Specialties to consider?

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jarhslof

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Pediatrics and FP: Patient population and medical underpinning—I would prefer much less patient interaction and would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Geriatrics: Patient population
EM: Medical underpinning—I would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Psych/Neuro: Patient population—I prefer having a definite knowledge of what is wrong with a patient, so I can determine exactly what it is I can perform / prescribe / treat to alleviate patient suffering.
Path: Patient population—I would prefer interacting with and treating live patients.
Heme/Onc: Patient population—I lack the emotional stamina.
ID: Medical underpinning—I would prefer a greater diversity of cases (I have read it is half treating HIV patients and half treating surgical infections).
OB/GYN: Medical underpinning—Hard pass on looking at female genitalia all day.
Uro: Medical underpinning—Hard pass on looking at male genitalia all day.
GI: Medical underpinning—Hard pass on performing colonoscopies.
Cardio: Patient population—Please someone correct me if I am wrong, but my preconceived notion of cardio is that much of patients’ problems could be alleviated by quitting smoking / eating a healthier diet / incorporating exercise.
Optho / Vascular / Thoracic / Cardiac / General: Medical underpinning?
Rads: Day-to-Day—I would prefer having patient interaction and being able to both diagnose and treat patients.
IR: Day-to-Day—I would prefer to have more clinic time than a half day a week.
Neurosurg: I double I will live and breath neurosurg like most attendings do.
PM&R: Patient population—I would prefer interacting with and treating more acute patients and conditions.

Derm: Interested, I value the amount of autonomy, the amount of variety, and the amount of flexibility (ability to do just clinic—although I would never do cosmetic—or incorporate Mohs for a more surgical approach to dermatological issues). Unsure if I would find the medical underpinning compelling. I hear it's boring?
Plastics: Interested, again, I would never do cosmetic procedures because I would not find that fulfilling, but burn / other areas of plastics I may find compelling.
Ortho: Interested, I think trauma would allow for variety, but I think ortho is more “mechanical” than “molecular” so I am unsure of how compelling I will find the musculoskeletal system.
ENT: Interested, ENT has variety of cases and also strikes a good balance between clinic and surgeries for me, but I am unsure of how compelling I will find head and neck anatomy.
Radiation Onc: Interested, but, again, I think I lack the emotional stamina treating cancer patients requires. However, I do think I would find the medical underpinning / physics of the treatment to be compelling.
Anesthesia: Interested, I think the medical underpinning (the pharm and physio) aspect of it is compelling, but the actual day-to-day seems to be now more supervision and less actual doing (unless **** is hitting the fan). And less direct patient interaction than I would like.

TL;DR: I value autonomy, variety, working with my hands and mind, being an “expert” rather than a “generalist,” complex problem solving, seeing quick results, receiving immediate gratification, helping patients recover from / helping them through serious conditions, patient interaction, and working hard (while being fairly compensated for doing so).

Would anyone have any advice on (1) Based on the things I value, does one specialty over the others stand out in particular? Should I cross any off that are on my “considering” list? (2) How do learn if I actually do enjoy operating? From shadow experience I love being in the OR but I don’t know how I could learn for myself if I actually enjoy the act of operating.

Any suggestions or advice is most welcome! Tagging @Raryn because you offered great advice is another one of these threads, but I would appreciate anyone's advice a great deal!

I'm an incoming M1, so I know this seems like jumping ahead of myself, but when I was thinking through my interests, I realized I am interested in some hella competitive specialties and I think getting involved in research early / shadowing early to confirm or deny interest / meeting physicians in the field would prove to be invaluable. Thanks so much, everyone!
 
Pediatrics and FP: Patient population and medical underpinning—I would prefer much less patient interaction and would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Geriatrics: Patient population
EM: Medical underpinning—I would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Psych/Neuro: Patient population—I prefer having a definite knowledge of what is wrong with a patient, so I can determine exactly what it is I can perform / prescribe / treat to alleviate patient suffering.
Path: Patient population—I would prefer interacting with and treating live patients.
Heme/Onc: Patient population—I lack the emotional stamina.
ID: Medical underpinning—I would prefer a greater diversity of cases (I have read it is half treating HIV patients and half treating surgical infections).
OB/GYN: Medical underpinning—Hard pass on looking at female genitalia all day.
Uro: Medical underpinning—Hard pass on looking at male genitalia all day.
GI: Medical underpinning—Hard pass on performing colonoscopies.
Cardio: Patient population—Please someone correct me if I am wrong, but my preconceived notion of cardio is that much of patients’ problems could be alleviated by quitting smoking / eating a healthier diet / incorporating exercise.
Optho / Vascular / Thoracic / Cardiac / General: Medical underpinning?
Rads: Day-to-Day—I would prefer having patient interaction and being able to both diagnose and treat patients.
IR: Day-to-Day—I would prefer to have more clinic time than a half day a week.
Neurosurg: I double I will live and breath neurosurg like most attendings do.
PM&R: Patient population—I would prefer interacting with and treating more acute patients and conditions.

Derm: Interested, I value the amount of autonomy, the amount of variety, and the amount of flexibility (ability to do just clinic—although I would never do cosmetic—or incorporate Mohs for a more surgical approach to dermatological issues). Unsure if I would find the medical underpinning compelling. I hear it's boring?
Plastics: Interested, again, I would never do cosmetic procedures because I would not find that fulfilling, but burn / other areas of plastics I may find compelling.
Ortho: Interested, I think trauma would allow for variety, but I think ortho is more “mechanical” than “molecular” so I am unsure of how compelling I will find the musculoskeletal system.
ENT: Interested, ENT has variety of cases and also strikes a good balance between clinic and surgeries for me, but I am unsure of how compelling I will find head and neck anatomy.
Radiation Onc: Interested, but, again, I think I lack the emotional stamina treating cancer patients requires. However, I do think I would find the medical underpinning / physics of the treatment to be compelling.
Anesthesia: Interested, I think the medical underpinning (the pharm and physio) aspect of it is compelling, but the actual day-to-day seems to be now more supervision and less actual doing (unless **** is hitting the fan). And less direct patient interaction than I would like.

TL;DR: I value autonomy, variety, working with my hands and mind, being an “expert” rather than a “generalist,” complex problem solving, seeing quick results, receiving immediate gratification, helping patients recover from / helping them through serious conditions, patient interaction, and working hard (while being fairly compensated for doing so).

Would anyone have any advice on (1) Based on the things I value, does one specialty over the others stand out in particular? Should I cross any off that are on my “considering” list? (2) How do learn if I actually do enjoy operating? From shadow experience I love being in the OR but I don’t know how I could learn for myself if I actually enjoy the act of operating.

Any suggestions or advice is most welcome! Tagging @Raryn because you offered great advice is another one of these threads, but I would appreciate anyone's advice a great deal!

I'm an incoming M1, so I know this seems like jumping ahead of myself, but when I was thinking through my interests, I realized I am interested in some hella competitive specialties and I think getting involved in research early / shadowing early to confirm or deny interest / meeting physicians in the field would prove to be invaluable. Thanks so much, everyone!

No offense, but this was an absolute eyesore to read. Your descriptions are really vague generalizations and it is evident that you only have a very superficial understanding of each of the specialties listed. This is totally normal for an incoming M1 but you need to recognize this so you don't make specialty choices based on such inaccuracies.

My suggestion is to wait until you start medical school and see what topics you enjoy/don't enjoy. Actively seek out shadowing opportunities in specialties you are really interested in. The first split to make is medicine vs surgery vs procedural. There is plenty of time to shadow different fields and get an idea of what you may like. If something clicks, start looking for some research opportunities in that field. If nothing clicks, pick a non-specific project (e.g. "cancer research") that applies to many specialties.

Above all, do well in your classes. Everything else will follow. Good luck, it's a fun ride and you only medical school once.
 
Pediatrics and FP: Patient population and medical underpinning—I would prefer much less patient interaction and would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Geriatrics: Patient population
EM: Medical underpinning—I would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Psych/Neuro: Patient population—I prefer having a definite knowledge of what is wrong with a patient, so I can determine exactly what it is I can perform / prescribe / treat to alleviate patient suffering.
Path: Patient population—I would prefer interacting with and treating live patients.
Heme/Onc: Patient population—I lack the emotional stamina.
ID: Medical underpinning—I would prefer a greater diversity of cases (I have read it is half treating HIV patients and half treating surgical infections).
OB/GYN: Medical underpinning—Hard pass on looking at female genitalia all day.
Uro: Medical underpinning—Hard pass on looking at male genitalia all day.
GI: Medical underpinning—Hard pass on performing colonoscopies.
Cardio: Patient population—Please someone correct me if I am wrong, but my preconceived notion of cardio is that much of patients’ problems could be alleviated by quitting smoking / eating a healthier diet / incorporating exercise.
Optho / Vascular / Thoracic / Cardiac / General: Medical underpinning?
Rads: Day-to-Day—I would prefer having patient interaction and being able to both diagnose and treat patients.
IR: Day-to-Day—I would prefer to have more clinic time than a half day a week.
Neurosurg: I double I will live and breath neurosurg like most attendings do.
PM&R: Patient population—I would prefer interacting with and treating more acute patients and conditions.

Derm: Interested, I value the amount of autonomy, the amount of variety, and the amount of flexibility (ability to do just clinic—although I would never do cosmetic—or incorporate Mohs for a more surgical approach to dermatological issues). Unsure if I would find the medical underpinning compelling. I hear it's boring?
Plastics: Interested, again, I would never do cosmetic procedures because I would not find that fulfilling, but burn / other areas of plastics I may find compelling.
Ortho: Interested, I think trauma would allow for variety, but I think ortho is more “mechanical” than “molecular” so I am unsure of how compelling I will find the musculoskeletal system.
ENT: Interested, ENT has variety of cases and also strikes a good balance between clinic and surgeries for me, but I am unsure of how compelling I will find head and neck anatomy.
Radiation Onc: Interested, but, again, I think I lack the emotional stamina treating cancer patients requires. However, I do think I would find the medical underpinning / physics of the treatment to be compelling.
Anesthesia: Interested, I think the medical underpinning (the pharm and physio) aspect of it is compelling, but the actual day-to-day seems to be now more supervision and less actual doing (unless **** is hitting the fan). And less direct patient interaction than I would like.

TL;DR: I value autonomy, variety, working with my hands and mind, being an “expert” rather than a “generalist,” complex problem solving, seeing quick results, receiving immediate gratification, helping patients recover from / helping them through serious conditions, patient interaction, and working hard (while being fairly compensated for doing so).

Would anyone have any advice on (1) Based on the things I value, does one specialty over the others stand out in particular? Should I cross any off that are on my “considering” list? (2) How do learn if I actually do enjoy operating? From shadow experience I love being in the OR but I don’t know how I could learn for myself if I actually enjoy the act of operating.

Any suggestions or advice is most welcome! Tagging @Raryn because you offered great advice is another one of these threads, but I would appreciate anyone's advice a great deal!

I'm an incoming M1, so I know this seems like jumping ahead of myself, but when I was thinking through my interests, I realized I am interested in some hella competitive specialties and I think getting involved in research early / shadowing early to confirm or deny interest / meeting physicians in the field would prove to be invaluable. Thanks so much, everyone!

Go for the one with medical underpinning.
 
To early to make a comprehensive list like this. There is a very good chance that your interests will change as you go through your rotations. A big mistake medical students make is that they find the subject matter of a particular field fascinating yet fail to realize that what a day to day practitioner does in the field is completely different.
 
To early to make a comprehensive list like this. There is a very good chance that your interests will change as you go through your rotations. A big mistake medical students make is that they find the subject matter of a particular field fascinating yet fail to realize that what a day to day practitioner does in the field is completely different.

Not even sure what OP's interests are currently...values variety but wants to be an expert, wants to solve complex problems but have quick results, wants to help patients with serious conditions but wants immediate gratification, interested in ENT but doesn't know if head/neck anatomy is 'compelling' (WTF), wants to work hard but is interested in derm....(pew pew pew, shots fired @ActinicKeratosis)
 
Pediatrics and FP: Patient population and medical underpinning—I would prefer much less patient interaction and would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Geriatrics: Patient population
EM: Medical underpinning—I would prefer to have a narrow range of focus / knowledge base rather than a broad range.
Psych/Neuro: Patient population—I prefer having a definite knowledge of what is wrong with a patient, so I can determine exactly what it is I can perform / prescribe / treat to alleviate patient suffering.
Path: Patient population—I would prefer interacting with and treating live patients.
Heme/Onc: Patient population—I lack the emotional stamina.
ID: Medical underpinning—I would prefer a greater diversity of cases (I have read it is half treating HIV patients and half treating surgical infections).
OB/GYN: Medical underpinning—Hard pass on looking at female genitalia all day.
Uro: Medical underpinning—Hard pass on looking at male genitalia all day.
GI: Medical underpinning—Hard pass on performing colonoscopies.
Cardio: Patient population—Please someone correct me if I am wrong, but my preconceived notion of cardio is that much of patients’ problems could be alleviated by quitting smoking / eating a healthier diet / incorporating exercise.
Optho / Vascular / Thoracic / Cardiac / General: Medical underpinning?
Rads: Day-to-Day—I would prefer having patient interaction and being able to both diagnose and treat patients.
IR: Day-to-Day—I would prefer to have more clinic time than a half day a week.
Neurosurg: I double I will live and breath neurosurg like most attendings do.
PM&R: Patient population—I would prefer interacting with and treating more acute patients and conditions.

Derm: Interested, I value the amount of autonomy, the amount of variety, and the amount of flexibility (ability to do just clinic—although I would never do cosmetic—or incorporate Mohs for a more surgical approach to dermatological issues). Unsure if I would find the medical underpinning compelling. I hear it's boring?
Plastics: Interested, again, I would never do cosmetic procedures because I would not find that fulfilling, but burn / other areas of plastics I may find compelling.
Ortho: Interested, I think trauma would allow for variety, but I think ortho is more “mechanical” than “molecular” so I am unsure of how compelling I will find the musculoskeletal system.
ENT: Interested, ENT has variety of cases and also strikes a good balance between clinic and surgeries for me, but I am unsure of how compelling I will find head and neck anatomy.
Radiation Onc: Interested, but, again, I think I lack the emotional stamina treating cancer patients requires. However, I do think I would find the medical underpinning / physics of the treatment to be compelling.
Anesthesia: Interested, I think the medical underpinning (the pharm and physio) aspect of it is compelling, but the actual day-to-day seems to be now more supervision and less actual doing (unless **** is hitting the fan). And less direct patient interaction than I would like.

TL;DR: I value autonomy, variety, working with my hands and mind, being an “expert” rather than a “generalist,” complex problem solving, seeing quick results, receiving immediate gratification, helping patients recover from / helping them through serious conditions, patient interaction, and working hard (while being fairly compensated for doing so).

Would anyone have any advice on (1) Based on the things I value, does one specialty over the others stand out in particular? Should I cross any off that are on my “considering” list? (2) How do learn if I actually do enjoy operating? From shadow experience I love being in the OR but I don’t know how I could learn for myself if I actually enjoy the act of operating.

Any suggestions or advice is most welcome! Tagging @Raryn because you offered great advice is another one of these threads, but I would appreciate anyone's advice a great deal!

I'm an incoming M1, so I know this seems like jumping ahead of myself, but when I was thinking through my interests, I realized I am interested in some hella competitive specialties and I think getting involved in research early / shadowing early to confirm or deny interest / meeting physicians in the field would prove to be invaluable. Thanks so much, everyone!
You're an incoming M1. Start school, after you get situated, join the student interest groups for every specialty that sounds the least bit interesting. These are typically free (or max $10-15), and often have hookups for dinners to meet with people on the field as well as shadowing opportunities. Set up some shadowing for the fields you're interested in, get some free dinners as available. As you get closer to the end of the year, pick the most competitive one remaining on your list and set up a summer research project. Otherwise, just focus on doing well in school.

You have years to decide yet. There's not really much more you can do at this point.
 
Pick the specialty that

1) requires the least amount of work
2) has the highest reimbursement
3) improves your chances with the ladies

*End of thread

*Note: if you f* up Step 1 like I did, just drop out of med school and save yourself from the misery I continuously go through
 
Have you checked out the Specialty Stories podcast?
 
Derm is the best. Mix of procedures and general Derm. It's so competitive though. Be ready to add two years to your postgrad training though if you don't match. If your step 1 scores aren't stellar look elsewhere. Shadow a dermatologist. If you like it get some research going. Look at other specialties as well. Ophtho is good but you have to get used to working on eyeballs all day. Most specialties have a ton of variability (even Derm despite the generalizations and lack of respect).

Yes we freeze a ton of AKs and use field therapy but it's cheaper than the Mohs down the line. We treat a ton of acne as well but ideally they have failed most of the first line treatments before they get to us. Also, most specialties are too fed up with ipledge to deal with it or are liability averse if they don't use it much (Bart Stupak's son committed suicide with accutane and many prescriptions in those days were outside of derm offices). Much like rheum we have tons of drugs to use for severe psoriasis now. Atopic derm is just now having its biologic era. Diseases like vitiligo and alopecia areata will finally be treated even in severe cases with JAK inhibitors. Not all derm is about steroids. You can't use Lotrisone on everything you need to actually make a diagnosis.

A good dermatologist can sense underlying cardiovascular disease, PCOS, diabetes, lupus, or thyroid disease without a lab test or biopsy. Of course our biopsy will confirm our suspicions or help lead management. Many of us are also dermatopathologists and often treat the inflammatory cells we see on biopsy when standard therapies fail (see dapsone with neutrophils).

We can save a hospital system and society money when we are available in the hospital to diagnose the underlying inflammatory disease that isn't bilateral cellulitis. We can diagnose the henoch schonlein purpura vasculitis saving the patient a kidney biopsy. We can diagnose the dialysis patients calciphylaxis potentially slowing the progression of their metastatic calcification. We can offer insight on DRESS (drug hypersensitivity syndrome), SJS, and TEN in terms of which medication caused it. We can expand or narrow a differential diagnosis of an immunosuppressed patient to systemic mycoses, zoster, sweets syndrome, or malignancy (lymphoma Cutis, leukemia cutis, or CTCL). Last, we do surgeries for benign and malignant tumors under local anesthesia which is much safer and cost effective.
 
As an incoming M1 I pretty much look at the ultra competitive specialties as impossible lol
 
What does medical underpinning mean?

Wikipedia defines "underpinning" as "the process of strengthening the foundation of an existing building or other structure."

Therefore I have concluded that "medical underpinning" is the skeleton, specifically osteoblasts

Therefore I have concluded that OP should become a bone doctor
 
What does medical underpinning mean?

Wikipedia defines "underpinning" as "the process of strengthening the foundation of an existing building or other structure."

Therefore I have concluded that "medical underpinning" is the skeleton, specifically osteoblasts

Therefore I have concluded that OP should become a bone doctor

Using Google "define: underpinning," it could also be "the set of ideas...that form the basis of something." Thus, in the context I used it in, "underpinning" means the basis (disease processes, organ system, etc.) a specialty is grounded in or centered on.
 
When I was choosing a specialty, I identified the biggest deal maker and the biggest deal breaker for me.

Find those.

Deal maker
- specialty must be the most innovative.
- ideally procedural
- specialized

Deal breaker
- attending life with more than 65 hours worked
- long round, overwhelming amount of clinic
- organ system I am not interested in, which include MSK and the skin

Initial thoughts during MS1-2: transplant surgery, general surgery, radiology

Ultimate decision: interventional radiology.
 
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