Sooo what specialty should I start focusing on?

[sharklasers]

Did well on step 1, have good preclinical grades, and just started my third year. Want some advice on what field to pursue.

I am pretty confident that I will not find a single field in particular that I fall in love with. I didn't like biology and more than chemistry or physics, just like I probably won't like cardio any more than derm or surgery.

Here is what I think an ideal job would consist of for me

1) Working with fun people - I know this isn't really in my control, but I know I could do anything in the world as long as I was doing it with people whose company I enjoy

2) Building a relationship with patients

3) Some procedural stuff, but not a specialty that is primarily procedures

4) Reasonable hours - want time for family, friends, fun

5) Salary - probably the least important of the 5, but still something I (like anyone else) would like to maximize

What fields should I give more thought to? Thanks!

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[sonofva]

Did well on step 1, have good preclinical grades, and just started my third year. Want some advice on what field to pursue.

I am pretty confident that I will not find a single field in particular that I fall in love with. I didn't like biology and more than chemistry or physics, just like I probably won't like cardio any more than derm or surgery.

Here is what I think an ideal job would consist of for me

1) Working with fun people - I know this isn't really in my control, but I know I could do anything in the world as long as I was doing it with people whose company I enjoy

2) Building a relationship with patients

3) Some procedural stuff, but not a specialty that is primarily procedures

4) Reasonable hours - want time for family, friends, fun

5) Salary - probably the least important of the 5, but still something I (like anyone else) would like to maximize

What fields should I give more thought to? Thanks!

Emergency medicine can fit all of these criteria... i mean, the relationships you'll build will be short term....haha. but the salary is good, shift work. if you get in a good ER, your coworkers will be the jam. and some procedures thrown in (tubes, LP, etc)...

 

[WaylonS]

This is some general advice.

Just because you did well on Step 1 does not mean you need/should pressure yourself to go into a competitive specialty. Do what you love.

Keep an open mind: as you go through third year, you're going to quickly realize what you do and don't like. Althought some people get stuck, the vast majority of people eventually figure out what they want to go into.

That being said, you might want to look into PM&R or derm

 

[sharklasers]

This is some general advice.

Just because you did well on Step 1 does not mean you need/should pressure yourself to go into a competitive specialty. Do what you love.

Keep an open mind: as you go through third year, you're going to quickly realize what you do and don't like. Althought some people get stuck, the vast majority of people eventually figure out what they want to go into.

That being said, you might want to look into PM&R or derm

Thanks, I appreciate it! All things being equal, I would choose internal medicine at this point, I definitely agree with what you are saying! But.. the only reason I would choose that is because of the possibility of opening up a practice with my best friend who is also pretty set on doing IM haha.

 

[Kahreek]

a im procedural subspeciality. But to be honest you were very broad, that description could go a long way to fit a various numbers of specialities. From fm to anesthesia, optho to ob/gyn, etc, etc

 

[sharklasers]

a im procedural subspeciality. But to be honest you were very broad, that description could go a long way to fit a various numbers of specialities. From fm to anesthesia, optho to ob/gyn, etc, etc

yeah true. but with the first three criteria being equal, i figure lifestyle would be the one to distinguish between everything else!

 

[survivordo]

Rural family med (more procedures) could be a fit. You also tend to make a bit more $$$ when you're out there in the boondocks.

Survivor DO

 

[sharklasers]

Rural family med (more procedures) could be a fit. You also tend to make a bit more $$$ when you're out there in the boondocks.

Survivor DO

Hmm thanks! I've actually always loved the idea of being a small town doc!

 

[IJL]

Given your handle, I recommend looking into becoming an evil doctor

 

[yehhhboiii]

Given your handle, I recommend looking into becoming an evil doctor

It's Dr. Sharklasers, I didn't spend six years in Evil Medical School to be called "mister," thank you very much.

 

[evilbooyaa]

I second the rural/family medicine route. You'll build long-term relationships with your patients, you'll get to do minor procedures (and if you go even more rural, you'll be doing C-sections and stuff). If you do mainly outpatient you'll have a decent schedule, you'll make decent money in non-saturated areas, most other family medicine docs are relatively relaxed, etc. etc.

However, you have a very broad and reasonable definition of what kind of doctor you want to be. I think based on that, there's a lot of specialties that are possibilities.

 

[sharklasers]

Isn't it difficult to get a rural medicine job? I feel like that's the kind if place with small town docs who everyone goes to since they were kids

 

[evilbooyaa]

Isn't it difficult to get a rural medicine job? I feel like that's the kind if place with small town docs who everyone goes to since they were kids

Can't say definitively one way or the other. I imagine with the maldistribution of doctors (generally NOT in rural areas) that it wouldn't be that difficult to find a rural FM job.

 

[theseeker4]

Isn't it difficult to get a rural medicine job? I feel like that's the kind if place with small town docs who everyone goes to since they were kids

If you don't have a particular small town in mind (which may or may not have its needs sufficiently met), rural areas are under served, not over served or saturated. This is the reason pay is usually better as a rural doctor. As an added bonus, I believe there are loan repayment/forgiveness programs for primary care doctors in rural and under served areas.

 

[JTster]

Did well on step 1, have good preclinical grades, and just started my third year. Want some advice on what field to pursue.

I am pretty confident that I will not find a single field in particular that I fall in love with. I didn't like biology and more than chemistry or physics, just like I probably won't like cardio any more than derm or surgery.

Here is what I think an ideal job would consist of for me

1) Working with fun people - I know this isn't really in my control, but I know I could do anything in the world as long as I was doing it with people whose company I enjoy

2) Building a relationship with patients

3) Some procedural stuff, but not a specialty that is primarily procedures

4) Reasonable hours - want time for family, friends, fun

5) Salary - probably the least important of the 5, but still something I (like anyone else) would like to maximize

What fields should I give more thought to? Thanks!

I actually had the same thoughts few days ago...I'm in a similar situation as you...Mhmmmm not sure what specialty...

 

[Winged Scapula]

Being an rural FP is about the worst thing you can do if you want a life.

Remember, as opposed to a specialist, patients will call their primary care physician for every thing. Unless there are several other local physicians available to share call, you can count on being on all the time. Don't disregard how disruptive that can be. It means no trips out of town, no wine with dinner, not even a quiet dinner without the phone ringing.

There's a reason why those jobs pay big bucks and its not just the location. It's a great job being the respected small town doc but it will be your life.

 

[WaylonS]

Being an rural FP is about the worst thing you can do if you want a life.

Remember, as opposed to a specialist, patients will call their primary care physician for every thing. Unless there are several other local physicians available to share call, you can count on being on all the time. Don't disregard how disruptive that can be. It means no trips out of town, no wine with dinner, not even a quiet dinner without the phone ringing.

There's a reason why those jobs pay big bucks and its not just the location. It's a great job being the respected small town doc but it will be your life.

True, although you can tailor your scope of practice (ie dont do obstetrics). However, I've worked with rural FP's who do a lot of skin biopsies, colonoscopies, and joint injections, so they're able to do a lot of procedures without having a super crazy call schedule.

 

[Winged Scapula]

True, although you can tailor your scope of practice (ie dont do obstetrics). However, I've worked with rural FP's who do a lot of skin biopsies, colonoscopies, and joint injections, so they're able to do a lot of procedures without having a super crazy call schedule.

I think you're misinterpreting how private practice works.

Someone has to be on call 24/7. We're not taking about ER call. I'm talking about someone has to answer the phone calls from patients around the clock. You cannot simply close your office at 5 pm and not answer calls until the next morning.

Patients call. And they call for stupid things. I was the recipient of a call this am at 530 to cancel an appointment for NEXT WEEK (they received the auto-call reminder yesterday). Yesterday (also at 530 am) the lab called with a potassium level; they couldn't reach the patient's internist (who ordered the labs), so decided to call me so they could write "MD aware". Patients call. Labs call. Families call. Nurses call. Insurance companies call. Medical colleagues call. And they don't always call during business hours.

My point is that it doesn't matter a darn bit if you don't do OB or *any* procedures. Being a small town family physician means that you will take more call than someone in a large group practice or someone in a larger city who has multiple other FPs to share call with.

 

[sharklasers]

So are you saying lifestyle is bad for all private practice? just primary care private practice? every specialty? lol

 

[Winged Scapula]

So are you saying lifestyle is bad for all private practice? just primary care private practice? every specialty? lol

I'm not saying that it is necessarily bad for all PP specialties. You won't have the buffer of residents that you would in an academic practice.

My point is that several made the suggestion that rural/small town FM would be a good choice for the OP. Students and residents often fail to see what goes on after hours in PP. Even a PP specialist will have the same issues but tend to have fewer patients, are less likely to practice in rural/remote/small towns, more likely to have partners and therefore, less likely to have the call burden that the PCP will.

 

[DrBowtie]

Derm is obvious answer.

 

[username456789]

Derm is obvious answer.

Yup.

 

[sharklasers]

Hmm maybe i'll do research in derm but then if I end up hating it, go into IM, aiming for a private practice or a subspecialty depending on how that goes.

 

[sharklasers]

Also, just curious about the future of derm, I'm under the impression that a lot more of dermatology, relative to other fields, is patients paying out of pocket, so is it pretty safe to say that derm is also less susceptible to the changes in health care the US is seeing?

 

[username456789]

Also, just curious about the future of derm, I'm under the impression that a lot more of dermatology, relative to other fields, is patients paying out of pocket, so is it pretty safe to say that derm is also less susceptible to the changes in health care the US is seeing?

It will depend on how your practice is structured, but the majority of visits/charges will still be billed through insurance, unless you really do just open a cosmetics-only boutique. But yes, there is the potential for cash pay visits to a higher degree than most other specialties.

Derm isn't the huge moneymaker people seem to think. If you're a superstar student and want to make the big bucks, there are other specialties that will afford you a higher paycheck. Derm is a great specialty for people who have a good personality, an eye and aptitude for detail/recognition, and a strong desire to maintain some semblance of a life/family outside of their daily job.

 

[kaleerkalut]

Also, just curious about the future of derm, I'm under the impression that a lot more of dermatology, relative to other fields, is patients paying out of pocket, so is it pretty safe to say that derm is also less susceptible to the changes in health care the US is seeing?

Interesting point. You may want to post this in the Derm forum for some answers.

 

[DrBowtie]

Interesting point. You may want to post this in the Derm forum for some answers.

No one really knows what is going to happen other than the fee schedule is getting chopped for pretty much everyone.

 

[Dral]

It will depend on how your practice is structured, but the majority of visits/charges will still be billed through insurance, unless you really do just open a cosmetics-only boutique. But yes, there is the potential for cash pay visits to a higher degree than most other specialties.

Derm isn't the huge moneymaker people seem to think. If you're a superstar student and want to make the big bucks, there are other specialties that will afford you a higher paycheck. Derm is a great specialty for people who have a good personality, an eye and aptitude for detail/recognition, and a strong desire to maintain some semblance of a life/family outside of their daily job.

All true.

Derm has the POTENTIAL to do ok if one moves to boutique type practice. But you have to like that sort of thing too. I have to admit, as a derm resident, Cosmetics can be kinda fun and rewarding...but I'm not doing cosmetics constantly on a daily basis either.

As WS said, rural FP as a lifestyle specialty is not such a great idea. Yes, you can tailor practice...you can even have a call service (which you'll have to pay for)...but even the call service can't handle everything.

My program has a call service. I'm on call today and sitting here just waiting for a call from one of the private practice patients with a question, a pharmacy about a Rx, or whatever else. Solo family med will be like this constantly. I can't imagine, but much respect to those who do that.

Usually the patients who actually call off hours are the ones that need the most hand-holding too. One might be on the phone with one of them for 45 minutes to reassure them that their wound is healing ok...something that might take 2 minutes in clinic for someone else.

Anyway, I digress. Rural FP is GENERALLY a 24/7/365 job.

 

[Food]

Derm is the answer to everything. Including happiness.

 

[Procyon]

^Nice avy, bro.