What are the Chances of Not Being able to Specialize?

[Thomas Hearns]

Sorry if this is a noob question... but does it happen often where you, as a doctor, get stuck in a career you don't want? Say you wanted to be a radiologist or something, but ended up in some other field like as a family practitioner. Does this happen often? I wouldn't want to be stuck doing something I didn't like =(

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[SuperTrooper]

Sorry if this is a noob question... but does it happen often where you, as a doctor, get stuck in a career you don't want? Say you wanted to be a radiologist or something, but ended up in some other field like as a family practitioner. Does this happen often? I wouldn't want to be stuck doing something I didn't like =(

You probably shouldn't choose medicine as a career if you can't see yourself being moderately content as a familiy practitioner.

 

[DeadCactus]

Not getting your top choice is a very possible reality. For example, I believe Derm has about a 50% rate of people getting in. I don't think it is very common for to not match into at least your top 3 or even top 2; but then again I have no numbers on that.

I agree with the poster above though, you should be able to be content in at least a few of the medical specialties...

 

[PugMD]

You probably shouldn't choose medicine as a career if you can't see yourself being moderately content as a familiy practitioner.

Personally, I don't want to spend 7+ years of my life developing my skills to pursue a profession I am 'moderately content' with. Not to mention the debt.

People change the direction of their careers as physicians all the time. If for some reason you decided to go into family practice, completed your residency, and later decided to pursue radiology, nothing would stop you.

 

[questionstoask]

You probably shouldn't choose medicine as a career if you can't see yourself being moderately content as a familiy practitioner.

i cant see myself as a family practioner. it has nothing in common with some of the other specialties.

 

[Captain Fantastic]

Panda Bear, where are you?

Google "Panda Bear, MD." He didn't match into EM the first go around and scrambled into FM. Later he reentered the match and is now an EM resident. Read his blog.

 

[SilkandSteel]

You probably shouldn't choose medicine as a career if you can't see yourself being moderately content as a familiy practitioner.

I disagree. I think it's perfectly fine to pursue medicine if you don't want to go into family practice. I think a lot of people do it.

To the OP, the chances that you'll land in you're most unwanted residency is probably slim. I feel that, unless you just suck soooo much in med school, this almost never happens. But if you don't have at least 3 or 4, maybe even 5, specialties which you would be happy doing, that might be a problem. Don't have your heart set on radiology or something. But who knows? Even if you don't have 3 or 4 specialties you think you'd be happy with NOW, that'll probably develop and change in med school. If you're devoted to medicine and have a few varied interests, I think you'll be fine.

~Silk and Steel

 

[foofish]

i cant see myself as a family practioner. it has nothing in common with other specialties.

Yup, family practice certainly has absolutely nothing in common with, say, pediatrics or internal medicine...

 

[questionstoask]

Yup, family practice certainly has absolutely nothing in common with, say, pediatrics or internal medicine...

i cant see myself in those specialties either. surgeons and radiologists and fp's are very, very different.

 

[SuperTrooper]

Personally, I don't want to spend 7+ years of my life developing my skills to pursue a profession I am 'moderately content' with. Not to mention the debt.

People change the direction of their careers as physicians all the time. If for some reason you decided to go into family practice, completed your residency, and later decided to pursue radiology, nothing would stop you.

I'm not saying you should settle for a career you are only "moderately content" with. I was trying to say that you should probably have some sort of a baseline interest in general family medicine if you're going to become any sort of doctor, specialist or not. Otherwise, you're gonna be pretty miserable in medical school for however many years, and might not even make it through.

 

[foofish]

i cant see myself in those specialties either. surgeons and radiologists and fp's are very, very different.

Right, but I was responding to the comment that family practice has absolutely nothing in common with any other specialty, which is a very different thing than whether or not you like any of the other specialties that have things in common with family practice.

 

[dutchman]

I heard something like 50% of medshool students don't get into their specialty of choice(note: this is not the same as specialties they applied to).

 

[coffeebythelake]

For example, I believe Derm has about a 50% rate of people getting in.

Dermatology with 50% acceptance rate?!!? I laugh at those statistics.

 

[DeadCactus]

Right, but I was responding to the comment that family practice has absolutely nothing in common with any other specialty, which is a very different thing than whether or not you like it.

"it has nothing in common with some of the other specialties."

Surgery and radiology would both qualify as "some". IM and peds would fall into the other part of the whole that is not the "some" being reffered to.

I heard something like 50% of medshool students don't get into their specialty of choice(note: this is not the same as specialties they applied to).

Even if it's true, how many of those 50% wanted a really competitive specialty? I think the stats make it worse than it sounds.

 

[dutchman]

Dermatology with 50% acceptance rate?!!? I laugh at those statistics.

probably something like 3% if you consider all the people that are interested.

 

[Wizard of Oz]

With derm you also have to consider that even with 50/50 odds (mind you I have no validation of that statistic), almost ALL of the students applying to derm are extremely competative.

Saying that half of M4's don't match the specialty that they want seems pretty high to me. US allo schools frequently report that most of their students match one of their top three choices, again realizing that the guy with a 190 step 1 score isn't going to be applying for plastic surgery.

Here's the good part--ultimately YOU are responsible for how well you do. Isn't it amazing that your ability to match will ultimately depend on your actions?

 

[Metatemujin]

Right, but I was responding to the comment that family practice has absolutely nothing in common with any other specialty, which is a very different thing than whether or not you like any of the other specialties that have things in common with family practice.

He didn't use the phrase "any other specialty", he used the phrase "some other specialties". So basically you tried to make fun of him after not fully comprehending what he wrote.

 

[Law2Doc]

For example, I believe Derm has about a 50% rate of people getting in.

Well, that's 50% of those left after most of those interested are explicitly told not to bother by their schools. So it's a misleadingly high use of percentages.
It's very possible not to be in the running for a competitive field. Your Step 1 score and roation year evaluations will largely decide how solid a candidate you are. But if you want to "specialize", there are certainly less competitive specialties out there, so coming from a US allo school you aren't necessarilly locked into FP if you don't want it. It may take longer, but you there are other tracks. That being said, it's best to go into medicine with an open mind and a willingness to be a clinician first and a specialist later. While primary care may not be a dream job, it is not a dirty word either.

 

[CTtarheel]

Check out this link (posted elsewhere all the time) http://www.nrmp.org/matchoutcomes.pdf

It sums up your chance of matching into each specialty if you rank it first.

Note, however, someone has to interview you before you can rank them!

 

[questionstoask]

Check out this link (posted elsewhere all the time) http://www.nrmp.org/matchoutcomes.pdf

It sums up your chance of matching into each specialty if you rank it first.

Note, however, someone has to interview you before you can rank them!

damn, residency placement is not as competitive as i thought. plastic surgery and dermatology are indeed impossible. but any other specialty, including orthosurgery can be had with good enough step1.

 

[dutchman]

damn, residency placement is not as competitive as i thought. plastic surgery and dermatology are indeed impossible. but any other specialty, including orthosurgery can be had with good enough step1.

yes it is

 

[PEN15]

like it or not a majority of us will end up in primary care.

 

[dutchman]

like it or not a majority of us will end up in primary care.

Exactly 43% of the people on this thread will end up in Prmary care, and 65% of that 43% will be forced into it.

 

[45408]

Check out this link (posted elsewhere all the time) http://www.nrmp.org/matchoutcomes.pdf

It sums up your chance of matching into each specialty if you rank it first.

Note, however, someone has to interview you before you can rank them!

And you realize that your chances of even getting an interview for rad onc with a 201 on Step 1 is pretty minimal, so you don't even bother.

 

[Thomas Hearns]

So what would the process be like to become a fp and then re-apply for some other residency later? would this make it easier to get into a specialty more interesting to you?

 

[alwaysaangel]

like it or not a majority of us will end up in primary care.

I've never understood why so many people have such distain for primary care.

Regardless of how well I do in medical school I will be doing primary care.

I should get a 270 on my step 1 just for giggles. It'd be kind of fun, when your classmates ask what your applying to:

Me: "Family Medicine"
Them: "Oh, how bad were your boards?"
Me: "270" :-D

 

[PEN15]

I've never understood why so many people have such distain for primary care.

Regardless of how well I do in medical school I will be doing primary care.

I should get a 270 on my step 1 just for giggles. It'd be kind of fun, when your classmates ask what your applying to:

Me: "Family Medicine"
Them: "Oh, how bad were your boards?"
Me: "270" :-D

When did I ever say that I had "such distain for primary care?"

OP: do well on your boards and everything will fall in to place.

 

[QuantumMechanic]

I've never understood why so many people have such distain for primary care.

chronic care

referring out the interesting cases

low pay

 

[Thomas Hearns]

I've never understood why so many people have such distain for primary care.

Regardless of how well I do in medical school I will be doing primary care.

I should get a 270 on my step 1 just for giggles. It'd be kind of fun, when your classmates ask what your applying to:

Me: "Family Medicine"
Them: "Oh, how bad were your boards?"
Me: "270" :-D

Not everyone has the same interests... I can't figure out why people have such a disdain for chemistry And I don't think I'd "hate" it or anything, but I don't like being forced into something, and I wouldn't enjoy being forced into something by my own ineptitude, so hopefully I will do well!

 

[alwaysaangel]

Not everyone has the same interests... I can't figure out why people have such a disdain for chemistry And I don't think I'd "hate" it or anything, but I don't like being forced into something, and I wouldn't enjoy being forced into something by my own ineptitude, so hopefully I will do well!

 

[alwaysaangel]

When did I ever say that I had "such distain for primary care?"

OP: do well on your boards and everything will fall in to place.

I didn't say you did. But you did make the comment that "Like it or not most of us will end up in primary care" pointing out the rather common feeling of hating primary care.

 

[PEN15]

Not everyone has the same interests... I can't figure out why people have such a disdain for chemistry And I don't think I'd "hate" it or anything, but I don't like being forced into something, and I wouldn't enjoy being forced into something by my own ineptitude, so hopefully I will do well!

you realize that your USMLE step 1 dictates what you specialize in whether you like it or not right?

 

[alwaysaangel]

chronic care

See to me this is the best part - but I realize others have different interests

referring out the interesting cases

People are interesting - not cases.

low pay

I don't know how anyone who didn't grow up with some other ridiculously privileged childhood (and I'm assuming the majority of us were not born with silver spoons) can call 142k per year "low pay."

142k per year is the average income stated on this (http://www.studentdoc.com/july_surv.html) site for FM the lowest paying specialty I could find. And according to the residency forums - those include a good number of women who work part-time which drags the average down considerably.

 

[PEN15]

I didn't say you did. But you did make the comment that "Like it or not most of us will end up in primary care" pointing out the rather common feeling of hating primary care.

Oh ok thanks for clarifying.

 

[etf]

I've never understood why so many people have such distain for primary care.

Regardless of how well I do in medical school I will be doing primary care.

I should get a 270 on my step 1 just for giggles. It'd be kind of fun, when your classmates ask what your applying to:

Me: "Family Medicine"
Them: "Oh, how bad were your boards?"
Me: "270" :-D

yeah seriously it must be an sdn thing where you're considered a loser if you do family practice. i mean, isn't that what a "doctor" is?

 

[alwaysaangel]

yeah seriously it must be an sdn thing where you're considered a loser if you do family practice. i mean, isn't that what a "doctor" is?

Its why I became a doctor.

In fact, when I first started working at the free clinic, I would get the X-ray results faxed to us. And I'm looking at them wondering WHO ON EARTH would go through 4 years of med school plus residency so they could sit in a room all day staring at X-rays and typing reports. I convinced myself it must be a non-MD position for a long time (you know like MAs, and other technicians), only to find out I was in fact correct the first time.

Honestly, no offense to anyone who wants to do radiology - I just can't imagine it.

 

[questionstoask]

.

 

[alwaysaangel]

what's your point?? my father works 35hrs/wk(and that includes the 2hr lunch that he takes every day) as a computer programmer and he gets paid about $200k, and he's an immigrant. he could take higher level jobs but he's afraid that he's old and if he gets fired, he'll be finished. i'd like my parents to respect me. they pay for my school, my car, etc, i need to pay them back when they're 65.

My point is if you think 142k is "low pay" then you have bigger problems than whether or not you'll get your chosen specialty.

 

[SilkandSteel]

Okay now I'm confused.

When you apply for/rank residencies, do you rank the specialty alone or do you rank the specialty program at such and so school? In other words, when many schools brag of placing students in their top 3 choices, do they mean choices like:

Surgery
Derm
Ortho

or choices like:

Surgery at X
Surgery at Y
Surgery at Z

?

I think I'm just being stupid, but someone please un-confuse me.

~Silk and Steel

 

[alwaysaangel]

Okay now I'm confused.

When you apply for/rank residencies, do you rank the specialty alone or do you rank the specialty program at such and so school? In other words, when many schools brag of placing students in their top 3 choices, do they mean choices like:

Surgery
Derm
Ortho

or choices like:

Surgery at X
Surgery at Y
Surgery at Z

?

I think I'm just being stupid, but someone please un-confuse me.

~Silk and Steel

Ask in the residency forum for a better answer. But when I was looking into it I got the impression its pretty bad to apply to more than one specialty because the programs will question your devotion if they find out.

So its

Surgery at X
Surgery at Y
Surgery at Z

So you pick a specialty, then apply like med school - go to interviews. But instead of getting a lot of acceptances and choosing - you do the ranking thing and they give you the highest rank residency possible based on your list (and the schools list).

 

[8744]

Panda Bear, where are you?

Google "Panda Bear, MD." He didn't match into EM the first go around and scrambled into FM. Later he reentered the match and is now an EM resident. Read his blog.

I just want to point out that this endorsement was entirely unsolicited. Look in the March 2006 archives for the entire saga.

 

[SilkandSteel]

Yeah, that's what I thought.

But if that's the case, then with all the schools bragging about placing like 95% of students in their top 3 choices, wouldn't your chances of getting into your specialty of choice be very high? I mean, especially if you listed like 5 programs in the same specialty as your top choices.

*is so confused*

~Silk and Steel

 

[8744]

You probably shouldn't choose medicine as a career if you can't see yourself being moderately content as a familiy practitioner.

....In other news, hospitals and clinics around the country were strangely quiet today after millions of doctors, citing concerns over their motivations, suddenly walked off the job....

 

[alwaysaangel]

Yeah, that's what I thought.

But if that's the case, then with all the schools bragging about placing like 95% of students in their top 3 choices, wouldn't your chances of getting into your specialty of choice be very high? I mean, especially if you listed like 5 programs in the same specialty as your top choices.

*is so confused*

~Silk and Steel

Well a medical school isn't going to recommend that a student with average grades, average rotation appraisals, and a 190 USMLE apply to derm. They're going to bring that student down to Earth and either get them to choose something else or have the apply for a transitional year (1 year residency programs in IM that you can do before you enter a competitive specialty).

This realistic advising keeps their students from havign no where to go and keeps their match numbers up.

 

[8744]

....Okay now I'm confused...

It's all in my blog. Start in the March 2006 archive and I believe you will find everything you ever wanted to know about the match.

If I have to put marsupial porn on my blog to get you to read it I will.

 

[deleted128318]

Okay now I'm confused.

When you apply for/rank residencies, do you rank the specialty alone or do you rank the specialty program at such and so school? In other words, when many schools brag of placing students in their top 3 choices, do they mean choices like:

Surgery
Derm
Ortho

or choices like:

Surgery at X
Surgery at Y
Surgery at Z

?

I think I'm just being stupid, but someone please un-confuse me.

~Silk and Steel

As I understand it, when ranking residency programs, you have to be aware of the possibility that you may not match in the more competitive specialties. For people applying to such, it is pretty common to rank multiple specialties to make sure you match. People who are more dedicated to say, plastics, will rank more plastics programs before a second specialty is listed in their rankings. You have to be aware that not matching in plastics is a possibility, and many people prefer to ensure that they will match in something than have to scramble and try to squeeze into plastics (really unlikely) so they will rank something less competitive farther down in their rankings. This is how it's been explained to me... Panda, set me straight if I'm way off.

I can't wait. It sounds like a good time.

 

[SilkandSteel]

If I have to put marsupial porn on my blog to get you to read it I will.

OKAY OKAY I'll read it!!!

No need to bring out the heavy artillery >.< eeeeew.

Silk and Steel

 

[Law2Doc]

Well a medical school isn't going to recommend that a student with average grades, average rotation appraisals, and a 190 USMLE apply to derm. They're going to bring that student down to Earth and either get them to choose something else or have the apply for a transitional year (1 year residency programs in IM that you can do before you enter a competitive specialty).

This realistic advising keeps their students from havign no where to go and keeps their match numbers up.

I think this post hits on the real reason the percentages are so high. If Joe AverageMedstudent comes to his advisor, mentor or the dean with his 200 USMLE and average med school record and says "I need a dean's letter for derm, optho, rads, etc." he is going to be patted on the head and sent back to try again. Schools don't leave you alone to apply unrealistically. You will be told what is unrealistic, often not so subtly. The folks who apply to competitive residencies are only those who have a legit shot at competitive residencies. So it's not so surprising when you have that degree of weeding out even before the application stage that the ultimate acceptance percentages are high.

 

[xylem29]

See to me this is the best part - but I realize others have different interests


People are interesting - not cases.



I don't know how anyone who didn't grow up with some other ridiculously privileged childhood (and I'm assuming the majority of us were not born with silver spoons) can call 142k per year "low pay."

142k per year is the average income stated on this (http://www.studentdoc.com/july_surv.html) site for FM the lowest paying specialty I could find. And according to the residency forums - those include a good number of women who work part-time which drags the average down considerably.

I think it's considered low because of the responsibility that you have as a family doctor, the hours you have to work, and the professional standard that you are held to - that in itself makes 142k seem small. And assuming that 142k is gross income, subtract taxes, overhead, insurances and you're left with around 70-90k a year which - considering once again, the years of training involved, the professional standards that you are held to, the threat of lawsuits, and the amount of hours you work - is a very unsatisfying pay.

 

[coffeebythelake]

From what I gather here, USMLE scores are really important. Does anybody have information on the average USMLE scores for the different specializations?