Specialty War!!!!!

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FM (throw some OB on that)
Peds
Psych
Neonatal
Endocrine
Ophthalmology

I thought about OB/GYN for a long long time and still think about it on and off but I guess I will have to see how it goes in med school. I think I would prefer doing FM with some OB mixed in.

I really like babies/children, think eyes are freaking fascinating, and think there is a lot that there is gonna come up in Psych and Endocrinology in my lifetime which makes it very attractive to me as I like to be involved in ever changing situations.

For some reason, endo is very intriguing to me too.
 
Lupus or not lupus. Haha jk.

Basically, focuses on autoimmune, musculoskeletal, soft tissue, and connective tissue disorders.

Then add that to my list. Musculoskeletal is what it's all about for me. Idk though, with the talk of the money and hours of EM, I wouldn't mind being a soberizer overnight
 
I don't mind working nights cause I can't sleep without pills.

I hope (and I do genuinely hope, I'm not being sarcastic) that you are able to maintain that type of schedule/lifestyle for several decades. One of the reasons for burnout in EM (and lots of fields) is that students enter the field in their early/mid-20s and they're young, dumb, and full of . . . energy. Especially the single ones, who don't have many real-world responsibilities by which to be tethered.

Then you get married.

Then you have a kid.

Maybe you have another kid.

Suddenly you're 40 years old and longing for a different pace. If you're fortunate, you've paid your dues with whatever group you've joined, and are no longer stuck working all the night/weekend shifts. And hopefully you continue to balance your work with your life in a way that is meaningful and enjoyable for you.

I only say this because I understand how easy it is to be blinded by youthful ambition and vigor. As a pre-medical student (and even as an early medical student) I was so sure I was gonna be an orthopedic surgeon for the rest of my life. I was an athlete all throughout school, I thought operating all day was awesome, and the idea of being "the guy" everyone depended on at any time of day, any day of the week sounded so badass.

I'm a non-trad student, so my timeline is a little different than some younger guys. Life continued outside of medical school, and I started to realize that as much as I had idealized being an orthopod (or a surgeon in general), I would be absolutely miserable in 8-10 years, if not sooner. Thankfully, I ended up selecting a field I like just as much (if not more) than ortho, and it will have much less of a stranglehold on my life.

Anyway, I didn't mean to turn this into all about me. Just trying to share a few bits of wisdom.
 
FM (throw some OB on that)
Peds
Psych
Neonatal
Endocrine
Ophthalmology

I thought about OB/GYN for a long long time and still think about it on and off but I guess I will have to see how it goes in med school. I think I would prefer doing FM with some OB mixed in.

I really like babies/children, think eyes are freaking fascinating, and think there is a lot that there is gonna come up in Psych and Endocrinology in my lifetime which makes it very attractive to me as I like to be involved in ever changing situations. Oh and Family Medicine, I would thoroughly enjoy because of the long term relationship with patients and the fact that I get to meet whole families, couples...which from a psych major stand point is super cool. Also having the opportunity to help my patients change lifestyles and behaviors is something I am really interested in.

Very few FM (if any) MDs that don't practice in the middle of nowhere do any OB.....malpractice is huge and most don't have the volume to feel like they maintain competency. Plus, it adds a lot of unpredictability (in an otherwise generally predictable lifestyle) and takes a lot of time away from the clinic where you are losing income.
 
Would it be premature to presume that EM will have less primary care as a result of healthcare reform (not just coverage but the rise of medical homes and coordinated care)?

I don't think that will happen. A lot of people that come to the ER do have a PCP but they just don't bother to talk to them before coming in. One of the EM docs I worked with said at some point PAs will be able to do probably 95% of the work regular EM docs do.
 
I hope (and I do genuinely hope, I'm not being sarcastic) that you are able to maintain that type of schedule/lifestyle for several decades. One of the reasons for burnout in EM (and lots of fields) is that students enter the field in their early/mid-20s and they're young, dumb, and full of . . . energy. Especially the single ones, who don't have many real-world responsibilities by which to be tethered.

Then you get married.

Then you have a kid.

Maybe you have another kid.

Suddenly you're 40 years old and longing for a different pace. If you're fortunate, you've paid your dues with whatever group you've joined, and are no longer stuck working all the night/weekend shifts. And hopefully you continue to balance your work with your life in a way that is meaningful and enjoyable for you.

I only say this because I understand how easy it is to be blinded by youthful ambition and vigor. As a pre-medical student (and even as an early medical student) I was so sure I was gonna be an orthopedic surgeon for the rest of my life. I was an athlete all throughout school, I thought operating all day was awesome, and the idea of being "the guy" everyone depended on at any time of day, any day of the week sounded so badass.

I'm a non-trad student, so my timeline is a little different than some younger guys. Life continued outside of medical school, and I started to realize that as much as I had idealized being an orthopod (or a surgeon in general), I would be absolutely miserable in 8-10 years, if not sooner. Thankfully, I ended up selecting a field I like just as much (if not more) than ortho, and it will have much less of a stranglehold on my life.

Anyway, I didn't mean to turn this into all about me. Just trying to share a few bits of wisdom.

I have no interest in a surgical field. Too much work for me, and I probably don't have the brains to match plastics or ortho.

I was only interested in EM because I just think its cool. Maybe I'm biased because my mentor for the past 4 years has been an EM. But I will probably be single and have nothing to do besides medicine for many years (I'm only 20 as a college senior), so I really don't mind nights/holidays/weekends.

Maybe my perspective will change later. I don't know. I just know I would rather do something like EM rather than surgery or (shudder) pediatrics. Besides, I hate kids.

My mind may completely change when I do rotations, haha.


Thanks for your advice anyways. What field DID you end up selecting?
 
1. OB/GYN
2. really like interventional cardiology but it is super competitive so who knows.
3. anything but neonatology
 
I hope (and I do genuinely hope, I'm not being sarcastic) that you are able to maintain that type of schedule/lifestyle for several decades. One of the reasons for burnout in EM (and lots of fields) is that students enter the field in their early/mid-20s and they're young, dumb, and full of . . . energy. Especially the single ones, who don't have many real-world responsibilities by which to be tethered.

Then you get married.

Then you have a kid.

Maybe you have another kid.

Suddenly you're 40 years old and longing for a different pace. If you're fortunate, you've paid your dues with whatever group you've joined, and are no longer stuck working all the night/weekend shifts. And hopefully you continue to balance your work with your life in a way that is meaningful and enjoyable for you.

I only say this because I understand how easy it is to be blinded by youthful ambition and vigor. As a pre-medical student (and even as an early medical student) I was so sure I was gonna be an orthopedic surgeon for the rest of my life. I was an athlete all throughout school, I thought operating all day was awesome, and the idea of being "the guy" everyone depended on at any time of day, any day of the week sounded so badass.

I'm a non-trad student, so my timeline is a little different than some younger guys. Life continued outside of medical school, and I started to realize that as much as I had idealized being an orthopod (or a surgeon in general), I would be absolutely miserable in 8-10 years, if not sooner. Thankfully, I ended up selecting a field I like just as much (if not more) than ortho, and it will have much less of a stranglehold on my life.

Anyway, I didn't mean to turn this into all about me. Just trying to share a few bits of wisdom.

Thanks for sharing. 👍
First off, I realize that I am a pre-med and that most likely I will change my mind later on down the road. With that said, I was thinking orthosurg very early on (had knee surgery), but now I've decided to keep my mind completely open and not lean one way or the other. I would like to think that it will be more exciting exploring several fields and ultimately choosing the one that's best for you rather than coming in dead-set on a certain specialty and limiting oneself.
 
Would it be premature to presume that EM will have less primary care as a result of healthcare reform (not just coverage but the rise of medical homes and coordinated care)?

People will still come in with colds over the weekend, or after normal hours. Others will still wait too long to get a condition checked out and decide that Sunday morning at 4 am is the best time to be seen. Etc. I hope it works out that way, but I doubt there will be a noticeable change.
 
I do enjoy the idea of surgery, but the only specialties I could see myself in are pediatric surgery and head and neck surgery with a focus on pediatrics and otology.
 
You don't want to do peds surg. 4 yrs med school, 5 yr gen surg residency, 2 yr research (unwritten requirement for fellowship), 2 yr fellowship (which is really hard to get without knowing someone), then taking call every 4th night if you live in a big city and get a great set up for the rest of your life. I talked to a ped surg that was the only one in a state for a few years - I.e. he was on call 24/7. He is now "lucky" enough to be one of 2 or 3 in his current area so he "only" takes q2 or q3 call..

You're saying he was the ONLY ped surgeon in his whole state? Where did he live?

Also, 5year residence + 2yr research is 7 total years which is what many gen surg residencies are anyway. Does a fellowship have to be done to be a ped surg?

EDIT: urg, forgot thread was this long. disregard my post if questions were already answered.
 
Very few FM (if any) MDs that don't practice in the middle of nowhere do any OB.....malpractice is huge and most don't have the volume to feel like they maintain competency. Plus, it adds a lot of unpredictability (in an otherwise generally predictable lifestyle) and takes a lot of time away from the clinic where you are losing income.

I actually know a FM that does OB stuff and she lives and works in Chicago.

Thanks for the tip though. I worry about OB because of the schedule and the super high malpractice. Have no issues working with overly emotional/messy patients. LOL
 
I actually know a FM that does OB stuff and she lives and works in Chicago.

Thanks for the tip though. I worry about OB because of the schedule and the super high malpractice. Have no issues working with overly emotional/messy patients. LOL

That's very uncommon. All FM MDs are trained to delivery, but, like I said, very few keep it up.

Honestly, I think if FM was what is supposed to be in practice, then it would be the coolest specialty.
 
You're saying he was the ONLY ped surgeon in his whole state? Where did he live?

Also, 5year residence + 2yr research is 7 total years which is what many gen surg residencies are anyway. Does a fellowship have to be done to be a ped surg?

EDIT: urg, forgot thread was this long. disregard my post if questions were already answered.

Majority of gen surg residencies are 5 years, the 7 year programs are typically very academic places because they incorporate 2 years of research. I don't know why someone one would do that unless they were really interested in academics. Might as well do one of the surgery subspecialties. To each their own though. More power to them.

FSU is saying its 5 years residency, 2 years of pre-fellowship research because its that competitive, and then 2 years of actualy fellowship. Pediatric surgery is more competitive than getting a plastics fellowship from general surgery.
 
I have no interest in a surgical field. Too much work for me, and I probably don't have the brains to match plastics or ortho.

I was only interested in EM because I just think its cool. Maybe I'm biased because my mentor for the past 4 years has been an EM. But I will probably be single and have nothing to do besides medicine for many years (I'm only 20 as a college senior), so I really don't mind nights/holidays/weekends.

Maybe my perspective will change later. I don't know. I just know I would rather do something like EM rather than surgery or (shudder) pediatrics. Besides, I hate kids.

My mind may completely change when I do rotations, haha.


Thanks for your advice anyways. What field DID you end up selecting?


I gotcha, I wasn't trying to insinuate that you were considering surgery, only to draw a very slight parallel between the rigors of surgery and the schedule of EM (which are admittedly very different). I was just pointing out that the general idea of what you are excited about and will to do at age 20 may change when you reach age 30 and probably will by the time you're 40. I trust that you will have put plenty of thought into your chosen specialty when the time comes, I just wanted to share a similar story of someone who had a similar "I don't mind those hours/shifts" mentality that eventually changed. Sure, the shift work of EM is very different than the surgery schedule, but the idea of working tons of nights/weekends may be similarly undesirable to some people.

I chose Dermatology, by the way.
 
Speaking of derm....

Noticed not many have posted any of the ROAD specialties.

Such optomism.

I know that pretty much every premed/M1 probably thinks they can match neurosurgery/plastics/derm, but I guess a lot of people here are more modest.
 
That's very uncommon. All FM MDs are trained to delivery, but, like I said, very few keep it up.

Honestly, I think if FM was what is supposed to be in practice, then it would be the coolest specialty.

How is it different from it is "supposed" to be?
 
Post which specialty is your top choice and let's see which are the most popular!

Pediatric hematology/oncology. I want to care for really, really sick kids.

I'm open minded to critical care/pulmonology as well, though I believe there is greater opportunity to develop lasting relationships with patients through the hem/onc route, which is what I like best of all!
 
Aeronautical pediatric radiation oncology... maybe also MOHS surgery with an emphasis on tropically-derived disease. Phasic radiomedicine.
 
How is it different from it is "supposed" to be?

FM is supposed to be the doc that cares for the whole family: delivers babies, sees ped and adults, takes care of gyn stuff, see their patients in the hospital and does minor surgical procedures. Most only do a minor subset of that stuff in the "real world."

A lot of family med docs practically function as internists without having the option to subspecialize.
 
Another noob question. Is a GI, nephro, cardiologist etc... Are they a hybrid between a surgeon and internist?
 
Majority of gen surg residencies are 5 years, the 7 year programs are typically very academic places because they incorporate 2 years of research. I don't know why someone one would do that unless they were really interested in academics. Might as well do one of the surgery subspecialties. To each their own though. More power to them.

FSU is saying its 5 years residency, 2 years of pre-fellowship research because its that competitive, and then 2 years of actualy fellowship. Pediatric surgery is more competitive than getting a plastics fellowship from general surgery.

I actually thought that peds surg was it's own residency and then people went to a fellowship after that... oops. That's why i was confused when i read FSU's post.

Thanks for the clerification!]

EDIT: Also didn't realize that peds surg was that competitive.
 
Another noob question. Is a GI, nephro, cardiologist etc... Are they a hybrid between a surgeon and internist?

Negative. (Though someone correct me if I'm wrong on some of this). For instance, I have a friend that's a GI fellow. He can do endoscopy. He can't do surgery. That would be a colorectal surgeon's job. Same with cardiologist. They can deal with the management of the diseases related to the heart, but the cardiothoracic surgeon will be doing the surgery.
 
Negative. (Though someone correct me if I'm wrong on some of this). For instance, I have a friend that's a GI fellow. He can do endoscopy. He can't do surgery. That would be a colorectal surgeon's job. Same with cardiologist. They can deal with the management of the diseases related to the heart, but the cardiothoracic surgeon will be doing the surgery.

There is a difference between procedures and surgery however in a field like interventional cardiology they do a ton of less invasive stuff like angioplasty, some heart defect repair, pacemakers, caths and stent placements. The only field I really know of where a true primary care physician performs actual surgery is in OB.
 
Dermatologists can apparently perform surgery. Not sure how it differs from plastics, though.

Derm does stuff like Mohs surgery or simple excisions. They're not doing grafts, free flaps with microvascular work, face/hand/breast reconstruction, scar revision, rhytidectomy/rhinoplasty, etc.