Specialty?

[mentisveritas]

Long post coming atcha, but I know people have asked various iterations of this question, so I hope it helps all those who are having or will have trouble deciding on a speciality!

I'm an incoming M1, and I want to have a good sense of what speciality suits me best going into med school, so I am able to begin shadowing and research early. I love to teach and conduct clinical research (did so in undergrad), and I want to land at a great academic residency program hopefully closer to home in California (by "great" I don't mean top 5, I mean the best program that fits me, but I don't want my research experiences, Step 1 score, etc. to limit my choices at all).

So here's where I'm having trouble deciding: I know from previous shadowing experiences and knowing myself I want to pursue a surgical specialty. Love neurosurgery, don't know if I would be able to commit my entire life to neurosurgery (wake up, round, OR, clinic, review charts, bed) because although I have no problem with working long hours etc. I don't know if I'm on level of commitment where I live and breathe neurosurgery; I don't think I would find the medical underpinning of ENT particularly enthralling; I might enjoy ortho trauma or ortho spine but unsure if I would enjoy using the tech used in an ortho OR; I'm not artistically gifted enough to do plastics (I honestly think plastics is a mix of surgery and art, correct me if I'm wrong); don't think I would enjoy working with the specific patient population of CT surgery; and urology, optho, and gen surg are likely out on the basis of the medical underpinning of the specialty. IR could potentially work, but there's something so special about putting knife to flesh and being in the OR. Anesthesia I'd get to be in the OR, but, again, to me there is no comparison between actually putting a knife to flesh and "procedures."

I could potentially shadow physicians over the summer, but I'll be traveling for most of it and also don't want to spend my last free summer in a hospital where I'll be spending the rest of my life 🙁

Would anyone have any advice other than what I probably deserve: "calm down" or "wait till M3"? Thanks a million!!!

 

[JP2740]

Looks like you've given potential fields some thought which is good. I don't know if you'll be able to answer the nuanced questions you have by shadowing. You have identified the things people usually find out from shadowing. Looks like you want something surgical... try to find a broad surgical topic and find a mentor there, or make a top 3 list and choose one to get involved with research in. You're an M1 so anyone you do something in will understand that interests change and you might ditch him or her after the first project. I would narrow down your list, talk to faculty in each area, get involved in research as above and let M3 take you further. Just my thoughts.

 

[educ8r]

I had an idea of what I wanted going in too. Turns out I was right but not necessarily for the reasons I thought. However, I think it is important to give everything a fair shake during rotations. You never know how your priorities might change during med school. You have a ways to go; it is a marathon not a sprint, etc, etc. That said, it is always easier to match in a competitive field if you have early research to draw on for your application.

 

[ortnakas]

"calm down" or "wait till M3"?

Listen to your own advice. You don't need to panic unless you're at the M3 and don't know yet... and even then you still have SOME wiggle room depending on what you're deciding between.

 

[OnePunchBiopsy]

So here's where I'm having trouble deciding: I know from previous shadowing experiences and knowing myself I want to pursue a surgical specialty. Love neurosurgery, don't know if I would be able to commit my entire life to neurosurgery (wake up, round, OR, clinic, review charts, bed) because although I have no problem with working long hours etc. I don't know if I'm on level of commitment where I live and breathe neurosurgery; I don't think I would find the medical underpinning of ENT particularly enthralling; I might enjoy ortho trauma or ortho spine but unsure if I would enjoy using the tech used in an ortho OR; I'm not artistically gifted enough to do plastics (I honestly think plastics is a mix of surgery and art, correct me if I'm wrong); don't think I would enjoy working with the specific patient population of CT surgery; and urology, optho, and gen surg are likely out on the basis of the medical underpinning of the specialty. IR could potentially work, but there's something so special about putting knife to flesh and being in the OR. Anesthesia I'd get to be in the OR, but, again, to me there is no comparison between actually putting a knife to flesh and "procedures."

Neurosurgery: I see what you are getting at: 7 years is a long time. However, in most surgical residencies I could see someone living and breathing it.
Ortho: Who doesn't enjoy using new and fancy tech in the OR? That is one of the best parts!
Plastics: Having done a plastics rotation, none of the surgeons I worked with considered themselves "artists." They just have a passion for making wounds look as pretty as possible.
IR & Anesthesia: You have some good points here; there is no substitute for the OR, or being the one to cut in the OR.

Considering that a vast majority of the specialties you mentioned require a stellar Step 1 score, I say set yourself up for surgery broadly during your first 2 years(surgery based research, surgery interest groups, shadowing, etc), find out your Step 1 score, then hopefully by the time you begin 3rd year you will have it narrowed it down to at most 3 specialties.

Don't bother shadowing general surgery before 3rd year: you will get LOTS of it during clerkships. Pre-clinical years are a great time to shadow the specialties not covered during clerkships to see if you enjoy them.

Best of luck!