What are some common premed misconceptions about medical specialties? What is it REALLY like?

[Doctoscope]

From my experience of speaking to other premeds, there seems to be quite a bit of misconceptions about certain medical fields that are blatantly wrong, like 40-hours a week surgical residency & training, matching into Im subspecialties right out of med school, or that EM is full of crazy adventures for the full 12 hours (I actually don't know about this one; I've heard from EM attendings that it's more like 11 hours of "boring work" and maybe 1 hour of the true crazy emergency stuff.

What are some common premed (or even med student) misconceptions about certain specialties? What is the actual reality behind it?

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[agiraffe999]

There is absolutely no decent surgical residency that is 40-hours a week. Certain specialities such as neurosurgery even get granted extensions from the 80 hour a week to 88 hours a week.

 

[Doctoscope]

There is absolutely no decent surgical residency that is 40-hours a week. Certain specialities such as neurosurgery even get granted extensions from the 80 hour a week to 88 hours a week.

Yep, hence the premed misconception about it (although I don't know how common it is). I've met multiple people in my postbacc who legitimately thought you worked 40 hours + paid for overtime in surgical residencies lol.

 

[la flame]

Yep, hence the premed misconception about it (although I don't know how common it is). I've met multiple people in my postbacc who legitimately thought you worked 40 hours + paid for overtime in surgical residencies lol.

lol wtf? aren't all residencies at LEAST 60/70 hours a week with the surgery ones hitting the 80's?

 

[over]

psych
i never shadowed or went to a psychiatrist, but i would believe it's less talking and more listening like how therapy works. the idea that a good psychiatrist should be super neurotypical and outgoing is common among the general public

 

[PipetteDreams]

... matching into Im subspecialties right out of med school...

Just in case people have heard of this - here's a quick, likely clarification:

This can be done in the physician-scientist tracks (ABIM fast tracking), in which the applicant is guaranteed a spot in their fellowship of interest upon matching to the categorical residency. Notably, this is a tiny portion of IM applicants, most of which have a PhD.

 

[Lucca]

something I didn't really appreciate as a pre-med is just how specialized you can get, especially if you spend your entire career in academic centers. There are cardiologists who specifically manage cardiovascular disease in only cancer patients. There are people who mostly see patients in their specialty with specific rare genetic conditions. There are cardiologists who almost exclusively read echos. These are more or less "bespoke" careers that arise from developing expertise, there are no "training paths" for them, per se, beyond what you need to become an attending in the broader specialty.

There are also specialties that are so incredibly broad...Sleep medicine is an interesting one that spans neurology, cardiology, psychiatry, and even ENT!

A more typical misconception is how much direct patient care physicians actually do...a typical day on IM is mostly consumed by rounding and charting. Everything else that happens, including time spent directly with the patient (esp if the team doesnt round in the room or the pt is sleeping / non-communicating), which I think is what most people think of as "doctor-ing" is a minority of the day. Many times, especially with intensive care, it can feel that there is much more deliberation than there is action in medicine. Probably for the best too! Just not what I think most people imagine the wards to be like.

 

[spottedcory]

I had the misconception that radiologists sit in dark rooms all day reading scans by themselves. I shadowed two who reaffirmed this stereotype (including one who said that they chose radiology specifically to not talk to people). But then on the interview trail one of my interviewers was having a blast reading scans with his coworkers (I feel like he was making eye contact with one of his coworkers during the interview) and he also frequently met with patients! His goals were very similar to mine so that was very cool to see--never thought I'd relate to a radiologist

 

[Matthew9Thirtyfive]

lol wtf? aren't all residencies at LEAST 60/70 hours a week with the surgery ones hitting the 80's?

Basically, yes lol.

 

[Matthew9Thirtyfive]

I had the misconception that radiologists sit in dark rooms all day reading scans by themselves. I shadowed two who reaffirmed this stereotype (including one who said that they chose radiology specifically to not talk to people). But then on the interview trail one of my interviewers was having a blast reading scans with his coworkers (I feel like he was making eye contact with one of his coworkers during the interview) and he also frequently met with patients! His goals were very similar to mine so that was very cool to see--never thought I'd relate to a radiologist

My mentor is a radiologist and interacts with patients regularly when he’s on service.

 

[OrthoTraumaMD]

That orthopaedic surgery is not cerebral.

 

[ciestar]

FM is more than outpatient

 

[deleted1040417]

80 hours a week for 5+ years sounds miserable . 60 for 3-4 years sounds doable -- 70 is pushing it.

Are there weeks that primary care can get that bad? I do recall seeing an IM resident with the most exhausted eyes I've seen and told me to run away from the field.

 

[ciestar]

80 hours a week for 5+ years sounds miserable . 60 for 3-4 years sounds doable -- 70 is pushing it.

Are there weeks that primary care can get that bad? I do recall seeing an IM resident with the most exhausted eyes I've seen and told me to run away from the field.

During residency? Yes. Inpatient months are rough. Especially as an intern... you spend very little time as a PCP. I spend 3 hours in clinic a week and im working like 70 hours right now on an inpatient service.

 

[Doctoscope]

That orthopaedic surgery is not cerebral.

What do you mean by that? Is it about the meme that says orthopods are "meatheads"?

 

[ciestar]

Curious @Amino Base, with your surprise reacts.. what did you think a FM residency entailed?

 

[deleted1040417]

Curious @Amino Base, with your surprise reacts.. what did you think a FM residency entailed?

I just hoped it was away from the 80-hour mark and more toward the 60 side. I really want to go into FM/IM. It's not that I don't respect PC residents, I was just in fantasy land.

 

[ciestar]

I just hoped it was away from the 80-hour mark and more toward the 60 side. I really want to go into FM/IM. It's not that I don't respect PC residents, I was just in fantasy land.

Most of my rotations are more toward the 60 side thankfully. Inpatient months are just busier. If you go IM, you’re basically on inpatient most of the year. I have inpatient 3 months of the year and only 2 months as a senior on the inpatient FM service. Some of my OB weeks were a bit longer because I had a weekend shift/nights thrown in. Honestly, it hasn’t been terrible and i havent worked many weekends.

 

[DNAJB6]

From my experience of speaking to other premeds, there seems to be quite a bit of misconceptions about certain medical fields that are blatantly wrong, like 40-hours a week surgical residency & training, matching into Im subspecialties right out of med school, or that EM is full of crazy adventures for the full 12 hours (I actually don't know about this one; I've heard from EM attendings that it's more like 11 hours of "boring work" and maybe 1 hour of the true crazy emergency stuff.

What are some common premed (or even med student) misconceptions about certain specialties? What is the actual reality behind it?

Is there anyone that really believes any of that?

 

[ciestar]

Is there anyone that really believes any of that?

apparently lol

 

[ciestar]

This ended up being a lot of talk about residency lol. And apparently IM residency sucks?

Anyone have any insight on how ID as a career is different from what is portrayed? Tbh not a lot is portrayed because no one talk about ID but anyway...

My IM colleagues will tell you their residency sucks in the terms of hours.

 

[Matthew9Thirtyfive]

Is there anyone that really believes any of that?

I am willing to bet that if you asked most people how many hours a resident works, they would say 40-50. Also, so many people do not understand how the match and GME work. I have talked to M1s who didn't know you have to do IM first to do things like heme/onc and cards.

 

[biomom]

This ended up being a lot of talk about residency lol. And apparently IM residency sucks?

Anyone have any insight on how ID as a career is different from what is portrayed? Tbh not a lot is portrayed because no one talk about ID but anyway...

My husband is an ID specialist. Standard IM suck fest, fellowship was miserable (top school). He has been in practice for years and loves every minute of it. It is literally never boring. He also earns well above the national average. He‘d do it again in a heartbeat.

 

[OrthoTraumaMD]

What do you mean by that? Is it about the meme that says orthopods are "meatheads"?

Yes. “As strong as an ox and half as smart” etc

 

[ciestar]

hours per week, times of day and weekends or c) all of the above?

All of the above

 

[biomom]

thank you for responding!! okay so five years of hell and then good stuff?

any chance I can get your husbands email and ask him some questions about his path and day-to-day? If not I completely understand!

I‘ll ask him. He’s swamped at the moment with covid plus regular cases. I can tell you a little. He rounds and sees hospital consults in the morning and has clinic/ does clinic consults in the afternoon. Sometimes he goes back to the clinic. He sees standard things like TB and HIV, but he also sees rare brain or travel infections. Cat bites, joints, Mrsa, crazy std stuff that you wouldn’t believe ... His most exciting cases are the weird mystery zebras. My husband is in a situation where he takes home call all the time, but he loves it. It builds relationships and referrals.

I’ll see if I can get him to talk to you.

 

[Matthew9Thirtyfive]

I‘ll ask him. He’s swamped at the moment with covid plus regular cases. I can tell you a little. He rounds and sees hospital consults in the morning and has clinic/ does clinic consults in the afternoon. Sometimes he goes back to the clinic. He sees standard things like TB and HIV, but he also sees rare brain or travel infections. Cat bites, joints, Mrsa, crazy std stuff that you wouldn’t believe ... His most exciting cases are the weird mystery zebras. My husband is in a situation where he takes home call all the time, but he loves it. It builds relationships and referrals.

I’ll see if I can get him to talk to you.

If it didn’t require the hell that is IM residency, it would be awesome.

 

[biomom]

Sometimes he goes back to the hospital after clinic, not clinic.

 

[biomom]

If it didn’t require the hell that is IM residency, it would be awesome.

IM is only 3 years. When he did it there was no 80 hour workweek. You can do it.

 

[Matthew9Thirtyfive]

IM is only 3 years. When he did it there was no 80 hour workweek. You can do it.

3 years of hours of rounding? Nah. Hard pass.

 

[biomom]

3 years of hours of rounding? Nah. Hard pass.

LOL. I understand.

 

[ciestar]

3 years of hours of rounding? Nah. Hard pass.

Hate rounding so much. The service im on now the attending barely rounds with us. It feels more like a sign out in the morning. On our FM service, we rounded for 4 hours a few times. Death.

 

[Matthew9Thirtyfive]

Hate rounding so much. The service im on now the attending barely rounds with us. It feels more like a sign out in the morning. On our FM service, we rounded for 4 hours a few times. Death.

Omg. I start on surgery and end with IM. It’d like the opposite of Dante.

 

[ciestar]

Omg. I start on surgery and end with IM. It’d like the opposite of Dante.

Surgery rounds and note writing is my favorite lol

 

[Matthew9Thirtyfive]

Surgery rounds and note writing is my favorite lol

lol yeah. Not looking forward to the hours, but it is what it is.

 

[stickgirl390]

I think there’s a misconception about OBGYN residents being stereotyped as “rude”. In my experience, they were just really efficient, especially on labor and delivery while managing emergency prenatal patients, antenatal/deliveries, and postpartum rounds. I think premed/med students just don’t realize what hard work looks like, so they call it “rude”.

 

[Doctoscope]

Yes. “As strong as an ox and half as smart” etc

Curious where that stereotype even came from. From all the sports med guys attracted to the field?

 

[OrthoTraumaMD]

Curious where that stereotype even came from. From all the sports med guys attracted to the field?

Many ortho surgeons started as athletes. Their camaraderie and positive attitude got somehow translated to “jocks” aka not smart. Funny because ortho is top 3 most competitive fields.

 

[ciestar]

I think there’s a misconception about OBGYN residents being stereotyped as “rude”. In my experience, they were just really efficient, especially on labor and delivery while managing emergency prenatal patients, antenatal/deliveries, and postpartum rounds. I think premed/med students just don’t realize what hard work looks like, so they call it “rude”.

No, there is a difference between working hard and being stressed and just being a jerk. The latter being my experience with OBGYN.

 

[NY_Med]

Many ortho surgeons started as athletes. Their camaraderie and positive attitude got somehow translated to “jocks” aka not smart. Funny because ortho is top 3 most competitive fields.

It is funny how true that stereotype is. I have shadowed three different orthopedic surgeons and one played D1 Soccer, one played D1 basketball, and one did D2 Track and Field.

 

[OrthoTraumaMD]

It is funny how true that stereotype is. I have shadowed three different orthopedic surgeons and one played D1 Soccer, one played D1 basketball, and one did D2 Track and Field.

Yes. Athletes are much more likely to encounter an orthopaedic surgeon early on in their lives than the average person because of injury and exposure to team physicians— and it isn’t a stretch to say that exposure to a job during one’s formative years makes one more likely to seek out that job later on. However being an athlete somehow translating to not being smart is a big stretch.

 

[AnatomyGrey12]

Yes. “As strong as an ox and half as smart” etc

Curious where that stereotype even came from. From all the sports med guys attracted to the field?

Many ortho surgeons started as athletes. Their camaraderie and positive attitude got somehow translated to “jocks” aka not smart. Funny because ortho is top 3 most competitive fields.

I have a theory orthopods started this myth themselves. Somehow they have convinced everyone else in the hospital they only hammer bones and can’t manage any basic medical conditions on any of their patients and they all need to be admitted to the trauma service or IM. Despite being some of the most successful academic students in medical school.... honestly it’s pure genius.

 

[deleted1079620]

I have a theory orthopods started this myth themselves. Somehow they have convinced everyone else in the hospital they only hammer bones and can’t manage any basic medical conditions on any of their patients and they all need to be admitted to the trauma service or IM. Despite being some of the most successful academic students in medical school.... honestly it’s pure genius.

My husband is this personality type and he’s successfully convinced me he can do practically nothing without my help, while simultaneously making me think he’s the smartest man I know. If he were in medicine I guarantee you he would run this scam.

Anecdotally, I’ve kinda seen this in action. An ortho surgeon I shadowed would walk into the OR while the scrub techs were setting up the room and start moving things and asking them questions, until they told him to go wait in the lounge until the patient was under and ready for him, lol. He actually bragged that he did this on purpose so they’d stop calling him to come to the room super early.

 

[Eye-eye]

You will learn how much you either love rounding or hate it, and how much that will impact your choice of specialty. Same for the OR, and the clinic. Honestly, if I didn't hate rounding/wards, love the OR, and love clinic (way more patient interaction, way less insanity, compared to wards), I have no clue what I would have picked. Rads, I guess? That was fun.

Oh, on another note, shadow as much as you can before med school in various specialties and then do as many different rotations as you can in med school. If you think you're going IM, don't do all IM subspecialties - you can figure that out during residency. Do as many different things as you can, so you don't miss out on something you never really considered that you turn out to fall in love with. There are tons of docs out there that got into a rotation last minute in M3 and changed their whole career path. Also, don't compare specialties by your role shadowing, or by the resident's role on the team, but by the actual attending's role. This will be hard to imagine as a premed but gets easier in M3. But as an example, don't compare your ophtho experience to your gen surg experience as standing in the corner of a clinic room vs seeing the cool parts of a bunch of surgeries as you run back and forth between the ORs. Compare instead the one time you got to sit behind the slit lamp and see what the attending ophthalmologist sees all day to the day of one surgery doc, including the morning rounds and all the waiting between surgeries. It helps put things in a more realistic perspective.

 

[OrthoTraumaMD]

I have a theory orthopods started this myth themselves. Somehow they have convinced everyone else in the hospital they only hammer bones and can’t manage any basic medical conditions on any of their patients and they all need to be admitted to the trauma service or IM. Despite being some of the most successful academic students in medical school.... honestly it’s pure genius.

I wish we were that conniving but the real answer is that we are extremely specialized, with huge patient lists, no “cap” and typically only one sad junior who runs the floor, answers patient calls from home, deals with consults ... similar to other specialties yes, but with the added bonus of our consults being a huge time suck because they typically require us to physically do something to the patient in addition to history and physical and writing a note and doing orders (casting, suturing, waiting for xrays or sometimes transporting patients or helping hold for the Xray ourselves, getting supplies)... it becomes dangerous to medically manage things we have not seen or studied in years on top of that. We cannot leave mid-plaster to go to the floor or answer a call, otherwise our current patient will be harmed when we have to re-reduce their wrist. MSK is also a totally different world that is mostly not taught in med school, and is so vast and immense that I can say that ortho residency is like doing med school all over again, with the added responsibility and terror of being a resident. So if I’m an old lady having an MI, I don’t want some plaster-covered resident who frequently violates work hour regulations, who is pulled in all different directions and who hasn’t seen a stethoscope in years trying to figure out if my ekg changes are normal or not. Same way that I don’t want a medical intern splinting my ankle sprain. We get called for “stupid” msk things all the time and are happy to do it, because we know most other docs have never studied it and know nothing about our field. It is nice to have the same reciprocation from others who know certain things better than we do.

 

[Doctoscope]

@AnatomyGrey12 @OrthoTraumaMD how do gen surg and ortho lifestyles differ post residency/fellowship? I've read gen surg is more medicine + surgery than ortho once you become an attending... does that mean there's inherently more "work" involved in gen surg?

 

[AnatomyGrey12]

@AnatomyGrey12 @OrthoTraumaMD how do gen surg and ortho lifestyles differ post residency/fellowship? I've read gen surg is more medicine + surgery than ortho once you become an attending... does that mean there's inherently more "work" involved in gen surg?

No there isn’t more work in GS. Orthopods are some of the most blue collar workers I know, although that is a trait that I personally think is similar across all surgical specialties. It is true there is a good amount of medicine in general surgery, as a lot of them are primary on their patients throughout the hospital stay (although some people have IM cover while inpatient).

Both have a wide range of what life post training is like. Both have the ability to customize to what you want if you are flexible with location and salary.

 

[Anti-PD1]

For neurosurgery

-It can get busy, but I love it, neurosurgeons love the acuity and pace, so time flies
-There is an amazing variety within the specialty. All neurosurgeons should know how to manage basic spine, neurotrauma, cortical tumors, shunts etc. But within neurosurgery, you can focus on complex or MIS spine, neurotrauma/critical care, open and endo cerebrovascular, functional, epilepsy, pediatrics, tumor, skull base, peripheral nerve. You can be private, privademic, academic.
-Neurosurgeons tend to be chill, have a good sense of humor, it helps to cope with the morbidity we see
-Not everything is death and dying, sure there are bad aneurysm ruptures, and traumas. Tumors can be depressing, but you can offer some salvage is terrible cases, preserve a patient's critical abilities in their last year of life. A lot of neurosurgery is improving peoples lives i.e. spine, epilepsy and movement disorder surgery, and preventing future calamities - coiling or clipping unruptured aneurysms, shunt for hydrocephalus. How many times I've seen acute SDH or EDH go from blown pupils to walking out of my hospital, it's very satisfying
-Most of neurosurgery is basic plumbing. We are always working to take pressure off the central and peripheral nervous system (i.e. cranis, EVD, decompression of spinal canal or nerve roots, evacuation of blood clot, shunts, tumors)
-Neurosurgery is very unrelated to neuroscience, the only exception is specific research/functional+epilepsy surgery
-Neurology and neurosurgery are very unrelated, except functional+epilepsy, still we live on different time scales - neurology treats MS, we treat herniation
-Being a neurosurgeon is not about being the smartest, it's about working hard and having clinical awareness, and hustle, and loving doing this
-You can decide how much you want to see your family i.e. your subspecialty and practice environment, having research interests or not

 

[Shunsui]

I've heard a lot about how anesthesia is monotonous work. Can anybody comment on this? (haven't had the chance to shadow an anesthesiologist yet)

 

[Angus Avagadro]

Anesthesia is very much like surgery. You can work at a small community hospital doing bread and butter cases or subspecialize at tertiary centers. So, yes, like anything, routine cases can be monotonous. Spine cases in neurosurg or ortho can be monltonous. There are anesthesia boards in Critical care, Pain management, Cardiothoracic, Pediatrics, Echocardiography, Acute pain services with nerve blocks for post surgical and cancer pain, etc. It's a very broad field.