, but as a resident spent most of her time with her own department and only worked with others tangentially. I know as a student, some of the times I made what I feel were important contributions to the team were when I could offer insight about something I learned/saw on a previous rotation that related to our current patient.

I know that's all touchy-feely mumbo jumbo, but that's the best I've got at the moment! I keep waiting for the epiphany that even the pragmatists will agree with!

 

[Temeraire]

Just finished up MS3 year. Over the course of the year, I noticed an unfortunate trend when it came to telling residents and attendings about what I am interested in. If I tell them I am interested in pain medicine, invariably they all happily go nuts trying to give me chronic pain patients to see (which I love, btw) and they commend me on going into a field with difficult patients. However, if I tell them I am applying to anesthesiology (which is the most common route to the pain medicine fellowship), I can see their eyes glaze over while they struggle to relate their specialty to anesthesia. Worse, some make snide comments about sudoku or crossword puzzles. I stopped telling people about going into anesthesia after a while. Sinks my heart a little.

 

[Slack3r]

I wrestle with this too. A big part of me is a traditionalist who wants to know and do everything, but I recognize the reality like you describe above. I really don't have a good answer yet, mostly just a gut feeling that more knowledge is usually better and knowing I would have farted away much of the additional time I had if I didn't have to learn things I'll rarely/never use. The best I've come up with is that it's important to understand what other fields do and how they do it, even if you won't actually be "doing" it yourself. The psychiatrist isn't going to be doing pelvic exams and colpo or deliver babies, but he will surely take care of women who have or will go through those things. He'll take care of postpartum depression and psychosis, not to mention the more systemically active gynecological disease that may present with psych complaints. It may help him/her make the correct referral the first time rather than bouncing them through multiple MDs until they get the right diagnosis.

There's been a lot of talk about the "silos" of medicine, and truthfully being a medical student is one of the few times you get to move between them. I didn't think about this until one of my last rotations this spring when one of my residents asked me semi-jokingly, "do you know everybody in this hospital?" In the subsequent conversation, she said she had been like that as a student too, but as a resident spent most of her time with her own department and only worked with others tangentially. I know as a student, some of the times I made what I feel were important contributions to the team were when I could offer insight about something I learned/saw on a previous rotation that related to our current patient.

I know that's all touchy-feely mumbo jumbo, but that's the best I've got at the moment! I keep waiting for the epiphany that even the pragmatists will agree with!

I do think it's important to have a well rounded education. We're not trained to be technicians, but instead trained to be physicians. It's important you have a broad exposure to a wide variety of pathologies in various fields. You don't treat individual, compartmentalized diseases or disorders. There is often incredible overlap between fields even within single patients. It's important to have at least a superficial knowledge of what other clinicians in other specialties can offer to your patients. It's incredibly myopic, and IMO lazy, to suggest otherwise.

 

[styphon]

It could work against you if you say you are interested in the specialty you are currently rotating in as they would expect you to strive extra-hard. If I had someone interested in a non-related field, and someone who claims to want to be in my field - yet hangs around while the student strives above them, it makes the student look weak and disinterested.

But I agree with one of the above posts as it could be a benefit if you say you are interested in a non-related field yet bust your ass in the current rotation. This shows great work ethic and motivation despite the current situation.

I did ortho as my last rotation of 4th year - told them I was going into family med, and they let me do outpatient clinic only. I ended up doing >50 injections, seeing lots of patients for the initial eval (as opposed to the post-op follow up). I even went back and did sports med again as an elective for my residency because I found it so helpful, and they were willing to adapt it to my needs. Of course now they have received tons of my referrals - so maybe it was in their best interest after all?

I also told OB/GYN attendings/residents that I was struggling with OB vs family medicine (which was truthful) and I ended up having a wonderful (bar one specific resident) clinical rotation where as most in my class did not. I also had a chance to develop close relationships with residents who are now attendings.

 

[Renaissance Man]

I don't think I've ever judged a student for being interested in one specialty vs. another.

However, getting "I'm still keeping my mind open" in May of MS3 is complete BS. Just tell me. I'm here to help.

I had the unfortunate pleasure of being on 4 rotations during my Ms3 year with an individual who was always "interested" in going into the field we were both currently on. By my counts he has wanted to be a pediatrician, psychiatrist, radiologist, and EM physician all within the last 7 months. To the OP, please don't be this guy. No one needs to play the game that hard.

As others have said, whenever I am honest with attendings/residents about my plans, I will usually get assigned patients or told pearls that relate to my future career.

 

[charmiedermie]

I love that this is still perpetuated. Why? As an example, if a student is interested in Psych, why should they care about the OB physical exam, or the proper way to suture a facial laceration, or any number of other things that they will, quite literally, never do again? It's a complete waste of everyone's time (faculty, resident, and student) to try to teach it to them if they're not one of the "I want to try everything at least once" group. The current medical education system is so outdated it's sickening, and we continue to adhere to it.🙂

Be honest and polite. Don't disrespect their field.

I had friends in 3rd yr lie about their specialty interest to game for grades, I knew it, maybe the clerkship consultants didn't, but I lost 90% of my respect and trust in them.

Not to sound like a gunner, but I highly doubt your classmates care about your respect or trust when they're going for Honors on a clerkship.

 

[charmiedermie]

I do think it's important to have a well rounded education. We're not trained to be technicians, but instead trained to be physicians. It's important you have a broad exposure to a wide variety of pathologies in various fields. You don't treat individual, compartmentalized diseases or disorders. There is often incredible overlap between fields even within single patients. It's important to have at least a superficial knowledge of what other clinicians in other specialties can offer to your patients. It's incredibly myopic, and IMO lazy, to suggest otherwise.

 

[Slack3r]

Not to sound like a gunner, but I highly doubt your classmates care about your respect or trust when they're going for Honors on a clerkship.

Spoken like a true derm applicant.

 

[charmiedermie]

Spoken like a true derm applicant.

Says the person going for derm. Nothing mean or gunnerish by what I said. Don't read more into it than what is there.

I don't understand why anyone would care about this ever.

Me neither. It's why I thought it was weird that he thinks clerkships are a moment to win his respect and trust by his classmates. It's like the people that want to skip rotation after lectures at the end of the day and are mad you don't follow what they do because it makes them look bad.

 

[ChiDO]

Tell them what they want to hear. I told my psych attending (early MS3) that I wanted ortho. At the end of the rotation, he told me he was giving me the highest grade he has ever given to a non-psych going student (an 88%). What about the lazy students who said psych was their first choice...100% for them all.

After that, I didn't take any chances, told most attendings I was still deciding and made some reference to the current rotation about it peaking my interest. Never got a "B" again.

 

[madchemist89]

Absolutely every rotation in third year is important, and you should do your best to learn as much as you can about each field. 3rd year may be your last time to study and learn about specialties that you will not be going into. Some students believe that the practice of medicine can be divided into neat little boxes. If there is one thing that I have learned this year, it is that every specialty of medicine is in some way intertwined. Half of your patients have a uterus and ovaries and will likely be pregnant at some point. Just one reason why you can't blow off OB-GYN. You will see patients presenting with mental illness on rotations other than psych. This is why you can't ignore psych and say that you will never do it again. If you're an internist, you can't just blow off surgical skills. Internists need to know how to do simple suturing and determine if a patient has a surgical abdomen. One reason why future internists can't disregard their surgery rotation. These are only a few examples. I can go on and on. Not taking every rotation seriously is limiting your growth as a physician.

 

[neusu]

My experience in medical school was that, generally, other doctors were supportive of my interest in a field that was not their own. They would try to point out things in their field I should know e.g. survival skills or things associated to my field. That being said, there were plenty of people who were dismissive of or offended by my career choice. This made the rotation uncomfortable, but I made a point to show interest in whatever rotation I was on. You can't win them all I suppose.

 

[BurghStudent]

Just be honest. Don't be that ortho bro who has a plastic skeleton at home for ****s and gigs and tell every attending you like their specialty #truestory.

 

[charmiedermie]

Exactly. Medicine may be a team sport, but medical school sure as hell isn't.

And maybe not even in medicine when malpractice papers are sent out. Then it is completely the ortho's fault.

 

[BearAttack]

I honestly don't understand why new M3s make a big deal out of this. No one cares if you aren't going into their specialty, and no one actually expects you to lie about it! Just say "I'm interested in _____, so I'm actually really excited to be on this rotation because <it's related in ____ way><I'll be seeing a similar/different patient population><I'm excited to work on my surgical skills> <I'll never see surgery again after this!> <miracle of life!> <babies!> <you see psych patients in every specialty> <IM is the core of all medicine> <every patient has brain>

Just act like you actually give a f*ck about being there and do your work and you won't have any problems.

I also don't understand why med students get offended by silly jokes making fun of their intended specialty. On my surgery rotation the attendings mocked me endlessly in the OR for wanting to go into ob/gyn because ob/gyns are perceived as inferior surgeons. I loved it - it made me feel like part of the family, worthy of being ribbed just like everyone else. And then they took extra time to teach me how to tie and suture "so you'll know what you're doing". It made for such a fun surgery rotation.

 

[Slack3r]

I honestly don't understand why new M3s make a big deal out of this. No one cares if you aren't going into their specialty, and no one actually expects you to lie about it! Just say "I'm interested in _____, so I'm actually really excited to be on this rotation because <it's related in ____ way><I'll be seeing a similar/different patient population><I'm excited to work on my surgical skills> <I'll never see surgery again after this!> <miracle of life!> <babies!> <you see psych patients in every specialty> <IM is the core of all medicine> <every patient has brain>

Just act like you actually give a f*ck about being there and do your work and you won't have any problems.

I also don't understand why med students get offended by silly jokes making fun of their intended specialty. On my surgery rotation the attendings mocked me endlessly in the OR for wanting to go into ob/gyn because ob/gyns are perceived as inferior surgeons. I loved it - it made me feel like part of the family, worthy of being ribbed just like everyone else. And then they took extra time to teach me how to tie and suture "so you'll know what you're doing". It made for such a fun surgery rotation.

Suture skills won't stop you from transecting the ureter... 😉

 

[BearAttack]

Three most important surgical procedures every OB/Gyn should know:

1). transection of left ureter
2). transection of right ureter
3). bilateral (go for the gold!)

 

[ShireCheshire]

Not to sound like a gunner, but I highly doubt your classmates care about your respect or trust when they're going for Honors on a clerkship.

You're silly. Stop it

 

[KinasePro]

So much denial in this thread.

People are petty, and a certain subset of the attendings/residents on your rotations will absolutely look at you differently depending on which field you're interested in. No need to put our heads in the sand and pretend this doesn't happen.

IMO, it's best to keep your cards close to your chest and find something interesting in all of your rotations. The most I divulged on my rotations was that I would "probably do something surgical, but I'm not sure exactly what" and with this strategy I fared better than some of my classmates who wore their interests on their sleeve.

 

[charmiedermie]

You're silly. Stop it

🙄

So much denial in this thread.

People are petty, and a certain subset of the attendings/residents on your rotations will absolutely look at you differently depending on which field you're interested in. No need to put our heads in the sand and pretend this doesn't happen.

IMO, it's best to keep your cards close to your chest and find something interesting in all of your rotations. The most I divulged on my rotations was that I would "probably do something surgical, but I'm not sure exactly what" and with this strategy I fared better than some of my classmates who wore their interests on their sleeve.

I think you worded it well. Residents and attendings who fill out your evaluations are human beings, and that includes having a bad day or being petty, and possibly taking it out on your eval. What you say can put you in a more positive or negative light, no matter how much people try to deny it.

Why would you tempt fate when you only have that person for several weeks and will never see them again? If you want to be a surgeon, why would you tell an attending on Psych or Pediatrics that you want to go into Surgery, when they might really hate Surgeons? Or why would you tell the people on OB that you want to do Family Med, when they think those residents are encroaching on their turf? Your only goal as a med student is to be evaluated on how you do on that rotation regardless of what you're choosing for your specialty. Why complicate things?

Funny the 3 people who've related their bad experiences in being honest about their field, are all Orthos.

 

[Wordead]

So much denial in this thread.

People are petty, and a certain subset of the attendings/residents on your rotations will absolutely look at you differently depending on which field you're interested in. No need to put our heads in the sand and pretend this doesn't happen.

IMO, it's best to keep your cards close to your chest and find something interesting in all of your rotations. The most I divulged on my rotations was that I would "probably do something surgical, but I'm not sure exactly what" and with this strategy I fared better than some of my classmates who wore their interests on their sleeve.

Truth.

I can't even believe people are saying that it doesn't change your grade at all. Not that many people are truly impartial. Whether you want to play that BS game of "I'm interested in going into your specialty" or not is a different story though. I got sick of it after the first half of the year and my clinical grades would have dropped if not for shelf scores being a large part of the grade.

 

[NickNaylor]

Not to sound like a gunner, but I highly doubt your classmates care about your respect or trust when they're going for Honors on a clerkship.

They may not, but it's not outside the realm of possibility that you may work with some of your classmates. It's possible to succeed without being a dick. Plenty of people do it. That people feel the need to be a dick also causes me to lose respect for them. They just come across as pathetic. And sure, they probably don't care about my judgment of their behavior, but most people have similar judgments. It's a good way to put yourself on the road to building a reputation.

A buddy of a buddy interacted with one of our classmates that epitomizes the "be a dick" approach at multiple interviews this year and shared similar thoughts. If you're a dick in medical school, you're unlikely to not be a dick when you graduate and move on to other things. Thinking you're going to change your behavior because it's not medical school anymore is somewhat laughable.

 

[MedSchoolSurvivor]

If you think that it doesn't make a difference to tell your attending or resident that you are going into a specialty that is much different than theirs (i.e. telling a outpatient pediatrician that you want to go into ortho), then you are kidding yourself. The two lowest grades I got during third year, were in the two rotations where I told the attendings I wanted to go into ortho. I felt like I was unfairly judged even though I was trying my best to learn, be excited, and function harmoniously within the machinery of the team. I would not tell your attendings or residents what you want to do, unless you actually want to do something related to their specialty.

As a side note, I give all my medical students perfect evals as my personal protest against the inherent subjective unfairness that is the third year grading system.

 

[Psai]

If you think that it doesn't make a difference to tell your attending or resident that you are going into a specialty that is much different than theirs (i.e. telling a outpatient pediatrician that you want to go into ortho), then you are kidding yourself. The two lowest grades I got during third year, were in the two rotations where I told the attendings I wanted to go into ortho. I felt like I was unfairly judged even though I was trying my best to learn, be excited, and function harmoniously within the machinery of the team. I would not tell your attendings or residents what you want to do, unless you actually want to do something related to their specialty.

As a side note, I give all my medical students perfect evals as my personal protest against the inherent subjective unfairness that is the third year grading system.

Honestly though some people don't deserve good grades. You know the kids that complain about having to come in at 6, don't pull their weight, leave early without telling anyone, throw their classmates under the bus

 

[tco]

Absolutely every rotation in third year is important, and you should do your best to learn as much as you can about each field. 3rd year may be your last time to study and learn about specialties that you will not be going into. Some students believe that the practice of medicine can be divided into neat little boxes. If there is one thing that I have learned this year, it is that every specialty of medicine is in some way intertwined. Half of your patients have a uterus and ovaries and will likely be pregnant at some point. Just one reason why you can't blow off OB-GYN. You will see patients presenting with mental illness on rotations other than psych. This is why you can't ignore psych and say that you will never do it again. If you're an internist, you can't just blow off surgical skills. Internists need to know how to do simple suturing and determine if a patient has a surgical abdomen. One reason why future internists can't disregard their surgery rotation. These are only a few examples. I can go on and on. Not taking every rotation seriously is limiting your growth as a physician.

This post literally made me lol. Too bad I'm certain it wasn't meant to.

If you're not an OB/GYN, the extent of your knowledge should be a basic vaginal and bimanual exam as well as knowing that a woman typically bleeds every month. If you're going into primary care, also know birth control. Everything else is consult/referral worthy. That's just one example. I could go into a breakdown like that for every specialty. The people who think they can do more than that and can manage mildly complex medical problems outside of their field are doing a disservice to their patients and are more dangerous than those who recognize their limitations and ask for help.

 

[repititionition]

This post literally made me lol. Too bad I'm certain it wasn't meant to.

If you're not an OB/GYN, the extent of your knowledge should be a basic vaginal and bimanual exam as well as knowing that a woman typically bleeds every month. If you're going into primary care, also know birth control. Everything else is consult/referral worthy. That's just one example. I could go into a breakdown like that for every specialty. The people who think they can do more than that and can manage mildly complex medical problems outside of their field are doing a disservice to their patients and are more dangerous than those who recognize their limitations and ask for help.

Certainly EM folks should understand placenta previa/abruptio, ectopics, PID, STI's, etc.

Why the defensiveness?

 

[tco]

Certainly EM folks should understand placenta previa/abruptio, ectopics, PID, STI's, etc.

Why the defensiveness?

Like I said, it was just an example. Of course one could pick the ED and point to basics that they need to know in every field (also Family Medicine, to some extent). But, that's really it... If you're dealing with a student who wants to do the ED, they're likely legitimately interested in everything, especially everything acute, which is not the situation I posed in my original post. The last one was from a tablet, so I wasn't about to reiterate what I had already said.

The "defensiveness" (poor word choice BTW) is because during my rotations this year as an intern (TY intern that is VERY medicine heavy), I've seen some basic medical management of fairly simple medical problems (poorly controlled diabetic, a-fib with rvr, HTN that developed into HTN emergency) while on my elective/selective rotations that were absolutely pathetic, and the residents and attendings were confident enough that they ignored my advice until the patient did poorly, consulted medicine, and got the exact answer I gave them. They're satisfied in their ignorance, and often feel that they "know" something about a field other than their own when they really have no clue. It's dangerous, and completely unnecessary.

 

[Armadillos]

Why is this even a question? Just be honest with them, they know only about 1/10 or less med students are going to do whatever specialty they are. I was pretty sure of doing psych from the beginning and was open about that. It didn't seem to diminish my experience or effect my evals. Except maybe in EM where there seemed to be a gentlemans agreement to save almost all of the honors for people doing EM which honestly is fine by me because it's not one of the core rotations done by everyone.